Sweden splits sick leave between two payers, and the handover happens on a specific day. For the first two weeks the employer pays sick pay (sjuklön) directly out of payroll under the Sick Pay Act. From day 15, the Swedish Social Insurance Agency (Försäkringskassan) takes over with sickness benefit (sjukpenning) — but only if the employer has filed the right report on time.

This guide covers how Swedish sick leave works in 2026: the 14-day employer period, the qualifying deduction that replaced the old waiting day, the 80% rate, when a medical certificate is required, and the rehabilitation duties that start long before an employee returns.

Key takeaways

  • The employer pays sjuklön for the first 14 calendar days of a sick period under the Sick Pay Act (Lag 1991:1047 om sjuklön).
  • Sick pay is 80% of the pay and benefits the employee loses by being absent.
  • A karensavdrag (qualifying deduction) is taken from the first sick pay payment — a fixed 20% of an average sick pay week, not a whole unpaid day.
  • A medical certificate is required from the eighth day of the sick period, not from day one.
  • From day 15, Försäkringskassan pays sjukpenning — and the employer must report the sick leave to the agency.

The 14-day employer sick pay period

The Sick Pay Act makes the employer, not the state, the first payer. When an employee reports sick, the employer pays sjuklön for calendar days 1 to 14 of that sick period, for the hours the employee would otherwise have worked.

Two details matter more than most employers expect. First, the period runs in calendar days, so weekends count toward the 14 even though no sick pay is due for non-working days. Second, if a new sick period starts within five calendar days of the previous one ending, the two are treated as one continuous period — the employee does not get a fresh 14-day clock or a second qualifying deduction.

Eligibility is immediate for open-ended employment. For short fixed-term contracts of less than one month, the employee must have worked for at least 14 calendar days before sick pay is due.

The karensavdrag: how the deduction works

Sweden abolished the old “karensdag” (one unpaid waiting day) on 1 January 2019 and replaced it with the karensavdrag — a fixed deduction of 20% of the sick pay an employee would receive in an average working week.

The change fixed an old unfairness. Under the waiting-day system, an employee who fell ill at the start of a 12-hour shift lost far more than someone on a short shift. The karensavdrag is the same amount regardless of when in the day or week the illness starts.

Element Rule
Sick pay rate 80% of lost pay and employment benefits
Qualifying deduction 20% of average weekly sick pay, taken once per sick period
Employer period Calendar days 1–14
Certificate Required from day 8
After day 14 Försäkringskassan sjukpenning, subject to its own assessment

The Sick Pay Act also caps how often the deduction can bite. Once an employee has had a karensavdrag taken on ten occasions in the preceding twelve months, no further deduction may be made for subsequent sick periods — a protection that matters for employees with frequent short absences and one that payroll systems configured outside Sweden almost never apply.

Employees with recurring illness can also apply to Försäkringskassan for särskilt högriskskydd (special high-risk protection), which limits how often the deduction can be applied and lets the employer reclaim sick pay costs.

Medical certificates from day 8

An employee does not need a doctor’s note to be off sick in Sweden for the first week. A läkarintyg (medical certificate) is required from the eighth day of the sick period, and the employee must give it to the employer to keep sick pay flowing.

Employers can ask for a certificate earlier, but only with särskilda skäl — special reasons, typically a documented pattern of short absences — and the requirement must be handled under the Sick Pay Act’s procedure rather than imposed informally. Many collective agreements set out how this is done, so check the applicable agreement before introducing an early-certificate rule.

Day 15: the handover to Försäkringskassan

If the absence continues past day 14, the employer must report the sick leave to Försäkringskassan. The employee then applies for sjukpenning, which is paid at roughly 80% of their qualifying income (SGI) up to an annual ceiling set in price base amounts and adjusted every year.

The 2026 numbers

Sweden re-sets these figures each January against the price base amount (prisbasbelopp), so any policy document that hard-codes them goes stale within a year:

Figure (2026) Amount
Prisbasbelopp SEK 59,200
Highest qualifying income (SGI) for sjukpenning SEK 592,000 (10 × prisbasbelopp)
Maximum sjukpenning at the normal level SEK 1,259 per calendar day

Two mechanics sit behind the headline “80%”. Försäkringskassan multiplies the SGI by 0.97 before applying the benefit rate, so the effective replacement rate is slightly under 80%. And sjukpenning at the normal level is limited to 364 days within a 450-day window; beyond that an employee must apply for the lower continued level, which is where long-term absences start to cost real income.

Sjukpenning is not automatic. Försäkringskassan assesses work capacity against a moving benchmark — the rehabiliteringskedjan (rehabilitation chain):

  • Days 1–90: capacity assessed against the employee’s ordinary job.
  • Days 91–180: assessed against any other work the employer can offer.
  • From day 181: assessed against the regular labour market as a whole.

This is why the day-15 handover is not the end of the employer’s involvement. The day-91 and day-181 assessments depend on what the employer has documented about adjusted duties and redeployment options.

Rehabilitation duties

Swedish employers have an active rehabilitation obligation under the Work Environment Act and the Social Insurance Code. Where an absence is expected to last 60 days or more, the employer must produce a written rehabiliteringsplan (plan for return to work) — in practice by around day 30 of the absence.

The plan is not a formality. It sets out the adjustments, phased return, and follow-up dates, and it is the document Försäkringskassan looks at when it assesses whether the employer has done enough at the 90- and 180-day marks.

Employer obligations

Swedish employers have six core duties on sick leave:

  1. Pay sjuklön for calendar days 1–14 at 80% of lost pay, applying the karensavdrag once per sick period.
  2. Apply the five-day rule so a recurrence within five days continues the previous period rather than starting a new one.
  3. Collect the medical certificate from day 8 and only require earlier certification where special reasons apply.
  4. Report to Försäkringskassan when the absence passes day 14.
  5. Produce a rehabilitation plan for absences expected to exceed 60 days and act on the adjustments in it.
  6. Keep sick leave records that show dates, hours, rate applied, and deductions — these are what get audited.

Common pitfalls

The same five mistakes come up repeatedly, especially in companies applying a group-wide absence policy to a Swedish entity.

1. Deducting a whole day instead of the karensavdrag

The waiting day has been gone since 2019. Deducting a full day’s pay overcharges employees on long shifts and undercharges those on short ones, and it is one of the most common payroll errors in Swedish entities of foreign groups.

2. Restarting the 14-day period after a short recurrence

If the employee returns and falls sick again within five calendar days, the periods join. Restarting the clock means a second qualifying deduction the employee should never have paid.

3. Demanding a certificate from day one

The statutory trigger is day 8. A blanket day-one certificate rule without special reasons and without the correct procedure is not enforceable, and it puts the employer offside with both the Act and most collective agreements.

4. Missing the day-15 report

Försäkringskassan cannot start paying sjukpenning until it knows about the absence. A late employer report is the single most common cause of a gap in an employee’s income at exactly the point they can least absorb it.

5. Treating rehabilitation as the agency’s job

The rehabilitation chain assesses the employer’s offer of adjusted work at day 91. Employers that document nothing during the first three months routinely find the assessment goes against them.

For wider context on Swedish leave, see our guide to annual leave entitlement in Sweden, the country-by-country comparison of sick leave across Europe, and the overview of the main types of leave employers manage.

Frequently asked questions

How many sick days do employees get in Sweden?

There is no fixed number of paid sick days. The employer pays sjuklön for the first 14 calendar days of each sick period, and Försäkringskassan can pay sjukpenning after that for as long as reduced work capacity is established.

How much is Swedish sick pay?

80% of the pay and employment benefits the employee loses by being absent, minus the karensavdrag on the first payment of the sick period.

What is the karensavdrag?

A qualifying deduction equal to 20% of the sick pay an employee would receive in an average working week. It replaced the old unpaid waiting day on 1 January 2019 and is applied once per sick period.

When does an employee need a doctor’s note in Sweden?

From the eighth day of the sick period. Earlier certification can be required only where special reasons exist and the statutory procedure is followed.

Who pays after 14 days?

Försäkringskassan, through sjukpenning, once the employer has reported the absence and the employee has applied. The benefit is income-related and capped.

Does the employer pay anything after day 14?

Not statutorily, but many collective agreements provide employer-funded top-up (sjuklön or sjukpension) above the state benefit, particularly for higher earners whose income exceeds the sjukpenning ceiling.

Putting it into practice

If you employ staff in Sweden, five checks cover most of the risk:

  1. Confirm payroll applies the 20% karensavdrag, not a full-day deduction.
  2. Configure the five-day continuation rule so recurring absences join rather than restart.
  3. Set the certificate requirement at day 8 and document any special-reason exceptions.
  4. Automate the day-15 report to Försäkringskassan so it never depends on someone remembering.
  5. Trigger a rehabilitation plan when an absence is forecast to pass 60 days, and record the adjustments offered.
You can take advantage of the free 14 days trial and explore Leave Balance.

A leave management system that tracks sick periods in calendar days, links recurrences within the five-day window, and flags the day-8 and day-15 milestones turns Sweden’s two-payer model into an ordinary payroll run instead of a manual reconciliation every fortnight.

Sources

Last updated: 26 July 2026. This article is general guidance, not legal advice. Sick pay rates, base amounts, and benefit ceilings are adjusted annually — confirm current figures with Försäkringskassan and the applicable collective agreement.