54% of Americans Can’t Afford a Week Off: The Hidden Cost of Sick Days

In many countries, taking a sick day is simple. In the U.S., it can cost you your job, your health or both.

Without a federal guarantee for paid sick leave, millions of Americans are forced to choose between income and well-being. We surveyed 1,000 U.S. working adults to uncover the real cost of calling in sick, and the results reveal a troubling pattern of burnout, job insecurity and financial pressure.

Key Takeaways

• 15% of Gen Z workers say they were fired or pushed out after taking sick leave.
• 54% of Americans can’t afford to take even one week of unpaid sick leave without falling behind on bills.
• 67% of Americans worked while sick in the past year.
• 1 in 3 U.S. workers now struggle with brain fog and insomnia from overworking.
• 21% of workers are experiencing anxiety or panic attacks from being overworked.
• More than 1 in 5 Gen Z workers are faking physical illness to take time off for mental health struggles.
• 45% of workers feel judged by coworkers for taking sick leave.
• 57% of U.S. workers took less than two full sick days last year.

Fear, Pressure and Policy Gaps Keep Americans From Taking Sick Days

Money pressure, lack of protections and career anxiety form a three-way vise that often forces employees to push through illness. All of these pressures add up. In the past year, 57% of Americans took two or fewer sick days, regardless of how often they may have needed rest.

Here are the main reasons so many Americans are afraid of taking sick time:

These fears aren’t unfounded. Nearly half of workers (45%) say they’ve felt judged by coworkers or supervisors after taking time off. Gen Z is especially affected — 59% report feeling judged, nearly double the rate of baby boomers (29%).

And for some, the cost of staying home sick is more than reputational — it’s professional. A few unlucky Americans have actually lost their jobs after taking time off due to illness:

Gen Z Faces the Harshest Consequences for Calling In Sick

For Gen Z, calling in sick can come with real consequences. 15% say they’ve already been fired or pushed out for taking sick leave in the past year, and another 41% worry they could be next. That’s a level of job insecurity far beyond what older generations report — less than 1% of baby boomers and only 9% of millennials say they’ve faced the same outcome. 

The result? Gen Z is far more likely to work through illness. More than half (52%) say they’ve gone to work sick in the past 30 days, compared to just 24% of baby boomers.

Economic pressure makes the sick day decision even harder. 3 in 10 workers say their employer has no formal sick leave policy, which often means losing pay to stay home. This hits low-income workers hardest; among those earning under $50,000, 15% cite lack of paid leave as the biggest barrier to staying home when ill (well above the national average of 5%).

For Low-Income Workers, a Sick Day Can Trigger Financial Fallout

For many, missing even a day or two of income has immediate consequences. More than half (54%) say they couldn’t afford to take unpaid sick leave for even a week without falling behind on essential expenses, and 1 in 4 (26%) fear they’d struggle to pay for groceries or bills after just one or two unpaid days.

Even the logistics of the job itself keep people clocked in while sick. 26% say the dread of returning to an overflowing inbox is enough to make them power through an illness.

Most Americans Are Working Through Illness — Especially Gen Z and Millennials

Faced with financial strain and workplace pressure, many Americans feel they have no choice but to work through illness. In the past year, 67% reported clocking in while visibly sick. Generationally, the pattern is stark:

And taking a legitimate sick day isn’t always easy. Securing paid time off often requires a doctor’s note, lab results or a telehealth visit — documentation that costs money, burns PTO and often demands same-day appointments. 

In fact, more than 1 in 4 Americans have used their own money to prove they were sick enough to stay home. This burden falls disproportionately on younger workers. While just 7% of baby boomers report out-of-pocket spending to justify a sick day, that number jumps to 52% for Gen Z.

The result is a troubling policy dynamic: while the pressure to prove illness spans generations, the financial fallout hits lower-earning and younger employees hardest.

High-Income Earners Feel More Confident (and Less Guilty) About Taking Sick Leave

Confidence in taking sick days rises with income — and, to a lesser extent, with gender. Nearly half (49%) of workers earning $150,000 or more believe taking time off has no impact on their chances of promotion, while 69% of those earning under $50,000 worry it could hurt their career.

Gender plays a role, too. 40% of women say they often feel guilty about taking time off, compared to just 28% of men, a gap that reflects enduring pressures around workplace commitment, reliability and caregiving expectations.

Why Workers Take Mental Health Days — But Lie About It

Despite widespread messaging about wellness, few employees feel supported by their workplaces. Only 24% believe their organization’s language around mental health and time off is genuinely sincere, leaving many to navigate emotional strain within the rigid boundaries of outdated policies.

When it comes to taking a mental health day, most workers feel trapped.

• 32% say they haven’t needed one
• 29% wanted one but didn’t feel they could take it
• 39% have taken one, but only 10% felt comfortable being honest with their employer and received a positive response

That silence often leads to secrecy. 19% of workers disguised mental health days as physical illnesses, and another 11% told their employer the real reason, but felt dismissed or unsupported. The result? A culture where fear, not trust, shapes how time off is requested.

Many feel forced to lie. 42% of all employees admit to exaggerating physical symptoms to justify time off for mental health — including two-thirds of Gen Z, compared to just 21% of baby boomers. 22% of Gen Z have gone so far as to lie about physical symptoms entirely for a much-needed mental health day.

Generational attitudes about mental health add another dimension to America’s sick day crisis. In the past year, 86% of Gen Zers say they’ve experienced stress or burnout that negatively impacted their productivity or physical health, compared to only 36% of baby boomers and 61% of Americans overall. 

Older generations are also less likely to acknowledge the need for mental health days whatsoever. 55% of baby boomers say they’ve never needed a mental health day, while only 14% of Gen Z say the same.

The data points to a cultural shift still in progress, where younger workers recognize psychological strain but don’t yet trust their workplaces to treat it as valid.

Weak Sick Leave Policies Are Driving Resignations

Poor sick-leave policies aren’t just causing frustration; they’re reshaping the workforce. 14% of Americans have quit or seriously considered doing so due solely to inadequate sick leave. Among Gen Z, that number nearly doubles to 27%, and 12% have already left a job over it. 

So, what does an ideal sick leave policy look like to American workers?

Most employees agree: sick leave is sick. 72% of workers favor a policy that offers a set number of days off without separating physical and mental health. Only 11% support a system that distinguishes between the two.

This demonstrates the value American workers place on taking personal time off to heal on their own terms. In other words, the same benefit that keeps viruses out of the office may also keep resumes off recruiters’ desks.

Companies Talk About Support, But Workers Still Feel Punished for Using Sick Days

Official messaging rarely reflects lived experience. While many companies claim to prioritize employee health, 28% of workers say they’ve had to use vacation days when sick, blurring the line between rest and recovery. For Gen Z, that number climbs to 44%, nearly four times the rate of baby boomers (12%).

Gen Z feels the stigma most keenly: just 1 in 3 feel sick days are respected without judgment or discouragement, nearly half the rate of baby boomers (64%). 

Until policies become easier to use than to ignore, employees will continue to shoulder the hidden costs. Simple fixes like self-certification for short illnesses, telehealth notes, and visible leader participation can erase much of that friction and protect productivity.

The Hidden Costs of Inadequate Sick Leave Are Adding Up

The penny-wise approach to sick leave is costing U.S. employers far more than they realize. Turnover, rising healthcare claims and declining productivity are just a few of the hidden costs. That means robust, stigma-free time off policies aren’t just compassionate — they’re a competitive edge. 

The consequences of insufficient sick leave accumulate quickly, harming employees firsthand and their employers in turn:

Most alarming, 35% admit to working through an illness only to become sicker, ultimately missing more time. For companies looking for ways to reduce labor costs, better sick leave policies aren’t an expense; they’re an investment in morale, retention and performance.

In the story these statistics tell, sick leave isn’t an employer-provided perk. It’s ultimately a structural necessity. It safeguards both personal health and business continuity. Until clear, generous and stigma-free policies become the norm, the true cost of sick days will continue to surface not on timesheets but in the hidden debits of burnout, turnover and lost human potential.

Methodology

TEAM Software constructed a questionnaire that surveyed 1,000 U.S. adults (18+) representing a range of generations and income brackets. This allowed a well-rounded snapshot of American workers and their experiences regarding sick days. Percentages cited throughout the article are unweighted survey results unless otherwise noted. Because some questions allowed multiple responses or rounding, totals may not always equal 100 percent.

Questions were formulated to explore the practical considerations of taking a sick day, current employer offerings and employee experiences.

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