Every worker in Massachusetts earns sick time. The only question is whether yours is paid, and that turns on a single number: eleven.
If your employer averaged 11 or more employees on the payroll last year, your 40 hours are paid. Fewer than 11, and you get the same 40 hours unpaid. Either way you cannot be disciplined for using them.
How you earn it
One hour of sick time for every 30 hours you work, up to 40 hours a year.
You start earning on your first day. You cannot use it until the 90th calendar day after you start, and that is 90 calendar days regardless of how many days you actually worked in that window.
Accrual runs on hours worked, including overtime. It does not run on hours you were paid but not working, so vacation and sick time themselves do not generate more.
Salaried workers exempt from overtime are assumed to work 40 hours a week unless their normal week is shorter.
Carrying it over
You can carry up to 40 unused hours into the next year. That does not give you 80 to spend. The annual use limit stays at 40. Your employer can also freeze accrual once your balance hits 40 until you draw it down.
What it pays
Your regular hourly rate, with one point worth knowing: tipped workers get the full minimum wage of $15.00 an hour for sick time, not the service rate.
You do not get overtime, holiday, or Sunday premium rates on sick time, and the rate excludes commissions and bonuses. Shift differentials are included.
How the 11-employee count actually works
This is where employers most often get it wrong, usually in their own favor.
It is an average across all pay periods of the previous year, not a headcount on any given day. And the count is broad:
- Full-time, part-time, seasonal and temporary employees all count.
- Employees who work outside Massachusetts count, even outside the country.
- Owners and officers on the payroll count.
- A worker supplied by a staffing agency counts for both the agency and the client.
A pay period with nobody on payroll counts as zero. If your employer’s size changes, it must give 30 days’ advance written notice before your sick time flips between paid and unpaid.
What you can use it for
Your own illness, injury or medical condition. Care for your child, spouse, parent, or your spouse’s parent. Routine medical appointments for yourself or any of those people. Preventive care, including screenings and checkups. Addressing the effects of domestic violence.
Adult children count. There is no age cutoff.
Since November 21, 2024, you can also use sick time for pregnancy loss or a failed round of assisted reproduction, adoption or surrogacy, for yourself or your spouse. That was added by the 2024 midwifery act and it is in force.
One caveat worth knowing: the regulations have never been updated for that change. They date from 2015 and say nothing about pregnancy loss. The statute and the Attorney General’s guidance control, but if an employer’s HR points at the regulation, that is why.
Telling your employer
For a foreseeable absence, your employer can require up to seven days’ notice in a written policy. For anything unforeseeable, the standard is whatever is reasonable in the circumstances.
You do not have to say any magic words. You do not have to cite the statute. Your employer just has to be on notice that you are using accrued time for a covered reason.
When they can ask for a doctor’s note
Not for a single day off. Documentation can be required only when your absence:
- Runs more than three consecutive scheduled workdays, or more than 24 consecutively scheduled work hours
- Falls in the two weeks before your final scheduled day of work
- Follows four unforeseeable, undocumented absences in three months, or three such absences if you are under 18
Two limits matter here. Your employer may never require documentation of the nature of your illness, or the details of domestic violence.
And if you have no health insurance, a signed statement from you is enough. You do not need a doctor’s note you would have to pay for. The same is true for domestic violence, where your own written statement is one of the accepted forms.
You have seven days after the absence to produce documentation, and you can send it by email.
You do not get paid for it when you leave
The statute is explicit: employers are not required to pay out unused earned sick time on separation. Some do by policy or union contract, but no law requires it.
This is different from vacation time, which Massachusetts treats as earned wages that must be paid out when you leave. People conflate the two constantly.
How it fits with PFML and FMLA
These do not stack into more total leave. They overlap.
Earned sick time is money. FMLA is job protection. Your employer can require you to use paid sick time during FMLA leave that would otherwise be unpaid, and the same hours count toward both.
Paid Family and Medical Leave has a seven-day unpaid waiting period, and sick time is the obvious way to cover it. You keep job protection during those days.
One rule changed in 2023 and most guides still have it backwards. You can now top off your PFML benefit with accrued sick or vacation pay, up to your full average weekly wage, without your PFML benefit being reduced. Before August 2023, doing that cut your benefit dollar for dollar. Anything written earlier says the opposite.
If your employer retaliates
Interfering with sick time is unlawful, and so is using it as a negative factor in an evaluation, a promotion decision, discipline, or a firing.
You can lose an attendance bonus for being absent. You cannot be disciplined for it.
Where to complain: the Attorney General’s Fair Labor Division, at (617) 727-3465. The Attorney General’s published position is unambiguous: “All workers in Massachusetts are entitled to the protections of the earned sick time law. The Attorney General will never inquire about immigration status.”
You can sue, and the damages are tripled
Earned sick time is enforceable through the Wage Act, which means treble damages are mandatory for a prevailing employee, plus costs and reasonable attorney’s fees. Class actions are allowed.
But there is a procedural trap that ends cases. You must file a complaint with the Attorney General first, then either wait 90 days or get written permission to sue sooner. You need proof of that filing to bring the case. The limitations period is three years, tolled while the Attorney General complaint is pending.
Common questions
How many sick days do you get in Massachusetts?
Up to 40 hours a year, earned at one hour for every 30 hours worked. Whether it is paid depends on employer size.
Does my employer have to pay me for sick time?
Yes if the employer averaged 11 or more employees on the payroll during the previous year. Below that threshold the same 40 hours are unpaid.
How many days can I call out before I need a doctor’s note?
More than three consecutive scheduled workdays, or more than 24 consecutively scheduled work hours. Your employer can never require documentation of the nature of your illness.
Do I get paid for unused sick time when I quit?
No, unless your employer’s policy or a union contract says so. This differs from vacation time, which must be paid out.
Can I use sick time after a miscarriage or failed IVF?
Yes. Since November 21, 2024, earned sick time covers pregnancy loss and failed assisted reproduction, adoption or surrogacy, for you or your spouse.
I work remotely for an out-of-state company. Do I get Massachusetts sick time?
Yes, if Massachusetts is your primary place of work. You do not need to spend half your time here, and the employer’s location does not matter.
Can I use sick pay on top of my PFML benefit?
Yes, up to your full average weekly wage. A 2023 amendment removed the offset. Guides written before then say otherwise.
Can I sue for denied sick time?
Yes, and treble damages plus attorney’s fees are mandatory if you prevail. You must first file with the Attorney General and wait 90 days or get written permission to sue sooner.
Do tipped workers get the service rate for sick time?
No. Tipped employees are paid the full minimum wage of $15.00 an hour for earned sick time.
Statutory text from G.L. c. 149 § 148C, as amended by St. 2024, c. 186, § 42, effective November 21, 2024, and G.L. c. 149 § 150. Regulations at 940 CMR 33.00, promulgated July 31, 2015 and not since amended for the 2024 statutory change. PFML provisions from G.L. c. 175M §§ 2 and 3, including the coordination amendment made by St. 2023, c. 28, § 57. Attorney General guidance current as of November 21, 2024. Figures verified September 5, 2026. General information, not legal advice.