Sick leave in Japan: rules, pay, and employee rights guide

In Japan, there is no general statutory entitlement to separate paid sick leave for ordinary illness, so short absences may receive coverage through annual paid leave or company sick-leave policies, while longer non-work-related absences may qualify for the health insurance injury and sickness allowance (shōbyō teatekin).

This guide explains the main rules for expat employees, including sick pay, paperwork, when shōbyō teatekin may apply, and how work-related illness or injury is treated differently. It is general information only, not legal, medical, or insurance advice.

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Key takeaways

• If you are off sick for a day or two, you may need to use your annual paid leave unless your employer provides separate sick leave.
• Some companies offer contractual paid or unpaid sick leave, so check your employment contract, staff handbook, or shūgyō kisoku (work rules), including any reporting or medical certificate requirements.
• If a non-work-related illness or injury keeps you off work for at least four consecutive days, shōbyō teatekin may be available through employee health insurance after a three-day waiting period, subject to the eligibility rules.
• If you have an illness or injury because of your job or while commuting, workers’ compensation insurance (rōsai) may apply instead of the standard health insurance allowance.
• Self-employed people and those with National Health Insurance coverage do not necessarily have the same sickness allowance as employees, so confirm your insurance scheme and available support before assuming you have coverage

What sick leave means in Japan

Sick leave in Japan is usually not a separate statutory entitlement for ordinary illness. Under Japanese labor laws and employment rights, the practical answer often depends on annual paid leave, employer policy, and health-insurance based support rather than a general legal right to paid sick days.

How annual paid leave works when you’re ill

Under the MHLW Working Conditions Handbook, workers in continuous employment for six months who have attended at least 80% of working days generally qualify for annual paid leave. The Tokyo Employment Service Center for Foreigners also explains that foreign workers have the same basic labor rights as Japanese workers in comparable jobs.

In practice, this means many employees use annual paid leave, often called nenkyū or yūkyū, for short illnesses such as flu or a fever. If you are off for one or two days, tell your manager or HR as early as possible and follow your employer’s procedure for reporting sickness and requesting leave.

For example, if an office worker in Tokyo becomes ill on Tuesday and returns on Thursday, they may use two days of annual paid leave rather than receive separate statutory sick pay. The downside is that those days come out of their annual leave balance, leaving less paid leave available later in the year.

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Japanese labor laws

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Employer sick leave and workplace rules

Some employers do offer separate sick leave, even though there is no general statutory requirement to provide it for ordinary illness. Whether it is available, paid, and how long it lasts depends on the employer’s rules and the employment contract.

Check your employment agreement, employee handbook, or company work rules (shūgyō kisoku). Look for reporting deadlines, whether sick days are paid or unpaid, requirements for a doctor’s note or medical certificate, and whether the company provides longer-term medical leave for extended absences.

What to do if you are too ill to work

When you can claim the injury and sickness allowance

Shōbyō teatekin, the injury and sickness allowance, is an important income-support benefit for eligible employees with social security coverage through Japan’s employee health insurance system.

It applies when you cannot work because of a non-work-related illness or injury, rather than a workplace or commuting accident, and is separate from any short-term sick leave your employer provides.

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The social security system in Japan

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Who can claim it?

For many expats covered by employee health insurance, the key conditions are that you must generally be unable to work because of a non-work-related illness or injury, complete the required waiting period, and not receive your full salary for the days claimed.

According to Kyōkai Kenpo’s injury and sickness allowance guidance, you need three consecutive waiting days before the allowance becomes payable, with payment potentially starting from the fourth day if you meet the other conditions. The waiting period can include weekends, public holidays, and days for which you use annual paid leave.

For example, if you stop work because of illness on Friday and remain unable to work through the weekend and into Monday, Friday to Sunday can form the three-day waiting period. Monday can then be the first day for which the allowance is payable, provided you meet the other eligibility requirements.

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How much can you get and for how long?

Kyōkai Kenpo generally calculates the daily allowance using your average standard monthly remuneration for health-insurance purposes, with the benefit amount broadly equivalent to two-thirds of the relevant daily amount.

Different calculation rules can apply if you have been insured for less than 12 months, so check the figure with your insurer.

You can get the allowance for a cumulative total of up to one year and six months for the same illness or injury. This means periods when you return to work with no allowance payment do not necessarily use up the 18-month payment entitlement.

If your employer continues paying some salary while you are absent, the allowance may be reduced or, depending on the amount paid, not payable for those days. Check the calculation with your health insurer before relying on a particular moment.

How to apply and what to prepare

• Get the correct application form from HR, Kyōkai Kenpo, or your own health-insurance society.
• Complete the employee section with the personal and insurance information requested.
• Ask your employer to complete the section confirming your absence and any salary paid during that period.
• Ask your treating doctor or other relevant medical provider to complete the section confirming your medical condition and inability to work.
• Submit the form to the insurer, keep copies of everything, and check how frequently it recommends submitting claims during a longer absence.

If you are not sure where to verify forms or branch details, use Kyōkai Kenpo’s sickness allowance page and branch directory first. If your question is about continuation after leaving a job, the Kyōkai Kenpo FAQ is the better place to check.

What changes if your illness is work-related?

If your illness or injury was due to work, or during qualifying travel to or from work, do not assume the ordinary injury and sickness allowance is the right route. Under the MHLW guidance for foreign workers and industrial accident compensation, eligible work-related cases usually belong under workers’ compensation insurance, commonly called rōsai.

Medical costs: Eligible treatment for a work-related or commuting injury or illness is generally covered through workers’ compensation insurance rather than ordinary health insurance. The forms and claim process are different, so tell the medical provider if you believe your condition is related to work or commuting.

Income support: Workers who cannot work because of an occupational or commuting injury or illness may qualify for temporary absence compensation benefits from the fourth day of incapacity if they meet the relevant conditions. For an occupational accident, the employer generally has separate compensation responsibilities for the first three days; the situation is different for commuting accidents.

Who to contact: Report the illness or injury to your employer, but do not stop there if there is disagreement over whether the case is work-related. Your local Labour Standards Inspection Office can provide information about workers’ compensation claims, and eligibility is not simply determined by whether your employer agrees that the incident was work-related.

A common mistake is assuming an injury that happens during work or commuting should simply be treated as ordinary sick leave. Report the circumstances promptly and check whether rōsai applies before assuming you need to rely on annual paid leave or ordinary health insurance.

What expats should check about healthcare, insurance, and culture

If you are new to Japan, the biggest practical issue is often not the law itself but navigating the system while ill. You may need English-speaking care, help understanding costs, or guidance what the healthcare system in Japan covers, how to find Japanese doctors and GPs, or when you need a larger facility such as a hospital in Japan.

Some workers also worry about the social side of calling in sick. Practices vary by employer, but the safest approach is to follow formal reporting rules, give clear updates, and use your benefit entitlements rather than guessing what seems polite.

Writer

Gary Buswell

Insider Tip

If your workplace asks for medical evidence, ask the clinic reception desk before you leave whether it can issue a medical certificate for your employer. Check whether your employer needs it in Japanese and whether the clinic charges an additional fee for issuing it.

If you have urgent symptoms such as chest pain, severe breathing trouble, heavy bleeding, or signs of stroke, seek professional medical care straight away and use Japan’s emergency services. Do not delay emergency care while waiting for workplace guidance or sorting out insurance paperwork.

How Cigna and Allianz Care can help

Eligible residents generally use Japan’s public health insurance system for covered medical care, but some expats also choose private or international insurance for additional benefits and services.

Depending on the policy, these might include access to particular private facilities, multilingual assistance, direct billing arrangements, or cover for treatment and services outside the scope of Japanese public insurance.

If you are comparing providers such as Cigna and Allianz Care through Expatica’s health insurance quotes page, focus on the policy details rather than the brand. Check the provider network, direct billing arrangements, multilingual support, claims process, exclusions and treatment of pre-existing conditions, waiting periods, and reimbursement limits.

Private international insurance does not necessarily replace compulsory Japanese public health insurance if you have to join it. Check your eligibility and enrolment obligations separately, particularly when you first arrive or change jobs.

Paying doctors, medication, and overseas bills while you are off work

Getting ill can create a cash-flow problem as well as a health and employment issue. You may need to pay your share of a clinic bill, buy medication, cover transport to follow-up appointments, or meet other out-of-pocket costs while you receive reduced income.

This can be harder if part of your money is still abroad. For example, an expat employee who needs a second consultation and extra medication next week may need to move money into Japan or receive financial help from family overseas while waiting for an employer or insurance payment.

Keep the payment side practical. Ask the clinic or pharmacy which payment methods it accepts, keep itemised receipts and other medical paperwork, and check with your insurer before assuming that a particular expense will be reimbursed.

How Wise can help with transfers and a multi-currency account

Wise can help with the practical side of managing money across countries. Depending on your account and the services available to you, you can use Wise to transfer money to Japan, receive money in supported currencies, and hold or convert funds in multiple currencies.

That can be useful if you need to move money from overseas, family is helping from another country, or your income has fallen while you are off work. If you expect to rely on international transfers, check Wise’s current availability, verification requirements, fees, exchange rates, and transfer or account limits in advance.

Customers can hold funds in their Wise account that they plan to use for currency exchange transactions. Transfers to and from Balance are subject to a 1 million JPY limit.

Useful sources

(checked 23 August 2026)

• Ministry of Health, Labour and Welfare for official labour, health insurance, and employee rights information in Japan.
• Tokyo Employment Service Center for Foreigners for English-language labour law basics for foreign workers in Japan.
• Japan Health Insurance Association, Kyōkai Kenpo for official guidance on the injury and sickness allowance, eligibility, waiting periods, and forms.
• e-Gov Japan legal database for the legal text behind Japanese employment and insurance rules.
• Japan Pension Service for longer-term pension and related social security information.
• Cigna Global for checking international health insurance options, claims support, and policy terms.
• Allianz Care for comparing international health insurance features, support, and plan scope.
• MHLW consultation services for foreign workers for multilingual help with workplace disputes and labour questions.