Sick leave in China is an approved absence for illness or a non-work-related injury, usually supported by medical evidence. It is not the same as the statutory medical treatment period: the latter is the protected period during which specified no-fault termination and mass-layoff routes are restricted.
Sick leave pay follows local wage rules, the employment contract and valid company policies; it may be below normal salary but generally cannot fall below the applicable statutory floor. Employers should require reasonable medical certificates, record each absence, calculate the protected period, maintain payroll and benefits, and review termination restrictions before acting. Work-related injuries follow a separate work injury regime.
This guide covers mainland China and focuses on the employer’s responsibilities for sick leave approval, payroll, medical-treatment-period tracking, documentation and employment decisions.
What is sick leave in China?
Sick leave is the practical HR and payroll term for time away from work because an employee is medically unable to work due to illness or a non-work-related injury. The employee normally follows the company’s reporting procedure and provides reasonable medical evidence.
The statutory medical treatment period is different. It is the protected period during which an employee stops working for treatment or recovery and the employer faces specific restrictions on no-fault termination, layoffs and fixed-term contract expiry.
| Concept | What it means | Main employer control |
|---|---|---|
| Ordinary sick leave | An approved absence because the employee is unable to work due to illness or a non-work-related injury. | Review the medical evidence, approve the recorded absence and apply the correct local payroll treatment. |
| Medical treatment period | A statutory protection period calculated under national and applicable local rules. | Track cumulative leave accurately and restrict employment decisions while the employee remains protected. |
| Work injury leave | Absence arising from a recognized work injury or occupational disease. | Use the separate work injury recognition, insurance, payroll and benefit process rather than ordinary sick-leave rules. |
| Company-provided paid sick leave | A contractual or policy benefit that may be more favorable than the statutory minimum treatment. | Apply the written promise consistently and distinguish it from the statutory medical treatment period. |
A short absence may remain mainly an attendance and payroll matter. Repeated or long-term absence can become a medical-treatment-period issue even when the employee has not been continuously absent.
Who is entitled to sick leave and medical-period protection?
Employees who are medically unable to work because of illness or a non-work-related injury may request sick leave under the applicable employment, medical and company procedures. This includes employees on probation and lawfully employed foreign employees.
Probation does not automatically remove medical-treatment-period protection. An employer should not treat illness itself as proof that the employee failed to satisfy recruitment conditions. A separate probationary termination analysis requires clearly documented recruitment conditions and evidence that supports the stated ground.
The employee’s short service may reduce the length of the applicable medical treatment period, but it does not mean that the employee has no protection. Shanghai’s official guidance, for example, confirms a three-month medical treatment period during the first year of service and states that probation does not remove that entitlement.
How long is the medical treatment period in China?
The national medical treatment period provisions generally provide a protected period from 3 to 24 months according to the employee’s total working years and service with the current employer.
| Total working years | Years with the current employer | National medical treatment period |
|---|---|---|
| Less than 10 years | Less than 5 years | 3 months |
| Less than 10 years | 5 years or more | 6 months |
| 10 years or more | Less than 5 years | 6 months |
| 10 years or more | 5 years to less than 10 years | 9 months |
| 10 years or more | 10 years to less than 15 years | 12 months |
| 10 years or more | 15 years to less than 20 years | 18 months |
| 10 years or more | 20 years or more | 24 months |
This is the national framework, not a substitute for local review. Shanghai uses a different local entitlement method based primarily on service with the current employer: three months during the first year, with one additional month for each subsequent full year, up to 24 months.
The national implementation notice also provides that certain serious or difficult-to-treat illnesses may justify an extension beyond 24 months through the applicable approval process. Employers should not assume that the ordinary maximum automatically ends protection in a complex medical case.
How is the medical treatment period calculated?
The medical treatment period is normally accumulated from the first sick-leave day. Repeated short absences can therefore use the protected period even when the employee returns to work between medical-leave episodes.
| Medical treatment period | National cumulative calculation window |
|---|---|
| 3 months | Accumulated within 6 months |
| 6 months | Accumulated within 12 months |
| 9 months | Accumulated within 15 months |
| 12 months | Accumulated within 18 months |
| 18 months | Accumulated within 24 months |
| 24 months | Accumulated within 30 months |
Under the national implementation method, calculation begins on the first sick-leave day, and rest days and statutory holidays falling within the sick-leave period are included.
Local methods can differ. The Shanghai official sick-pay and medical-period guidance states that 20.67 consecutive or cumulative sick-leave working days count as one month of the medical treatment period, excluding statutory holidays and rest days.
HR should therefore identify the employee’s applicable city before concluding that the protected period has been exhausted. The leave-management system, attendance records and payroll calculations must use the same method.
How is sick leave pay calculated in China?
China does not use one nationwide sick-pay percentage for every employee. The amount can depend on the local rule, the employee’s location and service, the length of the absence, the employment or collective contract, the employee handbook and any more favorable company policy.
A general floor reflected in official sick-pay guidance is that sick leave wages or illness relief during the medical treatment period may be below the local minimum wage but should not be lower than 80% of the applicable local minimum wage. A local rule or a more favorable contractual promise may require a higher payment.
2026 Shanghai update: Two long-standing Shanghai sick leave pay notices expired on August 15, 2026. From August 16, employers should no longer treat the former service-based sick leave pay percentages as the current mandatory Shanghai statutory formula. Employers should instead review the applicable wage-payment rules, employment contract and company policies while continuing to observe the statutory minimum protection. See our detailed guide to the Shanghai sick leave pay changes in 2026.
| Payroll question | What the employer should verify |
|---|---|
| Which city rule applies? | Confirm the employee’s documented work and payroll location and the current local sick-pay rule. |
| What is the calculation base? | Review the local rule, labor contract, collective contract, handbook and relevant salary components. |
| Does service affect the percentage? | Some local formulas vary according to service history or the duration of illness. |
| Is the company policy more favorable? | Apply any valid contractual or policy promise that exceeds the local minimum requirement. |
| How should the leave appear in payroll? | Show the approved leave, salary adjustment, deductions, contributions and net payment consistently. |
| Do statutory contributions continue? | While employment continues, coordinate social insurance and housing fund administration under the applicable local rules. |
Shanghai continues to apply local wage-payment rules and its own medical-treatment-period method. However, the former Shanghai service-based sick leave pay percentage rules expired on August 15, 2026. Employers should therefore verify the current legal and contractual basis before applying a sick leave pay formula.
Employers operating across several cities should not copy Shanghai, Beijing or another city’s payroll formula into a national policy without location-specific review.
For the wider rules governing wage components, minimum wages and payroll records, review HROne’s guide to China salary and wage regulations.
What medical documents can an employer require?
An employer may establish a reasonable sick-leave application and medical-document process through the employee handbook or leave policy. The process should be communicated before a dispute occurs and applied consistently across comparable cases.
A practical policy should state:
- when and how the employee must notify the manager or HR;
- what medical certificate, diagnosis certificate or sick-leave recommendation is required;
- whether the document must come from a qualified or locally accepted medical institution;
- the dates or period for which medical rest is recommended;
- whether an original, scan, system upload or later supplement is acceptable;
- how emergency admissions or situations where immediate documentation is unavailable will be handled;
- how an extension of sick leave should be requested;
- who reviews and approves the absence;
- when approved information is sent to payroll; and
- who may access the employee’s medical information.
Employers should collect only the information reasonably needed to verify the absence, administer pay and benefits and manage the employment relationship. Detailed diagnosis and treatment records should not be circulated to managers or unrelated functions merely because HR possesses them.
Can an employer reject or investigate a sick-leave request?
An employer should not reject genuine sick leave solely because the timing is inconvenient or the absence creates operational pressure. Where the employee follows the established process and provides valid evidence, an unsupported rejection can create attendance, wage and termination risk.
If a document is missing, inconsistent, expired, unclear or apparently issued by an unqualified institution, HR may request a reasonable supplement. The request should identify what is missing, provide a realistic deadline and preserve the employee’s opportunity to explain.
Where fraud is suspected, the employer should not move directly from suspicion to dismissal. A safer process is to:
- review the sick-leave policy and the document requirements that were communicated to the employee;
- compare the certificate with the leave request and attendance records;
- ask the employee to explain discrepancies or provide supplementary evidence;
- use lawful and proportionate verification methods;
- consider re-examination only where the policy, local rules and circumstances support it;
- protect the employee’s medical information; and
- document the facts before considering discipline.
Pre-employment screening is a separate process. Employers should not turn candidate screening into a general medical-history search designed to avoid future leave obligations. HROne’s guide to employee background checks in China explains the broader consent, privacy and documentation considerations for recruitment screening.
Can an employer terminate an employee during sick leave?
Termination depends on whether the employee is within the statutory medical treatment period, the legal route proposed by the employer and the available evidence.
Under the Labor Contract Law, an employer generally may not use the Article 40 no-fault termination routes or the Article 41 economic-layoff route while the employee is within the prescribed medical treatment period for illness or a non-work-related injury.
| Employment stage | Employer position | Required review |
|---|---|---|
| During the protected medical treatment period | Articles 40 and 41 generally cannot be used. | Confirm the local duration, accumulated leave, medical evidence and continuing payroll obligations. |
| Fixed-term contract expires during the protected period | The contract generally must be extended until the protected circumstance ends. | Check both the contractual expiry date and the actual medical-treatment-period end date. |
| Serious misconduct is alleged during sick leave | A separate Article 39 analysis may be possible, but illness itself is not misconduct. | Require a valid rule, proof of communication, reliable evidence, an investigation and the employee’s explanation. |
| The medical treatment period has ended | Termination is not automatic. | Assess whether the employee can perform the original job or other work reasonably arranged by the employer. |
| The employee cannot perform the original or reassigned work after the period ends | Article 40 termination may be considered with 30 days’ written notice or one month’s pay in lieu. | Review capability evidence, reassignment, notice, severance, local additional payments and union procedure where applicable. |
Shanghai’s local rules can require a medical subsidy of no less than six months of the employee’s wage, in addition to severance, in qualifying post-treatment-period termination cases where the employee cannot perform the original duties or reassigned work.
Employers should complete local legal and payroll review before communicating that the employee will be terminated or quoting a settlement amount. Before taking action, use HROne’s guide to employee termination in China to review lawful grounds, protected status, evidence, notice and final payroll.
How should employers manage long-term sick leave?
Long-term sick leave requires coordinated work across HR, payroll, line management and legal or compliance reviewers. The goal is not to pressure the employee to return before they are medically able, but to keep the absence, pay, protection period and business decisions accurately documented.
| Step | Employer action | Evidence to retain |
|---|---|---|
| 1. Confirm the case type | Determine whether the absence is ordinary sickness, a non-work-related injury or a possible work injury. | Employee report, medical certificate and incident information. |
| 2. Identify the local rule | Confirm the employee’s applicable payroll and employment city. | Labor contract, work-location record and payroll registration. |
| 3. Approve and record the absence | Enter each approved leave period in the HR and payroll systems. | Leave request, approval and attendance record. |
| 4. Calculate pay | Apply the local formula, statutory floor and any more favorable company promise. | Payroll worksheet, payslip and approval record. |
| 5. Track the protected period | Calculate cumulative leave under the applicable national or local method. | Medical-treatment-period tracker and supporting leave dates. |
| 6. Maintain communication | Request extensions and return-to-work information through one designated HR contact. | Written correspondence and updated medical documents. |
| 7. Assess work capacity | When the protected period is nearing its end, review whether the employee can return to the original role or another suitable role. | Medical information, job descriptions, capability assessment and reassignment record. |
| 8. Review any employment decision | Confirm legal basis, protected status, procedure, payments and local requirements before communication. | Approval memo, calculation file, notice and final payroll instructions. |
What sick-leave records should employers keep?
The employer should be able to reproduce how the absence was approved, how pay was calculated, how the treatment period was tracked and why any later employment decision was made.
| Record | Control purpose |
|---|---|
| Labor contract and employee master record | Confirms the employer, start date, service, workplace, salary and contract term. |
| Employee handbook and leave policy | Shows the application, documentation, verification and approval rules communicated to employees. |
| Sick-leave application and medical certificate | Supports the reason for absence and approved period. |
| Attendance and leave ledger | Supports cumulative medical-treatment-period calculations. |
| Payroll calculation and payslip | Shows the pay base, local formula, deductions, contributions and net payment. |
| HR and employee communications | Shows requests for documents, extensions, return-to-work updates and employee explanations. |
| Medical-treatment-period worksheet | Identifies the legal method, entitlement, calculation window, leave used and balance. |
| Original-job and reassignment analysis | Supports any post-treatment-period review under Article 40. |
| Disciplinary investigation records | Separates proven misconduct from assumptions based on illness or absence. |
| Termination and final-payroll file | Supports the legal route, notice, severance, local medical subsidy and final payment. |
Medical information should be stored with limited access. Managers generally need to know the approved absence, expected duration and any work restrictions—not every clinical detail in the employee’s medical file.
How sick leave connects to recruitment and onboarding
Sick-leave compliance begins before the first absence. Recruitment and onboarding determine which entity employs the worker, which city rules apply, what salary base appears in payroll and whether the leave policy is properly communicated.
Before issuing an offer, the employer should confirm:
- the legal employer and work location;
- the gross salary and payroll city;
- the applicable sick-pay and medical-treatment-period rules;
- the leave-request and medical-certificate process;
- the manager and HR approval responsibilities;
- how leave information reaches payroll;
- how medical information will be protected; and
- whether the company has the local HR capacity to administer long-term cases.
Where the foreign company does not have a suitable mainland China employing entity, HROne’s China EOR guide explains how local employment, payroll, statutory benefits, leave administration and employee records can be handled through an Employer of Record structure.
The offer and onboarding documents should not promise a global sick-pay rule that conflicts with the employee’s local entitlement. HR should also train managers not to reject leave, promise full salary, demand unrestricted medical records or discuss termination before the case has been reviewed.
Employers should also align sick leave with their broader China employee benefits framework, including statutory contributions, leave administration and supplementary policies.
Employer checklist for China sick leave
| Control area | Employer action |
|---|---|
| Policy | Maintain a China-specific sick-leave and medical-document procedure. |
| Onboarding | Explain reporting channels, documentation, payroll treatment and data access. |
| Local rule | Confirm the employee’s work and payroll city before calculating pay or protection. |
| Medical evidence | Request reasonable documentation and provide a process for emergencies and extensions. |
| Attendance | Record every approved sick-leave day accurately and consistently. |
| Pay | Apply the local formula, statutory floor and any more favorable company rule. |
| Protected period | Maintain a cumulative medical-treatment-period calculation for long or repeated absences. |
| Benefits | Coordinate ongoing payroll and statutory-benefit administration while employment continues. |
| Privacy | Restrict medical information to functions with a legitimate administrative need. |
| Suspected abuse | Investigate proportionately and obtain evidence before considering discipline. |
| Return to work | Review work capacity, restrictions and possible reassignment when appropriate. |
| Termination | Complete protected-status, legal, payment and local-rule review before communication. |
How HROne supports sick leave and payroll compliance
HROne supports foreign employers through China payroll outsourcing, statutory-benefit administration, employee-record coordination and practical China HR compliance support.
For sick-leave cases, HROne can help align local payroll treatment, documentation, medical-treatment-period tracking and employer processes with the employee’s work city and employment structure.
Speak with HROne about HR and payroll compliance support if you need help administering sick leave, long-term medical treatment periods or the related payroll and employment records.
FAQ: Sick leave in China
What is the difference between sick leave and the medical treatment period?
Sick leave is the approved absence from work because of illness or a non-work-related injury. The medical treatment period is the statutory protection period calculated under national and applicable local rules, during which specified no-fault termination and layoff routes are restricted.
Is sick leave paid in China?
Approved sick leave is generally paid, but the amount may be lower than normal salary. The calculation depends on local rules, the labor or collective contract, company policy and the employee’s circumstances. Sick pay or illness relief generally should not fall below the applicable statutory floor.
How long is the medical treatment period in China?
Under the national framework, the medical treatment period generally ranges from 3 to 24 months according to the employee’s total working years and service with the current employer. Local rules can use different entitlement or calculation methods, so the employee’s city must be checked.
What medical documents can an employer require?
An employer may require reasonable evidence under a communicated sick-leave policy, such as a medical certificate or sick-leave recommendation from a qualified medical institution showing the approved rest period. The employer should allow reasonable supplementation and avoid collecting or circulating unnecessary medical details.
Can an employer terminate an employee during the medical treatment period?
During the prescribed medical treatment period, an employer generally cannot use the Article 40 no-fault termination routes or Article 41 economic-layoff route. A fixed-term contract may also need to be extended. After the period ends, termination is not automatic and requires review of work capacity, reassignment, notice, severance and local requirements.
