Sick But Still Working? New Research Reveals Why Employees Feel Unable To Stay Home

A new study has found that workplace attendance points systems may be encouraging employees to come to work even when they are unwell, raising concerns about staff wellbeing, productivity and public health. Researchers from Harvard Kennedy School, the University of California, Berkeley, Stony Brook University and Wayne State University found that employees who face attendance penalties are significantly more likely to work while sick, even when paid sick leave is available.

The findings suggest that some workplace policies may be undermining the very protections designed to support workers.

The Hidden Pressure Behind Attendance Scores

Many employers use points-based attendance systems, where workers receive points or demerits for absences, lateness or leaving work early. In some companies, accumulating too many points can lead to disciplinary action or even dismissal.

According to the study, nearly half of the workers surveyed were subject to such systems. Researchers found that simply being exposed to an attendance points system increased the likelihood of employees coming to work while ill. The effect became even stronger when workers had already received points or faced consequences for absences.

Why This Matters for Corporate Teams

For office workers, coming into work while sick may appear to demonstrate commitment. However, experts warn that presenteeism - the act of working while unwell - can reduce productivity, prolong recovery and increase the spread of illness across teams.

The study found that many employees attended work specifically to avoid receiving attendance penalties. Researchers argue that fear of disciplinary action can outweigh the benefits of paid sick leave, leaving workers feeling they have little real choice.

Paid Sick Leave Alone May Not Be Enough

One of the most striking findings was that paid sick leave laws did not significantly reduce the impact of attendance points systems. Employees covered by sick leave protections were still likely to work while ill if attendance penalties remained in place.

The researchers suggest that organisations should review attendance policies alongside their wellbeing programmes if they want to create genuinely healthy workplaces.

A Wake-Up Call for Employers

As businesses place increasing emphasis on employee wellbeing, the study raises important questions about whether existing attendance policies are aligned with those goals.

Experts say companies need to strike a balance between maintaining staffing levels and ensuring workers feel able to take time off when they are genuinely unwell. Creating a culture where employees can recover without fear of penalties may ultimately benefit both workers and employers.

Published in the June 2026 issue of Health Affairs, the research, Points-Based Attendance Systems Associated With Presenteeism Despite Paid Sick Leave Protections, draws on 2024 survey data from more than 3,000 hourly service-sector workers at 63 large US firms.