Why workers cannot rest, even when sick (2024)

Korea Institute of Labor Safety and Health

Translated by Hye-eun Lee

1. Research Objectives and Background

This study investigates why precarious workers in South Korea are unable to take adequate sick leave despite illness or injury and proposes policy solutions to close this gap. The COVID-19 pandemic popularized the idea that “staying home when sick” is directly linked not only to individual health but also to the safety of society as a whole. However, South Korea remains the only OECD country with neither statutory paid sick leave nor a sickness benefit scheme. Even the government’s 2022 pilot sickness-benefit program fails to meet the needs of precarious workers. This study highlights how workers who already struggle to access workers’ compensation for occupational injuries are even less able to rest for non-work-related illnesses, and it calls for the institutional redesign of sickness benefits, introduction of paid sick leave, and universal coverage of workers’ compensation.

2. Methods

From May to September 2024, the research team conducted in-depth interviews with 30 precarious workers—including platform workers, freelancers, day laborers, agency workers, care workers, and migrant workers—to document:

• structural barriers to taking leave,
• emotional and economic consequences, and
• actual utilization of existing programs.

Interview data were analyzed qualitatively. In addition, the study reviewed international models of sickness benefits and paid sick leave, examined ILO and WHO standards, and reviewed government documents and statistics related to the South Korean sickness-benefit pilot project.

3. Results

1) Institutional status and issues regarding the right to rest when sick

South Korea lacks both a sickness benefit and statutory paid sick leave. Workers’ compensation covers only occupational injuries. Some public-sector and large-company employees receive paid sick leave via internal rules, but most workers must exhaust annual leave or take unpaid time off when ill. Freelancers, day laborers, and undocumented migrants often have no feasible path to take leave at all. Internationally, ILO Conventions 102, 130, and 134 and WHO standards frame paid leave as a basic right. Every other OECD country except the United States already operates a nationwide sickness-benefit scheme, and the United States is rapidly expanding state-level paid sick leave. Consequently, Korea is effectively the sole OECD member with no legal safety net for sick leave.

2) The reality of precarious workers and restrictions on the use of sick leave

Interview findings reveal multiple, intertwined obstacles to taking sick leave:

• Job insecurity – fear of non-renewal of contracts or dismissal after taking leave or filing a claim.
• Income loss – unpaid leave directly threatens subsistence and is effectively the same as unemployment.
• Bureaucratic burden – complex proof of income, employment, or illness deters applications from platform and freelance workers.
• Lack of replacement labor – For care workers or workers in small businesses, taking a break can mean losing their jobs or even the job itself disappears.
• Information gaps – Even if the system exists, there are many cases where people do not apply simply because they are unaware of it. Migrant workers in particular have difficulty accessing it due to language barriers and status instability.

3) Assessment of the pilot sickness-benefit scheme

The 2022–2024 pilot program falls short for precarious workers because of:

• Inadequate benefit levels – payments do not cover basic living costs.
• Restrictive income-calculation windows – since it is based on income from the previous months or 6 months, short-term employees and intermittent workers are excluded.
• Mandatory exhaustion of annual leave before benefits begin – The structure that forces the use of annual leave before paid sick leave undermines the concept of ‘sick leave.’
• No support for replacement staffing – Using sick leave is difficult due to the lack of workforce management.
• Cumbersome paperwork – The barrier to use is high due to complicated paperwork such as application forms, doctor’s opinions, and employment verification.
• Lack of publicity and accessibility: Workers on-site are not even aware that a pilot project is underway.

Low take-up was then used to justify a 75% cut in the 2025 budget and postponement of full implementation until 2027, further eroding national-level commitment.

4. Policy Recommendations and Conclusions

To guarantee the “right to rest when sick” for all workers, this study proposes:

1. Enact statutory paid sick leave covering every worker, regardless of employment type.
2. Broaden and simplify workers’-compensation coverage for platform and freelance labor.
3. Redesign the sickness-benefit scheme to include irregular and low-income workers.
4. Create public replacement-worker programs to support small businesses and care services.
5. Improve accessibility and outreach, including multilingual information and streamlined claims.

The right to rest while sick is not merely a welfare issue but a matter of labor rights, health rights, and social justice. A society that denies precarious workers the ability to recover from illness endangers everyone. Institutional reform is therefore imperative for both individual well-being and public health.