Extended sick leave in China: medical treatment periods and employer decisions

1. Separate the medical certificate from the protected period

A medical certificate supports the need to stop work and receive treatment or rest. It does not, by itself, calculate the full statutory period of employment protection. Under Articles 2 and 3 of the Medical Treatment Period Provisions, the national framework provides periods of 3 to 24 months based on total working years and service with the employer. Identify both service histories, the work location and any applicable local or more favourable arrangements before selecting a period.

Keep the medical advice, leave applications, approvals and actual attendance chronology consistent. If documents are incomplete or dates conflict, identify the specific issue and request appropriate clarification. A system entry marked unapproved is not enough to establish serious misconduct, and a doctor’s suggested rest period should not simply be treated as the statutory expiry date.

2. Calculate accumulated leave within the applicable window

Article 4 distinguishes the protected leave allowance from the period over which it is accumulated. Under that framework, 3 months are counted within 6 months; 6 within 12; 9 within 15; 12 within 18; 18 within 24; and 24 within 30. For example, a 3-month entitlement does not mean that any 6 months after the first absence automatically exhaust it. The actual accumulated sick leave must be reconciled within the relevant window.

The Ministry of Labor’s 23 May 1995 implementation notice starts the calculation from the first day of sick leave and includes rest days and statutory holidays during the sick-leave period. Prepare a dated ledger showing each absence, return to work and supporting document. Check the locally applicable calculation method before issuing a final end-date notice, especially where leave is intermittent or the service threshold changes.

Special illness requires an additional check. The same notice allows an appropriate extension, with enterprise and labor-authority approval, for certain serious conditions that remain uncured within 24 months. It also calls for local implementing rules. Do not assume that every diagnosis automatically gives the same extended period or that 24 months is an absolute ceiling in every case; verify the applicable conditions and procedure.

3. Check dismissal protection and contract expiry separately

Article 42(3) of the Labor Contract Law prevents dismissal under Articles 40 and 41 while an employee with illness or non-work-related injury is within the prescribed medical treatment period. That covers the relevant non-fault termination and economic-redundancy routes. A restructuring instruction or a planned redundancy payment does not remove this restriction.

If a fixed-term contract expires while the relevant protection still exists, Article 45 requires extension until that circumstance ceases. Do not process an ordinary expiry solely from the date printed in the contract. The law treats work-injury-related loss of capacity separately. A mutually agreed exit under Article 36, or a dismissal supported by an independently established Article 39 ground, needs its own consent, evidence and procedure review; medical-period protection should not be described as an absolute ban on every form of termination.

4. Expiry of the medical period is only the start of the next review

For a dismissal under Article 40(1), the prescribed medical period must have expired and the employee must be unable to perform both the original work and work separately arranged by the employer. Record the original duties, relevant work limitations, the alternative work actually proposed and the evidence bearing on whether it can be performed. The date alone does not establish these conditions. Review any other Article 42 protection that may still apply.

Where that route is available, Article 40 requires 30 days’ written notice or an additional month’s wages. Article 46 provides for statutory economic compensation, and Article 43 addresses advance notification of the reason to the trade union. Verify the applicable union procedure, compensation basis and any other required payments before giving notice. A short payroll label such as N+1 is not a complete legal review.

The medical-period provisions also contain labor-capacity appraisal rules for specified disability or difficult-to-treat illness. Use current rules when assessing the consequences of complete loss of working capacity. Since 1 January 2025, the Interim Measures on Illness and Disability Allowances allow qualifying basic-pension-insured persons below statutory retirement age, assessed as completely unable to work, to apply for an allowance; Article 14 replaces the former regional illness/disability early-retirement and withdrawal policies, while preserving the stated transition for existing recipients. The old medical-period text alone is insufficient for such a case.

5. Keep pay and workforce cover on a separate track

Article 5 of the Medical Treatment Period Provisions refers sick-leave wages, sickness relief and medical benefits to the applicable rules. Confirm the local pay basis, relevant duration bands, mandatory floor and contractual or policy enhancements; do not apply one global sick-pay percentage across all China locations. Keep payroll and social-insurance handling consistent with the actual employment status.

An employer can separately plan temporary workload cover and maintain appropriate contact about documents and a possible return. Document these operational arrangements without prematurely recording a termination or treating genuine medically supported absence as a performance failure. Give decision-makers the information needed for the employment decision and use agreed secure channels for detailed medical records.

6. Prepare the file before management selects an exit date

Bring together the employing entity and work city; contracts and amendments; total service and current-employer service evidence; the first sick-leave date and full absence ledger; medical and leave documents; local rules and any extension request; pay and insurance records; job requirements, alternative-work communications and any appraisal; and the proposed notice and union steps. Identify missing evidence before deciding whether continued leave management, a supported return, negotiation or a lawful exit is appropriate.

For an initial consultation, a foreign company can provide a non-confidential outline of the work location, service dates, absence pattern and decision deadline. A document review can then establish the relevant protection, the evidence still needed and the available next step. Detailed employee and medical files should follow only through agreed confidential arrangements.