Sick Leave in China: Medical Treatment Periods and Sick Pay by City

China’s sick leave law is governed by the Labour Law (劳动法) and the Regulation on the Medical Treatment Period for Enterprise Employees (企业职工患病或非因工负伤医疗期规定). The medical treatment period (医疗期) ranges from 3 to 24 months depending on the employee’s total working years, and sick pay varies significantly by city — from 60% to 100% of wages.

Key Takeaways

• The medical treatment period (医疗期) ranges from 3 to 24 months depending on service
• Sick pay rates vary by city — 60% to 100% of the minimum wage or average wage
• A medical certificate is required from day 1 of absence
• Social medical insurance covers treatment costs during the medical treatment period
• After the medical treatment period ends, the employer may terminate with severance

China’s Sick Leave Entitlement

China’s sick leave system is built on the medical treatment period (医疗期), which is the period during which the employer cannot terminate the employment contract due to illness. The length depends on the employee’s total working years and tenure with the current employer.

Total Working Years	Tenure with Employer	Medical Treatment Period
Less than 10 years	Less than 5 years	3 months
Less than 10 years	5+ years	6 months
10+ years	Less than 5 years	6 months
10+ years	5–10 years	9 months
10+ years	10–15 years	12 months
10+ years	15–20 years	18 months
10+ years	20+ years	24 months

During this period, the employer must pay sick pay and cannot terminate the employment.

Who Pays for Sick Leave?

Period	Pay Rate	Who Pays
Medical treatment period	Per city/local regulation	Employer
Social medical insurance	Treatment costs	Insurance fund
After medical treatment period	Varies by city	Employer (severance if terminated)

Sick Leave Pay Rates (Vary by City)

City	Sick Pay Rate	Minimum Floor	Source
Shanghai	100% of average wage (first 6 months)	80% of minimum wage	Shanghai regulations
Beijing	80% of minimum wage	80% of minimum wage	Beijing regulations
Guangzhou	80% of average wage	Not less than 80% of minimum wage	Guangdong regulations
Shenzhen	60% of average wage	Not less than 60% of minimum wage	Shenzhen regulations
Chengdu	70% of average wage	Not less than 70% of minimum wage	Sichuan regulations

The sick pay rate and minimum floor vary significantly by city and province. Employers must check the local regulations that apply to their workforce.

Medical Certificate Requirements

China requires a medical certificate from the first day of illness. The certificate must be issued by a hospital designated by the social medical insurance system.

The certificate must specify:

• The date of examination
• The expected duration of the absence
• Whether the employee is hospitalised
• The diagnosis

The employee must present the certificate to the employer. For social medical insurance claims, the certificate must be from a designated hospital.

How to Calculate Sick Pay in China

Example: An employee in Shanghai earning RMB 15,000/month is off sick for 90 calendar days (within the 6-month medical treatment period).

1. Shanghai rate (first 6 months): 100% of average wage
2. Daily sick pay: RMB 15,000 ÷ 30 = RMB 500/day
3. Sick pay for 90 days: RMB 500 × 90 = RMB 45,000

The employee’s normal earnings for this period would have been RMB 45,000, so the sick pay covers 100% in Shanghai.

After the Medical Treatment Period

When the medical treatment period ends and the employee cannot return to work:

• The employer may terminate the employment with severance
• Severance is calculated at 1 month’s salary per year of service
• The employee may be eligible for social insurance benefits
• Some cities provide additional protections for long-term illness

Employer Obligations and Penalties

Chinese employers must:

• Pay sick pay during the medical treatment period as prescribed by local regulations
• Register employees with the social medical insurance system
• Maintain medical certificates on file
• Cooperate with the social medical insurance system for claims
• Maintain records for at least 2 years after the employee leaves

Non-compliance can result in fines from the Ministry of Human Resources and Social Security (人力资源和社会保障部) and potential labour court proceedings.

Comparison With Other Countries

Country	Sick Days	Pay	Certificate Required
China	3–24 months medical treatment period	60–100% (by city)	Day 1
UK	28 weeks SSP	£116.75/week	Day 7
Australia	10 days personal/carer’s leave	Full rate	2+ consecutive days
US	Varies by state	Varies	Employer policy

FAQ

Why does sick pay vary so much by city in China?

China’s social insurance system is administered at the city and provincial level, not nationally. Each city sets its own sick pay rate and minimum floor based on local economic conditions and cost of living. This means the same employee may receive different sick pay depending on where they work.

Can the employer terminate during the medical treatment period?

No. During the medical treatment period, the employer cannot terminate the employment contract due to illness. After the medical treatment period ends, the employer may terminate if the employee cannot return to work, but must pay severance.

What is social medical insurance?

Social medical insurance (社会医疗保险) is China’s public health insurance system. It covers medical treatment costs during sick leave, including doctor visits, hospital stays, and medication. The employer and employee both contribute to the insurance fund.