As one of 11 kids in a migrant farm worker family, I toiled in the fields of California’s Central Valley under the bleakest of conditions in the 1950s and ‘60s, before Cesar Chavez’s movement offered us any relief. Getting sick or injured or showing symptoms of pesticide poisoning were not options. If they happened, you just worked through it. “If you don’t want to work, there’s plenty of people to take your place,” the foreman or farm labor contractor would say.

Little has changed since then in our country, especially for private-sector workers.

When her doctor ordered bed rest for Heather, from Cedar Crest, New Mexico, “my boss hounded me to come back, but I was way too sick. I told him I would be back as soon as I could. When I did go back to work early, he fired me and told me he needed someone he could count on.”

Noel, from Bellingham, Washington, kept working in severe pain with walking pneumonia: “I needed the money to pay for things like rent and food. When my quality of work suffered substantially from having to work while so sick, I was fired from my job because, according to my then-supervisor, I did not create a happy environment for the customers.”

U.S. workers who don’t have paid sick days face miserable choices: Go to work sick and expose others on the job or send an ill son or daughter off to daycare or school. By staying home, particularly in this economy, they risk losing their pay or even their jobs.

The choice is especially daunting for immigrant workers. In their countries of origin, surrounded by family, there are often alternatives when they or their loved ones became sick or injured. Those alternatives rarely exist here, where too frequently immigrants find themselves isolated in an alien environment with little, if any, means of support.

Some 40 million American workers can’t leave work when they are sick. Forty percent of private sector workers have no paid leave or job protections when they become ill. And millions of additional workers don’t have sick time to attend to an ill loved one. Eight in 10 low-wage workers lose pay, face discipline or risk losing their jobs altogether if they get sick.

Many of these low-wage, mostly immigrant workers who are organizing through affiliated local unions with help from our Los Angeles County Federation of Labor toil at physically arduous and often dangerous jobs. They include hotel housekeepers and sanitation and recycling plant workers. For them, real-life, serous financial dilemmas accompany getting sick, which happens too frequently given the nature of their work.

Twenty-three percent of American adults report losing or being threatened with losing their jobs because they had to take off time to tend to a sick child or relative. Sixteen percent have been fired or have a family member who was fired, disciplined or threatened for taking sick time.

This country must create a fundamental policy assuring every worker the right to earn paid, job-protected sick days so they aren’t faced with having to decide between their health and their family’s economic survival. The national movement for such a standard is growing.

More than a dozen drives for paid sick days are underway in states across the nation. Progress has been made from Portland, Oregon and San Francisco, California to Philadelphia, Pennsylvania.

But those and other pro-worker advances are now being undermined by state legislation aimed at preventing municipalities from enacting their own paid sick days ordinances and other worker protections. These state “preemption” measures began when in 2011, the Wisconsin Legislature passed and Gov. Scott Walker signed a law essentially axing Milwaukee’s 2008 paid sick days law, even though it was approved by nearly 70 percent of city voters. Pushing these preemption bills in states such as Mississippi, Florida, Arizona, Indiana and Michigan are anti-worker outfits such as the National Restaurant Association and the Koch brothers-backed American Legislative Exchange Council, which brought us cookie-cutter voter suppression and union-busting laws in a host of states.

Lawmakers proposing preemption bills argue workplace policies such as paid sick days should only be passed at the state level. But they either don’t propose such reforms or oppose them while millions of workers and their families suffer from lack of protection. Aren’t conservatives supposed to embrace the right of local people to control their own destiny as an expression of democratic principles? Or do they embrace democracy only if they agree with the policies and they don’t benefit working families?

No class of working people is in greater need of paid sick days than low-wage, immigrant workers. Ultimately, we need a national standard that benefits all workers in America such as that offered in the Healthy Families Act recently introduced in Congress.