Hong Kong sick leave is governed by Part VII of the Employment Ordinance (Cap. 57). The structure is unusual by international standards: paid sickness allowance is not granted as a flat annual entitlement but accrues monthly into a “sickness day” balance that an employee draws on when ill. The 4-day rule — sickness allowance is only payable for absences of four or more consecutive days — and the 80% sickness allowance rate are the two features that catch overseas employers off guard.
This guide covers the Employment Ordinance sick leave rules as they operate in 2026: how sickness days accrue, the 4-day rule, the sickness allowance calculation, certification, and the pitfalls Hong Kong employers most often run into.
Key takeaways
- Sickness days accrue at 2 days per completed month for the first 12 months of service, then 4 days per completed month thereafter, capped at 120 days.
- Sickness allowance is payable only when the employee is absent for 4 or more consecutive days with a valid medical certificate.
- The sickness allowance rate is 80% of the average daily wages earned in the 12 months preceding the absence.
- Sickness allowance is unavailable if the absence is shorter than 4 days, even if certified — the days reduce the balance but are unpaid statutorily.
- Employers cannot dismiss an employee on a paid sickness day except for summary dismissal reasons under section 9 of the Ordinance.
How sickness days accrue
Section 33 of the Employment Ordinance (Cap. 57) sets the accrual schedule:
| Period of service | Accrual rate per completed month |
|---|---|
| First 12 months | 2 days |
| Month 13 onward | 4 days |
The accumulated balance is capped at 120 sickness days. Once the cap is reached, no further accrual occurs until days are used. When sickness days are used, accrual resumes the next month.
The accrual ties to “completed month of employment” — partial months do not accrue. An employee in their second month of employment has 2 sickness days; in their third month, 4 days; and so on. From month 13, the rate doubles.
The 4-day rule
The most distinctive feature of Hong Kong sick leave is that sickness allowance is only payable for continuous absences of 4 or more days. A two- or three-day absence — even with a doctor’s certificate — uses sickness days from the balance but does not attract paid sickness allowance.
This is unusual internationally. Most jurisdictions pay sick leave from day one (or with a short waiting period). Hong Kong’s structure means short absences are effectively unpaid, with the days only counting toward the 120-day cumulative pool.
The “4 or more consecutive days” is calendar, not working days. Saturdays, Sundays, and public holidays count toward the consecutive run if the absence is medically continuous.
Sickness allowance: 80% of average daily wages
When the 4-day rule is met and a certificate is produced, sickness allowance is paid at 80% of the average daily wages earned by the employee in the 12 months immediately preceding the first day of the absence. If the employee has been employed for less than 12 months, the calculation uses the period of employment.
“Average daily wages” includes all wages and allowances paid during the reference period, divided by the number of days the employee worked. Periods on statutory leave (annual leave, sickness leave, maternity leave, etc.) are excluded from both the wage total and the day count to avoid distortion.
For commission-heavy roles, this calculation can produce significant variation between months. The 12-month averaging window smooths it, but employers in real estate, finance, and other commission-driven sectors should track the calculation carefully.
Certification
Sickness allowance requires a medical certificate from a registered medical practitioner, registered Chinese medicine practitioner, or registered dentist. The certificate must specify:
- The number of days the employee is unfit for work
- The nature of the illness or injury (in general terms)
- The date of the consultation
A certificate from any registered practitioner is valid — the employer cannot insist on a panel-only doctor without a clear contractual basis. Public clinics, private GPs, and traditional Chinese medicine practitioners are all acceptable.
Protection against dismissal
Section 33 makes it unlawful to dismiss an employee on a paid sickness day except for grounds of summary dismissal under section 9 (gross misconduct, fraud, repeated wilful disobedience, etc.). This is a meaningful protection: an employee on certified sick leave drawing sickness allowance cannot be terminated even by giving notice.
Compensation for unlawful dismissal during sickness days is one month’s wages plus the equivalent of the unpaid sickness allowance, plus a further punitive sum.
Employer obligations
Hong Kong employers under the Employment Ordinance have five core obligations on sick leave:
- Track sickness day accrual at the section 33 rates and apply the 120-day cap.
- Apply the 4-day rule correctly — short absences use days but do not trigger sickness allowance.
- Pay sickness allowance at 80% of average daily wages for qualifying absences, calculated over the proper 12-month reference period.
- Accept valid medical certificates from any registered practitioner, including registered Chinese medicine practitioners.
- Not dismiss employees on paid sickness days except on summary dismissal grounds under section 9.
Records of sickness days accrued, taken, and paid must be kept under the Employment Ordinance’s general record-keeping requirement and made available to the Labour Department on request.
Common pitfalls
Hong Kong employers — particularly multinationals applying global sick leave policies — fall into the same five traps:
1. Paying for absences under 4 days
Some employers, particularly multinationals from jurisdictions with first-day sick pay, pay sickness allowance for one-, two-, or three-day absences. Doing so is a contractual choice, not a statutory requirement — and the days do not count against the statutory pool unless the employer’s policy says they do.
2. Calculating allowance on basic pay
Sickness allowance is 80% of average daily wages, not 80% of basic pay. The 12-month averaging includes commissions, fixed allowances, and other regular payments. Calculating on basic alone underpays employees in commission-heavy roles.
3. Forgetting the 12-month accrual change
The accrual rate doubles from 2 to 4 days per month after 12 months of service. Payroll systems that don’t auto-step the accrual at the first anniversary leave employees short of days they are entitled to.
4. Refusing Chinese medicine certificates
Registered Chinese medicine practitioners are explicitly recognised under section 33. Employers who reject TCM certificates as a category are violating the Ordinance.
5. Dismissing during certified sickness
Section 33’s protection against dismissal on paid sickness days is one of the strongest in Asian employment law. Employers who terminate during certified sick leave — even with proper notice — face section 33 unlawful dismissal claims and statutory penalties.
For broader context on Hong Kong leave entitlements, see our overview of annual leave in Hong Kong and the main types of leave employers manage.
Frequently asked questions
How do sickness days accrue in Hong Kong?
Two days per completed month for the first 12 months of service, then four days per completed month, capped at a maximum balance of 120 sickness days.
What is the 4-day rule?
Sickness allowance is only payable when the employee is absent for four or more consecutive days with a valid medical certificate. Shorter absences use days from the balance but do not trigger paid sickness allowance.
What rate is sickness allowance paid at?
Eighty percent of the employee’s average daily wages over the 12 months immediately preceding the first day of the absence (or the period of employment if shorter).
Are TCM (Chinese medicine) certificates valid?
Yes. Certificates from registered Chinese medicine practitioners are explicitly recognised under section 33 of the Employment Ordinance.
Can an employer dismiss an employee during certified sick leave?
Generally, no. Section 33 prohibits dismissal on paid sickness days except for grounds of summary dismissal under section 9 (gross misconduct, fraud, etc.).
Does unused sickness leave get paid out on termination?
No. Unlike annual leave, accrued sickness days are not paid out on termination. They are a contingent entitlement, not an accrued one.
Putting it into practice
If you employ staff in Hong Kong, the practical to-do list is short:
- Confirm your payroll system tracks sickness day accrual at 2 days per month for year 1, then 4 days per month, capped at 120.
- Apply the 4-day rule correctly — short absences use days but are unpaid statutorily, unless the contract provides otherwise.
- Calculate sickness allowance at 80% of average daily wages over the proper 12-month reference period.
- Accept certificates from any registered practitioner, including registered Chinese medicine practitioners.
- Train managers on the section 33 dismissal protection — terminating during certified sick leave is rarely defensible.
A modern leave management system tracks Hong Kong’s monthly accrual, applies the 120-day cap, enforces the 4-day rule, and calculates the 12-month sickness allowance window automatically — so payroll for commission-heavy roles is correct without manual recomputation.
Sources
- Employment Ordinance Cap. 57 (Hong Kong e-Legislation) (primary source)
- Labour Department — Sickness Allowance
Last updated: 5 May 2026. This article is general guidance, not legal advice. For complex cases — including average wage calculations for commission-driven roles or dismissal disputes — consult a Hong Kong-qualified employment lawyer.