There are currently no federal legal requirements for paid sick leave. For companies subject to the Family and Medical Leave Act (FMLA), the Act does require unpaid sick leave. FMLA provides for up to 12 weeks of unpaid leave for certain medical situations for either the employee or a member of the employee's immediate family. In many instances paid leave under an employer’s paid time off (PTO) policy may be substituted for unpaid FMLA leave.

Employees are eligible to take FMLA leave if they have worked for their employer for at least 12 months; have worked for at least 1,250 hours over the previous 12 months; and work at a location where at least 50 employees are employed by the employer within 75 miles.

Because federal law does not require sick leave, if an employee quits their job before using all of their sick leave, the employer is not obligated to pay the employee for that time—unless the employer’s policy or state or other law requires the employer to pay the employee for unused sick leave.

Some states, cities, and counties may have laws that require employers to provide employees with paid sick leave.

In New York, while federal law does not mandate paid sick leave, the state has its own regulations that provide for paid sick leave. Under the New York State Paid Sick Leave law, which went into effect on September 30, 2020, employers are required to provide a minimum amount of paid sick leave to employees. The amount of leave depends on the size and net income of the employer. Employees earn sick leave at a rate of at least one hour for every 30 hours worked and can use sick leave for various reasons, including illness, diagnosis, care, treatment of a health condition, or for certain family and safety needs. Employers with 100 or more employees must provide up to 56 hours of paid sick leave per year, while smaller employers must provide between 40 to 56 hours depending on their size and income. The FMLA still provides for up to 12 weeks of unpaid leave for certain medical situations, and employees in New York may also be eligible for benefits under the New York Paid Family Leave law. If an employee leaves their job, New York law does not require employers to pay out unused sick leave unless the employer's policy states otherwise.