One in five American workers took zero sick days last year—and that's a problem for everyone. Here's how to get the sick days you need.

By Charlotte Hilton Andersen
February 05, 2018
Photo: eldar nurkovic / Shutterstock

Marcy* is a vice president at a Fortune 500 company, a mom of two school-age children, an active volunteer in her community and others (she flew to Houston for a week to help rebuild after the hurricane), a world traveler, a leader at her church, a gardener, a runner, and hot yoga enthusiast. Oh, and she hasn't taken a single sick day since 2007.

It isn't that she never gets sick-just never sick enough. "We are given a bucket of PTO [personal time off] days and whether you use them for vacation or staying home sick, the company doesn't care," she explains. "I'm not going to waste them sitting at home nursing a cold. To me, PTO days are for vacation or inpatient hospital stays and that's it."

Think Marcy is extreme? She's the norm. One in five American workers under age 45 took no sick days-and of those who did, nearly 60 percent took fewer than five days off in 2017, according to the most recent labor statistics. The numbers look even worse for older workers, with nearly half of Americans 46 and older saying they took no sick days last year. And it's not just because everyone is taking fabulous two-week vacations. In 2017, 54 percent of Americans didn't use all their vacation days, with the majority using less than half of their allotted time off, according to a separate study released by the U.S. Travel Association's Project Time Off.

Part of the problem is the way our labor laws work. The United States is one of the few developed industrial nations that doesn't guarantee paid sick leave by law. Since 1993, the Family and Medical Leave Act allows certain employees to take up to 12 weeks of unpaid leave for a new baby or an illness, but the only thing it guarantees is that you'll still have a job when you get back. For low-wage or un-salaried workers, the situation is even more dire: If you don't work, you don't get paid. Period. With more than a third of all U.S. workers being freelancers, temps or other contingent employees, that's a lot of people with no paid time off at all.

The other issue is our work culture. Not all offices subscribe to the "you can rest when you're dead" mentality, but there are plenty where the office culture overtly or subtly discourages workers from taking sick days, or insists they do some work from home even when they take a sick day, says Alison Green, of the popular blog Ask A Manager and author of How to Get a Job: Secrets of a Hiring Manager.

"In certain types of dysfunctional cultures, you can find a dynamic where people are made to feel like slackers if they take sick days and where there's heavy pressure to come in regardless of whether you're sick," she says. Or, managers may inadvertently discourage people from taking sick days. "If you have a manager who herself never stays home, and people see her powering through it when she's sick, that usually makes people feel they're expected to do the same-even if the manager doesn't actually feel that way." (Related: Your Guilt-Free Guide to Taking a Mental Health Day)

Docs have picked up on this trend too. "It's commonplace in American culture to avoid missing work, even when you're ill," says Kevin J. Goist, M.D., assistant professor of clinical medicine at The Ohio State University Wexner Medical Center. People often feel guilty that others will be inconvenienced by their absence and stressed out worrying about all the work they'll need to make up when they return-or even possibly losing their job, he says. While understandable, working when you're sick is still a bad idea.

Staying home when you're sick not only helps you heal faster but it also protects others from your disease if you're contagious, Dr. Goist explains-something that's especially important if you work with people who may have compromised immune systems. You may also be hurting the quality of your own work. "Studies have demonstrated that working while ill limits the quality and efficiency of your work, which could lead to mistakes or longer times to complete projects," he adds.

If you have a boss who encourages the "work at all costs" mentality, Green advises banding together with your coworkers and deciding as a group that you're going to assert yourselves about sick leave and take it when you need it. "It's much harder for a manager to penalize a whole group, and this one is worth sticking together on," she says. If you work in a field where you have clients or customers who depend on you, you should also work with your manager to ensure there are protocols in place to cover for you and other sick employees so you won't feel pressured to come in, she adds.

Once you take the sick day, you still need to use it to rest and recover-a feat that may be easier said than done if your office is one that encourages you to work from home or be on call when you're out of the office, regardless of why. Thanks to the internet, smartphones, and other modern tech, it's totally possible for workers to stay connected to their jobs 24/7 and in some fields, this may be not just encouraged but expected, Green says.

"In some jobs being willing to at least check email when [you're sick] is part of the deal," she explains. "But if you're too sick to be able to do that, it's smart to say something like, 'I'm sick enough that I won't be on email today.'"

How do you know when to suck up the sniffles and head to work or call in sick? If you have a fever, vomiting, a very sore throat, diarrhea, or extreme fatigue, stay home, Dr. Goist says, especially between November and March, aka peak flu season. (Related: More People Are Hospitalized for the Flu Right Now Than Ever Recorded)

When you do call in sick, what you don't say is just as important as what you do. "People often feel like they're supposed to give enough details to 'prove' they really need a sick day. But in most offices, you don't need to do that," Green says. "In general, it's enough to simply say, 'I woke up sick today and I'm not well enough to come in so I'm going to take a sick day today.' If you're very ill and think you'll need more than one day, it's helpful to say that too, so that you're managing expectations appropriately."

This may sound like a pain but it's worth the trouble, says Gregory Ambuske, D.O., an internal medicine physician at UCHealth Primary Care Clinic-Broomfield. It is vitally important to take appropriate sick days and actually rest when you are sick, he says, adding that your body is trying to communicate what it needs to you and you should listen or risk compromising your health long term. "Stay hydrated, reduce activity, put your workaholic tendencies aside, and realize your organization will go on without you." Your body (and your coworkers) will thank you.

* Not her real name.