A Deep-Dive Comparison of Sick Leave Policies in Different U.S. States: California, New York, Texas

Sick leave is a cornerstone of employee rights and workplace wellness in the United States. However, unlike many countries with national paid sick leave standards, America’s sick leave landscape is shaped by a complex web of federal, state, and local laws. This means your right to sick leave as an employee—and your obligations as an employer—can vary significantly depending on your location.

In this comprehensive guide, we will compare sick leave policies among three major states—California, New York, and Texas—highlighting key differences, legal requirements, and best practices. We’ll also cover how to obtain legitimate, verifiable medical certificates for sick leave using trusted telemedicine platforms like Havellum, and provide you with authoritative resources for further reading.

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1. The Federal Baseline: What the FMLA Provides

Before analyzing state law, it’s crucial to understand the federal floor for leave rights: the Family and Medical Leave Act (FMLA). FMLA provides certain employees with up to 12 weeks of unpaid, job-protected leave per year for personal or family medical reasons. However, FMLA only applies to employers with 50+ employees and to employees who have worked at least 1,250 hours during the past 12 months.

FMLA does not mandate paid sick leave. That’s where state laws come in—some, like California and New York, set paid leave requirements that go far beyond the federal minimum.

To learn more about federal leave rules and proper documentation, see Understanding the FMLA: Navigating Leave Documentation and Lawful Medical Notes.

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2. California: The Leader in Employee Sick Leave Protections

2.1 Statewide Paid Sick Leave

California has been at the forefront of paid sick leave legislation. Under the Healthy Workplaces, Healthy Families Act of 2014, most employees in California (including part-time and temporary workers) are entitled to:

• Accrue at least one hour of paid sick leave for every 30 hours worked
• Use at least 24 hours (three days) of paid sick leave per year
• Some localities, such as San Francisco and Los Angeles, mandate even more generous policies.

2.2 Usage and Documentation

Sick leave can be used for an employee’s own illness, preventive care, or to care for a family member. Employers can require reasonable advance notice for foreseeable absences and documentation (such as a doctor’s note) for absences longer than three days.

2.3 Additional Protections

California law prohibits retaliation against employees who use sick leave and requires sick leave balances to be displayed on pay stubs.

2.4 Best Practices: Medical Certificates

For extended absences, a legitimate, verifiable doctor’s note is essential. Havellum provides compliant telemedicine medical certificates accepted in California, with same-day appointments available. Learn how to get a lawful doctor’s note in How to Obtain a Legitimate Doctor’s Note in the USA: A Comprehensive Guide for Workers and Students.

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3. New York: Robust Paid Sick Leave at State and City Levels

3.1 Statewide Paid Sick Leave Law

New York’s paid sick leave law went into effect in 2021. Key features:

• Employers with 100+ employees: Must provide at least 56 hours of paid sick leave per year.
• Employers with 5-99 employees: At least 40 hours paid sick leave per year.
• Employers with <5 employees and net income <$1 million: At least 40 hours unpaid sick leave per year.

3.2 Local Enhancements

New York City and Westchester County have their own sick leave ordinances, but the state law now sets the minimum standard.

3.3 Usage and Documentation

Sick leave can be used for the employee’s own illness or that of a family member, as well as for “safe leave” (issues related to domestic violence, etc.). Employers can request reasonable documentation (such as a doctor’s note) for absences of more than three consecutive days, but cannot demand excessive medical information.

3.4 Best Practices: Medical Certificates

In New York, a verifiable, HIPAA-compliant doctor’s note is often required. Havellum offers digital, instantly verifiable certificates that meet New York’s stringent requirements. For details, see Doctors Note USA: Your Guide to Getting Medical Documentation.

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4. Texas: No Statewide Paid Sick Leave Law

4.1 State Policy Overview

Texas does not have a statewide paid sick leave law. The state legislature has pre-empted cities from enacting their own paid sick leave rules, so requirements are largely set by individual employers.

4.2 Employer Policies

• Sick leave, if provided, is entirely at the discretion of the employer.
• Most large employers offer some form of paid sick leave as a benefit, but it is not required by law.
• Federal FMLA protections apply for eligible employees.

4.3 Documentation

Texas employers may require a doctor’s note or medical certificate for absences, especially those lasting three or more days, or if sick leave is being used excessively.

4.4 Best Practices: Medical Documentation

For Texas employees, having a professional, verifiable doctor’s note is crucial to avoid benefit denial or disciplinary action. Havellum provides legitimate, telemedicine-issued certificates that can be verified by HR at any Texas company.

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5. Key Differences and Similarities

Feature	California	New York	Texas
Paid Sick Leave	Yes (min. 3 days/yr)	Yes (min. 40–56 hrs/yr)	No (employer’s choice)
Who’s Covered	Most employees	Most employees	Employer policy
Accrual	1 hr/30 hrs worked	Set by employer size	No minimum
Documentation	After 3+ days	After 3+ days	Employer’s choice
Doctor’s Note	Often required	Often required	Often required
Enforcement	Strong	Strong	Weak

No matter the state, providing a legitimate, verifiable medical certificate is essential for compliance and protection.

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6. How to Obtain a Legitimate Medical Certificate for Sick Leave

6.1 Traditional In-Person Visit

• Visit a primary care provider, urgent care, or hospital.
• Receive a doctor’s note after assessment.
• Submit to your employer as required.

6.2 Telemedicine Solutions

Telehealth is now widely accepted for sick leave documentation. Havellum enables you to:

• Book a same-day online consultation with a licensed U.S. provider (Book appointment)
• Receive a verifiable, HIPAA-compliant medical certificate by email
• Use the unique verification code to prove authenticity to employers

For a step-by-step process and more information, see How to Obtain a Legitimate Doctor’s Note in the USA: A Comprehensive Guide for Workers and Students.

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7. Special Cases: Mental Health Sick Leave

All three states recognize mental health as a valid reason for sick leave. Employers may not discriminate against employees using sick leave for psychological conditions.

A mental health certificate can be obtained from a licensed therapist, psychologist, or psychiatrist. Havellum provides mental health certificates that are accepted in all states; learn more in Mental Health and Leave: How to Use Psychological Medical Certificates for Paid Leave and How to Obtain a Psychotherapy Doctor’s Note in the USA: A Comprehensive Guide.

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8. Employer and Employee Best Practices

For Employers

• Understand your state and local sick leave laws.
• Communicate clear policies to employees.
• Accept telemedicine and mental health documentation in compliance with the law.
• Use secure verification for medical certificates.

For Employees

• Know your rights and obligations in your state.
• Notify your employer promptly of your absence.
• Provide proper documentation—never submit forged or unverifiable notes.
• Use reputable providers like Havellum for fast, compliant, and accepted medical certificates.

Havellum: The Most Professional Provider of Doctor’s Notes and Medical Certificates.

Explore why Havellum is trusted for compliance and professionalism in

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9. Risks of Fake or Non-Compliant Notes

No matter your state, submitting a fake, template, or unverifiable medical certificate can result in:

• Disciplinary action or termination
• Loss of pay or benefits
• Legal or immigration consequences
• Damage to your professional reputation

Use only reputable, verifiable providers. For troubleshooting and more, see Doctors Note USA: Your Guide to Getting Medical Documentation.

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10. Additional Resources from Havellum

• How to Obtain a Legitimate Doctor’s Note in the USA: A Comprehensive Guide for Workers and Students
• Doctors Note USA: Your Guide to Getting Medical Documentation
• How to Obtain a Psychotherapy Doctor’s Note in the USA: A Comprehensive Guide
• Mental Health and Leave: How to Use Psychological Medical Certificates for Paid Leave
• Havellum: The Most Professional Provider of Doctor’s Notes and Medical Certificates
• Havellum Services

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11. Conclusion

Sick leave rights and requirements can vary dramatically depending on where you work in the United States. California and New York offer strong protections and paid leave, while Texas leaves sick leave policy to individual employers. Regardless of your state, the need for legitimate, verifiable medical documentation is universal. With Havellum, employees can obtain fast, professional, and accepted medical certificates—ensuring compliance, peace of mind, and workplace protection.

Havellum.

Article provided by the Havellum Medical Team. For appointments, services, and more, visit