1) The core rule: “approved leave” is not automatically “paid leave”

In Philippine labor practice, an approved medical or mental health leave typically means the employer has authorized the employee’s absence (so it is not treated as AWOL or a disciplinary infraction). Approval alone, however, does not create a legal duty to pay wages unless there is a source of pay entitlement such as:

A statute (law) that mandates leave with pay or a cash benefit;
The Labor Code’s Service Incentive Leave (SIL) (or a special law equivalent);
A CBA (collective bargaining agreement);
An employment contract, handbook, or company policy granting paid sick/medical leave;
A long-standing company practice that has ripened into a benefit protected by the non-diminution of benefits principle.

If none of these sources applies and the employee does not work, the default rule in wage law is the “no work, no pay” principle.

2) “Wages” vs “leave pay” vs “cash benefits”: why the label matters

Philippine rules often distinguish among:

Wages/salary: compensation for work actually performed (or deemed paid by law, e.g., certain holidays or mandated paid leaves).
Leave pay: wages paid even when no work is performed because the law/policy treats the day as paid (e.g., SIL used as sick leave).
Social insurance cash benefits: payments primarily funded by social insurance systems like the SSS (e.g., SSS sickness benefit, SSS maternity benefit). These are not “wages” in the strict sense, but they function as income replacement.

This matters for payroll computation, reimbursements, taxation, and whether an employer may treat the SSS payment as an offset against salary under an integration policy.

3) Private sector baseline: what the Labor Code does (and does not) guarantee

A. No general statutory “sick leave with pay” in the private sector

For most private-sector employees, Philippine law does not provide a blanket entitlement to paid sick leave as a stand-alone statutory benefit.

B. The statutory floor: Service Incentive Leave (SIL) under the Labor Code

The Labor Code generally grants eligible employees five (5) days Service Incentive Leave per year. SIL is often used for either vacation or sickness, depending on company rules.

Key points commonly applied in practice:

SIL is typically available after one year of service.
Unused SIL is commonly convertible to cash at year-end (subject to lawful policy and implementing rules).
If an employee uses SIL for illness (including mental health conditions), those days are paid.

Important: not everyone is covered by SIL. The Labor Code excludes certain categories, commonly including:

Government employees;
Managerial employees (and certain officers);
Field personnel (as defined/treated under labor standards);
Employees already enjoying at least 5 days leave with pay;
Employees of establishments regularly employing fewer than a threshold number (commonly cited as fewer than 10);
Certain workers paid purely by commission or results-based schemes (depending on classification).

Because coverage depends heavily on classification, disputes often center on whether a worker is truly “field personnel,” “managerial,” or otherwise exempt.

C. Contract/policy/CBA sick leave often exceeds the statutory floor

Many employers provide separate sick leave credits (e.g., 7/10/15 days) beyond SIL. Once granted, these become enforceable under:

contract and company policy; and/or
non-diminution of benefits if consistently and deliberately provided over time.

4) Mental health leave is treated like medical leave for wage purposes (with one big caveat)

Philippine law recognizes mental health as part of health and promotes mental health policies (notably under the Mental Health Act, RA 11036), but there is no universal private-sector law that mandates a separate, paid “mental health leave” category.

In practice, a mental health condition (e.g., major depressive disorder, anxiety disorder, bipolar disorder, PTSD) is handled as:

sick leave (if the employer provides sick leave or SIL is used), and/or
SSS sickness benefit (if eligibility requirements are met), and/or
leave without pay (if paid credits are exhausted and no other paid leave applies).

What does change for mental health cases is often the confidentiality, documentation, and anti-discrimination handling (see Sections 11–12).

5) When wages are legally payable during medical or mental health leave

A. When the employee uses paid leave credits (SIL or company sick leave)

If the leave is charged against:

SIL (where applicable), or
contractual/company sick leave credits, or
paid leave granted by a CBA,

then the employer must pay the leave pay according to the governing rules (daily rate or salary continuation, per policy).

B. When a special law mandates leave with pay (commonly overlapping with health/medical situations)

Several statutes create leave with pay entitlements that may be triggered by medical or trauma-related circumstances:

VAWC Leave (RA 9262) Women employees who are victims of violence (as defined in the law) are entitled to up to 10 days leave with pay, extendable as provided by law and rules, often for medical/psychological care, legal proceedings, and safety planning.
Special Leave for Women (Magna Carta of Women, RA 9710) Typically recognized as up to two (2) months with full pay for qualified women employees who undergo surgery due to gynecological disorders, subject to statutory conditions (including required length of service).
Expanded Maternity Leave (RA 11210) / SSS Maternity Benefit While not “medical leave” in the ordinary sense, it is a health-related leave with income replacement. The SSS benefit and any required salary differential rules can result in full or near-full pay outcomes (details in Section 7).
Public sector special leaves (CSC rules) For government employees, paid sick leave is generally a core entitlement (see Section 9).

C. When the employer is legally required to treat certain days as paid (by specific labor standards rules)

Some pay rules are not “leave” rules but can affect pay during absence, such as:

holiday pay rules (regular holidays),
rules on authorized absences affecting holiday entitlement,
and policy rules on whether paid leave counts as “days paid” for benefits.

These issues are fact-specific and often hinge on whether the day is charged to paid leave, unpaid leave, or considered unauthorized.

6) When wages are not legally payable during approved medical or mental health leave

Approved medical/mental health leave is commonly unpaid when:

the employee has no remaining paid leave credits (SIL/sick leave) and there is no special law granting paid leave; and
the employee does not work during the period.

Approval in this context typically prevents discipline for absence, but does not itself create wage entitlement.

7) The SSS sickness benefit: income replacement during illness (including mental health)

For many private-sector employees, the most important “paid” support for longer illnesses is the SSS Sickness Benefit, which is a cash allowance for days the member cannot work due to sickness or injury.

A. Typical eligibility requirements (high-level)

Common requirements under SSS rules include:

The employee is unable to work due to sickness/injury and is either hospital-confined or on home confinement (as medically certified).
The employee has paid the required minimum number of contributions within the relevant look-back period.
The period of incapacity meets the minimum duration requirement (commonly at least 4 days).
Proper notice to employer/SSS and submission of medical documentation.

Mental health conditions can qualify if a licensed physician (often a psychiatrist) certifies that the employee is unfit for work and specifies the confinement/rest period.

B. How the amount is commonly computed

A commonly applied formula is:

Daily sickness allowance is a percentage (commonly 90%) of the member’s Average Daily Salary Credit (ADSC), subject to SSS rules.

C. Duration limits

SSS rules impose caps (commonly described as):

A maximum number of compensable days per calendar year (often 120 days), and
A maximum for the same illness (often 240 days), after which disability evaluation may be triggered.

D. Employer’s role: advancing and reimbursement

For employed members, the system typically works like this:

The employer advances the sickness benefit to the employee (once requirements are met), then
The employer seeks reimbursement from the SSS.

E. Coordination with company sick leave (“integration”)

Many employers adopt an integration policy, such as:

Employee receives full salary during sick leave; employer later recovers the SSS sickness benefit as reimbursement; or
Employee receives the SSS sickness allowance plus employer “tops up” the difference to full pay; or
Employee receives only the SSS allowance for days beyond paid leave credits.

The legality and fairness depend on:

clear written policy,
proper notice to the employee, and
ensuring the employee is not deprived of a minimum legally required benefit.

8) Employees’ Compensation (EC) benefits for work-related sickness or injury (SSS/GSIS-administered)

When the medical or mental health condition is work-related (e.g., injury at work, occupational disease, or potentially work-aggravated mental health conditions, depending on evidence and compensability rules), the employee may be entitled to Employees’ Compensation benefits.

EC benefits can include income benefits such as Temporary Total Disability (TTD) and related supports, administered through:

SSS for private sector, or
GSIS for public sector.

EC income benefits are not “wages,” but they can be a significant replacement income stream when an illness/injury is compensable.

9) Public sector (government): paid sick leave is the norm

For government employees under Civil Service rules, the framework is materially different:

Vacation Leave (VL) and Sick Leave (SL) credits typically accrue (commonly 15 days each per year in many standard arrangements).
Sick leave may be used for medical or mental health reasons, subject to documentation.
Longer-term illnesses can involve rules on extended sick leave, special leave privileges, commutation, and agency/CSC procedures.

Because of these structural differences, “approved medical leave” in government employment much more often means with pay (to the extent of available credits), though extended leave beyond credits may become unpaid depending on circumstances and governing rules.

10) Sector-specific regimes: when special rules apply

A. Kasambahay (Domestic Workers) – RA 10361

Domestic workers have specific statutory protections, including leave-related benefits and mandatory coverage in social protection programs (SSS, PhilHealth, Pag-IBIG) subject to conditions. Paid leave entitlements may differ from the ordinary private-sector SIL framework.

B. Seafarers

Seafarers are often governed by the standard employment contract and maritime jurisprudence, where “sickness allowance” and medical repatriation rules can create wage-like payments during illness, subject to contract terms, medical assessment, and time limits.

C. Probationary/fixed-term/project employees

Leave pay often depends on:

whether leave credits accrue under policy,
whether the employee is covered by SIL, and
whether SSS benefit eligibility is met.

Approval of leave prevents attendance/discipline consequences but does not guarantee paid status unless a benefit source applies.

11) Documentation, medical confidentiality, and fitness-to-work requirements

A. Medical documentation is the gatekeeper

Employers typically require:

medical certificate indicating diagnosis (sometimes only “fit/unfit for work” without detailed diagnosis),
duration of rest/confinement,
and, where needed, a clearance or fitness-to-work certificate upon return.

For mental health cases, employers should avoid insisting on unnecessary details; documentation can focus on functional limitations and recommended accommodations.

B. Confidentiality and data privacy

Medical and mental health information is sensitive personal information under the Data Privacy Act (RA 10173). Good practice (and often necessary compliance) includes:

limiting access to HR/authorized personnel,
storing medical records securely,
collecting only what is necessary, and
disclosing information strictly on a need-to-know basis.

C. Workplace accommodations and non-discrimination

Mental health conditions can intersect with disability protections:

Some employees may qualify as persons with disability under relevant standards and protections (e.g., Magna Carta for Persons with Disability, RA 7277, as amended), triggering duties relating to reasonable accommodation and non-discriminatory treatment.
The Mental Health Act (RA 11036) strengthens a rights-based approach and workplace mental health promotion, though it does not itself create a universal paid leave entitlement.

12) Pay-related side effects during medical/mental health leave

A. Salary deductions and “no work, no pay”

If leave is unpaid, the employer may lawfully deduct pay for days not worked, provided:

the deduction is for the actual absence, and
payroll treatment follows lawful computation of monthly-paid vs daily-paid arrangements and does not violate minimum wage and wage deduction rules.

B. Allowances and benefits during leave

Whether allowances continue depends on their nature:

If an allowance is integrated into the wage or paid unconditionally, it may continue.
If it is contingent on work performed (e.g., meal allowance tied to attendance), it may stop during unpaid leave, subject to policy and non-diminution issues.

C. 13th month pay impact

13th month pay is generally based on basic salary earned during the calendar year:

Paid leave days that are paid as part of basic salary commonly count.
Unpaid leave periods usually reduce the base because no salary was earned for those days.

D. Contributions (SSS/PhilHealth/Pag-IBIG) during unpaid leave

When employees are on prolonged unpaid leave, contribution obligations and coverage continuity can become complicated and depend on:

whether wages are still being paid,
whether the employee remains in active employment status, and
agency-specific rules on remittance and qualifying contributions.

13) Long illnesses: exhaustion of leave credits, extended leave, and potential termination for disease

A. After paid leave credits are exhausted

A typical sequence is:

Use available paid leave credits (SIL/company sick leave).
If illness persists, transition to unpaid leave (still “approved”).
Apply for SSS sickness benefit (and/or EC, if compensable), subject to eligibility.

B. Termination due to disease (authorized cause) is tightly regulated

The Labor Code recognizes disease as an authorized cause for termination under specific conditions, commonly requiring:

that the employee suffers from a disease not curable within a period (often referenced as six months) and continued employment is prohibited by law or prejudicial to health; and
certification by a competent public health authority; and
payment of required separation pay; and
observance of due process requirements.

This doctrine is often relevant when an employee is on extended medical/mental health leave and cannot return to work within a medically reasonable period.

14) Enforcement: where wage disputes over medical/mental health leave usually land

Common dispute patterns include:

Employee claims the leave should be paid because it was “approved,” but employer treats it as unpaid after credits are exhausted.
Misclassification (e.g., SIL coverage disputes: field personnel/managerial/exempt categories).
Employer offsets SSS benefits against salary in a way the employee claims is unlawful or not properly disclosed.
Non-payment of statutory special leaves (VAWC leave, special leave for women, maternity-related salary differential issues).
Retaliation or discrimination connected to mental health disclosures or treatment.

Remedies can include:

money claims for unpaid leave pay/wages and statutory benefits,
complaints through labor standards enforcement mechanisms or adjudicatory bodies (depending on the issue and forum),
and, in severe cases, claims tied to constructive dismissal or unlawful termination.

15) Practical synthesis: what “entitlement to wages” usually looks like in real cases

Scenario A: Short illness (3 days)

If the employee has SIL or company sick leave credits: typically paid (charged to credits).
SSS sickness benefit usually does not apply if below minimum compensable days.

Scenario B: Illness with 14 days home rest (physical or mental health)

First layer: paid leave credits (SIL/sick leave) → paid days.
Remaining days: may become unpaid, but employee may be eligible for SSS sickness benefit for compensable days (subject to contributions and documentation).
Employer may integrate SSS benefit with salary if policy allows.

Scenario C: Condition tied to VAWC (psychological care, trauma)

Up to 10 days leave with pay under RA 9262 (subject to requirements), potentially overlapping with medical/mental health needs.

Scenario D: Exhausted credits, extended incapacity

Approved leave may continue, but wages may stop under “no work, no pay.”
Income replacement may come from SSS sickness benefit, EC (if work-related), and other applicable benefits.
Long-term inability to work may trigger lawful processes for disability benefits or disease-based termination rules (if all statutory conditions are met).

Key takeaways

Approval of leave ≠ entitlement to wages. Approval usually means the absence is authorized, not necessarily paid.
Paid entitlement must come from a legal or contractual source: SIL, company policy/CBA, or special laws (e.g., VAWC leave, special leave for women, maternity frameworks).
SSS sickness benefit is often the main income replacement for longer illnesses, including medically certified mental health conditions.
Mental health leave is generally handled under the same wage rules as medical leave, but with heightened confidentiality and anti-discrimination considerations.
After paid credits are exhausted, leave is commonly unpaid, though social insurance benefits may still be available.