Over the course of my twenties, I realized I had never actually taken a proper break. I came to Japan when I was 19, fresh from high school graduation. Even when there was a school break, I would spend it on part-time jobs, internships, or job-hunting. While others were taking a gap year exploring and traveling, I set out to build my life to secure financial stability and job security as my priority.
I would say that I am ambitious and sort of an overachiever. I wanted to reach a certain amount in my bank account, so I took up many side hustles to help with that goal. I also wanted to be promoted to manager within three years, but in Japan, that promotion speed is unheard of unless you’re working at a startup-sized company.
I moved from a traditional Japanese company to a multinational one, only to encounter a surge of unmet expectations from my manager. Feeling unsupported, isolated, and disappointed in myself combined into the perfect recipe for drowning in depression.
With all the stress from professional and personal life, I struggled with insomnia and unstable emotions. I had no motivation to clean my own room or show up to the office.
Luckily I was able to take advantage of Japan’s sickness allowance system (傷病手当, shoubyou teate), and get the time off I desperately needed to recover. This article is about my experience, and how you can do the same.
What is Japan’s sickness allowance system?
Many people hesitate to take extended leave due to worries about losing part of their income and the stigma of career breaks due to mental health issues. However, sickness allowance is designed to ease those concerns by providing partial wage compensation, up to two-thirds of your salary, when you’re unable to work due to illness or injury, including mental health conditions.
Who is eligible for it?
In Japan, sickness and injury allowance is one of the benefits provided by a company’s health insurance and mutual aid associations. Think of it as a perk available to all workers as long as they are enrolled in the company’s designated health insurance.
Is there any stigma to using it?
Future employers would not be notified about this leave, so only you and your current employer are aware of the matter. The allowance can be used for up to 18 months, and knowing this kind of safety net exists can make a world of difference during tough times of personal recovery.
After I decided to take the medical leave, I discovered that many colleagues in my department had done the same. Some had done so for the exact same reason as I, and others for reasons such as grief, or physical medical conditions. However, there is no obligation to tell your peers why you took the leave.
Therefore, the stigma and shame that I was afraid of was basically non-existent. There was no judgment for taking long stretches of leave due to mental health issues.
My experience
Before going on leave
Especially coming from a culture where failure is stigmatized, though, I still worried that taking leave might affect my Permanent Residency application or be seen as a weakness. This fear led me to ignore clear signs of emotional distress. I pushed through my emotional breakdown for months, which ultimately extended my recovery time.
I also consulted with a lawyer and confirmed that a short leave (three to six months) would not affect my visa renewal or PR application. A sudden drop in salary without medical reasons and changing workplace matters more. However, if you are thinking of going back to your home country, ensure that the number of cumulative days you are outside Japan does not exceed 180 days in a year.
During my leave
In the end I took leave for three months to recover my health. The sickness allowance system was a lifesaver, because I was able to pay my rent, groceries, and other living costs, while still being able to save a bit of money every single month.
But since I had never taken a true break without trying to stay productive, the recovery period was more challenging than I had expected. My doctor’s advice was simply to eat well, sleep well, and exercise well.
The first month was particularly difficult as I adjusted to a completely new routine. My initial goal was to restore a healthy sleep schedule; once I achieved that, my emotions stabilized, and I could begin going to the gym and socializing again.
The second month was when my physical health gradually improved with proper sleep and nutrition. I also went back to my home country to be with close family, my strongest support pillar. As long as the Japanese doctor was well informed and consulted regarding my travel, I was able to still claim the sickness allowance. The allowance would just be delayed, as I needed to collect documents from the clinic and then submit them.
At first, even with my family, I was genuinely afraid to show my vulnerable state, worrying that I would be seen as a failure. However, that was a delusion I created for myself, because nobody was being judgmental over me taking mental health leave. The relief of knowing that helped me to finally focus on the most important part of recovery: my mental health.
The third month was by far the most important month as I faced my inner voice. I took on journaling, meditation, and regular appointments with a therapist. I was able to understand my own trigger points, coping mechanisms, and emotional patterns. I took up new hobbies, reconnected with old friends, and also checked some items off my bucket list.
At the end of the day, there was no one but myself that could heal myself. Slowly I was able to feel better and be confident enough to go back to work again. Even though I could have taken additional months to rest longer, I informed my manager and HR that I was ready to be back.
With a final doctor diagnosis, I was able to be reinstated after three months of leave.
How to take sickness allowance
Now that you’re aware of this system, it’s important to understand how it works and how to use it effectively. The allowance will not be paid by your employer, but by your health insurance during the leave’s duration, so there will be document submission deadlines that are important to keep in mind. In addition, do not assume that the payment will be similar to how your salary is being paid.
First, find the right doctor
Don’t just go to a general practitioner; you need a mental health specialist who understands corporate burnout and is able to prescribe the right treatment plan and medical certificate (診断書, shindansho). Doctors typically start by giving a one-month leave, but this can be extended upon further observation and request.
During my visits, I was able to extend my leave twice, from March to May. In more serious cases, such as with anxiety or depression, you may get a three-month leave from the initial diagnosis.
Second, submit the certificate to the HR and notify managers beforehand
By law, you are able to take immediate leave without any handover. If your work situation becomes difficult to the point where immediate leave is needed, then just know you have the right to do so, with a doctor’s note. However, if handover is doable and you are capable of doing so physically and mentally, then try to plan the start of your leave before the weekend.
Next, check the submission deadlines
Any delay in submission might result in up to two months’ delay in receiving the allowance.
In my case, if I failed to submit by the 15th, the documents would be processed next month. For example, if I took leave from January 20th until the end of February, then before February 15th I would need to submit the form to insurance for those January 20th to January 31st dates. I would then receive the allowance payment on March 15th, whereas the February payment would reach my bank account on April 15th.
Here is a table for better visual comprehension:
| Medical Leave Date | Submission Deadline | Allowance Payment Date |
|---|---|---|
| January 20–January 31st | Before February 15th | March 15th |
| January 20–January 31st | After February 15th | April 15th |
| Whole month of February | Before March 15th | April 15th |
| Whole month of February | After March 15th | May 15th |
*Please note that each insurance association has different guidance and timelines.
Calculating your allowance
The allowance is based on a daily rate derived from your standard monthly remuneration (標準報酬月額, hyoujun houshuu getsugaku), and tops out at a standard monthly remuneration of 1,390,000 yen a month. I was able to take home 70% of my monthly salary, but the exact calculation can be more complex.
However, remember when I wrote that you can claim the sickness allowance because of mandatory health insurance enrollment? Be aware that the monthly subscription fee still needs to be paid even during the period of leave. Therefore, during my period of leave, I was not left with two-thirds of my salary. I did receive this amount, but I still had to deduct the insurance payment.
Additionally, although the medical leave is available for up to 18 months, my company’s policy stated that if I was unable to return to work within 6 months, my permanent contract would be terminated. I could have chosen to terminate the contract and continue the recovery for a year, but I decided to be reinstated after 3 months of leave.
Conclusion
If you are at the point where even getting through the day feels heavy, I hope this article reminds you that there are options and that you do not have to navigate them alone. You’ve contributed to the insurance system throughout your career, and you have every right to use it when you genuinely need support.