Q: Can I use sick leave for a therapy appointment in California?

A: Yes. California paid sick leave covers "diagnosis, care, or treatment of an existing health condition of, or preventive care for, an employee or an employee's family member."¹ The statute draws no line between physical and mental health, and the Department of Industrial Relations lists the covered use in its own words as "recover from physical/mental illness or injury" and "to seek medical diagnosis, treatment, or preventative care."²

A therapy session is treatment of an existing health condition. A first consultation, before anyone has diagnosed anything, is preventive care or diagnosis. Both are inside the statute.

You do not have to burn the whole day

This is the practical point most people miss. "An employee may determine how much paid sick leave they need to use," and although an employer may set a minimum increment, that increment may not exceed two hours.³ The Labor Commissioner states the right directly: an employer "may not deny the employee the right to use those accrued paid sick days, including the right to use paid sick leave for a partial day (e.g., to attend a doctor's appointment), and may not discipline the employee for doing so."⁴

So a 4pm session costs you the time you actually take, charged in increments of no more than two hours — not a full day.

How much you have

The default accrual rate has been the same since 2015 — not less than one hour for every 30 hours worked, from the start of employment.⁵ Since 1 January 2024 (SB 616), the floor rose:

  • Milestones (where an employer uses an accrual method other than one-per-30): at least 24 hours by the 120th calendar day and at least 40 hours by the 200th calendar day of employment, calendar year or 12-month period.⁶
  • Use: an employer may limit your use of accrued sick days to 40 hours or five days per year.⁷
  • Front-loading: if the employer grants the whole entitlement up front, no accrual or carryover is required, and "the term 'full amount of leave' means five days or 40 hours."⁷
  • Accrual cap: an employer has no obligation to let your total accrual exceed 80 hours or 10 days.⁸
  • Waiting period: you may start using accrued days on the 90th day of employment.⁹

On the 40-hours-or-five-days phrasing, the Labor Commissioner's published position is "whichever is more": an employee working 10-hour days is entitled to use a minimum of 50 hours, and an employee working 6-hour days who takes five days still has 10 hours left.⁴ That reading is tied to the annual use floor and to front-loading. The Labor Commissioner states the accrual cap flatly at 80 hours or ten days with no such gloss — do not assume it works the same way.

Notice, pay, and coming back

If the need is foreseeable — which a scheduled weekly session is — you must give "reasonable advance notification"; if it is not, "notice as soon as practicable."¹⁰ Your employer must pay the sick leave "no later than the payday for the next regular payroll period" after it is taken.¹¹ And if you leave and are rehired within one year, previously accrued and unused sick days are reinstated.¹²

An employer also may not require you to find someone to cover your shift as a condition of using paid sick days.¹³

What you do not have to say

Nothing in the paid sick leave statute requires you to name a diagnosis, produce a note, or explain what the appointment is for. Requesting leave "for a medical appointment" is a complete request. The Labor Commissioner does allow an employer to ask for documentation where it has information suggesting the leave is not for a valid purpose, but not to deny leave solely for want of a doctor's note.⁴ What your employer does learn is separately protected — an employer may not retaliate for using or attempting to use paid sick leave, and adverse action within 30 days of a complaint, of cooperating with an investigation, or of opposing a prohibited practice raises a rebuttable presumption of unlawful retaliation.¹⁴

If therapy is showing up on your insurance and you are worried about who sees it, that is a different mechanism with its own answer. Does therapy show up on my insurance record? →

If it goes wrong

The Labor Commissioner enforces this, not the Civil Rights Department.¹⁵ A wage claim for withheld sick leave has a three-year deadline; a retaliation complaint has one year.¹⁶ The penalties are set out in the statute: the dollar value of withheld sick days multiplied by three, or $250, whichever is greater, up to $4,000; plus $50 per day of continuing violation, up to a further $4,000, where other harm resulted.¹⁷

Do this: book the session, tell your employer you need the time for a medical appointment, and ask in writing what the company's minimum sick-leave increment is — if the answer is more than two hours, that is unlawful and quoting Labor Code section 246(k) usually ends the conversation. If cost rather than time is what is stopping you, start here. What therapy costs in California →

Sources

  1. Labor Code §246.5(a)(1) — leginfo.legislature.ca.gov. Section last amended by Stats. 2025, Ch. 148 (AB 406), effective 1 October 2025.
  2. Department of Industrial Relations, Paid Sick Leave in California — dir.ca.gov.
  3. Labor Code §246(k) — leginfo.legislature.ca.gov.
  4. Labor Commissioner's Office (DLSE), California Paid Sick Leave: Frequently Asked Questions — dir.ca.gov. The "whichever is more" construction originates in DLSE Opinion Letter of 7 August 2015, construing the then-applicable 24-hour/three-day floor; the FAQ applies the same reasoning to 40 hours/five days — dir.ca.gov.
  5. Labor Code §246(a)(1) and (b)(1).
  6. Labor Code §246(b)(3).
  7. Labor Code §246(d) — "an employer may limit an employee's use of accrued paid sick days to 40 hours or five days in each year of employment, calendar year, or 12-month period… The term 'full amount of leave' means five days or 40 hours." Amended by Stats. 2023, Ch. 309, §2 (SB 616), effective 1 January 2024.
  8. Labor Code §246(j).
  9. Labor Code §246(c).
  10. Labor Code §246(m).
  11. Labor Code §246(n).
  12. Labor Code §246(g)(2).
  13. Labor Code §246.5(b).
  14. Labor Code §246.5(c)(1)–(2).
  15. Labor Code §248.5(a) — leginfo.legislature.ca.gov.
  16. DLSE, How to File a Wage Claim — dir.ca.gov; Labor Code §98.7(a)(1) — leginfo.legislature.ca.gov.
  17. Labor Code §248.5(b)(2)–(3).

All sections read on the operative text on 18 August 2026. This page describes the statute; it is not legal advice. Some California cities have paid sick leave ordinances more generous than the state floor.

If the reason is violence — domestic violence, sexual assault, stalking — a separate statute protects the time off and keeps the reason confidential, at employers of 25 or more. Time off work after domestic violence →

Summoned for jury duty? The Rules of Court have a hardship ground for a mental impairment that would expose you to undue risk of harm. Can I be excused from jury duty for anxiety? →

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