Sick Leave Pay in Japan: The Sickness Allowance

Last updated: 13 October 2026 · rules as published by Kyokai Kenpo and the Health Insurance Act in October 2026

If you are off sick and your employer does not pay you for those days, what covers the gap, if you are in an employer’s health insurance, is the sickness allowance (傷病手当金, shōbyō teate-kin). After 3 days in a row off work, it pays for each further day you cannot work: two-thirds of a daily rate worked out from your health insurance grade, for up to 1 year and 6 months in total. On a grade of ¥300,000 that is ¥6,667 a day.

The YenTake calculator does not work this out. It covers months in which you are paid a salary. The allowance is not salary: it is not taxed, it comes from your grade rather than your pay, and premiums are still owed on top. The figures below are worked out for this page.

Who can get it

The allowance is paid to people insured through an employer: Kyokai Kenpo (協会けんぽ), which covers most smaller companies, or a company’s own health insurance society (健康保険組合). The rules on this page are the Health Insurance Act’s and Kyokai Kenpo’s; a society follows the same Act. Four conditions all have to be met:

• The illness or injury is not from work. An injury at work or on the way to it belongs to workers’ accident insurance (労災保険) instead, and you cannot choose between them.
• You cannot do your job. This is judged on the doctor’s opinion and the work you do. Rest at home counts, and so does treatment you paid for yourself.
• 3 days in a row off, then the days after them. The first 3 days are a waiting period (待期) and are not paid; the allowance starts on the fourth.
• No salary for those days — or less than the allowance (below).

If you are on the National Health Insurance (国民健康保険) instead — self-employed, say, or between jobs — the law lets a city pay a sickness allowance but does not require one. Ask your city. The allowance is also not paid on voluntarily continued insurance (任意継続) after you leave a job, except as described further down.

How much it pays

The Health Insurance Act sets the formula. Take the average of your standard monthly remuneration (標準報酬月額) — the insurance grade your premiums are charged on — for the 12 months in a row up to the month the allowance starts, counting only months with your current insurer. Divide it by 30 and round to the nearest ¥10. Two-thirds of that, rounded to the nearest yen, is the allowance for each day, weekends included.

If your grade changed during the 12 months, the average is what counts: Kyokai Kenpo’s own example has six months at ¥160,000 and six at ¥180,000, which gives ¥3,780 a day. If you have been with your current insurer for less than 12 months, the daily rate is worked out on the lower of your own average so far and a fixed figure — for Kyokai Kenpo, ¥320,000 for an allowance starting on or after 1 April 2025. That catches people who changed insurer: move from a company’s society to Kyokai Kenpo six months before falling ill, on a ¥500,000 grade throughout, and the daily rate is worked out on ¥320,000, not ¥500,000. Changing employer within Kyokai Kenpo is different: the earlier months still count, and the claim form asks for the earlier employer.

If your employer still pays you something for the days off, the allowance is cut by it. If what you are paid is less than the allowance, you get the difference: on the ¥300,000 grade, a day paid at ¥2,000 still brings ¥4,667 of allowance.

The 1 year and 6 months is counted from the first day paid, and only days actually paid count towards it — go back to work for a while and the time left waits for you. A disability pension for the same illness, or an old-age pension once you have left the job, can reduce the allowance or stop it; your insurer will ask about them on the form.

What it leaves you, compared with your take-home

The allowance is not taxed. The Health Insurance Act says no tax may be charged on a health insurance benefit, so no income tax is withheld and it does not count as income for resident tax. No employment insurance is taken from it either.

Your premiums carry on. Health insurance and pension premiums are charged on your grade, and the only months they are waived are maternity and childcare leave — not sick leave. Your employer still pays them to the insurer, and your half is still yours: with no salary to deduct it from, you settle it with your employer.

Put together, for a 30-day month off on the ¥300,000 grade, aged under 40 in Tokyo: the allowance is ¥200,010, less ¥42,570 of health insurance and pension, which leaves ¥157,440. A working month on ¥300,000 takes home ¥249,610 on the same terms, so the allowance leaves about 63% of it. On ¥500,000 it is ¥262,440 against ¥408,690, about 64%. Resident tax on last year’s income is left out of both and is still due; the resident tax guide explains why it lags a year.

How to claim

The claim is the health insurance sickness allowance claim form (健康保険傷病手当金支給申請書). It has four pages: two for you (the days you are claiming, what the illness is, any pensions), one for your employer to certify which days you worked and what you were paid, and one for your doctor (療養担当者) to state the period you could not work. Kyokai Kenpo takes it online or by post to its branch for your prefecture; a health insurance society has its own form and address.

There is a deadline: the right to each day’s allowance lapses 2 years from the day after that day. Kyokai Kenpo says it pays within 10 working days of receiving a claim it can accept.

If you leave your job while off sick

The allowance can carry on after you leave, for what is left of the 1 year and 6 months, if two things are true: you had been insured for 1 year or more without a break up to your last day as an employee — time on the National Health Insurance, on voluntarily continued insurance or in a public servants’ mutual aid association (共済組合) does not count — and on that last day you were already getting the allowance or met its conditions — which means not working that day. Once you are well enough to work, it stops for good, even if you become unable to work again.

Unemployment benefit is for people who are able to work, so it is not a second income for the same weeks; the resident tax guide for changing jobs covers what happens to that bill when the salary stops.

Questions people ask

Do weekends and paid leave count towards the 3 waiting days?

Yes. Kyokai Kenpo says the waiting period includes paid leave and days off such as weekends and public holidays, and it does not matter whether you were paid for them. What matters is that the 3 days are in a row: two days off and then a day back at work does not complete it.

Is the sickness allowance taxed?

No. The Health Insurance Act says no tax may be charged on a health insurance benefit, so no income tax is withheld from it and it is not counted as income for resident tax. Your social insurance premiums, though, carry on while you are off.

Can I still get it after I leave my job?

Yes, if you had been insured as an employee for 1 year or more without a break up to your last day (National Health Insurance, voluntarily continued insurance and mutual aid associations do not count), and on that last day you were already getting the allowance or met the conditions for it. It then carries on for the rest of the 1 year and 6 months. Once you are well enough to work, it stops for good, even if you become unable to work again.

Does the YenTake calculator work this out?

No. The calculator works out a month in which you are paid a salary. The allowance is not salary: it is untaxed, it is worked out from your insurance grade rather than your pay, and premiums are still owed on top. Use the figures on this page instead.

Sources

• Kyokai Kenpo — 傷病手当金 (the four conditions, the waiting period, the formula and its example, the ¥320,000 figure, 1 year and 6 months, the allowance after leaving and the periods that do not count towards it). Japanese.
• Kyokai Kenpo — 健康保険傷病手当金支給申請書 (the claim form and its four pages, the earlier employer asked for when it changed within 12 months, the 2-year limit counted for each day, payment within 10 working days). Japanese.
• Kyokai Kenpo — よくあるご質問：療養給付 (injuries at work or on the way to it go to workers’ accident insurance). Japanese.
• Health Insurance Act (健康保険法) — e-Gov: 第62条 (no tax on benefits), 第99条 (the allowance, the formula and its rounding, the period), 第104条 (after leaving), 第108条 (salary and pensions), 第159条・第159条の3 (premiums waived only for childcare and maternity leave), 第161条 (premiums shared and paid by the employer), 第193条 (2 years). Japanese.
• Employees’ Pension Insurance Act (厚生年金保険法) — e-Gov: 第81条の2・第81条の2の2 (the same two waivers), 第82条 (premiums shared). Japanese.
• National Health Insurance Act (国民健康保険法) — e-Gov: 第58条第2項 (a city may pay a sickness allowance). Japanese.