Paid Family and Medical Leave in the
June 13, 2022
United States
Sarah A. Donovan
Paid family and medical leave (PFML) refers to partially or fully compensated time away from
Specialist in Labor Policy
work for specific and generally significant family caregiving needs, such as the arrival of a new

child or serious illness of a close family member, or an employee’s own serious medical needs.
In general, day-to-day needs for leave to attend to family matters (e.g., a school conference or

lapse in child care coverage), a minor illness, and preventive care are not included among family
and medical leave categories.
Although the Family and Medical Leave Act of 1993 (FMLA; P.L. 103-3) provides eligible workers with a federal
entitlement to unpaid leave for a limited set of family caregiving and medical needs, federal law does not require private-
sector employers to provide paid leave of any kind. Currently, employees may access paid family or medical leave if it is
offered by an employer or they may use leave insurance benefits (such as temporary disability insurance or, less commonly,
family leave insurance) to finance unpaid medical leave or family caregiving leave. In addition, workers in certain states may
be eligible for state family and medical leave insurance benefits that can provide some income support during periods of
leave.
Employer provision of PFML in the private sector is voluntary, although some states and localities require employers to
allow employees to accrue paid sick leave or paid time off that may, in some cases, be used for short family and medical
absences. According to a national survey of employers conducted by the Bureau of Labor Statistics, 23% of private-industry
employees had access to paid family leave (i.e., parental leave and family caregiving leave) through their employers in March
2021, and 42% had access to employer-supported short-term disability insurance policies. The availability of these benefits
was more prevalent among professional and technical occupations and industries, high-paying occupations, full-time
workers, and workers in large companies (as measured by number of employees). Announcements by several large
companies in recent years indicate that access may be increasing among certain groups of workers.
In addition, 12 states (including the District of Columbia) have enacted legislation to create state paid family and medical
leave insurance programs, which provide cash benefits to eligible workers who engage in certain caregiving activities or for
whom a serious medical issue interferes with their regular work duties. As of May 2022, eight states operate such programs,
which offer 8 to 52 weeks of total benefits to eligible workers in a benefit year (in those states, total family leave insurance
benefits are limited to 5 to 12 weeks). Four other states have enacted laws creating such programs, but they are not yet
implemented and paying benefits.
Many advanced-economy countries entitle workers to some form of compensated family and medical leave. Whereas some
provide for leave to employees engaged in family caregiving (e.g., of parents, spouses, and other family members), many
emphasize leave for new parents, mothers in particular. As of 2020, the United States is the only Organisation for Economic
Co-operation and Development (OECD) member country to not provide for paid leave to new mothers employed in the
private sector. A smaller majority of member countries provides benefits to fathers and other non-birth parents. Caregiving
benefits of some type are provided in nearly 75% of OECD countries. Few OECD member countries do not provide a
medical leave benefit (either through social insurance, an employer mandate, or both) for absences resulting from workers’
serious medical needs.
There is currently a tax incentive in the United States for employers that provide qualifying paid family and medical leave to
certain employees. This incentive is temporary, and is scheduled to expire at the end of 2025. Proposals to expand national
access to paid family and medical leave have been introduced in the 117th Congress. For example, the Build Back Better Act
(H.R. 5376) proposed, among other things, a new federal cash benefit for eligible individuals engaged in certain types of
family and medical caregiving. Using a different approach, the Expanding Small Employer Pooling Options for Paid Family
Leave Act of 2021 (H.R. 5161) proposed to allow multiple employer welfare arrangements that may potentially create
additional opportunities for certain employers to pool risk and affect the costs of providing such benefits.
This report provides an overview of PFML in the United States, summarizes state-level family and medical leave insurance
program provisions, reviews PFML policies in other advanced-economy countries, and describes recent federal legislative
action to increase access to paid family leave.
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Contacts
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Congressional Research Service

Paid Family and Medical Leave in the United States

Introduction
Paid family and medical leave (PFML) refers to partially or fully compensated time away from
work for specific and generally significant family caregiving needs (paid family leave) or for the
employee’s own serious medical condition (paid medical leave). Family caregiving needs include
those such as the arrival of a new child or serious illness of a close family member. Medical
conditions that may qualify for medical leave generally must be severe enough to require medical
intervention and interfere with a worker’s performance of key job responsibilities. Although the
Family and Medical Leave Act of 1993 (FMLA; P.L. 103-3, as amended) provides eligible
workers with a federal entitlement to unpaid leave for a limited set of family caregiving needs,
federal law does not require private-sector employers to provide paid leave of any kind.1
Currently, employees may access PFML if offered by an employer.2 Employers that provide
PFML may qualify for a federal tax credit (the Employer Credit for Paid Family and Medical
Leave). The tax credit is up to 25% of paid leave wages paid to qualifying employees, and is
designed to encourage employers to provide PFML to their employees by reducing the cost to
employers of providing such leave.3 Qualifying employees include those whose earnings do not
exceed 60% of a “highly compensated employee” threshold (the tax credit earnings threshold is
60% x $135,000 = $81,000 in 2022). The tax credit is available through December 2025.
Some workers may use leave insurance benefits (such as temporary disability insurance or, less
commonly, family leave insurance4) to finance unpaid medical leave or family caregiving leave.
In addition, some states have created family and medical leave insurance programs, which
provide cash benefits to eligible workers who engage in certain (state-identified) family
caregiving activities or who must be absent from work as a result of the worker’s own significant
medical needs.5 In these states, workers can mitigate lost earnings during periods of unpaid

1 The Family and Medical Leave Act of 1993 (FMLA) allows employees to use employer-provided paid leave during
periods of unpaid FMLA-entitled leave. An overview of FMLA is in CRS Report R44274, The Family and Medical
Leave Act: An Overview of Title I, by Sarah A. Donovan. Workers who are covered by the Americans with Disabilities
Act (ADA) may also qualify for unpaid leave in certain cases, and employers cannot apply separate rules governing
paid leave for workers with and without disabilities. For more information see Equal Employment Opportunity
Commission, Employer-Provided Leave and the Americans with Disabilities Act, May 9, 2016, https://www.eeoc.gov/
eeoc/publications/ada-leave.cfm.
2 The federal government, for example, became one such employer in December 2019 with the enactment of the
FY2020 National Defense Authorization Act (FY2020 NDAA, P.L. 116-92). The FY2020 NDAA created a new paid
parental leave benefit (i.e., leave for the arrival of a new child and for bonding with that child) for most federal civil
service employees. The paid leave must be taken together with the federal employee’s FMLA entitlement. An overview
of the FY2020 NDAA, including information on the paid parental leave benefit is in CRS Report R46144, FY2020
National Defense Authorization Act: P.L. 116-92 (H.R. 2500, S. 1790), by Pat Towell.
3 For more information see CRS In Focus IF11141, Employer Tax Credit for Paid Family and Medical Leave, by Molly
F. Sherlock.
4 For example, certain employees in New Hampshire will soon be able to opt in to a family leave insurance program
operated by a commercial insurance carrier that is to cover New Hampshire state employees. Governor Chris Sununu,
“Full Steam Ahead: NH Releases Paid Family Medical Leave Request for Proposal (RFP),” press release, March 2022,
https://www.governor.nh.gov/news-and-media/full-steam-ahead-nh-releases-paid-family-medical-leave-rfp. In April
2022, Virginia law established family leave insurance as a class of insurance in the state. The law defines family leave
insurance as an insurance policy issued to an employer and related to an employee benefit program to cover a portion
of earnings lost due to specified family care reasons. It provides that policies may be included in a short-term disability
policy (including as an amendment or rider to such a policy), or written as a separate group insurance policy purchased
by an employer. Virginia General Assembly, Acts of Assembly, Ch. 131, approved April 7, 2022.
5 In some states, medical leave is financed through state short-term disability insurance programs (sometimes called
temporary disability insurance (TDI), in this context).
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family and medical leave by combining an entitlement to unpaid leave with state-provided
insurance benefits.
Some congressional proposals introduced in the 117th Congress seek to enhance national access to
paid family and medical leave by expanding upon existing mechanisms (i.e., voluntary employer
provision or financing of leave through social insurance). For example, the Expanding Small
Employer Pooling Options for Paid Family Leave Act of 2021 (H.R. 5161, 117th Congress)
proposes to allow multiple employer welfare arrangements (MEWAs), as covered by the
Employee Retirement Income Security Act (ERISA; P.L. 93-406), to include family and medical
leave benefits, which may potentially create additional opportunities for certain employers to pool
risk and affect the costs of providing such benefits. Similar to the state leave insurance approach,
the Family and Medical Insurance Leave Act (FAMILY Act; H.R. 804 and S. 248, 117th Congress)
proposes to create a national wage insurance program for persons engaged in family caregiving
activities or who are unable to work as a result of their own serious health condition.
Members of Congress who support increased access to paid leave generally cite as their
motivation the significant and growing difficulties some workers face when balancing work and
family responsibilities, and the financial challenges faced by many working families that put
unpaid leave out of reach. Expected benefits of expanded access to PFML include stronger labor
force attachment for family caregivers and workers experiencing serious medical issues, and
greater income stability for their families; and improvements to worker morale, job tenure, and
other productivity-related factors. Some studies identify a relationship between paid leave and
family well-being as measured by a range of outcomes (e.g., child health, mothers’ mental well-
being).6 Some Members have expressed concerns about new policies to expand access to paid
family and medical leave citing the potentially high costs of such policies. Potential costs include
the financing of payments made to workers on leave, other expenses related to periods of leave
(e.g., hiring a temporary replacement or productivity losses related to an absence), and
administrative costs. In the case of tax incentives, there is a cost in terms of forgone federal tax
revenue.7 The magnitude and distributions of costs and benefits would depend on how the policy
is implemented, including the size and duration of benefits, how benefits are financed, and other
policy factors.
This report provides an overview of PFML in the United States, summarizes state-level family
and medical leave insurance program provisions, reviews PFML policies in other advanced-
economy countries, and describes recent federal legislative action to increase access to paid
family and medical leave.
Paid Family and Medical Leave in the United States
Throughout their careers, many workers encounter a variety of medical needs and family
caregiving obligations that conflict with work time. Some of these are broadly experienced by
working families but tend to be short in duration, such as episodic child care conflicts, school
meetings and events, routine medical appointments, and minor illnesses experienced by the
employee or an immediate family member. Others are more significant in terms of their impact on
families and the amount of leave needed, but occur less frequently in the general worker
population, such as the arrival of a new child or a serious medical condition that requires inpatient

6 For a discussion see the “Research on Paid Family and Medical Leave” section of this report.
7 The tax credit for employer provided paid family and medical leave was estimated to reduce federal income tax
revenue by $4.3 billion when it was first enacted for 2018 and 2019 as part of P.L. 115-97. The 10-year budget window
estimate of the two-year tax credit can be found in Joint Committee on Taxation, Estimated Budget Effects Of The
Conference Agreement For H.R.1, The “Tax Cuts And Jobs Act,” JCX-67-17, December 18, 2017.
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care or continuing treatment. Although all these needs for leave may be consequential for
working families, the term family and medical leave is generally used to describe the latter, more
significant and disruptive group of needs that can require longer periods of time away from work.
As defined in recent federal proposals, family caregiving and medical needs that would be
eligible for leave generally include the following:
 the arrival and care of a newborn child or a newly-placed adopted or fostered
child (i.e., a “newly-arrived child”),
 the serious medical needs of certain close family members, and
 the employee’s own serious medical needs that interfere with the performance of
his or her job duties.8
In practice, day-to-day needs for leave to attend to family matters (e.g., a school conference or
lapse in child care coverage), minor illness (e.g., common cold), or preventive care are not
generally included among family and medical leave categories.9
Employer-Provided Paid Family Leave and Short-Term
Disability Insurance
Although federal law does not require private sector employers to provide paid family or medical
leave to their employees, some employers offer such paid leave to their employees as a voluntary
benefit.10 Employers can provide the paid leave directly (i.e., by continuing to pay employees
during period of leave), but financing potentially-long periods of leave can be cost prohibitive in
some cases. As an alternative, some employers offer short-term disability insurance (STDI) to
employees to reduce wage-loss during periods of unpaid medical leave (i.e., when employees are
unable to work due to a non-work-related injury or illness).11 Such policies can be purchased
from commercial insurance companies, which pay cash benefits to covered employees when
certain conditions are met.
STDI reduces wage-loss (during periods of unpaid leave) related to a covered employee’s own
medical needs, but does not pay benefits when an employee’s absence is related to caregiving,
bonding with a new child, or the family military needs that are included in some definitions of
family leave. STDI benefits may be claimed for pregnancy- or childbirth-related disabilities, and

8 Some recent federal proposals would also provide paid leave or cash benefits to workers with certain military family
needs (e.g., the FAMILY Act) or for needs related to the death of a family member (e.g., the Build Back Better Act, as
introduced in H.R. 5376 [117th Congress] on September 27, 2021).
9 Some federal proposals would increase access to other types of paid leave, such as paid sick leave that could be used
for absences related to minor illness, routine care, and other needs. Proposed paid sick leave entitlements are often
relatively short in duration. For example, the Healthy Families Act (H.R. 2465 and S. 1195, 117th Congress) would
require certain employers to allow their employees to earn 1 hour of leave per 30 hours of work, up to a maximum of
56 hours per year. The bill would allow employees to use such leave to attend to medical needs (including routine
medical appointments), to attend a child’s school meeting, and for certain medical, legal or other needs related to
domestic violence, sexual assault, or stalking, among other uses.
10 In some states, an employer’s provision of or contributions to short-term disability insurance (or temporary disability
insurance)—one mechanism workers can use to finance unpaid medical leave—is not voluntary. See the “State-Run
Family Leave, Medical Leave, and Temporary Disability Insurance Programs” section of this report for a discussion.
11 Workers’ compensation provides cash and medical benefits to workers who suffer a work-related injury or illness,
and benefits to the survivors of workers killed on the job. For discussion see CRS Report R44580, Workers’
Compensation: Overview and Issues, by Scott D. Szymendera.
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as such may be used to finance a portion of maternity leave in some circumstances.12 Family
leave insurance (FLI), a newer concept, provides cash benefits to workers engaged in certain
caregiving activities. Currently, FLI is not broadly available from private insurance companies.13
As a result, many employers seeking to provide leave for family caregiving must provide the
leave benefit directly (i.e., offer paid family leave).
According to a national survey of employers conducted by the Bureau of Labor Statistics (BLS),
23% of private-industry employees had access to paid family leave (separate from other leave
categories) through their employer in March 2021.14 The BLS survey defines paid family leave as
leave provided specifically to care for a family member, parental leave (i.e., for a new child’s
arrival), and maternity leave that is granted in addition to any sick leave, annual leave, vacation,
personal leave, or short-term disability leave that is available to the employee. BLS does not
collect information on employer-provided paid medical leave, but does estimate access to
employer-supported STDI.15 In March 2021, 42% of private sector employees had access to STDI
policies that were financed fully or in-part by their employers. STDI benefits often replace a set
percentage of an employee’s earnings, sometimes up to a maximum weekly benefit amount (e.g.,
a policy might replace 50% of earnings lost while the employee is unable to work up to $600 per
week); in other cases the wage replacement rate may vary by workers’ annual earnings or workers
may receive a flat dollar amount (e.g., $200 per week). BLS reports that among workers who
receive a fixed percentage of lost earnings (72% of those private industry workers with STDI
coverage), the median fixed percentage was 60%. Of those subject to a maximum weekly benefit,
the median maximum benefit was $881 per week. The median number of benefit weeks available
to employees with access to STDI plans was 26 weeks.16

12 This is because maternity leave generally describes time off work for a combination of needs: (1) leave for a
mother’s physical recovery from childbirth, and (2) time to care for and bond with a new child. The first is technically
medical or disability-related leave, as it is leave from work for the mother’s own incapacitation. STDI benefits may be
paid to a pregnant woman or new mother under these circumstance, but are not available to non-birth parents (e.g.,
fathers, parents of adopted children). The second component of maternity leave is considered family or caregiving
leave, taken to care for or bond with the newly-arrived child, and is not covered by STDI.
13 Some states with leave insurance programs allow employers to purchase private leave insurance plans—including
plans that cover family leave insurance claims—and New York state requires that employers purchase such privately-
insured coverage. If interest from employers in private plans is sufficiently large, the availability of private FLI policies
may increase (i.e., such that employers in states without leave insurance programs may purchase FLI policies). See
footnote 4 for information on a change in Virginia law that may increase employers’ access to commercial FLI policies
in that state. As of 2022, the market is too small to be reported as a separate line of insurance (i.e., it is subsumed in
other lines of insurance) when reported to insurance regulators.
14 The BLS-measure is inclusive of paid maternity- or paternity- only plans (i.e., it may be the case the share of private
sector workers with access to employer-provided paid leave to care for a seriously-ill spouse was less than 23% in
March 2021). An employer that makes a full or partial payment towards an insurance plan (including a state leave
insurance plan covering family leave) is considered by BLS to provide paid family leave. If there is no employer
contribution to the plan (employee-paid only), then such an insurance plan is not considered to be an employer-
provided benefit.
15 BLS also collects information on employer-provided paid sick leave, which may be used for needs that would qualify
for medical leave (e.g., an overnight hospital stay) and for a broader set of needs as well (e.g., minor ailments, annual
physical). Whereas federal proposals seek to provide several weeks or months of paid medical leave, employer-
provided sick leave tends to be one week or less per year. BLS estimates that 77% of private sector workers had access
to employer-provided paid sick leave in March 2021; the median number of days that could be earned in a given year
was six (among those limited to a fixed number of sick days per year). BLS, National Compensation Survey: Employee
Benefits in the United States, March 2021, September 2021.
16 The 90th percentile value was also 26 weeks, suggesting that STDI plans offering more than 26 weeks of benefits
were relatively rare. Ninety percent of workers with access to plans had at least 12 weeks of benefits and 75% had at
least 13 weeks of benefits.
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As shown in Table 1, employee access to employer-provided paid family leave and employer-
supported STDI is not uniform across occupations and industries, and varies widely across wage
groups. In particular, access was more prevalent among managerial and professional occupations;
information, financial, and professional and technical service industries; high-paying occupations;
full-time workers; and workers in relatively large companies (as measured by number of
employees). Announcements by several large companies suggest that access to related types of
paid leave may be increasing among certain groups of workers.17 This may be partially-reflected
in BLS statistics which indicate a 5 percentage point increase in private sector workers’ access to
paid family leave between March 2019 (18%) and March 2021 (23%).18 However, access rates
did not increase for all groups over this period (e.g., the share of private sector workers in the
leisure and hospitality industry with access to employer-provided paid family leave fell from 11%
in March 2019 to 9% in March 2021; trend not shown in Table 1). The share of all private sector
employees with access to employer-supported STDI did not increase over that time period; it was
42% in March 2019 and March 2021.
Table 1. Private Sector Workers with Access to Employer-Provided Paid Family
Leave and Employer-Supported Short-Term Disability Insurance, March 2021
Employer-Supported
Employer-Provided
Short-Term Disability
Paid Family Leave
Insurance
Category
(% of workers)
(% of workers)
All Workers
23%
42%
By Occupation

Management, professional, and related
37%
57%
Service
13%
22%
Sales and office
25%
41%

17 Among new company policies announced in recent years, some emphasize parental leave (i.e., leave taken by
mothers and fathers in connection with the arrival of a new child), and others offer broader uses of leave. Examples of
companies that offer paid leave benefits for broader purposes include Google, which recently increased the number of
weeks of leave available to employees who give birth from 18 to 24, the number of weeks of parental leave for non-
birthing parents from 12 to 18, and the number of weeks for caregiver leave from 4 to 8; Goldman Sachs, which, in
addition to preexisting family leave policies, now offers 5 days of paid bereavement leave for a non-immediate family
member, 20 days of paid leave for the loss of an immediate family member, and 20 days of paid leave if the employee,
employee’s spouse, or surrogate experiences a miscarriage or stillbirth; Levi Strauss & Co.’s, which offers employees 8
weeks of paid family leave to care for family members with serious health conditions in addition to 8 weeks of paid
leave to care for a new child; the U.S. Steel Corporation, which offers non-union ("non-represented”) employees 8
weeks of paid time off for a new child (in addition to 6-8 weeks of short-term disability for birth mothers), extended
bereavement leave (up to 15 days) for the death of an immediate family member, and the ability to purchase additional
vacation days. Google’s policy change announcement was reported in several newspapers, including at
https://www.businessinsider.com/google-increases-vacation-days-and-parental-leave-for-employees-benefits-2022-1;
Godman Sachs’s policy change was reported at https://www.wsj.com/articles/goldman-sachs-rolls-out-new-worker-
benefits-to-combat-employee-burnout-11638210617; Levi Strauss & Co. announced its new policy at https://www.
levistrauss.com/2020/02/27/levi-strauss-co-introduces-paid-family-leave/; U.S. Steel Corporation announced its new
policy on March 21, 2019 at https://www.ussteel.com/media/newsroom/-/blogs/u-s-steel-announces-enhanced-benefits-
for-workforce.
18 The increase in access to paid family leave between March 2019 and March 2021 may also reflect a compositional
change in the employment, resulting from the disproportionate impacts of the COVID-19 pandemic on certain groups
of workers, such as those employed in the leisure and hospitality sector, who tend to have relatively low access to paid
leave. Disproportionate job loss among such groups can raise the share of workers with access to paid leave even if
employer policies do not change (i.e., because a portion of workers without such access to the benefit are no longer
included among employed workers).
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Paid Family and Medical Leave in the United States

Employer-Supported
Employer-Provided
Short-Term Disability
Paid Family Leave
Insurance
Category
(% of workers)
(% of workers)
Natural resources, construction, and maintenance
15%
36%
Production, transportation, and material moving
13%
48%
By Industry

Construction
12%
28%
Manufacturing
21%
64%
Trade, Transportation, and Utilities
21%
42%
Information
45%
71%
Financial Activities
41%
67%
Professional and Technical Services
37%
61%
Administrative and Waste Services
9%
20%
Education and Health Services
28%
35%
Leisure and Hospitality
9%
18%
Other Services
15%
29%
By Average Occupational-Wage Distribution

Bottom 25%
12%
19%
Second 25%
21%
42%
Third 25%
25%
48%
Top 25%
37%
64%
By Hours of Work Status

Ful -time
27%
50%
Part-time
11%
18%
By Establishment Size

1 to 99 employees
17%
31%
100 to 499 employees
28%
51%
500 or more employees
35%
64%
Source: Bureau of Labor Statistics (BLS), 2021 Employee Benefits Survey, September 2021, Table 17 (insurance)
and Table 33 (paid leave).
Notes: The BLS survey defines paid family leave as leave “granted to an employee to care for a family member
and includes paid maternity and paternity leave. The leave may be available to care for a newborn child, an
adopted child, a sick child, or a sick adult relative. Paid family leave is given in addition to any sick leave, vacation,
personal leave, or short-term disability leave that is available to the employee.” The BLS survey defines short-
term disability plans as those that “provide benefits for non-work-related il nesses or accidents on a per-disability
basis, typically for a 6-month to 12-month period. Benefits are paid as a percentage of employee earnings or as a
flat dol ar amount. Short-term disability insurance (STDI) benefits vary with the amount of pre-disability earnings,
length of service with the establishment, or length of disability.” An employer that makes a ful or partial payment
towards a STDI plan is considered by BLS to provide employer-supported STDI. If there is no employer
contribution to the plan (i.e., if it is entirely employee-financed), then such an insurance plan is not considered to
be employer-supported STDI. Employees may also be able to use other forms of paid leave not shown in this
table (e.g., vacation time), or a combination of them, to provide care to a family member or for their own
medical needs.
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Paid Family and Medical Leave in the United States

A 2017 study by the Pew Research Center (Pew) examined U.S. perceptions of and experiences
with paid family and medical leave and provides insights into the need for such leave among U.S.
workers and its availability for those who need it.19 Pew reports, for example, that 27% of persons
who were employed for pay between November 2014 and November 2016 took leave (paid and
unpaid) for family caregiving reasons or their own serious health condition over that time period,
and another 16% had a need for such leave but were not able to take it.20 Among workers who
were able to use leave, 47% received full pay, 36% received no pay, and 16% received partial pay.
Consistent with BLS data, the Pew study indicates that lower-paid workers have less access to
paid leave; among leave takers, 62% of workers in households with less than $30,000 in total
annual earnings reported they received no pay during leave, whereas this figure was 26% among
those with total annual household incomes at or above $75,000.
The Pew survey reveals differences in access to family and medical leave across demographic
groups. For example, 26% of Black workers and 23% of Hispanic workers indicated that there
was a time in the two years before the interview they needed or wanted time off (paid or unpaid)
for family or medical reasons and were not able to take it; by contrast 13% of White workers
reported they were unable to take such leave. Relatedly, among those who did take leave,
Hispanic leave-takers were more likely than Black or White workers to report they took leave
with no pay.21
State-Run Family Leave, Medical Leave, and Temporary Disability
Insurance Programs
Some states have enacted legislation to create state leave insurance programs, which provide cash
benefits to eligible workers who take time away from work to engage in certain caregiving
activities and for qualifying medical reasons. As of May 2022, eight states (including the District
of Columbia [DC])—California, Connecticut, DC, Massachusetts, New Jersey, New York, Rhode

19 Juliana Horowitz, Kim Parker, Nikki Graf, and Gretchen Livingston, Americans Widely Support Paid Family and
Medical Leave, but Differ Over Specific Policies, Pew Research Center, March 2017, http://pewresearch.org;
hereinafter “Horowitz et al., 2017.” Pew’s findings are based on two large-scale, nationally representative surveys. The
first survey collected data from the general population, and is used to measure U.S. attitudes toward and perceptions of
paid family leave, as well as the availability of leave for those who had a recent (i.e., within the last two years) need for
family or medical leave. The second survey collected information from individuals who had a recent need for family or
medical leave, and is used to study leave-taking in detail (e.g., economic and demographic characteristics of workers
who were able and unable to meet their needs for leave, reasons the workers needed leave, duration of leave when
taken, and the percentage of pay provided to those who were able to take leave).
20 These survey results are summarized on page 52 of Horowitz et al., 2017. For workers who took family and medical
leave and those who had such a need but were unable to take leave, the areas of greatest demand were for leave to care
for the worker’s own serious health condition and for leave to care for a family member with a serious health condition.
The survey questionnaire defines a serious health condition as “a condition or illness that lasted at least a week and
required treatment by a health care provider … required an overnight hospital stay … [or] was long-lasting, requiring
treatment by a health care provider at least twice a year.” See https://www.pewsocialtrends.org/dataset/family-and-
medical-leave-study/.
21 This finding is consistent with research by Ann Bartel et al., (2019), who also find that “Hispanic workers have lower
rates of paid-leave access and use than their White non-Hispanic counterparts.” Ann Bartel, Soohyn Kim, Jaehyun
Nam, Maya Rossin-Slater, Christopher Ruhm, and Jane Waldfogel, “Racial and ethnic disparities in access to and use
of paid family and medical leave: evidence from four nationally representative datasets,” Monthly Labor Review,
January 2019, https://www.bls.gov/opub/mlr/2019/article/pdf/racial-and-ethnic-disparities-in-access-to-and-use-of-
paid-family-and-medical-leave.pdf.
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Island, and Washington—have active programs.22 Four additional programs—those in Colorado,
Delaware, Maryland, and Oregon—await implementation.23
In May 2022, total benefits available in a benefit year (typically a 12-month period) under the
state leave insurance program to eligible claimants ranged from 8 to 52 (Figure 1). Selected
information on state leave insurance benefits is displayed in Figure 2 and Table A-1 provides a
summary of key provisions of state leave insurance laws.
Figure 1. Weeks of Total Benefits Available in a Benefit Year under State Leave
Insurance Programs, May 2022

Source: CRS based on information in Table A-1 on state leave insurance laws.
Notes: The figure provides total weeks of benefits available in a benefit year (typically a 12-month period) to
eligible claimants covered by a state leave insurance program. In some cases, states limit the number of weeks
that may be claimed during a benefit year for particular family or medical leave events, and those limits may be
less than the total amount shown in this figure. For example California limits claims for family leave events to 8
weeks in a benefit year. Benefits are subject to eligibility conditions, and are calculated using state-specific benefit
formulae. Some states provide additional weeks of benefits if certain conditions are met.
The first four states to offer family leave insurance (FLI)—California, New Jersey, New York,
and Rhode Island—did so by building upon existing state temporary disability insurance (TDI)
programs (i.e., that provide benefits to workers absence from work due to a significant medical
condition).24 As a result, these programs tend to offer separate entitlements to FLI benefits and
TDI benefits. (To simplify the discussion, the terms TDI and medical leave insurance (MLI)
benefits are used interchangeably in this section.25) For example, eligible California workers may

22 Hawaii and Puerto Rico require employers to provide short-term disability insurance but not family leave insurance
to their employees, and as such are not included in this discussion. New Hampshire is to allow private sector employers
with more than 50 employees and certain individuals to opt in to its leave insurance program for state employees.
Because participation is voluntary for all private sector employers, the program is not included in this discussion. See
footnote 4 for more information on the NH program.
23 Benefit payments for the Oregon program are to start in September 2023; benefits payments for the Colorado
program are to start in January 2024; benefits for the Maryland program are to start in January 2025; and benefits for
the Delaware program are to start in January 2026.
24 California was the first state to provide family leave insurance (FLI) benefits; the program took effect (FLI benefits
became payable) on July 1, 2004. FLI benefits became payable in New Jersey on July 1, 2009, in Rhode Island on
January 1, 2014, and in New York on January 1, 2018.
25 Whereas these four states provide for TDI benefits for serious health-related absences, the newer programs use the
term medical leave insurance benefits. Broadly speaking, the terms temporary disability absence and medical leave
both describe a workplace absence due to a significant health condition that prevents a worker from performing his or
her regular work duties. Definitions vary from state to state, but they are broadly similar. These types of leave differ
from sick leave, which can be used for more minor ailments and for routine medical care. In addition, paid sick leave
tends to be compensated at regular rates of pay, whereas state TDI and MLI benefits are generally paid at less than the
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take up to 52 weeks of MLI and up to 8 weeks FLI. By contrast, newer programs tend to offer a
total amount of annual benefit weeks to workers, who may allocate them across the various needs
categories (e.g., caregiving needs, medical needs) with some states capping the maximum amount
that can be allocated to a single category. For example, Washington provides a total of 16 benefit
weeks per year that may be used for a variety of family or medical needs, but limits FLI claims to
12 weeks and MLI claims to 12 weeks.26 All states included in Table A-1 offer (or will offer) FLI
benefits through their programs to eligible individuals who take leave from work for the arrival of
a new child by birth or placement, and to care for close family members with a serious health
condition; some states provide family leave insurance in other circumstances.27
Table A-1 shows the following:28
 Benefit Duration: The maximum weeks of insurance benefits available to
workers vary across states. Longer-running state programs offer between 26
weeks (New York) and 52 weeks (California) in 2022, but most weeks of benefits
are set aside for MLI in these states. Newer programs (i.e., those that
implemented their programs in 2020 or later) tend to offer fewer total weeks of
benefits—the range is 8 total (DC) to 25 total (Massachusetts); generally this is
because newer programs offer fewer weeks of medical leave than longer-running
programs.
 Benefit Amount: Weekly benefits amounts range from 50% to 100% of an
employee’s average weekly earnings and all states cap benefits at a maximum
weekly amount ($170 per week for MLI benefits in New York to $1,540 per
week for FLI or MLI benefits in California). Most states with leave insurance
programs have or plan to have a progressive benefit formula.
 Eligibility: Program eligibility typically involves in-state employment of a
minimum duration, minimum earnings in covered employment, or contributions
to the insurance funds. Delaware’s program further conditions benefit eligibility
on a worker’s tenure with the current employer.
 Financing: All programs are financed through payroll taxes, with some variation
in how taxes are allocated between employers and employees.
Some state leave insurance programs provide job protection directly to workers who receive
insurance benefits, meaning that employers must allow such a worker to return to her or his job
after leave (for which the employee has claimed insurance benefits) has ended. For example,
Oregon is to provide job protection to leave insurance claimants who worked at least 90 days with
their current employer before taking leave. Workers may otherwise receive job protection if they
are entitled to leave under (the federal) FMLA or state family and medical leave laws, and
coordinate such job-protected leave with the receipt of state insurance benefits. (See Table A-2
for a summary of relevant state laws). For example, job protection does not accompany leave

worker’s regular rate of pay (an exception is lower wage workers in Oregon). A waiting period is often required before
the payment of TDI or MLI benefits; such a waiting period is generally not required for sick leave pay. Finally, paid
sick leave benefits are generally available for shorter total durations than TDI or MLI benefits, see footnote 15 for
additional discussion.
26 Washington provides 2 additional weeks of benefits for a serious health condition if an employee’s pregnancy results
in incapacitation, raising the limit on MLI benefits to 14 weeks and bringing total benefits to 18 weeks in such cases.
27 For example, some states provide family leave insurance for certain military family needs, for time away from work
to address needs related to sexual or domestic violence (i.e., safe leave).
28 For reasons noted in footnote 22, Hawaii, New Hampshire, and Puerto Rico are not included in the table.
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insurance benefits in California. However, California employees claiming FLI benefits may be
eligible for job protection under the FMLA (federal protections) or the California Family Rights
Act; California workers claiming MLI for pregnancy or childbirth-related disabilities may be
eligible for job protection under FMLA or the California Fair Employment and Housing Act. A
California worker otherwise claiming benefits for a serious health condition that makes her or
him unable to perform his or her job functions may be eligible for job protection under FMLA for
up to 12 weeks.29

29 Although California workers may qualify for up to 52 weeks of temporary disability insurance under the state
program, FMLA provides only 12 weeks of job-protected leave (for workers meeting eligibility conditions).
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Figure 2. State Leave Insurance Programs, Selected Benefit Information as of May 2022

Source: CRS, based on information in Table A-1 on state leave insurance laws.
Notes: This graphic summarizes program information for states that provide for a family leave insurance benefit. “FLI” indicates family leave insurance, “MLI” indicates
medical leave insurance, and “TDI” indicates temporary disability insurance. “Total” weeks of benefits indicates the maximum number of combined benefit weeks
available in a state benefit period (generally a 12-month period). Where states limit the category of leave insurance benefits (e.g., FLI, MLI) that may be counted toward
that total, these limits are noted in parentheses. Benefit durations for the DC program are scheduled to increase in 2022.
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Research on Paid Family and Medical Leave
A relatively small literature examines relationships between U.S. workers’ access to and use of
paid family and medical leave and related labor market and social outcomes. Much of this
research emphasizes experiences and outcomes related to parental leave (i.e., leave related to the
birth and care of new children), which is a subset of the broader family caregiving category. The
focus on parental leave is driven in part by data availability, as the arrival of a new child is
somewhat easier to observe in large-scale survey data than other family and medical events.30
Parental leave—and maternity leave in particular—is also a more prevalent and better understood
workplace benefit than family caregiving or medical leave. For this reason survey respondents
may be more likely to identify a reported workplace absence as maternity or paternity leave than
they are to specify their use of medical leave or caregiving leave with great precision.31
Survey data generally allow a period of leave to be observed (and therefore studied) if the worker
is taking leave at the time of the interview, or if the survey asks for information on past leave-
taking. That is, information on leave is generally available conditional on the worker’s use of
such leave. Some workers may have access to workplace leave, but not take it for a variety of
reasons. Information on workplace access to paid family and medical leave, including parental
leave, in survey data is comparatively scarce, as are details of parental leave benefits (e.g.,
duration, eligibility conditions, and wage replacement) offered by employers.32 For these reasons
studies of the state leave insurance programs (see the “State-Run Family Leave, Medical Leave,
and Temporary Disability Insurance Programs” section of this report) form an important branch
of research on U.S. workers. The parameters of these programs are clearly established in state
laws. In addition, the broad coverage of these programs and, in some cases, the availability of

30 Many household surveys ask participants directly about births or researchers can infer the arrival of a new child in
the demographic information collected from family members; for example, from birth dates or new names added to the
family rosters. By contrast, detailed information on the incidence, timing, duration, and severity of a medical condition
or family caregiving arrangement, as defined in federal policy or proposals, is less visible outside of surveys designed
to collect those particular data; for example, the National Study of Caregiving (NCOS) collects information on
caregiving as well as labor earnings, health status, and to some extent workplace leave. A helpful discussion of data
availability and the limitations of commonly-used surveys is in Amy Batchelor, Paid Family and Medical Leave in the
United States: A Data Agenda, Washington Center for Equitable Growth, March 2019, https://equitablegrowth.org/wp-
content/uploads/2019/03/030719-paid-leave-data-report-1.pdf.
31 For example the Current Population Survey (CPS) asks a worker who reports that she or he is absent from work
during the survey reference week to indicate the main reason for the absence. “Maternity/Paternity leave” is among the
14 options (including “other”) provided to the respondent to characterize the main reason for the absence, which allows
for a parental leave absence to be observed. The survey also asks if the worker is being paid by her or his employer
during the time off, allowing for the leave to be characterized as paid or unpaid. Respondents who are away from work
for needs related to a serious health condition could select the response “own illness/injury/medical problems” but this
category would also capture those on leave for minor issues or preventive care. Similarly, a worker who takes leave to
care for seriously ill close family member could indicate the leave was for “other family/personal obligation[s],” but
again this category would include a range of family and personal needs that are not strictly considered to be family
leave. See https://www.census.gov/programs-surveys/cps/technical-documentation/questionnaires.html.
32 Some researchers have worked to fill gaps in this area by collecting their own data. For example Claudia Goldin, Sari
Pekkala Kerr, and Claudia Olivetti compiled data on a sample of private sector firms (1,135 firms) from multiple
sources, including through direct contact with some firms, to learn the details of employers’ paid parental leave
policies. They describe these policies as complex and sometimes opaque: “Firms do not always clearly state whether
their short-term (or temporary) disability program is included in the number of [paid parental leave (PPL)] weeks they
claim to offer and whether workers who take PPL are first required to exhaust their vacation, and sick days. Even more
difficult is figuring whether all workers at the firm are covered.” Claudia Goldin, Sari Pekkala Kerr, and Claudia
Olivetti, Why Firms Offer Paid Parental Leave: an Exploratory Study, NBER Working Paper 26617, January 2020,
https://www.nber.org/papers/w26617.
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administrative data provide methodological advantages over studies of workers with employer-
provided leave.33
Research on Paid Parental Leave in California
In 2004, California was the first state to launch a family leave insurance program, building upon
its existing temporary disability insurance program, and currently is the most studied.34 Research
findings indicate that greater access to paid family leave (i.e., through the California program)
resulted in greater leave-taking among workers with new children, with some evidence that the
increase in leave-taking was particularly pronounced among women who are less educated,
unmarried, or nonwhite.35 Although the program has been associated with greater leave-taking—
in terms of incidence and duration of leave—for mothers and fathers, there is some indication that
some workers are not availing themselves of the full six-week entitlement offered by the
California program, suggesting that barriers to leave-taking remain (e.g., financial constraints,
work pressures, concerns about employer retaliation).36 One study observes that employer
characteristics appear to matter to workers’ use of the California leave insurance benefits, raising
the possibility that workplace culture plays a role in workers’ leave-taking decisions.37
Some studies of the California program have considered the relationship between paid parental
leave and parents’ (mothers especially) attachment to the labor market. In theory, the availability
of such a benefit may encourage parents to stay in work prior to the birth or arrival of a child
(e.g., to qualify for benefits) and, because a full separation has not occurred, facilitate the return
to work. Further, if the job held prior to leave sufficiently accommodates the needs of a working
parent of a young child (e.g., if work hours align with traditional child care facility hours), a
parent may be more likely to return to his or her same employer, which can benefit both the

33 As noted in the “Employer-Provided Paid Family Leave” section of this report, employer-provided leave is
concentrated among higher-paying occupations, larger firms, and certain industries. This lack of broad coverage creates
challenges for researchers trying to disentangle, for example, the effects of leave-taking on employment and earnings
outcomes from the effects of holding a high-paying professional job on the same outcomes. On the other hand, broad
program coverage can complicate the identification of a meaningful comparison group in studies that seek to contrast
outcomes for workers with access to paid leave to those otherwise similar workers without access to paid leave.
34 A smaller body of research studies has considered the social and economic effects of state leave insurance program
in New Jersey and Rhode Island. For example, Tanya Byker examines the impacts of state leave insurance in California
and New Jersey on mothers’ labor force attachment. Tanya Byker, “Paid Parental Leave Laws in the United States:
Does Short-Duration Leave Affect Women’s Labor-Force Attachment?” American Economic Review: Papers and
Proceedings, vol. 106, no. 5 (2016), pp. 242-246 hereinafter “Byker, 2016.” It is worth noting that the California
legislature has amended the program several times since it took effect in 2004—for example, in 2018 the state changed
the benefit formula from a flat 55% of usual wages to a progressive formula that replaces 60%-70% of usual wages—
and for this reason the findings of earlier studies may not hold for the current program. This change was made by
California Assembly Bill No. 908, which was signed into law on April 11, 2016; see https://leginfo.legislature.ca.gov/
faces/billNavClient.xhtml?bill_id=201520160AB908.
35 Maya Rossin-Slater, Christopher Ruhm, and Jane Waldfogel, “The Effect of California’s Paid Family Leave Program
on Mothers’ Leave-Taking and Subsequent Labor Market Outcomes,” Journal of Policy Analysis and Management,
vol. 32, no. 2 (2013), pp. 224-245.
36 Charles Baum and Christopher Ruhm, The Effects of Paid Leave in California on Labor Market Outcomes, NBER
Working Paper 19741, 2013, http://www.nber.org/papers/w19741; Ann Bartel, Maya Rossin-Slater, Christopher Ruhm,
Jenna Stearns, and Jane Waldfogel, Paid Family Leave, Fathers’ Leave-Taking, and Leave-Sharing in Dual-Earner
Households, NBER Working Paper no. 21747, 2015, http://www.nber.org/papers/w21747.
37 In particular, program claims are higher among workers employed in higher-paying firms; this relationship is
particularly strong among lower-paid workers in such firms. See Sarah Bana, Kelly Bedard, Maya Rossin-Slater, and
Jenna Stearns, Unequal Use of Social Insurance Benefits: The Role of Employers, NBER Working Paper no. 25163,
October 2018, http://www.nber.org/papers/w25163.
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worker (e.g., who avoids costly job search, and the loss of job-specific skills and benefits of
company tenure) and employers (e.g., who avoid the costs of finding a replacement worker).
Empirical findings are mixed, with some studies observing a positive relationship between paid
parental leave and mothers’ labor force attachment, and others finding little evidence of such a
connection.38 Another branch of research examines linkages between paid parental leave and
family well-being. These generally find positive relationships along a variety of measures (e.g.,
timing of children’s immunizations, mothers’ mental health, and breastfeeding duration).39
Economist Maya Rossin-Slater reviews the broader literature on the impacts of maternity and
paid parental leave in the United States, Europe, and other high-income countries.40 She notes the
wide variation in paid leave policies across countries (see “Family and Medical Leave Benefits in
OECD Countries” section of this report), but nonetheless offers four general observations: (1)
greater access to paid leave for new parents increases leave-taking; (2) access to leave can
improve labor force attachment among new mothers, but leave entitlements in excess of one year
can have the opposite effect (i.e., long separations can weaken labor force attachment among
mothers); (3) access to leave can improve children’s well-being, but extending the length of
existing entitlements does not appear to further improve child outcomes; and (4) a limited
literature on U.S. state-level leave insurance programs does not reveal notable impacts (positive
or negative) of these programs on employers, but further research on employers’ experiences is
needed.
Research on Paid Family Caregiving and Medical Leave
A smaller but growing number of studies examine the social and economic impacts of paid family
caregiving leave more generally (i.e., to care for a seriously ill or injured family member) or paid
medical leave, despite the prevalence of such leave among U.S. workers.41 In addition to data

38 A summary of earlier studies’ findings for labor market outcomes is in Maya Rossin-Slater, “Maternity and Family
Leave Policy,” in The Oxford Handbook of Women and the Economy, ed. Susan L. Averett, Laura M. Argys, and Saul
D. Hoffman (New York: Oxford University Press, 2018); hereinafter “Rossin-Slater 2018.” More recently, Tanya
Byker finds a positive association between state leave insurance benefits in California and New Jersey and women’s
labor force attachment in the months before and after a birth; see Byker, 2016. By contrast, one study considered the
labor market outcomes of first-time mothers who claimed California’s paid family leave insurance benefits just as the
program launched (i.e., in the months around July 2004). The results indicate a decrease in employment and earnings
for this group in both the short-run (1-5 years later) and long-run (6-11 years later). See Martha Bailey, Tanya Byker,
Elena Patel, and Shanthi Ramnath, The Long-Term Effects of California’s 2004 Paid Family Leave Act on Women’s
Careers: Evidence from U.S. Tax Data, NBER Working Paper no. 26416, October 2019, http://www.nber.org/papers/
w26416.
39 For example, Choudhury and Polacek found that the rate of late infant immunizations fell by about five percentage
points for children born in California after the implementation of the California Paid Family Leave Program in 2004.
Improvements in on-time immunization rates were greater for poor children relative to non-poor children. See Agnitra
Roy Choudhury and Solomon Polachek, The Impact of Paid Family Leave on the Timing of Infant Vaccinations, IZA
Discussion Papers, No. 12483, Institute of Labor Economics (IZA), Bonn, 2019. Another team of researchers observed
positive relationships between the implementation of the California program and breastfeeding duration, with larger
effects for some disadvantaged mothers (e.g., mothers with less than a high school education, mothers with family
incomes below the federal poverty line). See Jessica E. Pac, Ann P. Bartel, Christopher J. Ruhm, Jane Waldfogel, Paid
Family Leave and Breastfeeding: Evidence from California, NBER Working Paper No. 25784, Issued in April 2019.
40 Rossin-Slater 2018.
41 Among workers reporting they took leave for an FMLA-qualifying reasons (even if they were not eligible for
FMLA-protected leave) in 2018, most (50.5%) reported that leave was taken for the worker’s own illness; about 18.6%
reported leave to care for a child, spouse, or parent with a serious medical need (and other 5.3% report taking leave to
care for a non-FMLA covered individual). Scott Brown, Jane Herr, Radha Roy, and Jacob Alex Klerman, Employee
and Worksite Perspectives of the Family and Medical Leave Act: Supplemental Results from the 2018 Surveys,
Appendix Exhibit B4-3, Abt Associates Inc. (Prepared for the Dept. of Labor), July 2020, https://www.dol.gov/
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availability issues noted earlier in this section, the wide variety of needs encompassed by these
types of leave create methodological hurdles. For example, the impacts of medical leave (or
caregiving leave) for workers and for their employers may differ if leave is used rarely (e.g., to
recover from a one-off surgical procedure) than for a chronic ailment. Medical leave needs can
also vary in terms of duration, further complicating efforts to establish generalizable findings.
Nonetheless, the introduction of broad-coverage state leave insurance programs creates the
potential for additional research in these areas. For example, one recent study asks whether
greater access to paid caregiving leave through the California and New Jersey state programs
helped workers remain attached to the labor market when their spouse became disabled or
otherwise experienced a serious health shock. They find some evidence that access to paid
caregiving leave reduces the likelihood that such workers decrease their work hours due to
providing care, but did not find similar effects for other measures of labor supply (such as
employment or full-time status). They suggest that the lack of broader labor supply impacts may
be influenced by the relatively short period of caregiving leave (6 weeks in each state during the
study time period), which may be insufficient in some cases (e.g., severe chronic illness or
extended recovery periods), or because caregivers were unaware that the state programs offer
benefits for spousal care. Lack of program awareness was identified in another study of the
California and New Jersey programs as a potential reason that the programs had not been
associated with an increase in leave taking among those likely to provide elder care.42 The study
also considered that the structure of the state leave insurance benefits (e.g., definition of
caregiving, timing and duration of leave, employer notice requirements, lack of job protection) do
not meet the needs of caregivers in those states.
Some studies examine employers’ experiences with the increased access to paid leave through the
state programs. One study compares employer outcomes in New York, following the state’s
adoption of a family leave insurance program, to those of similar employers in Pennsylvania, a
neighboring state that does not have a leave insurance program.43 The study focused on
employers with 10-99 employees. They found that in the first year of implementation, employers
with 50-99 employees reported an increase in the ease of dealing with employee absences
(statistically significant results were not observed for employers with 10-49 employees). At the
same time, however, they found that the albeit-small share of employers who report opposition to
the state program has increased from 4.1% in 2016 to 9.5%.44 (A subsequent study by the same
research team found that employers’ support for state programs increased during the COVID-19
pandemic).45 Another study looked at the relationship between the establishment of state
programs and firm-level performance (as measured by firms’ return on assets and other financial

agencies/oasp/evaluation/fmla2018.
42 See Brant Morefield, Abby Hoffman, Jeremy Bray, and Nicholas Byrd, Leaving it to the Family: the Effects of Paid
Leave on Adult Child Caregivers, L&M Policy Research (Prepared for the Dept. of Labor), July 2016,
https://www.dol.gov/sites/dolgov/files/OASP/legacy/files/Paid_Leave_Leaving_it_to_the_family_Report.pdf.
43 The research team collected information from employers in both states before and after the implementation of the
New York program, allowing them to assess how the new policy may have changed employer views and outcomes.
Ann P. Bartel, Maya Rossin-Slater, Christopher J. Ruhm, Meredith Slopen, and Jane Waldfogel, The Impact of Paid
Family Leave on Employers: Evidence from New York, NBER Working Paper 28672, April 2021,
https://www.nber.org/papers/w28672.
44 The authors note that opposition appears pronounced among smaller employers.
45 The research team re-contacted as many employers from the original study sample as possible. Ann P. Bartel, Maya
Rossin-Slater, Christopher J. Ruhm, Meredith Slopen, and Jane Waldfogel, Support for Paid Family Leave among
Small Employers Increases during the COVID-19 Pandemic, NBER Working Paper 29486, December 2021,
https://www.nber.org/papers/w29486.
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measures).46 It found evidence of improved firm-level performance after the establishment of
state programs for firms headquartered in states with leave insurance laws; the study’s authors
attribute improvements to greater employee retention and the nomination of women to executive
positions.47
Some additional insights to the potential impacts of paid medical leave, as defined in federal
proposals, can be gained from research on the social and economic impacts of paid sick leave.48
For example, one study found that access to paid sick leave is associated with lower (involuntary)
job separation rates.49 By extension, one might speculate that access to paid medical leave may
have similar impacts on job stability. Some caution is warranted however, in directly applying the
results of paid sick leave studies to medical leave. Research on paid sick leave will likely capture
the impacts of relatively short period of leave (e.g., less than one week), as well as the effects of
preventive care and absences for minor illness and injury. Paid medical leave, by definition, does
not include preventive care, and tends to allow for several weeks of leave.
Family and Medical Leave Benefits in OECD
Countries
Many advanced-economy countries entitle workers to family leave benefits and medical leave
benefits (sometimes referred to as sickness benefits outside the United States), which are often
provided—at least in part—through social insurance. Whereas some countries provide family
leave benefits to employees engaged in family caregiving (e.g., of parents, spouse, and other
family members), many emphasize leave for new parents, and mothers in particular. Where
broader family caregiving benefits are provided, such benefits are most commonly available to
parents caring for a seriously ill, injured or disabled child. Medical leave (or sickness) benefits
are provided in most OECD countries through a combination of employer-provided paid leave
and social insurance benefits that replace a portion of a worker’s lost earnings.
Parental Leave Benefits
As of April 2020, The Organisation for Economic Co-operation and Development (OECD)
Family Database counts 37 of its 38 members as providing for some paid parental leave (i.e., to
care for children) and maternity leave, with wide variation in the number of weeks and rate of
wage replacement across countries. This is shown in Figure 3, which plots the OECD’s estimates
of weeks of full-wage equivalent leave available to mothers. The benefits summarized in this
figure includes maternity leave benefits and other leave benefits provided to mothers to care for
children. Weeks of full-wage equivalent leave are calculated as the number of weeks of leave
available multiplied by the average wage payment rate. For example, a country that offers 12

46 Benjamin Bennett, Isil Erel, Léa Stern, and Zexi Wang, Paid Leave Pays Off: The Effects of Paid Family Leave on
Firm Performance, NBER Working Paper 27788, December 2020, https://www.nber.org/papers/w27788.
47 The study presents some evidence that leave insurance programs are associated with an increase in the share of
female executive officers who are below the age of 51 (the median age for female executives), and that firms in states
with leave insurance programs had lower rates of employee turnover.
48 BLS estimates that 77% of private sector workers had access to employer-provided paid sick leave in March 2021;
the median number of days that could be earned in a given year was six (among those limited to a fixed number of sick
days per year). BLS 2021 Employee Benefits Survey, Table 33 (access) and Table 36 (median sick leave days),
September 2021, https://www.bls.gov/ncs/ebs/.
49 Heather D. Hill, “Paid Sick Leave and Job Stability,” Work and Occupations, vol. 40, no. 2 (May 2013).
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weeks of leave at 50% pay would be said to offer 6 full-wage equivalent weeks of leave (i.e., 12
weeks x 50% = 6 weeks).
Figure 3. Average Full-Wage Equivalent Weeks of Paid Leave Available to Mothers
OECD Member Countries’ Leave Benefit Provisions as of April 2020

Source: OECD, Family Database, Indicator Table PF2.1.A, http://www.oecd.org/els/family/database.htm.
Notes: Leave available to mothers includes maternity leave and leave provided to care for children. Average ful -
wage equivalent weeks are calculated by the OECD as the product of the number of weeks of leave and
“average payment rate,” which describes the share of previous earnings replaced over the period of paid leave
for “a person earning 100% of average national ful -time earnings.” Leave benefits are subject to country-specific
eligibility requirements, which may limit benefit to workers in certain types of employment relationships, who
have been employed for a particular duration, or who have made contributions at a certain level to a social
insurance program.
A smaller majority (31 of 38) of OECD countries provided leave benefits to new fathers in
2020.50 In some cases, fathers were entitled to a week (e.g., Mexico) or less (Greece) at full pay,
whereas other countries provided several weeks of full or partial pay (e.g., Spain provided 12
weeks at full pay, and the United Kingdom provided 2 weeks at an average payment rate of
18.8%). Some countries provide a separate entitlement to fathers for child caregiving purposes.
This type of parental leave can be an individual entitlement for fathers or a family entitlement that
can be drawn from by both parents. Figure 4 summarizes paid leave benefits reserved for fathers
in OECD countries in 2020; it plots the OECD’s estimates of weeks of full-wage equivalent of
combined paternity leave and parental leave reserved for fathers.

50 This section reports OECD data on fathers’ parental leave benefits in 2020 because it is the most current year of data
available from the OECD Family Database. However, in June 2019 the European Parliament and the Council of the
European Union issued Directive 2019/1158 on Work-life Balance for Parents and Carers (and Repealing Council
Directive 2010/18/EU), which among other things directed EU Member States to “take the necessary measures to
ensure that fathers or, where and insofar as recognised by national law, equivalent second parents, have the right to
paternity leave of 10 working days that is to be taken on the occasion of the birth of the worker’s child.” The Directive
allow provided that Members State are “to ensure that each worker has an individual right to parental leave of four
months that is to be taken before the child reaches a specified age, up to the age of eight, to be specified by each
Member State or by collective agreement. That age shall be determined with a view to ensuring that each parent is able
to exercise their right to parental leave effectively and on an equal basis” and that “two months of parental leave cannot
be transferred.” In light of this directive, some EU member countries may have changed their policies in ways that are
not reflected in Figure 2. The directive is at https://eur-lex.europa.eu/eli/dir/2019/1158/oj.
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link to page 38

Paid Family and Medical Leave in the United States

Figure 4. Average Full-Wage Equivalent Weeks of Paid Leave Available to Fathers
OECD Member Countries’ Leave Benefit Provisions as of April 2020

Source: OECD, Family Database, Indicator Table PF2.1.B, http://www.oecd.org/els/family/database.htm.
Notes: Leave available to fathers includes paternity leave and leave reserved for fathers to care for children.
Average ful -wage equivalent weeks are calculated by the OECD as the product of the number of weeks of leave
and “average payment rate,” which describes the share of previous earnings replaced over the period of paid
leave for “a person earning 100% of average national ful -time earnings.” Leave benefits are subject to country-
specific eligibility requirements, which may limit benefit to workers in certain types of employment relationships,
who have been employed for a particular duration, or who have made contributions at a certain level to a social
insurance program.
Other Family Caregiving Benefits
Most OECD countries provide for paid caregiving leave, but qualifying needs for leave, leave
entitlement durations, benefit amounts, and other program features vary across the member
countries. (See summary information in Table B-1.51) For example, in some OECD countries,
parents may access paid leave to care for a child below a certain age (e.g., Estonia), and in others
paid caregiving leave may be used to care for a family member who is not (necessarily) a child.52
In some countries employees are fully compensated during leave (e.g., Australia), whereas in
others employees receive partial wage replacement (e.g., in Canada employees on leave receive
55% of lost earnings up to a maximum weekly amount). According to a 2018 report by the World
Policy Analysis Center, OECD caregiving benefits are often financed through national social
insurance programs.53

51 The table is based on information published by the Organisation for Economic Cooperation and Development
(OECD) and includes only those OECD countries for whom such policies were identified. OECD member countries,
like the United States, that provide an entitlement to eligible employees to unpaid leave are not included. See OECD
Family Database, Indicator PF2.3 Additional Leave Entitlements of Working Parents, Table PF2.3.B, updated June 12,
2016; available from http://www.oecd.org/els/soc/PF2_3_Additional_leave_entitlements_of_working_parents.pdf.
52 In most cases, the family member concept is restricted to a child, parent, and spouse; but this is not always the case.
For example, in 2015 the Netherlands expanded its concept of family member to include extended family (e.g., a
grandparent) and non-family members with whom the employee has a close relationship. This change was made in
accordance with the Dutch Modernizing Leave Arrangements and Working Times Act (Wet modernisering regelingen
voor verlof en arbeidstijden), which took effect on January 1, 2015.
53 Amy Raub, Alison Earle, and Paul Chung et al., Paid Leave for Family Illness: A Detailed Look at Approaches
Across OECD Countries, WORLD Policy Analysis Center, 2018, https://www.worldpolicycenter.org/sites/default/files/
WORLD%20Report%20-%20Parental%20Leave%20OECD%20Country%20Approaches_0.pdf.
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link to page 41 Paid Family and Medical Leave in the United States

Medical Leave Benefits
Table B-2 provides summary information on OECD country medical leave benefits. Most
countries provide for several months of leave benefits that compensate workers for a portion of
earnings lost while absent from work. In the majority of OECD member countries, medical leave
is provided through a combination of employer-provided paid leave and social insurance benefits
(usually with an employer providing benefits for a certain number of days or weeks, after which
benefits are paid by through a social insurance program).54
Recent Federal PFML Legislation and Proposals
The overarching goal of PFML legislative activity in the 117th Congress has been to increase
access to family and medical leave by reducing the costs incurred by employers and workers
associated with providing or taking leave.55 For example, the Expanding Small Employer Pooling
Options for Paid Family Leave Act of 2021 (H.R. 5161) proposes to allow multiple employer
welfare arrangements, as covered by the Employee Retirement Income Security Act (ERISA; P.L.
93-406), to include family and medical leave benefits.56 Such a change may potentially create
additional opportunities for certain employers to pool risk and affect the costs of providing such
benefits.
Other proposals aimed to make leave more accessible to workers by providing a cash benefit to
workers on leave. The Build Back Better Act (BBBA, H.R. 5376) proposed, among other things,
a new federal cash benefit for eligible individuals engaged in certain types of family caregiving,
including self-care for serious medical conditions.57 Similarly, the establishment of a national
family and medical leave insurance program, such as that proposed in the Family and Medical
Insurance Leave Act (FAMILY Act; H.R. 804/S. 248) would provide cash benefits to eligible
individuals who are engaged in certain caregiving activities (including self-care).58 The New
Parents Act (S. 2764) would allow eligible new parents to temporarily access (borrow) up to 3
months of Social Security benefits before the current-law retirement benefit eligibility age. In
return, eligible parents would need to repay benefits by either accepting an increase in their Social
Security retirement age or accepting a temporary reduction in future Social Security old-age
benefits by an amount determined by the Social Security Administration. Cash benefits proposed
by the BBBA and FAMILY Act and temporary access to Social Security benefits proposed by the
New Parents Act could potentially make the use of unpaid leave (e.g., as provided by FMLA or
voluntarily by employers) affordable for some workers.

54 Information on how this is done in some OECD countries is in Table 4 of Amy Raub, Paul Chung, and Priya Batra,
et al., Paid Leave for Personal Illness: A Detailed Look at Approaches in OECD Countries, World Policy Analysis
Center, 2018, https://www.worldpolicycenter.org/sites/default/files/WORLD Report - Personal Medical Leave OECD
Country Approaches_0.pdf.
55 This section provides examples of proposed legislation, introduced as of May 2022, to illustrate the types of
approaches considered in the current Congress.
56 A discussion of multiple employer welfare arrangements is in Department of Labor, Multiple Employer
Arrangements under the Employee Retirement Income Security Act (ERISA)” A guide to Federal and State Regulation,
Employee Benefits Security Administration, August 2013, https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/
our-activities/resource-center/publications/mewa-under-erisa-a-guide-to-federal-and-state-regulation.pdf.
57 An overview of the cash benefit proposed in the BBBA is in CRS In Focus IF11994, Build Back Better Act:
Universal Comprehensive Paid Leave, by Sarah A. Donovan and Barry F. Huston
58 The FAMILY Act, as introduced in the 116th Congress, is described in CRS Report R46390, Paid Family and
Medical Leave: Current Policy and Legislative Proposals in the 116th Congress, by Molly F. Sherlock, Barry F.
Huston, and Sarah A. Donovan.
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Appendix A. State Leave Insurance Programs, Selected Provisions as of May
2022
Table A-1. State Family and Medical Leave Insurance Program Provisions, as of May 2022
Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
California
52 weeks total, of which up to 8 weeks of family leave insurance
For workers with an average
The worker must have
Payrol tax on
(FLI) may be claimed for
weekly wage (AWW) less than
earned $300 in wages
employees.

one-third of the state AWW,
in California that were

The care of a new child by birth, adoption, or foster
care,
FLI and TDI benefits are 70% of
subject to the state
the worker’s AWW. In general,
TDI/FLI payrol tax

A serious health condition of a qualified family member, and
when a worker’s AWW are
over the worker’s base

Certain needs related to the military deployment of a
one-third of the state AWW or
period.e
qualified family member.
more, benefits are calculated as

Up to 52 weeks of temporary disability insurance (TDI) benefits
60% of the worker’s AWW, up
may be claimed for the employee’s own temporary disability.
to a maximum amount ($1,540
per week in 2022).d

Colorado
12 weeks total, which may be claimed for the fol owing family and Workers receive 90% of the
The worker must have
Payrol tax on
(Benefits
medical leave events:
portion of their AWW that is
earned at least $2,500
employers and
payable January 
50% or less of the state AWW,
in wages that were
employees.

The care of a new child by birth, adoption, or foster care,
2024)
and they receive 50% of the
subject to the paid

Employers with nine or

A serious health condition of a qualified family member,
portion of their AWW that is
family and medical leave fewer employees are

Needs related to the stalking of the employee or a qualified
above 50% of the state AWW,
insurance payrol tax
exempt from the
family member, or sexual assault or abuse, or domestic
up to a maximum amount
over the worker’s base
employer portion of
violence to the employee or a qualified family member,
($1,100 in 2024). In each year
period.e
payrol tax

after 2024, the maximum

Certain needs related to the military deployment of a

contributions.
qualified family member, and
weekly benefit is 90% of the
state AWW.

The employee’s own serious health condition.
4 weeks of additional medical leave benefits may be claimed for a
serious health condition related to pregnancy complications or
childbirth complications, bringing total benefits to 16 weeks in
such cases.
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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
Connecticut
12 weeks total, which may be claimed for the fol owing family and Workers receive 95% of the
Benefit recipients must
Payrol tax on

medical leave events:
portion of their AWW that is
have earnings of at least employees.

less than or equal to the
$2,325 in the highest

The care of a new child by birth, adoption, or foster care,
earnings from a 40 hour
earning quarter within

A serious health condition of a qualified family member,
workweek compensated at the
the base period.e

Certain needs related to the military deployment of a
CT minimum hourly wagef plus
They must also be
qualified family member,
60% of the portion of their
currently or recently

AWW that is above this

The care of a qualified military family member with a serious
employed (i.e.,
il ness or injury,
threshold, up to a maximum
employed in the last 12
amount. The maximum weekly

weeks).

Up to 12 days for needs related to domestic violence (for
benefit is set at 60 times the CT
employee or a qualified family member),
minimum wage. ($780 weekly as

To serve as an organ or bone marrow donor, and
of January 1, 2022, increasing to

$840 on July 1, 2022, and $900

An employee’s own serious health condition.
on June 1, 2023.)
2 additional weeks of benefits may be claimed for a serious health
condition if an employee’s pregnancy results in incapacitation,

bringing total benefits to 14 weeks in such cases.
Delaware
In general, 12 weeks total of family and medical leave benefits
Workers receive 80% of their
Workers must be
Payrol tax on covered
(Benefits
may be claimed in a benefit year.
AWW, up to a maximum
employed by their
employers, who may
payable in
In general, 12 weeks of benefits may be claimed in a benefit year
amount ($900 per week in 2026 current employer for
opt to share costs (up
January 2026)
for the care of a new child by birth, adoption, or foster care;
and 2027).h
12 months and have
to 50%) with covered
however, employers with fewer than 25 employees may elect to
worked for the current
employees.
limit parental leave benefits to 6-12 weeks in a benefit year from
employer for at least
Employees and
January 2026 through December 2030.
1,250 hours in the 12-
employers may opt out
months preceding
Up to 6 weeks of benefits may be claimed onceg in a 24-month
of contributions if the
leave.i
periods for the fol owing family and medical leave events:
employee is not

expected to meet

A serious health condition of a qualified family member,
eligibility conditions.

Certain needs related to the military deployment of a
qualified family member, and

An employee’s own serious health condition.

CRS-21

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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
District of
Through September 2022,j 8 weeks total, of which up to
Benefits are 90% of the portion
The worker must have
Payrol tax on covered
Columbia

of a worker’s AWW that is
worked for at least one employers.

8 weeks of benefits may be claimed for the care of a new

child by birth, adoption, or foster care,
150% or less of 40 hours
week in the 52 calendar
compensated at the DC
weeks preceding the

6 weeks for a serious health condition of a qualified family
minimum wage (i.e., “150% of
qualifying event for
member, and
the DC minimum weekly
leave for a covered

6 weeks for the employee’s own serious health condition.
wage”), plus 50% of average
DC-based employer,
In addition, a worker is entitled to 2 weeks of benefits for
earnings above 150% of the DC
and at least 50% of that
prenatal care (i.e., potentially increasing the entitlement to 10
minimum weekly wage, up to a
work must occur in
total weeks of benefits for some workers), as long as the
maximum weekly amount
DC for such a DC-
duration of benefits claimed for prenatal care and for the
($1,009 per week in 2022).
based employer.
employee’s own serious health condition do not exceed 6 weeks.
Due to a surplus in the DC Universal Paid Leave Fund, starting
between July 1, 2022-October 1, 2022,k 12 weeks total, of which
up

12 weeks of benefits may be claimed for the care of a new
child by birth, adoption, or foster care,

12 weeks for a serious health condition of a qualified family
member, and

12 weeks for the employee’s own serious health condition
In addition, 2 weeks may be claimed for prenatal care (i.e.,
potentially increasing the entitlement to 14 total weeks of
benefits for some workers), as long as the duration of benefits
claimed for prenatal care, and for the employee’s own serious
health condition do not exceed 12 weeks.
CRS-22

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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
Maryland
12 weeks total, which may be claimed for the fol owing family and Workers receive 90% of the
The worker must have
Payrol tax on
(Benefits
medical leave events:
portion of their AWW that is
worked 680 hours or
employees and on
payable in

65% or less of the state AWW;
more in the 12-month
employers with 15 or

the care of a new child by birth, adoption, or foster care,
January 2025)
they receive 50% of the portion
period immediately
more employees.

a serious health condition of a qualified family member,
of their AWW that is above
preceding the first day

certain needs related to the military deployment of a
65% of the state AWW, up to a
of benefits.m
qualified family member,
maximum amount ($1,000 per

week in 2025).l

the care of a military family member, who is the claimant’s
next of kin, with a serious health condition resulting from
military service, and

an employee’s own serious health condition.
12 additional weeks of benefits may be claimed for a serious
health condition if the individual previously claimed benefits for
the care of a new child (or vice versa), bringing total benefits to
24 weeks in such cases.
Massachusetts
25 weeks total,n of which up to 12 weeks of FLI benefits may be
Workers receive 80% of the
The worker meets the
FLI is financed through

claimed for
portion of their AWW that is
financial eligibility
a payrol tax on

50% or less of the state AWW;
requirements for
employees.

the care of a new child by birth, adoption, or foster care,
they receive 50% of the portion
receiving

MLI is financed through

a serious health condition of a qualified family member, and of their AWW that is above
unemployment
a payrol tax on

certain needs related to the military deployment of a
50% of the state AWW, up to a
insurance (i.e., in 2022,
employers and
qualified family member;
maximum amount ($1,084.31
the worker would have
employees. Employers
and up to 25 weeks of FLI benefits may be claimed for the care of per week in 2022).
had to have earned at
with fewer than 25
a military family member with a serious il ness or injury.
least $5,700 in the last
employees are exempt
4 completed calendar
Up to 20 weeks of medical leave insurance (MLI) may be claimed
from the employer
quarters).
for the employee’s own serious health condition.
portion of the MLI
payrol tax
contributions.
CRS-23

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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
New Jersey
38-52 weeks total,o of which up to 12 weeks (or 56 intermittent
Workers receive 85% of their
The worker meets the
FLI is financed through
days) may be claimed for the FLI events:
AWW, up to a maximum
financial eligibility
a payrol tax on

amount equal to 70% of the
requirements for
employees.

the care of a new child by birth, adoption, or foster care,
statewide AWW ($993 per
unemployment

TDI is financed through

a serious health conditionp of a qualified family member, and week in 2022).
insurance. In 2022,
a payrol tax on

needs related to domestic or sexual violence to the
these are 20 or more
employers and
employee or a qualified family member.
calendar weeks with
employees.
Up to 26 weeks of TDI benefits may be claimed for an
earnings of $240 in
employee’s own temporary disability, for a single period of
each week in the base
disability.
period, or at least
$12,000 in earnings
during the base period.e
New Yorkq
26 weeks total, of which up to 12 weeks of FLI benefits may be
For FLI benefits, 67% of the
For FLI benefits,
FLI is financed through

claimed for
employee’s AWW, up to a
workers must have ful -
a payrol tax on

maximum amount ($1,068.36
time employment (20
employees.

the care of a new child by birth, adoption, or foster care,
per week in 2022).
or more hours per

TDI is financed through

a serious health condition of a qualified family member, and
For TDI benefits, 50% of the
week) for 26
a payrol tax on

certain needs related to the military deployment of a
employee’s AWW, up to a
consecutive weeks or
employees and
qualified family member,
maximum amount ($170 per
175 days (which need
contributions by
and up to 26 weeks of TDI benefits may be claimed for an
week in 2022).
not be consecutive) of
employers. Employers
employee’s own temporary disability.
part-time employment.
A separate formula is used to
finance all insurance
In some cases, TDI or FLI benefits may be claimed for the
calculate COVID-19-related FLI
For TDI benefits,
policy costs beyond
employee’s or the employee’s child’s mandatory or precautionary and TDI benefits.s
workers must have
what they are
order of quarantine or isolation due to COVID-19.r
worked for a covered
permitted by law to
employer for at least 4
col ect from
consecutive weeks.
employees.
CRS-24

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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
Oregon
12 weeks total, which may be claimed for the fol owing family and Starting in September 2023,
$1,000 in earnings
Payrol tax on
(Benefits
medical leave events:
workers receive 100% of the
during the base period.e employers and
payable in

portion of their AWW that is
employees.

the care of a new child by birth, adoption, or foster care,
September
65% or less of the state AWW;

Employers with fewer
2023)

a serious health condition of a qualified family member,
they receive 50% of the portion
than 25 employees are

needs related to domestic or sex violence to the employee
of their AWW that is above
not required to
or a qualified family member, and
65% of the state AWW, up to a
contribute, but may do

maximum amount. The

the employee’s own serious health condition.
so voluntarily and by
maximum benefit formula is
2 additional weeks of benefits may be claimed for certain medical
doing so may qualify for
120% of the state AWW.
conditions related to pregnancy, childbirth, and recovery
state assistance.
(including lactation), bringing total benefits to 14 weeks in such
cases.
Rhode Island
30 weeks total, of which up to 5 weeks may be claimed for the
4.62% of wages received in the
The worker must have
Payrol tax on
FLI events:
highest quarter of the worker’s
earned wages in Rhode
employees.

base period (i.e., approximately
Island, paid into the

the care of a new child by birth, adoption, or foster care,
and
60% of weekly earnings), up to a insurance fund, and for
maximum weekly amount ($978
claims filed in 2022,

a serious health condition of a qualified family member,
per week in 2022).
received at least
and up to 30 weeks of TDI benefits may be claimed for the
$14,700 in the base
employee’s own temporary disability.
period;e a separate set
Starting January 1, 2023, workers may claim up to 6 weeks (of
of criteria may be
the total 30 weeks) of benefits for FLI events.
applied to persons
earning less than
$14,700.
CRS-25

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Earnings and
State
Weeks of Insurance Benefits Available in a Benefit Year
Benefit Formula and
Employment
Program
(typically a 12-month period)a
Maximum Weekly Benefitb
Requirementsc
Financing
Washington
16 weeks total, of which up to 12 weeks of FLI benefits may be
Workers whose AWW is 50%
The worker must have
FLI is financed through

claimed for
or less than the state AWW
worked 820 hours or
a payrol tax on

receive 90% of their AWW.
more in the qualifying
employees.

the care of a new child by birth, adoption, or foster care,
Otherwise, workers receive
period.e

MLI is financed through

a serious health condition of a qualified family member, and
approximately 20% of the state

a payrol tax on

certain needs related to the military deployment of a
average weekly rate plus 50% of
employers and
qualified family member; and
their AWW, up to a maximum

employees. Employers

amount ($1,327 per week in

the death of a qualified family member (effective June 9,
with fewer than 50
2022, benefits limited to 7 days).
2022).
employees are not
and up to 12 weeks of MLI benefits for an employee’s own

required to contribute,
serious health condition.
but may do so
voluntarily and by doing
2 additional weeks of MLI benefits may be claimed if an
so may qualify for state
employee’s pregnancy results in incapacitation, bringing total
assistance.
benefits to 18 weeks in such cases.
Source: CRS based on the fol owing sources: California: California Unemployment Insurance Code §§2601-3307 and program information from http://www.edd.ca.gov/
Disability/. Colorado: Colo. Rev. Stat. §8-13.3-501-524 and program information from https://famli.colorado.gov/. Connecticut: General Statutes of Connecticut sections 31-
49e to 31-49t, and 31-51ss, and program information from https://ctpaidleave.org/. Delaware: Laws of Delaware, Volume 83, Chapter 301 (151st General Assembly),
available from https://legis.delaware.gov/SessionLaws/Chapter?id=41361. District of Columbia: D.C. Official Code §§32-541.01 et seq. and program information from
https://dcpaidfamilyleave.dc.gov/. Maryland: Enrol ed Senate Bil 0275, Maryland General Assembly, 2021 Regular Session, available from https://mgaleg.maryland.gov/
mgawebsite/Legislation/Details/SB0275?ys=2022RS (Md. Code Ann. §§8.3-101 to 8.3-1001; effective June 1, 2022 and January 1, 2023); Md. Code Ann. §§3-1201 to 3-
1211. Massachusetts: MGL c. 175M and program information from https://www.mass.gov/orgs/department-of-family-and-medical-leave. New Jersey: N.J. Stat. Ann. §43:21-
25 and program information from https://myleavebenefits.nj.gov/. New York: New York Workers’ Compensation Law §§200-242 and program information from
http://www.wcb.ny.gov/content/main/DisabilityBenefits/employer-disability-benefits.jsp and https://paidfamilyleave.ny.gov/. Oregon: Oregon Rev. Stat. 657B and program
information from https://www.oregon.gov/employ/PFMLI/Pages/default.aspx. Rhode Island: Rhode Island General Laws §§28-39-1 to 28-41-42 and program information
from https://dlt.ri.gov/individuals/temporary-disability-caregiver-insurance. Washington: Rev. Code Washington, Chapter 50A.05 and program information from
https://paidleave.wa.gov/.
Notes: This table provides information on state programs that provide for family leave insurance in addition to medical leave insurance or temporary disability insurance.
Hawaii and Puerto Rico require employers to provide temporary disability insurance but not family leave insurance to their employees, and as such are not included.
New Hampshire allows private sector employers to opt in to its leave insurance program for state employees; because participation is voluntary for all private sector
employers, the program is not included in the table.
a. All states included in this table provide FLI benefits to eligible workers who provide care to a family member with a serious health condition. The set of family
members generally includes a child, parent, spouse or domestic partner, and grandparent; some states provide benefits for the care of other relatives such as
grandchildren and siblings.
b. In general, individuals cannot claim TDI or medical leave insurance benefits and family leave insurance benefits for the same week.
CRS-26

c. In general, workers must meet earnings and employment requirements while employed by a “covered employer” or while in “covered employment.” Rules vary
from state to state, but these terms generally capture employment and earnings for which state TDI/FMLI program contributions were col ected.
d. Starting January 1, 2023, the California program wil provide up to 55% of an employee’s AWW up to a statutory maximum.
e. For California, Colorado, Connecticut, New Jersey, Oregon, and Rhode Island the “base period” or “qualifying period” is typically the first four of the last five
completed quarters that precede the insurance claim. For example, a claim filed on February 6, 2017, is within the calendar quarter that begins on January 1, 2017
(i.e., the first calendar quarter). The base period for that claim is the four-quarter period (i.e., 12-month period) that starts on October 1, 2015. In Massachusetts,
the base period is the last four completed quarters preceding the benefit claim. In Washington, the base period is either the first four of the last five completed
quarters or the last four completed quarters that precede the insurance claim.
f.
As of January 2022, 40 times the CT minimum wage is $520. The product increases to $560 on July 1, 2022, and $600 on June 1, 2023
g. Delaware law provides that a covered worker is eligible for family and medical leave benefits “not more than once in a 24-month period.” However, if certain
conditions are met, a worker may use benefits intermittently. Further clarification on use of benefits is expected to be included in regulations governing the
Delaware leave insurance program.
h. In each year after 2027, the maximum weekly benefit is increased in proportion to the annual average increase, if any, in the Consumer Price Index for All Urban
Consumers, for the Philadelphia-Camden-Wilmington Metropolitan area (as published by the Bureau of Labor Statistics [BLS]).
i.
Delaware employers with 10-24 employees are only covered by the parental leave provisions, but may opt-in to the medical leave benefit provisions or other family
leave benefit provisions. Employers with fewer than 10 employees are not covered by any leave benefit provisions, but may opt-in to the program.
j.
DC law provides that projected program costs and revenues are to be evaluated each year and, if sufficient funds are available, the leave entitlement is to be
expanded according to a schedule provided at D.C. Official Code §32-541.01.04a. Expansions are to take effect at the start of the next fiscal year. If projected funds
do not support an expansion, benefits would be reduced to a minimum of 8 weeks, of which 8 weeks of benefits may be claimed for the arrival of a new child by
birth, adoption, or foster care, 6 weeks for a serious health condition of a qualified family member, and 2 weeks for the employee’s own serious health condition.
k. The DC Acting Chief Financial Officer certified on March 1, 2022 that sufficient funds are available for the increase in paid leave benefits to take effect on July 1,
2022. Mayor Muriel Bowser’s 2023 budget proposal (published March 16, 2022) would delay implementation of the expansion of paid leave benefits until October 1,
2022. As of May 24, 2022, the DC Council has not voted on the mayor’s 2023 budget proposal.
l.
In each year after 2025, the maximum weekly benefit is increased in proportion to the annual average increase, if any, in the Consumer Price Index for All Urban
Consumers, for the Washington-Arlington-Alexandria, DC-VA-MD-WV Metropolitan area (as published by BLS).
m. In addition, a claimant must exhaust all employer-provided leave that is not required by law before claiming the leave insurance benefit.
n. Massachusetts law provides for up to 20 weeks of medical leave in a benefit year and 12 weeks of family leave in a benefit year, except that a covered individual
taking family leave in order to provide care for a covered military family member with a serious il ness or injury may use up to 26 weeks of family leave (MGL c.
175M as added by St. 2018, c. 121., Section 2(c)(1)). It provides family and medical leave benefits for those periods of leave, with the exception of the first 7 calendar
days of such leave; consequently, while up to 26 weeks of leave are provided, workers may receive only 25 weeks of benefits. This interpretation is supported by
regulations for the Massachusetts program at 458 CMR 2.12 Weekly Benefit Amount (7) which notes “[n]o family or medical leave benefits are payable during the
first seven calendar days of an approved initial claim for benefits. The initial seven day waiting period for paid leave benefits wil count against the total available
period of leave in a benefit year.”
o. Assuming eligibility conditions are met, 52 weeks of TDI benefits may be used for two separate but consecutive periods of disability.
p. On March 25, 2020, NJ expanded the definitions of a serious health condition and compensable disability as applied to the NJ state leave insurance program to
include, during a state of emergency, “an il ness caused by an epidemic of a communicable disease, a known or suspected exposure to a communicable disease, or
efforts to prevent spread of a communicable disease, which requires in-home care or treatment” of the employee or family member of the employee. The same law
CRS-27

modified the NJ leave insurance program to waive the waiting period for benefits if, during a state of emergency, the employee’s disability results from an “il ness
caused by an epidemic of a communicable disease, a known or suspected exposure to the disease, or efforts to prevent the spread of the disease requiring in-home
care or treatment.” See NJ P.L. 2020, Ch. 17.
q. New York differs from other states with leave insurance programs in that it provides temporary disability and family leave insurance to employees largely through a
col ection of private plans purchased by employers, rather than a centralized state plan. Employers also have the option of obtaining insurance through the NY State
Insurance Fund, which was created by Article 6 of New York’s Workers’ Compensation Law, and serves to “to compete with other carriers to ensure a fair market
place and to be a guaranteed source of coverage for employers who cannot secure coverage elsewhere.” Additional information is at https://ww3.nysif.com/.
r. NY Governor Cuomo signed NY state bil S. 8091 into law on March 18, 2020. In addition to creating an entitlement to paid sick leave in some instances, the new
law provides that workers employed by certain small businesses who are subject to a mandatory or precautionary order of quarantine or isolation due to COVID-
19 may qualify for NY state paid family leave benefits and enhanced temporary disability benefits, and claim these benefits concurrently. Additional information is at
https://www.nysenate.gov/legislation/bil s/2019/s8091 and https://paidfamilyleave.ny.gov/COVID19.
s. An enhanced TDI benefit is available to certain employees who are subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19, and
this benefit is claimed concurrently with FLI benefits. The enhanced TDI benefit is calculated as the difference between the employee’s AWW and amount of the FLI
benefit, up to a maximum weekly TDI benefit of $2,043.92. The FLI benefit is capped at $840.70 per week for claims related to a quarantine or isolation order.

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Table A-2. Job Protection for State Leave Insurance Program Beneficiaries
Is Job Protection Provided for In
Acts Authorizing State Leave
State
Insurance Benefits?a
Job Protection Provided by Other State Leave Laws
California
No
California Family Rights Act: Provides an eligible employee up to 12 workweeks of unpaid job-protected
leave during any 12-month period to care for and bond with a newly-arrived child, care for a family member
who has a serious health condition or for needs related to the employee’s own serious health condition
(except for conditions covered by the California Fair Employment and Housing Act), and for certain military
family needs. Eligibility conditions are similar to the federal FMLA. The California Family Rights Act applies to
employers with 5 or more employees (a lower threshold than the federal FMLA).
California Fair Employment and Housing Act: Allows an employee incapacitated by pregnancy,
childbirth, or a related medical condition to take up to 4 months of unpaid job-protected leave.
Colorado
Yes, covered employees that have
N/A
been employed with their current
employer for at least 180 days before
the start of leave are entitled to job
protection.
Connecticut
No
Connecticut Family and Medical Leave Act: Provides up to 12 workweeks of unpaid job-protected leave
during any 12-month period for the care of newly-arrived child, care of a family member with a serious health
condition, needs related to the employee’s own serious health condition, certain military family needs, and to
serve as an organ or bone marrow donor. Provides up to 2 additional workweeks of job-protected leave
during the 12-month period for a serious health condition that occurs during pregnancy and results in
incapacitation. Workers may also use 26 additional workweeks of job-protected leave in a single 12-month
period to care for a family member who is a member of the U.S. armed forces, if the member incurred a
serious injury or il ness in the line of duty. An employee is eligible for such leave after completing 90 days of
employment with the current employer.
Connecticut Pregnancy Disability Leave: Requires that employers (and their agents) with 3 or more
employees, employment agencies, and labor organizations provide a “reasonable amount” of unpaid job-
protected leave for pregnancy-related disabilities.
Delaware
Yesb
N/A
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Is Job Protection Provided for In
Acts Authorizing State Leave
State
Insurance Benefits?a
Job Protection Provided by Other State Leave Laws
District of
No
District of Columbia Family and Medical Leave Act: Provides up to 16 weeks of unpaid job-protected
Columbia
leave during any 24-month period for the care of newly-arrived child, or the care of a family member with a
serious health condition, and 16 weeks in any 24-month period for needs related to the employee’s own
serious health condition. To be eligible, an employee must have been employed by the same employer for 1
year without a break in service and have worked at least 1,000 hours during the 12-month period preceding
the leave request.
District of Columbia Pregnancy Disability Leave: Employers must make “reasonable accommodations”
for pregnant employees with pre-birth complications or employees recovering from childbirth. Such
accommodations can include unpaid job-protected leave.
Maryland
No
Maryland Parental Leave Act: Provides 6 weeks of unpaid job-protected leave for the care of a newly-
arrived child. To be eligible, an employee must have worked for the employer for 12 months and for 1,250
hours in the 12-months that precede leave, and be employed at a worksite for which the employer employs at
least 15 workers within 75 miles of the site. The law applies to employers with 15-49 employees.
Massachusetts
Yes
Massachusetts Parental Leave Act: Provides 8 weeks of unpaid job-protected leave for the care of a
newly-arrived child. To be eligible, an employee must have completed his or her probationary period (as set by
the employer), which cannot exceed 3 months. The law applies to employers with a least 6 employees.
New Jersey
No
New Jersey Family Leave Act: Provides eligible employees unpaid job-protected leave (12 weeks in a 24-

month period) to care for a newly-arrived child, or to care for a family member with a serious health
condition. The law applies to all New Jersey employers with 30 or more employees (worldwide). To be
eligible, an employee must have been employed for at least 12 months by the employer, and must have worked
at least 1,000 hours in the 12 months preceding leave.
New Jersey Security and Financial Empowerment Act: Provides up to 20 days of unpaid job-protected
leave in a 12-month periods for certain needs, if the employee or the employee’s family member has been the
victim of a domestic or sexual violence offence. The law applies to all employers with 25 or more employees.
To be eligible, an employee must have been employed for at least 12 months for the employer, and must have
worked at least 1,000 hours in the 12 months preceding leave.
New York
Yes, for family leave insurance
N/A
recipients.
No, for disability insurance recipients.
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Is Job Protection Provided for In
Acts Authorizing State Leave
State
Insurance Benefits?a
Job Protection Provided by Other State Leave Laws
Oregon
Yes, if employed by the current
Oregon Family Leave Act: Provides 12 weeks of unpaid job-protected leave within any 12-month period
employer for at least 90 days before
for specific family caregiving needs, including bereavement (additional leave may be available if certain
taking leave.
conditions are met)c. Leave for bereavement is limited to 2 weeks (of the 12 week total) per death of a family
member. The law applies to employers with at least 25 employees. To be eligible, an employee must have been
employed by the current employer for at least 180 days prior to leave; with the exception of leave to care for
a new child, the employee must have worked at least 25 hours per week during the 180-day period.
Oregon Military Family Leave Act: Provides 14 days of unpaid job-protected leave per deployment to an
employee whose spouse is a military member called to active duty during a period of military conflict. The law
applies to employers with at least 25 employees. To be eligible, an employee must work at least 20 hours per
week for the employer, on average.
Rhode Island
Yes, for family leave insurance
Rhode Island Parental and Family Medical Leave Act: Provides 13 consecutive weeks of unpaid job-
recipients.
protected leave in a 2-year period for the care of a newly-arrived child or a family member with a serious
No, for disability insurance recipients.
health condition. The act applies to private sector employers with at least 50 employees, state government
employers, and local government employers with at least 30 employees. Employees must have worked for
their current employer for 12 consecutive months before using leave.
Washington
Yes, if employed by an employer with
N/Ae
50 or more employees, and has
worked for the employer for at least
12 months and worked at least 1,250
hours in last 12 months.d
Source: CRS, based on the fol owing sources: California: California Unemployment Insurance Code §§2601-3307, California Government Code §12945 and §12945.2.
Colorado: Colo. Rev. Stat. §8-13.3-509. Connecticut: Conn. Gen. Stat. §§31-49e-31-49t, §31-51nn, and §46a-60. Delaware: Laws of Delaware, Volume 83, Chapter 301 (151st
General Assembly), available from https://legis.delaware.gov/SessionLaws/Chapter?id=41361. District of Columbia: D.C. Official Code §§32-541.01 et seq., §§32-501 et seq.,
§32-1231.01, and §32-1231.03. Maryland: Enrol ed Senate Bil 0275, Maryland General Assembly, 2021 Regular Session, available from https://mgaleg.maryland.gov/
mgawebsite/Legislation/Details/SB0275?ys=2022RS (Md. Code Ann. §§8.3-101 to 8.3-1001; effective June 1, 2022 and January 1, 2023); Md. Code Ann. §§3-1201 to 3-
1211. Massachusetts: MGL c. 175M and MGL c. 149, §105D. New Jersey: N.J. Stat. Ann. §§43:21-25 et seq., §34:11B1-16, and §34:11C1-5. New York: New York Workers’
Compensation Law §§200-242. Oregon: Oregon Rev. Stat. 657B.060, 659A.171, and 659A.093. Rhode Island: Rhode Island General Laws §§28-41 et seq. and §§28-48 et
seq. Washington: Rev. Code Washington §50A.35.010 and §50A.30.010.
a. This column indicates whether temporary disability insurance (TDI) or family and medical leave insurance (FMLI) benefit receipt confers job protection to benefit
recipients, meaning a recipient must be returned to the job held at the time of benefit application or receipt. This column does not include information on job
protection provided under the Family and Medical Leave Act (FMLA; P.L. 103-3) for employees who meet FMLA eligibility criteria, or under similar state laws.
b. Delaware differs from other states in that it conditions eligibility for the benefit on an employee’s tenure with her or his employer. To be eligible for the benefit and
job-protected leave, the employee must have worked for at least 12-months with the current employer and worked at least 1,250 hours for the current employer
in the 12-months that precede leave.
CRS-31

c. Female employees are entitled to an additional 12 weeks of job-protected leave (in the same 12-month period) for a pregnancy- or childbirth-related disability that
prevents the employee from performing any available job duties offered by her employer. Employees that take 12 weeks of leave to care for a newly arrived child
may take an additional 12 weeks (in the same 12 months) for the care of a child who does not have a serious health condition but requires home care.
d. Like most states listed in this table, Washington State provides employers the option of providing leave insurance benefits to their employees through a private (or
voluntary) plan. In Washington State, employees receiving leave insurance benefits through a private plan receive job protection during periods of family and medical
leave if they have worked for the employer for at least nine months and 965 hours during the 12 months immediately preceding the leave.
e. Washington State requires employers with at least 8 employees to provide leave to women with pregnancy-related disabilities. However, CRS could not determine
the extent to which such leave is job-protected.

CRS-32

Appendix B. Caregiving Leave and Medical Leave
Benefits in OECD Countries
This appendix provides information on caregiving leave benefits and medical leave benefits
available in OECD countries. The level of detail provided on such benefit programs is determined
by the availability of reliable information from public sources located through various searches.
For this reason, some programs are described in considerably more detail than others. While this
appendix aims to provide useful descriptions of benefit programs across OECD countries, it
should not be viewed as an exhaustive compilation of benefit program information. Relatedly,
when a particular benefit program feature is not described for a given country, it should not
necessarily be interpreted as evidence that the feature is lacking.

CRS-33

Table B-1. Paid Family Caregiving Leave Policies in Selected OECD Countries as of January 2020
Country
Paid Caregiving Leave
Australia
Up to 10 days of leave per year to care for a sick family or household member.
Austria
Up to 2 weeks of leave per year to care for a child under the age of 12 years; up to 1 week to care for an immediate family or household
member.
Belgium
Up to 12 months per episode of il ness to care for a seriously il family member; leave must be taken in blocks of 1 to 3 months. Two months of
leave per episode to provide palliative care to a terminally il family member; leave must be taken in 1-month blocks.
Canadaa
Up to 35 weeks per year to care for a critically il child under the age of 18 years, and up to 15 weeks to care for a critically il adult family
member. Up to 26 weeks to care for a person of any age who requires end-of-life care. In all cases, the individual receiving care need not be a
family or household member, but the caregiver must be considered “like family” to the person receiving support.
Chile
Up to 10 days per family, per year to care for a child at serious risk of death. Additional paid leave may be available for a seriously il child under
one age 1.
Czech Republic
In general, up to 9 consecutive days per episode to care for a seriously il household family member, or a sick (need not be seriously il ) child
under the age of 10 years.
Estonia
Up to 14 days per family, per episode to care for a child under the age of 12 years. Up to 7 days per episode to care for an adult family
member. Up to 5 working days per year to care for a family member with a severe disability.
Finland
Up to 4 days per episode to care for a child under the age of 10 years; benefit levels are determined by col ective agreement.
France
Up to 3 years per episode to care for a child under the age of 20 years with a serious il ness or disability. Up to 3 months of leave (with a
possible extension to 6 months) to care for a close family member who is terminally il .
Germany
Up to 10 days per child, per year (maximum of 25 days in a year, per parent) to care for a child under the age of 12 years. Up to 10 days (total
per dependent family member) to care for a dependent family member with an unexpected il ness.
Greece
Up to 22 days per year to care for a child who is under age 18 or a spouse with certain serious il nesses. Up to 4 days (per parent, per year for
each child under age 16) to visit a child’s school. Up to 1 hour per day to care for a child or spouse with a disability.
CRS-34

Country
Paid Caregiving Leave
Hungary
Up to 14 days per year, per family to care for a child who is 6-12 years old; up to 42 days per year, per family to care for a child who is age 3-5
years; up to 84 days per year, per family to care for a child who is age 1-2 years; and unlimited days for a child under the age of 1 year.
Ireland
Up to 3 days in a 12-month period, with a maximum of 5 days in a 36-month period to care for a close family member.
Israel
Workers may deduct the fol owing from their own sick leave entitlement: up to 8 days per year to care for a child under the age of 16 years (16
days may be used if the parent is a single parent); 18 days per year (36 for a single parent) to care for a child with special needs; 7 days per
episode to attend a spouse’s medical appointments and for treatments related to pregnancy; and 6 days per year to care for a spouse or parent
over age 65.
Italy
Up to 2 years over the course of the employee’s career to care for a seriously il or disabled family member. Family members cannot use such
caregiving leave concurrently.
Japan
Up to 93 days (total per dependent family member) to provide care to a seriously il dependent family member who requires constant care for
at least 2 weeks.
Latvia
Up to 14 days per episode to care for a child under the age of 14 at home. Up to 21 days per episode to care for a child under the age of 14
who is hospitalized.
Luxembourg
Up to 12 days to care for a child under age 4 and up to 18 days to care for a child ages 4-12 years. Up to 5 days to care for a child ages 13-18
who is hospitalized. Care days are doubled for a disabled child. Up to 52 weeks in a 104-week period to care for a child under the age of 18
years who is seriously or terminal y il .
Netherlands
Up to 10 days of leave to care for a sick family (including certain friends) or household member.
New Zealand
Up to 5 days per year may be used from the employee’s sick leave entitlement to care for a partner or dependent family member.
Norway
Up to 10-15 days per year, depending on family composition, (20-30 days for a single parent) to care for a child under the age of 12 years;
additional days may be provided for the care of child with a severe il ness. Up to 5 working years (1300 work days) per episode to care for a
child under age 18 who requires continuous care due to il ness, injury, or disability. Up to 60 days per episode to care for a terminally-il family
member (including an unrelated person with a family-like relationships).
CRS-35

Country
Paid Caregiving Leave
Poland
Up to 14 days per year to care for a family member. Up to 60 days to care for a child under age 8 (age 14 if the child is disabled or chronically
il ) in exceptional circumstances (e.g., school closure).
Portugal
For families with one child, up to 30 days per year (per family) to care for a child under the age of 12 years and up to 15 days to care or a child
over the age of 12 years. In both cases, families may claim one additional day per year for each additional child in the family. Up to 6 months per
episode (per family), with the possibility of an extension, to care for a chronically-il child.
Slovak Republic
Up to 10 days per year to care for a family member.
Slovenia
Up to 15 days per episode, per family to care for a child under the age of 8 years. Up to 7 days to provide care to a co-resident family member;
up to 6 additional months per family may be granted for severe il ness.
Spain
Up to 2 days per episode to provide care to an il family member. Unlimited paid leave is provided to care for a seriously ill child under the age
of 18 years; in such cases, parents may not use leave concurrently.
Sweden
Up to 120 days per child, per year to care for a child under the age of 12 years (15 years in some cases). Up to 100 days per episode to provide
care to a seriously il family member (including certain unrelated persons with a family-like relationship).
Switzerland
Up to 3 days per episode, per family to care for a child. At least 3 weeks to care for a seriously-il child for workers in their first year of service;
thereafter paid leave is provide in accordance with the customary practice of the canton or col ective agreement.
Source: Organisation for Economic Co-operation and Development (OECD), OECD Family Database, Indicator PF2.3 Additional Leave Entitlements of Working
Parents, Table PF2.3.B, updated January 2020; available from http://www.oecd.org/els/soc/PF2_3_Additional_leave_entitlements_of_working_parents.pdf.
Notes: Leave benefits are subject to country-specific eligibility requirements, which may limit benefits to workers in certain types of employment relationships, who have
been employed for a particular duration, or who have made contributions at a certain level to a social insurance program.
a. Information for Canada is from the official Government of Canada information web page on Employment Insurance Caregiving Benefits at https://www.canada.ca/en/
services/benefits/ei/caregiving.html.

CRS-36

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Table B-2. Medical Leave Benefits in OECD Member Countries
As of July 2021 (unless otherwise noted)
Country
Benefits
Australiaa
Employers provide benefits at ful pay rates for up to 10 days per year (part-time workers’ days are pro-rated).
In 2020, Australia replaced a set of social insurance benefits, including a sickness allowance for workers’ extended medical needs, with a
single benefit called the job seeker payment. Workers who are temporarily unable to work due to health conditions may be eligible for the
job seeker payment, if certain conditions are met.
Austria
Employers provide benefits at ful pay rates for up to 6 to 12 weeks (depending on employee tenure), after which employers provide up to
4 weeks of benefits, compensated at 50% of pay. Social insurance benefits are available to employees who do not receive their ful rate of
pay from an employer after a 3-day waiting period. Recently insured workers may claim up to 26 weeks of benefits. Up to 52 weeks of
benefits are available to workers who were insured for at least 6 of the last 12 months. Benefits may be extended in some cases. Social
insurance benefits are paid at a rate of 50% of gross wages or salary, up to a maximum amount; the rate rises to 60% from 43rd day of
il ness.
Belgium
Belgium provides separate medical leave benefit entitlements to hourly-paid workers and salaried workers.
Employers of hourly-paid workers provide benefits at ful pay rates for the first 7 days of sickness, fol owed by another 7 days, compensated
at 85.88% of pay. For the 15th to 30th day of sickness, employers provide 25.88% of the portion of the employee’s regular earnings that are
used to calculate the medical leave benefit. Employers of salaried workers provide benefits at ful pay rates for 1 month.
Social insurance benefits are available after two weeks for hourly-paid workers and one month for salaried workers. Social insurance
benefits are paid at a rate of 60% of lost earnings, up to a maximum amount, and are available for one year.
Canadab
Employers provide 3 days of benefits at ful pay.c Workers in certain provinces may be entitled to additional days of employer-provided
leave. Social insurance provides up to 15 weeks of benefits paid at 55% of average earnings, up to a maximum amount. Additional amounts
may be available to some workers based on family composition and family income.
Chileb
Social insurance provide benefits paid at ful -pay (based on recent earnings). A 3-day waiting period applies, but benefits from the first day
of incapacity are provided if the sickness period is at least 11 days.
Colombiab
Employers provide two days of benefits at ful -pay. Social insurance provides benefits for up to 180 days. Benefits are paid at 66.6% of
average earnings after a 2-day waiting period for up to 90 days; the rate is reduced to 50% from the 91st to the 180th day of incapacity.
Costa Ricab
Social insurance provide benefits paid at a rate of 60% of average earnings after a 3-day waiting period.d
Czech Republic
Employers provide 14 days of benefits at 60% of an employee’s adjusted regular rate (adjusted regular earnings are calculated by applying a
progressive formula to the employee's average hourly earnings) for their usual work hours. Social insurance benefits are available on the
15th day of sickness. Benefits are paid at 60% of a daily assessment base (calculated by applying a progressive formula to the worker's
regular daily earnings, up to a maximum) from the 15th to the 30th calendar day of sickness. The rate rises to 66% on the 31st day, and
72% on the 61st calendar day of sickness. Benefits are available until the 380th calendar day of sickness; in some cases, benefits may be
extended.
CRS-37

link to page 45
Country
Benefits
Denmark
Employers provide benefits for 30 calendar days. Some must provide benefits the ful rate of pay and others provide benefits at a lower
rates of pay. Social insurance benefits are available for 22 weeks (in a 9-month period that starts on the first day of sickness). Benefits are
calculated as the product of usual working hours and the employee's average hourly pay, capped at a maximum amount (approximately
$17.60 per hour in 2021).
Estonia
Employers provide benefits from the 4th-8th day of sickness. Medical leave benefits are paid from social insurance starting on the 9th day of
sickness up to 182 consecutive calendar days (240 days for selected il nesses). Benefits are calculated as 70% of average pay (100% rate in
some instances, such as for incapacity due to pregnancy or childbirth).
Finland
Employers provide benefits at the ful rate of pay for the first 9 days of sickness (50% rate of pay for new employees). Social insurance
benefits are available after 9 days of employer-provided benefits for up to 60 working days of benefits; in some cases, benefits may be
extended. Benefits cannot exceed 300 working days in any 2-year period for the same il ness. Benefits are calculated using a progressive
formula.
France
Benefits are provided by social insurance, but some long-tenure employees may qualify for an employer-provided supplement to social
insurance payments. Social insurance benefits are available for 12 months over a 3-year period, and may be extended in some instances.
Benefits are calculated as 50% of an employee’s basic daily earnings over the last 3 months, up to a maximum amount.
Germany
Employers provide benefits at the ful rate of pay for up to 6 weeks. Social insurance benefits for the same il ness are available for up to 78
weeks over a 3-year period. Benefits are calculated as 70% of usual earnings, up to a maximum amount.
Greece
Private sector employers pay benefits for 3 days at a rate of 50% of pay. From the 4th to 15th day of sickness, the employer pays the
difference between the social insurance medical leave benefit and the employee’s wage. Social insurance pays benefits from the 4th to 15th
day of sickness at a rate of 50% of the pay typical insured worker with similar wages to the employee (an amount determined by the social
insurance program), and at a rate of 100% for the remainder of the sickness period. (Public sector workers are paid their ful wages
throughout sickness periods.) The duration of benefits may be 182, 360, or 720 days, depending on how long an employee has contributed
to the social insurance program.
Hungary
Employers provide benefits for up to 15 days (annually) at a rate of 70% of the daily gross earnings. Social insurance benefits may be
claimed after 15 days of employer-provided benefits for up to 1 year. Benefits are paid monthly at a rate of 60% of recent average gross
earnings (50% in some cases), up to a maximum amount.
Icelande
Iceland provides a flat-rate medical leave benefit to eligible workers unable to work due to a non-work related il ness or injury. The daily
benefit amount in 2022 is ISK 2,029 (USD $16.43), with an additional ISK 557 (USD $4.51) per child in the home. Benefits are available for
up to 52 weeks in any 2-year period. These benefits are generally claimed concurrently with union-provided benefits or benefits provided
by an individual’s local social services agency.
Ireland
Benefits are paid by social insurance. In 2022, workers with average weekly earnings of €300 or more can claim a €203 weekly benefit; a
smaller benefit is available to workers with average weekly earnings below €300. Social insurance benefits may be claimed for up to one
year by workers who have made at least two years of payments to social insurance, and up to two years by workers who have made at
least five years of payments to social insurance.
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Country
Benefits
Israelb
As of 2018, no statutory benefits are provided. Employees may receive benefits under col ective agreements.
Italy
In general, employers pay benefits for the duration of the sickness period; benefit payments to employees are deducted from an employer’s
required contributions to the national social insurance program. (Some workers receive benefits directly from the social insurance
program). Private sector employees receive 50.0%-66.7% of average pay, depending on benefit duration (rates increase with duration), for
up to 6 months. Public sector employees receive 50%-100% of average pay, depending on benefit duration (rates decrease with duration),
for up to 18 months.
Japanf
Social insurance benefits for at least 6 weeks. Benefits during the first week of sickness are paid at a rate that is below 60% (source did not
provide an exact rate), thereafter benefits are paid at a higher rate that is between 60%-79% of earnings.
Koreab
As of 2018, no statutory benefits are provided.
Latvia
Employers provide leave benefits from the 2nd to 10th day of sickness. Employers must pay at least 75% of average earnings for the 2nd and
3rd day of sickness, fol owed by 80% of average earnings until the 10th day of sickness. Social insurance benefits may be claimed after 10
days of employer-provided benefits for up 26 weeks for a continuous absence or 52 weeks of intermittent benefits over a 3-year period,
with some possibility of extended benefits. Benefits are calculated as 80% of earnings that are subject to social insurance contributions, up
to a maximum amount.
Lithuania
Employers provide 2 days of leave benefits at 62.06% (or higher) of the employee’s recent average earnings. Social insurance benefits may
be claimed after 2 days of employer-provided benefits for up to 4 months for a continuous absence, with some possibility of extended
benefits. Sickness benefits are paid at a rate of 62.06% of recent average earnings, up to a maximum amount.
Luxembourg
Employers provide leave benefits at the employee’s regular rate of pay, up to a maximum amount (€11,009.65 per month in 2021) until the
end of the month in which falls the 77th day of incapacity for work during an18-month period. (80% of wages paid during sickness are
refunded to employers from a largely-mandatory mutual insurance scheme, Mutualité des Employeurs) Social insurance benefits may be
claimed after employer-provided benefits are exhausted for the remainder of the sickness period. Benefits are limited to 78 weeks,
including benefits provided by employers.
Mexicob
As of 2019, social insurance provides benefits paid at 60% of recent earnings for up to 52 weeks; benefit duration may be extended in
some cases.
The Netherlands
Leave benefits are provided by the employer, who may use private insurance to provide benefits. Employer-provided benefits are paid at a
rate of 70% of pay, up to a maximum amount, and cannot be less than the minimum daily wage in the first year of sickness. Benefits are
available for up to 104 weeks.
New Zealandg
Employers provide 10 days paid sick leave per year, compensated at ful pay. Employees may carry over up to 20 days of paid sick leave in
each of these 12-month periods.
Employees who have lost earnings due to a personal health condition may also qualify for a jobseeker support benefit, an income-tested
benefit. Benefit amounts are determined by the individual’s family composition (e.g. marital status, number of children) and conditional on
earnings being below a threshold (that is specific to the individual’s family situation).
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Country
Benefits
Norwayh
Employers provide 16 days of benefits at ful pay. Social insurance provides medical leave benefits for the remainder of the sickness period
(52 week total, including employer-provided benefits). To remain eligible, workers must demonstrate their intention to return to work as
soon as possible, with the default objective of returning to work within eight weeks. Social insurance benefits are paid at 66% of average
earnings, up to a maximum amount.
Poland
Employers provide 33 days (14 days for workers age 50 and older) of benefits at 80% of usual earnings (100% for occupational injuries or
il nesses, and selected medical conditions). Social insurance provides medical leave benefits for up to 182 days (270 days for tuberculosis or
pregnancy), fol owing the 33 days of employer-provided benefits. In general, benefits are paid at 80% of usual earnings (70% in the case of
hospitalization and 100% for selected medical conditions).
Portugal
Social insurance provides up to 3 years of benefits paid at 55% of recent average earnings for the first 30 days of sickness, after which the
benefit rate is increased to 60% (31st to 90th day of sickness), 70% (11th to 365th day of sickness), and 75% (after 1 year).
Slovak Republic
Employers provide 10 days of benefits. The first 3 days of benefits are paid at 25% of average earnings, and 55% of average earnings
thereafter. Social insurance benefits are paid starting at the 11th day of sickness, for up to 52 weeks. In general, benefits are calculated at
55% of average earnings in the previous year, up to a maximum amount.
Slovenia
Employers provide 30 days of benefits, and social insurance provide benefits starting on the 31st day of il ness. The benefit payment rate
ranges from 70%-90% for the first 90 days, depending on the cause of absence, and 80%-100% for the duration of the sickness period. The
benefit duration period is determined by designated medical professionals.
Spain
Employers provide benefits from the 4th to 20th day of il ness at a rate of 60% of recent average earnings (that are subject to social
insurance contributions), and at a rate of 75% starting on the 21st day of sickness. Employers are reimbursed by social insurance for
benefits paid after the 15th day of sickness. Benefits are paid for up to 365 days, and may be extended by 180 days if a cure is expected in
that period.
Switzerland
As of 2018, employers provide ful -pay for “a limited period.” This period must be at least 3 weeks during the first year of employment,
and a longer period thereafter. Alternatively, employers may provide sickness insurance policies for their employees, if they pay at least
half of the insurance premiums, among other conditions.
The insurance contract specifies the benefit rate (usually 80% of recent pay) and the maximum period for which medical leave benefits are
payable. The minimum duration is 720 days within 900 days.
Sweden
Employers provide benefits at 80% of pay for up to 14 days. Social insurance benefits may be claimed after 14 days of employer-provided
benefits and for up to 90 days. Benefits may continue after 90 days, but are provided under different terms. In 2022, workers receive
benefits paid at 76.5% of pay, up to a daily maximum.
Turkeyb
As of 2018, social insurance provides benefits paid at 66.7% of average daily earnings (50% of average earnings if hospitalized), up to a
maximum amount, after a two-day waiting period. There is no established limit on the duration of benefits.
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Country
Benefits
United Kingdomi
Employers provide a benefits paid at a flat rate to certain employees working under an employment contract for up to 28 weeks of
incapacity after a 3-day waiting period.
After employer-provided benefits are exhausted, social insurance provides benefits paid at a flat rate after a seven-day waiting period.
Benefits are generally available for up to 365 days; some workers have no time limits on benefits. Additional benefits may be available
under certain circumstances.
United States
N/A
Source: CRS based on information in MISSOC database (European Union countries) at https://www.missoc.org/; International Social Security Association, Country
Profiles (2018 and 2019), at https://ww1.issa.int/country-profiles; and program information provided on selected countries’ official government websites.
Notes: Benefits are conditional on employees meeting eligibility requirements (e.g., social insurance payments, insured status, and tenure with employer) and program
requirements (e.g., receipt of doctor’s note confirming incapacity). Benefits may be different for certain groups of workers (e.g., self-employed workers, public sector
workers). Benefits may be subjected to a waiting period. Other benefits may be available to workers who are unable to work due a serious medical condition.
a. Australian Government information at “Who gets paid sick and carer’s leave?” at https://www.fairwork.gov.au/leave/sick-and-carers-leave/paid-sick-and-carers-leave,
and https://www.servicesaustralia.gov.au/jobseeker-payment.
b. International Social Security Association, Country Profiles (2018 and 2019), at https://ww1.issa.int/country-profiles.
c. Canada Labour Code (R.S.C., 1985, c. L-2), Section 206.6 Personal Leave, at https://laws-lois.justice.gc.ca/eng/acts/L-2/.
d. Analysis by the World Policy Center indicates that employers are obligated to provide benefits for some period, but CRS could not locate additional details for this
requirement. See https://www.worldpolicycenter.org/data-tables.
e. Icelandic Health Insurance program page at https://www.sjukra.is/english/social-insurance-in-iceland/cash-sickness-benefits/.
f.
World Policy Center at https://www.worldpolicycenter.org/data-tables.
g. New Zealand Ministry of Social Development, Job Seeker Support at https://www.workandincome.govt.nz/products/a-z-benefits/jobseeker-support.html. Benefit
amounts as of April 2022 are at https://www.workandincome.govt.nz/map/deskfile/main-benefits-cut-out-points/jobseeker-support-cut-out-points-current.html.
h. Norwegian Labor and Welfare Administration information at https://www.nav.no/en/home/benefits-and-services/sickness-benefits and https://www.nav.no/en/home/
rules-and-regulations/membership-of-the-national-insurance-scheme. Within four weeks of claiming benefits, a worker and her or his employer must submit a plan
(oppfølgingsplan) describing steps to be taken to return the worker to work as soon as possible.
i.
United Kingdom Government information on Statutory Sick Pay at https://www.gov.uk/employers-sick-pay, and the Employment and Support Allowance at
https://www.gov.uk/employment-support-allowance.
CRS-41

Paid Family and Medical Leave in the United States

Author Information

Sarah A. Donovan

Specialist in Labor Policy

Acknowledgments
Many thanks to CRS Research Assistant Isobel Sorenson, who provided research support for this report,
and CRS Graphics Specialist Brion Long, who produced the state leave insurance program graphic.

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
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Congressional Research Service
R44835 · VERSION 19 · UPDATED
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