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Client off work sick
Struggling to get my head round some of this, any help would be much appreciated
Client (single no kids) was previously earning c.950 a month as a part time teacher. With marking/prep responsibilities I’m sure we can argue he was doing over 16 hours. Living in rented accommodation.
Client is now too unwell to work due to depression and degenerative spinal condition and is on half sick pay from one job of 440pm (he is not sure if he is going to get any sick pay from the other where he was only getting 76pm). In three months time he is due to go down again to 220pm. After another 3 months he will go down to 0.
My first question is when does he need to apply for SSP? Can he apply for it immediately and have it added on to his contractual sick pay? Does he apply for it in 3 months to top up the lower rate of sick pay to the SSP rate? Or in 6 when his contractual sick pay stops completely?
My understanding is that he’ll then be on SSP (and potentially some contractual sick pay) for 28 weeks. Once this expires he should claim ESA. If for whatever reason client is not able to claim SSP, does his contractual sick pay count as ‘earnings’ and potentially prevent him from claiming CBESA in the first three months? After these three months, can the sick pay earnings be disregarded as permitted work when calculating HB?
Was thinking about WTCs - I don’t know client’s work history but if he was working full time in the past before his health began to deteriorate, might he be able to claim WTC for a bit (claiming after having been on SSP/ESA for 20 weeks, treated as being in work until he has been off sick for 28 weeks, WTC run on for a further 4 weeks)? Otherwise I don’t think he would be entitled unless he returns to work.
Hope this makes some kind of sense…it feels like stuff that is straightforward and that I should know the answer to but am getting myself a bit mixed up.
My first question is when does he need to apply for SSP? Can he apply for it immediately and have it added on to his contractual sick pay? Does he apply for it in 3 months to top up the lower rate of sick pay to the SSP rate? Or in 6 when his contractual sick pay stops completely?
SSP will probably be included in his pay already; it’s paid for the first 28 weeks of the period of limited capability
My understanding is that he’ll then be on SSP (and potentially some contractual sick pay) for 28 weeks. Once this expires he should claim ESA. If for whatever reason client is not able to claim SSP, does his contractual sick pay count as ‘earnings’ and potentially prevent him from claiming CBESA in the first three months? After these three months, can the sick pay earnings be disregarded as permitted work when calculating HB?
I don’t hink it will stop CBESA being paid, just IRESA; it’s the SSP that will put paid to any ESA
Was thinking about WTCs - I don’t know client’s work history but if he was working full time in the past before his health began to deteriorate, might he be able to claim WTC for a bit (claiming after having been on SSP/ESA for 20 weeks, treated as being in work until he has been off sick for 28 weeks, WTC run on for a further 4 weeks)? Otherwise I don’t think he would be entitled unless he returns to work.
if in doubt bang a claim in
Hope this makes some kind of sense…it feels like stuff that is straightforward and that I should know the answer to but am getting myself a bit mixed up.
This is just off the top of my head, so subject to what anyone else thinks;
1. There is nothing in the rules to stop you getting SSP and contractual sick pay at the same time - but usually the employer offsets any SSP and pays the balance on top up to the level of the contractual sick pay, so I presume this comes from the contract of employment.
2. As above I cannot see why someone cannot get CESA and contractual sick pay at the same time, without the CESA being reduced, unless the contract of employment says otherwise.
3. You cannot claim WTC for the first time whilst you are off sick.
Hope this is correct!
CSP and SSP are often paid together. As above, SSP normally forms the first £80 odd per week of CSP, with the balance being CSP.
Indeed cESA and CSP can be paid together. It happens often with government workers who frequently get full pay for 6 months followed by half pay for 6 months. People often don’t realise that they can get cESA for the last 6 months while they’re on half pay.
I’m not aware of when someone can claim WTC. I think I’ve assisted with claims while someone’s off work sick. After all, you’re treated as being in work provided you worked sufficient hours before you went off work sick.
SSP won’t always put paid to irESA provided the applicable amount is higher than the income.
My first question is when does he need to apply for SSP?
He shouldn’t really need to “apply”, he just needs to comply with the employer’s medical evidence requirements, and they should pay SSP and whatever contractual sick pay may be due.
Once this expires he should claim ESA.
Provided the employer does it correctly, you can advise him to start the ball rolling on the ESA claim when he gets his SSP1. This might be about week 25 or so. (Exceptionally, an employer can opt out of the SSP scheme, provided their sick pay exceeds SSP, and they comply with certain reporting requirements. But even then, I think they still issue an SSP1 to indicate when ESA can begin. See http://www.rightsnet.org.uk/forums/viewthread/7051/ )
If for whatever reason client is not able to claim SSP, does his contractual sick pay count as ‘earnings’ and potentially prevent him from claiming CBESA in the first three months?
No, it’s not earnings from work done, and permitted work shouldn’t be an issue either. c-ESA plus contractual sick pay should be ok.
3. You cannot claim WTC for the first time whilst you are off sick.
As long as you fit the rules at the point you went off sick (30 hours/age 25+, or whatever the circs might be), then WTC can be claimed while on SSP, or otherwise in the first 28 weeks of sickness.
SSP won’t always put paid to irESA provided the applicable amount is higher than the income.
The available top-up benefit during SSP isn’t ESA, it’s Income Support.
That’s great thanks all for your assistance :). The only thing that I am a little unsure about is why client believes his wage is going to go down to 220pm after 3 months - that’s below the rate of SSP, but it won’t have been 28 weeks since he stopped work? Which seems to suggest that he is not getting SSP at the moment? I’ll tell him to double check with his employer what is going on.
3. You cannot claim WTC for the first time whilst you are off sick.
As long as you fit the rules at the point you went off sick (30 hours/age 25+, or whatever the circs might be), then WTC can be claimed while on SSP, or otherwise in the first 28 weeks of sickness.
Client wouldn’t have normally qualified for WTC as not doing enough hours. However what I was wondering was if he could get the hours requirement reduced to 16 by arguing that he is entitled to the Disability Element - assuming that SSP started straight away he would need to do 20 weeks on that and then if he can fulfil the other parts of the ‘fast-track’ qualifying benefit test he should be able to get WTC for the next 8 weeks (until he is no longer treated as being in work) plus the 4 week WTC run on. Depends really on when his SSP/ESA is due to start - if it is 8 or more weeks after he stopped work then this won’t work.
Ah, I misunderstood. Without citing the actual rules, I’d suggest: no. To qualify for WTC during sick leave, you must have worked the right number of hours before you go on sick leave. The intention is that the claimant not suffer a loss of entitlement during temporary leave periods. It is not intended that they become entitled to in-work credits that they were not entitled to whilst actually working.
I’d welcome to evidence to contrary though.
@Craven, agreed that people on SSP are one of the categories of people who can claim IS. In theory, one’s partner could be claiming irESA, in which case SSP is deducted as income. However, point duly taken that someone on SSP cannot get ESA in their own right.
Ah, I misunderstood. Without citing the actual rules, I’d suggest: no. To qualify for WTC during sick leave, you must have worked the right number of hours before you go on sick leave. The intention is that the claimant not suffer a loss of entitlement during temporary leave periods. It is not intended that they become entitled to in-work credits that they were not entitled to whilst actually working.
I’d welcome to evidence to contrary though.
Yep I get you now. Doesn’t make a great deal off difference as WTC would to a large extent have come off his HB/CTS and would have ended pretty quick anyway.