How to decide when you’re too sick to work


To go to work or to stay home? That is the question that many people face when feeling sick. This question is often met with feelings of guilt, especially if this means extra work for your co-workers; feelings of frustration or disappointment when you cannot afford to miss work due to lack of sick pay benefits; or, feeling overwhelmed at the thought of how much work will be waiting for you when you return! 

When you’re not feeling well, the focus should be on getting better; however, this is often not the reality. So, you ask yourself, “How sick am I”?

Sometimes this is not even a question—you’re sick and you know that going to work is not an option. At least medically, it shouldn’t be. Sometimes it’s not an option: You have to show up. Other times are not as straightforward, so you question the benefit of showing up versus taking time off to get better.

Although the workplace culture is slowing changing, there continues to be an expectation to show up no matter what, and you should when you are able. Accountability in the workplace is vital. However, I’ve never seen a special award for the employee who always comes to work sick. In fact, your presence in the workplace may end up causing more harm than good.

Workplace illness at a glance

  • $234 billion in lost productivity from absenteeism (staying home) and presenteeism (going to work sick), with the latter accounting for an estimated $150 billion in loss.
  • Typical flu outbreaks cost employers $10.4 billion.

Three out of 10 workers have stayed home because of stress.

  • One-quarter of workers have stayed home as a result of fatigue from being overworked.
  • 50 million U.S. workers don’t have paid sick leave.
  • There are no federal legal requirements for paid sick leave. It’s important to know your company’s policies.
  • Studies show that if the national average of sick days (2.41 days/year) were used, the cost to business would be minimally affected.


Presenteeism is the practice of coming to work while sick. Research has shown that showing up sick or not fully functioning causes losses in productivity or the ability to do one’s job fully, increases in mistakes, poor health, exhaustion, and potential for spread of illness. It is also critical to recognize mental health issues and stress as illness.

Illness is not always visible. Many companies have policies on mental health days as awareness regarding the importance of changing the conversation and stigma grows.

What causes sick days?

  • New physical or mental illness, injury
  • Chronic medical condition flare-ups
  • Stress and workplace exhaustion or burnout
  • Unhealthy lifestyle choices leading to inability to function (e.g. staying up late, hangover)
  • Care for sick family members
  • Workplace avoidance (e.g. low satisfaction, problems with co-workers or boss, bullying)

When to consider staying home

S= Sense of impending doom (general feeling of not feeling well), excessive sleepiness, safety concerns, side effects of medications

IIntolerable pain or discomfort (e.g. fever, chills, migraines)

C= highly Contagious or communicable illness (easily spread; transmitted from one person to another)

K= difficulty Keeping up with symptoms (e.g. nausea, vomiting, diarrhea)

DDoctor’s orders or need to see a doctor

AAbility to do your job greatly affected, accessibility issues (e.g. new injury requiring workplace adjustments in order to do your work)

YYou and your symptoms are the focus; difficulty concentrating or completing tasks (e.g. agitation or anxiety)

When to see a doctor (examples)

  • Difficulty breathing
  • Pain that is worsening or persistent without relief
  • Need for intervention (such as a procedure, surgery, specific testing or treatment)
  • Suspicion of serious illness (e.g. chest pain, worsening headache, high fever, inability to take liquids by mouth, excessive sleepiness or confusion)
  • Worsening of symptoms over time or no improvement.
  • Chronic medical condition that may be made worse by illness (e.g. the flu in someone who has asthma)
  • Thoughts of harming yourself or others
  • Any new or concerning symptoms you are unsure about

Staying well

  • Proper nutrition; nutritious foods as medicine
  • Plenty of water
  • Adequate sleep
  • Exercise
  • Stress and mental health management
  • Wash hands
  • Limit unnecessary contact with others who are ill
  • Take preventive measures (take prescribed medications, dress for weather, take time off to heal)

Most people want to be well and work, but when you’re sick, you’re sick. Try to accept this without guilt and take the responsibility to take care of yourself. Communicate early and often with your job and do your part in getting better. Be familiar with your company’s policy on sick days, and make sure to get a letter from your doctor regarding your illness and expectation of absent days if needed.

Stay well!

Tamiko Morgan, MD, MPH, is a board-certified pediatrician, medical director at a national health plan, and former Minority Health Policy Fellow at Harvard. Her work has primarily focused on caring for medically and socially high-risk populations. She is the founder of the health and wellness company 2 E.D.I.F.Y., LLC and author of the book “VIP Very Important Patient: The African American Woman’s Guide to Health Care, Healing, & Wellness.” Contact her at