Getting paid while you’re on medical leave depends on where you live, where you work, and what insurance you carry. There’s no single federal program that guarantees paid medical leave for all workers, but a growing number of states run their own programs, and many employers offer coverage through short-term disability insurance. Here’s how to figure out which options apply to you and how to access them.
Check Whether Your State Has a Paid Leave Program
Thirteen states and Washington, D.C. have passed laws creating paid family and medical leave programs: California, Colorado, Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, and Washington. If you work in one of these states, you’re likely already paying into the program through small payroll deductions, and you can file a claim when you need time off for a serious health condition.
Several of these programs are still launching. Delaware, Maine, and Minnesota begin in January 2026. Maryland starts in July 2026. If you’re in one of those states, you may already be contributing to the fund even though benefits aren’t available yet.
Each state sets its own benefit amount, but they generally replace a portion of your wages rather than your full paycheck. Washington State, for example, caps its weekly benefit at $1,647 in 2026. Most programs use a formula that replaces a higher percentage of income for lower earners and a lower percentage for higher earners, so the exact amount varies.
To apply, you typically file a claim through your state’s paid leave agency (not through your employer). You’ll need documentation from a healthcare provider confirming your medical condition, which we’ll cover below.
Understand What FMLA Does and Doesn’t Do
The federal Family and Medical Leave Act gives eligible workers up to 12 weeks of job-protected leave per year, but it’s unpaid. Its value is that your employer must hold your position (or an equivalent one) while you’re out. You qualify for FMLA if you meet three criteria: you’ve worked for your employer for at least 12 months, you’ve logged at least 1,250 hours in the past year, and your workplace has 50 or more employees within a 75-mile radius.
FMLA matters even if you have a paid leave source because it protects your job while you collect benefits from a state program or disability insurance. Without it, or without a similar state-level protection, an employer could technically replace you while you’re out on paid leave. Some state programs include their own job protection provisions. Maryland’s Flexible Leave Act, for instance, prohibits employers from firing, demoting, or disciplining workers who use their leave rights.
If your leave is foreseeable (a scheduled surgery, for example), you’re required to give your employer 30 days’ advance notice. For emergencies, you notify them as soon as practicable.
Look Into Short-Term Disability Insurance
If your state doesn’t have a paid leave program, short-term disability (STD) insurance is the most common way people get paid during medical leave. Many mid-size and large employers offer it as a benefit, sometimes at no cost to employees. If yours does, check your benefits paperwork or ask HR whether you’re enrolled.
Short-term disability typically replaces 50% to 80% of your normal pay. Some plans step down over time, paying 80% for the first eight weeks and then dropping to 70%. Benefits last between 13 and 26 weeks, though some plans extend up to a year. There’s a waiting period before payments begin, usually around 14 days but ranging from 7 to 30 days depending on the plan. During that gap, you’ll either use accrued sick time, vacation days, or go without pay.
Five states (California, Hawaii, New Jersey, New York, and Rhode Island) require employers to provide disability insurance, so workers in those states have a baseline of coverage regardless of employer generosity. In other states, if your employer doesn’t offer it, you can purchase an individual policy through a private insurer, though premiums are higher and approval may depend on your health history.
What You Need From Your Doctor
Whether you’re filing under a state program, FMLA, or a disability policy, you’ll need a medical certification from your healthcare provider. The specific form varies, but the information requested is consistent across most programs. Your provider will need to supply:
- Diagnosis and timeline: When the condition started, how long it’s expected to last, and a description of relevant medical facts including symptoms, hospitalizations, medications, and any referrals for treatment like physical therapy.
- Functional limitations: A statement that you cannot perform the essential duties of your job, along with the nature of your work restrictions and how long those restrictions will last.
- Treatment schedule: If your leave involves ongoing appointments (chemotherapy sessions, dialysis, etc.), an estimate of dates, duration of treatments, and recovery periods between them.
Give your doctor a heads-up before your appointment so they have time to complete the paperwork thoroughly. Incomplete certifications are one of the most common reasons claims get delayed. Your employer or the state agency can request recertification periodically for longer leaves.
Intermittent Leave for Chronic Conditions
You don’t always need to take medical leave in one continuous block. If you have a chronic condition like asthma, diabetes, epilepsy, or a condition requiring recurring treatment, you can take intermittent leave in smaller increments. This could mean leaving early for medical appointments, taking a few days off during a flare-up, or working a reduced schedule during treatment.
To qualify, your condition must require periodic visits to a healthcare provider (at least twice a year), continue over an extended period, and cause episodes of incapacity that may come and go unpredictably. Your doctor’s certification needs to include an estimate of how often these episodes occur and how long each one typically lasts. Notably, you don’t need to be actively receiving treatment during every absence. If your doctor has told you to stay home when certain triggers are present, those absences still count.
Intermittent leave can be taken in increments as small as one hour, making it practical for things like weekly infusion appointments or days when symptoms prevent you from working safely.
Options If You’re Self-Employed
Freelancers, independent contractors, and sole proprietors aren’t covered by FMLA or employer-sponsored disability plans. Your options are narrower but not nonexistent.
Some states allow self-employed workers to voluntarily opt into their paid leave programs. New York, for example, lets self-employed individuals buy into the state’s Paid Family Leave and disability system by purchasing an insurance policy. You’re required to buy both coverages together. If you’re a business owner with employees in the state, you’re already required to carry coverage for your staff and can add yourself by submitting a voluntary coverage form to the Workers’ Compensation Board.
Outside of state programs, your main option is an individual disability insurance policy purchased through a private insurer. These policies vary widely in cost and coverage. Premiums depend on your age, health, occupation, and the benefit amount you choose. The earlier you buy one, the more affordable it tends to be, and you’ll have an easier time qualifying before any health issues arise.
Steps to Take Before You Need Leave
The best time to sort out your paid leave options is before a medical situation forces you to. Start by checking whether your state has a paid leave program and what it covers. Review your employer’s benefits package for short-term disability and any company-provided paid sick leave. If you have a disability policy, read the fine print on waiting periods, benefit duration, and what qualifies as a covered condition.
If you’re in a state without mandated paid leave and your employer doesn’t offer disability coverage, consider purchasing an individual policy. Even a basic plan that replaces 50% to 60% of your income can prevent a financial crisis during recovery from surgery or a serious illness. Keep copies of your benefits documents somewhere accessible, so you’re not scrambling to find them when you’re already dealing with a health problem.