Dissecting the sick day stigma: Why do we feel guilty about calling in sick to work?

I woke up with searing pain in my abdomen one morning. The next thing I knew, I was filing for a leave. It all sounds very simple, as sick leaves are indeed allotted for medical emergencies like this. But the only difference is it cost me the last of my allotted sick days. Just like that, I’m left with no cushion for the rest of the year—that’s four months that I have to force myself not to get sick. 

I don’t really mind, but as I sprinted back and forth to the bathroom, I couldn’t help but feel like the pain was exacerbated by another factor that isn’t supposed to be part of the equation: bubbling guilt.

Can you believe it? I’m guilty that I’m sick. And I’m even guiltier that I’ve used up all my sick leaves, as this means that I have regularly been out of the office for the first half of the year. 

This sent me into a tirade of whys—why I’m thinking about what my co-workers would think, why I’m letting the mountain of deadlines haunt me, and why I’m putting all these above my body’s current state. 

Will my inability to suck it up and go to work anyway be seen as lacking tenacity? Why did I have to take that many leaves anyway? Why couldn’t I just get sick strategically and make my sick leaves last?

So, instead of resting it off, I worry. even in my fever dreams, about what could be happening in the office. 

Where is this guilt coming from?

'Yes!' attitude: Presenteeism and hustle culture 

I realize these anxious thoughts could be self-driven, and that my participation in perpetuating presenteeism is largely founded on my fear of being accused of laziness, of faking it, or simply just not being competent enough to bother. My recurring thoughts of wanting to rest must have meant something—and perhaps our collective sentiments of “Gusto ko mag-leave!” warrant some sort of public attention.

It’s a line too often chucked out in the open now, an apostrophe we exclaim randomly to the winds. It’s as if a sick day would magically solve our problems, a desperate plea that maybe the world can stop moving long enough for us to catch our breaths.

It can’t, but it can help us slow down and perhaps not think about when the next bill will come or how much cash is left for lunch. But alas, prices are skyrocketing. So, the only option is to hustle. Hustle through day after day after day of tasks. Before you know it, you’re vomiting with fever and no sick days left. 

Why do we always wait for the worst before our bodies force us to listen? Perhaps we dance to the rhythm of the hustle culture too much and, with it, presenteeism. 

By corporate definition, presenteeism pertains to the phenomenon where employees show up against all odds at the workplace despite being sick, feeling burnt out or exhausted, or simply not their 100%, which then leads to unproductivity. 

Harvard Business Review deepens our understanding of this concept better by explaining that presenteeism, at its nature, comes with misconceptions that posit that employees only pretend to be ill to avoid duties. Researchers stress, however, that presenteeism is largely based on the assumption that employees do care about their jobs, so much so that they show up even when they can’t—and shouldn’t.

Because we’re scared of losing too much, we try to work through it all, even if we can’t do 100%. You're good as long as your boss sees you answering emails and providing reports when you need to. 

According to human behavior expert Claire Brummel, it could also have something to do with certain situations with a manager or superior "where we have had our needs negatively impacted when we have needed time off work for being legitimately ill."

"Every time a manager has acted in a way that has been detrimental to our needs when we have called in sick, it has conditioned us to feel anxious. That's because, subconsciously, we fear that our needs will be compromised when we do the same thing in the future," she said.

The problem is that people can’t always tell when you’re sick. Outwardly, you may look fine. But inside, your head is buzzing, and you can’t keep your eyes open. But you show up anyway. To them, an empty chair means pushed-back deadlines, late submissions, and decreased value. 

So, the instructions are clear: Be there and work right where they can see you.

Sick day reasons that resonate

It turns out that I’m not alone. People across the country experience the same stigma imposed, fear-based it seems, and it’s even more difficult for people with no benefits at all. There are Filipinos who work on a daily wage, no-work-no-pay policy. And there’s not much room to breathe, much less rest. 

The stigma exists not just in perception but within us. Since we’re far too exploited, it’s become a survival requirement not to be sick. According to a study by Milieu Insights, a survey software company in Southeast Asia, Filipino workers have a tendency to work through sick days. And while the hustle culture persists precisely because of how difficult it has become to survive, it’s important to look at the systems in place and ask why they exist in the first place.

It’s as if sick days have become a privilege rather than a right—that we should be extremely grateful that we’re given a chance to rest. And we are. It’s just that it’s later weaponized against us.

One can only guess where this attitude and perception are coming from, but viewing sick leave as something you earn rather than a fundamental right could be traced back to the items in the Labor Code of the Philippines—or lack thereof.

Looking into the material, there’s no specific mention of sick leaves. In its stead lies the Service Incentive Leave (SIL), a mere five days of leave with pay, provided that the employee has already served at least a year of service. Employers have free reign over what they provide employees or not—be it an additional five or 10 days of sick leaves or none at all. And this supposed generosity could be why most workers end up feeling guilty. 

The message is clear: Not everyone has access to rest, so suck it up because you’re needed here. 

Now, is there any hope for us? Other countries in the world have it figured out, it seems. 

According to the ch.ch website, a service of the Confederation, cantons, and communes, employees in Switzerland can be entitled to up to 730 days of sick leave over a 900-day period, depending on the insurance coverage. This is a sickness benefit insurance an employer may invest in, but without it, employers are mandated by law to provide you with paid sick days up to three weeks after a year of employment. This can increase every additional year of your employment, and paid sick leaves can go up to a maximum of four months. 

We can definitely learn a thing or two from this, but one can argue that this has been made possible thanks to the collective decision by the Swiss to assert their rights as human beings. Health, wellness, and leisure shouldn’t be a reward we collect after a day’s hard work. And with up to 730 days of sick leave under their belt, the Swiss remain the top OECD performers in labor productivity. 

There’s so much left to address when it comes to employee rights in the country—a dialogue that goes beyond just the grant of sick days. Thankfully, most companies embrace the importance of health, so others enjoy up to 15 paid sick days a year. The problem lies with the negative perceptions surrounding it, a stigma that holds the power to brand someone a scarlet letter.

And I suppose it’s also important to address our superiors, too. A heavy, glaring, and different line separates a performing (but sick and burnt-out) employee from one who doesn’t. And most of the time, it might be good to stop and think that maybe something needs to be changed about how you handle your people. 

Because most of the time, voices dismissed as “complaints” mean something good, relevant, and just what you need to help your team move ahead. The productive environment you wish to drive heavily relies on employee health and wellness. 

Unfortunately, the big bad boss also exists inside our heads. It’s a never-ending cycle because it’s psychological warfare, but presenteeism mostly exists because of factors like fear. And so it continues—we show up, feel guilty, and in turn, perpetuate stigmas because we’re all self-driven to always be there 100%. 

Using sick days shouldn’t be equated to laziness or a means to escape tasks. Sick days exist because we’re not robots. It’s a benefit you were promised to receive in exchange for toil, not a bridge to punishment each time you try to take one.