ESA & Occupational sick pay

HelenESA

My husband is unwell and has been unable to work and received SSP for 28 weeks as well as reduced 1/2 pay from his employer. His employer gave him form SSP1and will continue to pay him reduced 1/2 pay while he is unable to return to work.  Can someone please tell me if he would qualify for new style ESA contributory benefit. He continues to be unfit for work with continuation sick certificates from his doctor. His  employer pays him a reduced income which is in excess of £152 a week that my husband pays tax & N.I on. Prior to being unwell he has worked continuously for many years with a full N.I contribution record so I know that he ticks that box. 

Ross_Alumni

Hello @HelenESA

Wishing you a warm welcome to the community, I hope you've had a nice Saturday so far. 

Sorry to hear that your husband isn't well at the moment, does he have a time in mind for going back to work? It must be frustrating for him to not be able to work, hopefully he gets better soon.

I just wanted to let you know that I have moved your discussion over to our ESA category which you might find it useful to browse for related discussions. This is a very supportive and welcoming community so I'm sure you'll enjoy taking part here. 

Take care

flour

He should claim new style ESA as soon as SSP ends and you get the SSP1 form.

Even if you continue to get payments from the employers own company sick pay beyond SSP ending. He can apply online at gov . uk or if he has difficulty online he can call the universal credit helpline to start the claim on the phone.

You can backdate the start date of ESA by up to 3 months.

You'll need to give the fit notes to both the DWP as well as the employer. You can give it to the DWP online or make a copy and post it by free post. 

If he became ill or disabled due to an accident or disease from work there is also Industrial Injuries disablement benefit and if you are on a low income universal credit. You can claim universal credit and ESA together at the same time. Universal Credit will stop any tax credits or other legacy benefits though so use a benefit calculator such as 'entitled to' as a starting point to make sure you'll be better off.

He might want to think about PIP. He's already had difficulties for 3 months and should claim if  there is a fair chance he'll have difficulties for the next 9 months. Pip takes a long time to arrange (around 10 months) and doesn't pay any money until then so it often makes sense to file a claim and then wait and see. 

Often, at times like this when there is a big change it's a good idea to do a benefits check with citizens advice. To make sure your claiming everything you're entitled to and to arrange help with forms. 

HelenESA

flour said:

You claim new style ESA as soon as SSP ends and you get the SSP1 form.

Even if you continue to get payments from the employers own company sick pay beyond SSP ending. He can apply online at gov . uk or if he has difficulty online he can call the universal credit helpline to start the claim on the phone.

You'll need to give the fit notes to both the DWP as well as the employer. You can give it to the DWP online or make a copy and post it by free post. 

If he became ill or disabled due to an accident or disease from work there is also Industrial Injuries disablement benefit and if you are on a low income universal credit. You can claim universal credit and ESA together at the same time. Universal Credit will stop any tax credits or other legacy benefits though so use a benefit calculator such as 'entitled to' as a starting point to make sure you'll be better off.

He might want to think about PIP. He's already had difficulties for 3 months and should claim if  there is a fair chance he'll have difficulties for the next 9 months. Pip takes a long time to arrange (around 10 months) and doesn't pay any money until then so it often makes sense to file a claim and then wait and see. 

Thank you flour for your helpful reply. Am I right in thinking then that the must not earn more than £152 to be eligible rule only applies to those that are actually working and therefore because my husband is doing no work he can still earn in excess of £152 and be eligible for new style ESA contributory?

flour

Hi Helen

I understand now. This is about the Permitted Work limit of £152 per week in 2022/23 and making sure if the payment from work is considered.

As he is not providing a service he cannot be considered to be working and therefore he is not doing permitted work and so the £152 and other rules don't apply.

Indeed company sick pay can typically go on for up to 18 months (or longer depending on the employer) yet SSP runs out after the first 6 months and then new style ESA starts.

calcotti

HelenESA said: Am I right in thinking then that the must not earn more than £152 to be eligible rule only applies to those that are actually working and therefore because my husband is doing no work he can still earn in excess of £152 and be eligible for new style ESA contributory?

You are correct. Occupational sick pay is ignored for new style ESA. The permitted work limit of £152/week is not relevant as he is not working. He should claim the ESA to start the day after the SSP end date.

HelenESA

It shows as normal salary on his payslip and his employer have said that they will continue to pay at the reduced rate while he is not working. His employer may have insurance that pays them to cover the payment but if they do he does not know about it. My husband still receives his wage direct from his employer and gets Tax & N.I deducted in the normal way. If his employer has insurance to cover them making the payment could it make a difference to my husband not being eligible for receiving new style ESA or reducing the payment he may possibly receive?

HelenESA

Thank you Ross_Scope  flour and calcotti for all your useful help. I suddenly don't feel so alone. He will be off work for quite some time and the whole process is quite daunting. 

calcotti

HelenESA said:

If his employer has insurance to cover them making the payment could it make a difference to my husband not being eligible for receiving new style ESA or reducing the payment he may possibly receive?

Not if he remains employed. 

Ross_Alumni

HelenESA said:

Thank you Ross_Scope  flour and calcotti for all your useful help. I suddenly don't feel so alone. He will be off work for quite some time and the whole process is quite daunting. 

Yes it can certainly be very daunting, and I'm sorry to hear that you have previously felt alone. Always remember that this community is here if you or your husband ever want to join in. We do have numerous categories about benefits but also others about more general subjects where we talk about movies, music and other fun topics  

calcotti

Have you used a benefits calculator to check eligibility for any means tested benefits?
https://www.gov.uk/benefits-calculators

flour

HelenESA said:

Thank you Ross_Scope  flour and calcotti for all your useful help. I suddenly don't feel so alone. He will be off work for quite some time and the whole process is quite daunting. 

You're very welcome Helen.

Many people find the whole process quite overwhelming but you've made a much better start than many. 

A lot will instead live off savings etc as opposed to start looking in to contribution based benefits asap and wait until it's too late as their last full year of NI slips too far into the past. They are then left with Universal Credit only. So you're already off to a great start.

Make sure to look after both yourself and your husbands state of mind as the paperwork can be stressful. This could mean sharing the load by getting help from other agencies for filling in forms such as the Citizens Advice or a charity connected with his health condition. Also spread out answering the form over a couple of weeks if you can as it'll take the pressure off.

In addition, do not feel pressured by the paper work. For example if a form asks a question which does not fit in with his health. Do not feel pressured to tick a box - instead write your not ticking a box because none apply and then explain why instead and then go on to explain the difficulties.

PIP
I would suggest starting PIP too. There no time limit on applying for PIP (unlike NS ESA in payment) but because the delays are so long it's better to get in the queue sooner. You can also get extra time to return a PIP form.

PIP is for anyone with a health condition which they've had for 3 months and expect to have for another 9 months and which gives them some difficulty against specific tests, in practice you should always apply and try not to think 9 months ahead as health can get better or worse or stay the same (only someone with a very short term illness should not apply).

Your husband can claim PIP and new style ESA together at the same time neither are means tested (except ESA is against his pension income if he has any).