Japan does not have a statutory paid sick leave entitlement. This surprises overseas employers familiar with most other developed economies, but it is the position under the Labor Standards Act (労働基準法). Instead, Japanese employees use their annual leave (nenkyū, 年休) for short illness and rely on the Injury and Sickness Allowance (傷病手当金, shōbyō teate-kin) from the Health Insurance system for extended absence beyond what nenkyū covers.

This guide explains how the system works in 2026: why there is no dedicated paid sick leave, how nenkyū is used for sickness in practice, how the Injury and Sickness Allowance from kenkō hoken (健康保険) works, and the contractual sick leave structures that distinguish good Japanese employers from the statutory floor.

Key takeaways

  • The Labor Standards Act provides no dedicated paid sick leave. Employees use annual paid leave (nenkyū) for short illness.
  • For absences beyond nenkyū lasting 4 or more days, employees enrolled in Health Insurance (kenkō hoken) receive an Injury and Sickness Allowance of approximately two-thirds of the standard remuneration, paid for up to 18 months for the same illness.
  • The first 3 consecutive days of absence are an unpaid waiting period under Health Insurance — payment begins on day 4.
  • Many Japanese employers offer contractual sick leave (byoukyū, 病休) on top of nenkyū, particularly large companies, but this is not statutory.
  • Employees who dismiss for illness without exhausting Health Insurance protections face significant restrictions under the Labor Contract Act and case law.

Why there is no statutory paid sick leave

The Labor Standards Act (1947) was modelled on a system that consciously did not separate sick leave from annual leave. The view was that workers needed a single pool of paid days off they could use for any purpose. That structure has persisted: nenkyū serves both vacation and short-term illness purposes, and longer illness is handled through national Health Insurance rather than employer payroll.

Article 39 of the Labor Standards Act sets out nenkyū entitlement. After 6 months of continuous service with 80% attendance, an employee receives 10 days of paid annual leave, increasing with tenure to a maximum of 20 days from year 6.5 onward. These days are the worker’s primary buffer for short illness.

Nenkyū used for illness in practice

When an employee takes one or two days off sick in Japan, the typical practice is:

  • The employee notifies their manager and submits a nenkyū application (written or via HR system) covering the absence.
  • The day is paid at the regular wage rate.
  • A medical certificate is generally not required for nenkyū — the leave is a worker’s right under article 39 and the employer cannot demand the reason.

This is administratively the same as taking a vacation day. The downside is that frequent illness erodes the holiday balance, leaving less for genuine vacation. Nenkyū is also use-it-or-lose-it after a 2-year carry-over period under article 115 (which sets the statute of limitations on labour rights).

The Injury and Sickness Allowance

For longer absences, the Health Insurance Act provides the Injury and Sickness Allowance — a partial wage replacement administered by the employee’s Health Insurance Society or the Japan Health Insurance Association (Kyōkai Kenpo).

Eligibility

To qualify, the employee must:

  • Be enrolled in Health Insurance (almost all regular employees are, plus most part-timers meeting the eligibility threshold)
  • Be unable to work due to non-occupational injury or illness (occupational injury is covered by Workers’ Compensation Insurance, separately)
  • Have been absent for 4 or more consecutive days, with the first 3 days as an unpaid waiting period
  • Have a medical certificate confirming inability to work
  • Not be receiving full wages from the employer for the period

Amount

Roughly two-thirds (2/3) of the standard daily remuneration based on the average of the 12 months preceding the absence. The exact formula uses the standard monthly remuneration (標準報酬月額) — the salary band under which Health Insurance contributions are calculated — divided by 30 to derive the daily figure.

Duration

Payable for up to 1 year and 6 months for the same injury or illness counted from the first payment day. Multiple distinct illnesses can each have their own 18-month period.

Coordination with employer pay

If the employer continues paying any portion of the wage during sickness, the Injury and Sickness Allowance is reduced or eliminated to the extent the employer pay covers two-thirds of standard remuneration. This is why many employers structure contractual sick leave deliberately — paying half wages for an extended period while letting Health Insurance top up to two-thirds.

Contractual sick leave (byoukyū)

Many Japanese companies — particularly large companies and multinationals — offer contractual sick leave (byoukyū) on top of nenkyū. Common structures include:

  • 30 to 90 days of paid sick leave per year at full wage, available before nenkyū is touched
  • Tiered systems where the first 30 days are at full pay, the next 60 at partial pay, then unpaid with Health Insurance top-up
  • Unlimited sick leave at full pay in some senior or unionised contexts

These are entirely contractual. There is no statutory minimum for byoukyū. Smaller companies and many startups offer no byoukyū at all, leaving employees to rely entirely on nenkyū and Health Insurance.

Termination for illness

The Labor Contract Act and accumulated case law restrict termination for illness. Specifically:

  • Dismissal during sick leave is generally permitted only after the employee’s recovery period (often a contractual 1- to 3-year leave of absence period — kyushoku) has been exhausted.
  • Even after exhaustion, the employer must demonstrate that no alternative work could reasonably be offered.
  • Discriminatory dismissal — for example, terminating an employee with a chronic illness while keeping others — is a frequent cause of unfair dismissal litigation under article 16 of the Labor Contract Act.

Employer obligations

Japanese employers have five core obligations relating to sick leave:

  1. Provide nenkyū under article 39 of the Labor Standards Act and accept its use for sickness without demanding medical reasons.
  2. Maintain Health Insurance enrolment for all eligible employees and not interfere with Injury and Sickness Allowance claims.
  3. Apply contractual sick leave consistently if offered, and document the structure in work rules (shūgyō kisoku) for companies with 10 or more employees.
  4. Coordinate employer pay with Health Insurance so the allowance is correctly reduced or eliminated where employer pay covers two-thirds of standard remuneration.
  5. Follow termination rules for ill employees, including the typical kyushoku leave of absence period under work rules.

Common pitfalls

Five issues come up frequently for foreign employers and multinationals operating in Japan:

1. Treating nenkyū as vacation only

Some foreign employers refuse to accept nenkyū applications for illness, expecting a “sick leave” to exist separately. There is no separate statutory sick leave — refusing nenkyū for illness is a violation of article 39.

2. Requiring a medical certificate for nenkyū

Nenkyū is a right exercised at the worker’s choice. Demanding medical justification routinely is inconsistent with article 39 and frequent grounds for labour bureau guidance.

3. Forgetting the 3-day Health Insurance waiting period

The first 3 consecutive days of absence are unpaid under Health Insurance. Employees often expect day-one allowance and are surprised. Clear communication helps.

4. Failing to coordinate employer pay with allowance

If the employer pays full wages, no Injury and Sickness Allowance is owed. If the employer pays half, the allowance tops up to two-thirds. Mis-coordination either overpays the employee (rare) or under-pays (more common, when employers don’t realise the allowance is reduced).

5. Premature dismissal for chronic illness

Japanese case law strongly protects ill employees. Dismissal during contractual leave of absence periods or without exploring alternative work invariably leads to litigation under article 16 of the Labor Contract Act.

For broader context on Japanese leave entitlements, see our overview of annual leave in Japan and the main types of leave employers manage.

Frequently asked questions

Is there a statutory paid sick leave in Japan?

No. The Labor Standards Act provides no dedicated paid sick leave. Employees use annual paid leave (nenkyū) for short illness and rely on the Injury and Sickness Allowance from Health Insurance for extended absence.

How much is the Injury and Sickness Allowance?

Roughly two-thirds of the standard daily remuneration based on the 12-month average of standard monthly remuneration, payable from day 4 of consecutive absence for up to 18 months for the same illness.

Can I refuse a nenkyū application for sickness?

Generally, no. Nenkyū is a worker’s right under article 39 of the Labor Standards Act. The employer’s only adjustment power is the limited “operational adjustment” (jiki henkō ken) to shift the timing for genuine business reasons, which rarely justifies refusal for sick days.

What is byoukyū?

Byoukyū is contractual sick leave offered by many Japanese employers on top of nenkyū. It is not statutory. Structures vary widely by employer and industry.

When does the 3-day waiting period start?

From the first day of consecutive absence. The first 3 days are unpaid under Health Insurance; the allowance begins on day 4.

Can I dismiss an employee on long-term sick leave?

Termination for illness is heavily restricted by case law. Most Japanese employers grant a kyushoku leave of absence of 1 to 3 years before considering dismissal, and even then must demonstrate reasonable accommodation efforts.

Putting it into practice

If you employ staff in Japan, the practical to-do list is short:

  1. Confirm your work rules (shūgyō kisoku) clearly describe how nenkyū and any contractual byoukyū interact with Health Insurance.
  2. Train managers to accept nenkyū applications for illness without demanding medical reasons.
  3. Coordinate employer pay with the Injury and Sickness Allowance to avoid double-pay or under-pay.
  4. Set up a kyushoku leave of absence policy for chronic illness — typically 1 to 3 years with documented return-to-work expectations.
  5. Communicate the 3-day Health Insurance waiting period clearly to employees so the first allowance payment is not a surprise.
You can take advantage of the free 14 days trial and explore Leave Balance.

A modern leave management system tracks nenkyū balances, separates statutory and contractual sick leave, and integrates with Health Insurance allowance coordination — so the gap between nenkyū exhaustion and the allowance kicking in is visible to HR before payroll surprises anyone.

Sources

Last updated: 5 May 2026. This article is general guidance, not legal advice. For complex cases — including dismissal of ill employees and Workers’ Compensation versus Health Insurance classification — consult a Japan-qualified employment lawyer (rōdō bengoshi).