Sick leave may be used for absence necessitated by an employee’s own illness or injury or the illness or injury of an immediate family member, including a domestic partner or family partner.

Sick leave is earned at the rate of one-half (1/2) day per biweekly pay period, prorated based on an employee’s FTE (full-time equivalent) percentage of employment. Employees earn sick leave immediately upon starting employment with the City.​ Employees may accumulate up to a total of 163 days of sick leave. At the end of each year, any employee with a sick leave balance of more than 150 days may receive payment for the excess days, subject to the terms of the applicable employee benefits handbook or other employment agreement.

The City of Madison offers optional wage insurance program (short-term and long-term disability insurance), the premiums for which depend on an employee's use of sick leave during a 12-month tracking period. If an employee who has elected to enroll in the wage insurance program exhausts their available sick leave, they may file a claim with the wage insurance insurer (The Hartford) and the employee may be eligible for income continuation payments while in an absent without pay status from the City.