This is just window-dressing for a bigger issue. First, the lack of paid sick days is a norm for the industry. Who knows why it's that way. Presumably the unions have focused on larger pay raises than on sick days. In the end it sort of washes out. The unions and the company take the total pay package budget and divide it amongst the number of employees. In the end the pay and benefits all add up to the same number. For example, if the target pay package is $150,000, it doesn't really matter if you have $120,000 in wages and $30,000 in benefits, or $100,000 in wages and $50,000 in benefits. Such has been played around with, for example on the amount of copay in insurance benefits.
The real issue is about time off in general. Since PSR has been implemented, the railroads have had the desire to reduce the workforce. This requires a worker to cover longer shifts. In transportation, the crews are bound to a maximum amount of time on duty. In the past a worker could mark off pretty much at will. There were enough spare engineers, brakeman, dispatchers, and signal maintainers to cover if someone wanted unpaid time off. With the desire for less employees, the number of spare employees has been cut. The trains still need to be covered. The result has been the adaptation of more stringent attendance policies. These policies have had the result of employees not being able to take needed time off. As mentioned, we have daily, weekly, and monthly hours caps. There are some loopholes in this. A train crew can only work 5 continuous days. If a sixth is worked, then 48 hours of undisturbed rest is required. If a crew leaves the home terminal on the sixth day, but returns on the seventh, then 72 hours rest is required. If a deadhead is in the string of days, then it breaks the number of continuous days. For example, I might have been at work for 9 straight days, but since my 5th. day was a deadhead, it doesn't count. They also sometimes delay a train until 24 hours from the crew's last duty. This way the continuous days are broken.
Let me tell you that after 9 straight days, one needs time off. besides just being burnt out, one still has other needs, such as time with family, paying bills, and household chores. This says nothing about being able to have a set day to attend appointments with doctors. I've had a broken dishwasher which I couldn't fix myself. My wife wanted me there to talk with the repairman. It had to wait for six months so that I could attend to it during my vacation.