What does a limit on sick days, or even a mix of sik days and vacation mean? What happens if you get sick when the quotum is used up? If I use up all my accrued PTO and get sick I can still take time off. I'll just go negative on my PTO balance. I think my company only allows me to go up to 40 hours of negative territory before I have to get approval. If I quit with a negative balance, that gets taken out on my final paycheck.