Israel does not fund sick pay through social insurance. The employer pays it directly, out of a balance the employee accrues month by month — which makes the Israeli system feel more like an annual leave entitlement than a state benefit, and makes accurate balance tracking an employer’s problem rather than an insurer’s.
The rules themselves are compact: accrue 1.5 days a month, cap at 90, and pay on a three-step ladder that starts at zero.
Key takeaways
- Employees accrue 1.5 sick days for each full month of employment — 18 days a year — up to a maximum accumulated balance of 90 days.
- Payment is tiered: the first day is unpaid, days two and three are paid at 50%, and from the fourth day the full wage is paid.
- Sick pay (dmei machala) is paid by the employer, not by the National Insurance Institute.
- A medical certificate is required; the employer may require it before paying.
- Unused sick days are not paid out on termination unless a contract or collective agreement says otherwise.
- Separate statutes allow employees to draw on their sick balance to care for a sick child, parent or spouse, on their own conditions and limits.
The accrual system
The Sick Pay Law, 5736-1976 sets the entitlement as an accruing balance rather than an annual allowance. An employee earns 1.5 days for every full month worked — 18 days across a full year — and the balance carries forward until it reaches the statutory ceiling of 90 days.
Two consequences follow directly from that design:
New employees have almost nothing. Someone two months into a job has accrued three days. There is no front-loaded annual allowance to draw on, which is why an early illness so often ends up partially unpaid.
Long-serving employees accumulate a serious liability. An employee at the 90-day cap is holding, in effect, four and a half months of employer-funded income protection. That is a real balance-sheet item for employers with tenured staff, and the reason accurate tracking matters even when nobody is currently sick.
Part-time employees accrue proportionally, based on their scope of employment. The accrual is a function of months worked, not of hours worked in any given month.
The payment ladder
The Sick Pay (Amendment No. 4) Law, 2011 set the rates that apply today:
| Day of absence | Paid at |
|---|---|
| Day 1 | Nothing |
| Days 2 and 3 | 50% of the wage |
| Day 4 onwards | 100% of the wage |
The ladder resets with each absence. Three separate two-day illnesses across a year produce three unpaid days and three half-paid days — and never reach the 100% tier at all. For employers, that structure is what keeps short-absence cost low; for employees, it is what makes short absences expensive.
Days are debited from the accrued balance as they are used. A day paid at 50% still consumes a day of balance — the tier affects the money, not the deduction.
The rate applies to the wage the employee would have earned had they worked. For employees on variable hours or output-based pay, that means a calculated average rather than a nominal figure, which is where most Israeli sick pay disputes actually start.
Full pay from day one: the exceptions
Regulations under the Sick Pay Law provide that employees receiving treatment for defined serious conditions — including malignant disease and regular dialysis — are entitled to 100% of the wage from the first day of absence for treatment or periodic examination, drawn from the accrued balance up to the 90-day ceiling.
This is a narrow carve-out, not a general “serious illness” principle. Its practical importance is that an employer applying the standard 0/50/100 ladder to a cancer patient attending regular treatment is underpaying, and the pattern of frequent short absences that treatment produces is exactly the pattern the ladder penalises hardest.
Using sick days for family care
Israel has separate statutes allowing an employee to charge absence to their own sick balance in order to care for a family member:
- Sick Pay (Absence due to Child’s Illness) Law, 1993 — days for a sick child, with entitlement varying by the child’s age, the child’s condition and whether both parents are employed.
- Sick Pay (Absence due to Parent’s Illness) Law, 1993 — days to care for a dependent parent.
- Sick Pay (Absence due to Spouse’s Illness) Law, 1998 — days to care for a spouse.
Each has its own annual limit and its own eligibility conditions, and each draws on the employee’s accrued sick balance. Employers frequently either refuse these absences outright or fail to debit them correctly — both are errors, and the second one quietly inflates the employee’s remaining balance.
Certification
The employer is entitled to a medical certificate before paying sick pay. Certificates may be issued by a physician of the employee’s health fund (kupat holim) or by a private physician.
Employers may not demand a diagnosis. The certificate establishes the period of unfitness for work, and that is the extent of the information the employer is entitled to. Policies requiring employees to disclose the nature of an illness are common in practice and wrong in law.
Termination and unused days
Accrued sick days are not paid out on termination. Unlike annual leave, which carries a statutory payout obligation, sick pay is contingent — it is a right to be paid if you are sick, not a deferred wage.
That distinction is worth stating explicitly in the employment contract, because the accrual mechanics look so much like annual leave that employees reasonably assume the same treatment. Contracts and collective agreements can grant a payout, and some sectoral agreements do, but the statutory default is no payout.
Common employer pitfalls
1. Treating sick days as an annual allowance
The entitlement accrues at 1.5 days a month and carries forward to 90. It is a running balance, not an 18-day yearly grant that resets in January.
2. Paying the first day
The first day of each absence is unpaid by statute. Employers may improve on that, but they should do so knowingly and consistently.
3. Not debiting the balance for half-paid days
Days two and three are paid at 50% but consume a full day of balance each. Debiting only half a day inflates the balance over time.
4. Applying the ladder to protected treatment absences
Employees receiving treatment for defined serious conditions, such as malignancy or dialysis, are entitled to full pay from day one for those absences.
5. Refusing family care absences or failing to debit them
Child, parent and spouse illness leave draw on the same accrued balance under separate statutes. Both refusing them and forgetting to deduct them are errors.
6. Paying out unused sick days on termination
There is no statutory payout. Doing it by habit creates a precedent and a cost that the law does not require.
For how a purely employer-funded model compares with insurance-funded systems, see our guides to sick leave in the UAE and sick leave in Singapore, and for an overview of leave categories generally, the main types of leave employers manage.
Frequently asked questions
How many sick days do employees get in Israel?
Employees accrue 1.5 days for each full month of employment — 18 days a year — up to a maximum accumulated balance of 90 days.
How is sick pay calculated in Israel?
The first day of each absence is unpaid, days two and three are paid at 50% of the wage, and from the fourth day the full wage is paid. Each day used, at any rate, debits one day from the accrued balance.
Who pays sick pay in Israel?
The employer. Israeli sick pay is not funded by the National Insurance Institute; it is a direct employer obligation under the Sick Pay Law, 5736-1976.
Can employees use sick days for a family member?
Yes. Separate statutes allow absence for a sick child, a dependent parent or a spouse, drawn from the employee’s own accrued balance, each with its own annual limits and conditions.
Are unused sick days paid out when employment ends?
No, unless a contract or collective agreement provides for it. Accrued sick days are a contingent entitlement, not deferred wages.
Does an employer have to pay from day one for serious illness?
For defined conditions, including malignant disease and regular dialysis, regulations provide full pay from the first day of absence for treatment or periodic examination, drawn from the accrued balance.
Putting it into practice
- Run sick leave as a running balance with monthly accrual and a hard 90-day ceiling — not an annual allowance.
- Debit one full day for every day used, whatever the pay tier.
- Configure the 0/50/100 ladder to reset per absence, and code the day-one-full-pay exceptions separately.
- Track child, parent and spouse care absences against the same balance under their own limits.
- Say in the contract that unused days are not paid out on termination, so expectations match the statute.
An accrual-based sick leave system with a 90-day ceiling, a three-tier payment ladder and three separate family-care statutes drawing on the same balance is not something a spreadsheet handles well. Software that holds the balance, applies the tier, and debits correctly is the difference between a clean payroll and a年-end reconstruction exercise.
Sources
- Sick Pay Law, 5736-1976 — ILO NATLEX
- Sick Pay (Amendment No. 4) Law, 2011 — ILO NATLEX
- Israel Ministry of Labour — employee rights
Last updated: 23 July 2026. This article is general guidance, not legal advice. Sectoral collective agreements frequently improve on the statutory minimum — check the applicable agreement before setting policy.