Stat Sick Pay Fraud

FionaSheila16

We have a small business, and have an issue with an employee who has been claiming statutory sick pay since April. Along the way we were notified that he has been working in a similar role, during hours he was normally working in the cafe and in the evenings and at weekends too. We have photographic proof and a signed declaration from his manager to confirm this, so we were advised to hold a meeting whereby he could confirm he was working elsewhere and we could then terminate his employment. He refused to attend the meeting and resigned yesterday. My question is, can we report him? We have paid this person almost £1500 to date which we can ill afford, and we know that we can't reclaim it back but are there different rules if the employee has committed fraud / gross misconduct?

sangie595

I think you would struggle to mount any such claim against the individual. Regardless of the circumstances, having claimed for so long this individual must have provided you with a fit note from their doctor. Having done so, you are not in a position to refuse to accept the doctors medical opinion. If you had wanted to query that, then that is what you should have done - albeit I wouldn't have recommended going down that route! Your evidence is that they nevertheless worked - not that the sickness was feigned. We all know it was, don't we? But that is not the same thing as evidence. This gets too complicated and I fear you would be throwing good money after bad trying to recover what you have paid them.

On the other hand, you are not without alternatives. For starters, I would lay bets that this person is now claiming ESA. Benefits fraud, now that is much more serious. So I think I'd be tempted to parcel up copies of my evidence and documents relating to the dismissal and make sure they get into the hands of the Benefits Agency / DWP. I'd probably make sure that a copy of it all got to the GP who provided me with the fit note too - I doubt that most doctors would take kindly to being lied to by a patient and being involved in fraudulent activity, and might be considerably less believing of their next feigned illness. There are many people who claim SSP who find that their employers are less than sympathetic and less believing of their illness, despite the fact that they are telling the truth and deserving of support from their employer. These bad apples tend to leave a nasty taste in the mouth of employers and make them into the kind of bad employer that doesn't support or believe their employees. So I think they deserve whatever happens to them. And please don't let the fact that you had one bad experience change your minds about supporting ill employees. Most people are honest.

Undervalued

FionaSheila16 wrote: »

We have a small business, and have an issue with an employee who has been claiming statutory sick pay since April. Along the way we were notified that he has been working in a similar role, during hours he was normally working in the cafe and in the evenings and at weekends too. We have photographic proof and a signed declaration from his manager to confirm this, so we were advised to hold a meeting whereby he could confirm he was working elsewhere and we could then terminate his employment. He refused to attend the meeting and resigned yesterday. My question is, can we report him? We have paid this person almost £1500 to date which we can ill afford, and we know that we can't reclaim it back but are there different rules if the employee has committed fraud / gross misconduct?

Obviously you can report him to HMRC and, in theory at least, the police if you consider he has committed fraud.

You may also have a valid civil claim agains the person for some or all of the money you have paid. Whether that is cost effective to pursue may be another matter.

Given that this chap has been off work for 15 to 20 weeks he must, presumably, have been submitting "fit notes". Is it possible his doctor said he was fit for certain duties but you exercised your right as an employer to say "no, do your full job or no job at all"?

It is under certain circumstances possible to have two jobs and be fit for one yet signed off sick from the other.

It has to be said that your management of this employee seems to be somewhat lacking! That doesn't excuse fraudulent behaviour but you may well have been able to have prevented some of it. Three or four months is a very long time for a business, especially a small one, to be paying sick pay without investigating and, if necessary, taking some action.

Also, the fact that you can "ill afford" it is irrelevant. The cost would have been the same had he been in a coma on life support.

Sadly some employees will take the proverbial and you may well have been unfortunate enough to suffer one. However you do also need to keep on top of your game if you employ staff.

Edited to add....

I see Sangie has posted whilst I was writing this and there is quite a bit of overlap in our responses.

FionaSheila16

sangie595 wrote: »

I think you would struggle to mount any such claim against the individual. Regardless of the circumstances, having claimed for so long this individual must have provided you with a fit note from their doctor. Having done so, you are not in a position to refuse to accept the doctors medical opinion. If you had wanted to query that, then that is what you should have done - albeit I wouldn't have recommended going down that route! Your evidence is that they nevertheless worked - not that the sickness was feigned. We all know it was, don't we? But that is not the same thing as evidence. This gets too complicated and I fear you would be throwing good money after bad trying to recover what you have paid them.

On the other hand, you are not without alternatives. For starters, I would lay bets that this person is now claiming ESA. Benefits fraud, now that is much more serious. So I think I'd be tempted to parcel up copies of my evidence and documents relating to the dismissal and make sure they get into the hands of the Benefits Agency / DWP. I'd probably make sure that a copy of it all got to the GP who provided me with the fit note too - I doubt that most doctors would take kindly to being lied to by a patient and being involved in fraudulent activity, and might be considerably less believing of their next feigned illness. There are many people who claim SSP who find that their employers are less than sympathetic and less believing of their illness, despite the fact that they are telling the truth and deserving of support from their employer. These bad apples tend to leave a nasty taste in the mouth of employers and make them into the kind of bad employer that doesn't support or believe their employees. So I think they deserve whatever happens to them. And please don't let the fact that you had one bad experience change your minds about supporting ill employees. Most people are honest.

Helpful, thank you.

Takeaway_Addict

FionaSheila16 wrote: »

We have a small business, and have an issue with an employee who has been claiming statutory sick pay since April. Along the way we were notified that he has been working in a similar role, during hours he was normally working in the cafe and in the evenings and at weekends too. We have photographic proof and a signed declaration from his manager to confirm this, so we were advised to hold a meeting whereby he could confirm he was working elsewhere and we could then terminate his employment. He refused to attend the meeting and resigned yesterday. My question is, can we report him? We have paid this person almost £1500 to date which we can ill afford, and we know that we can't reclaim it back but are there different rules if the employee has committed fraud / gross misconduct?

Do their other employer know whats happened then I take it? If not.....I'd be vindictive and tell them....and send a letter before action requesting the money back...you may not be able to do something but that little satisfaction you'll get when you think about them opening the letter and have a mini sinking feeling

sangie595

I'd have to say that I don't think the employers management was "lacking". Most employers have a tendency to believe fit notes written by doctors! Even a large employer would struggle to be able to evidence that a doctor's opinion was not accurate, and that with the resources of an organisation and occupational health behind them. A small employer doesn't really stand a chance. And I'm afraid that doctors often have to take the honesty of their patients for granted, even when they can't independently verify a condition. Stress, anxiety, bad back etc - there's loads of conditions that are easy to fake. And for employers it's hard to find the balance between believing and not believing. They know as well as we do that most people don't lie, but some do. They just often don't know or can't prove which are lying, so operate on the basis that everyone is. And that is what leads to most of the problems then for employees- managing sickness absence processes, for example, have emerged from exactly this dilemma. Employers can no longer say "jack's worked hard for us for ten years and so if he's off sick for six months that's fair enough" because then they have to treat Neville, who has actually been there eighteen months but has already had five weeks of sickness and is now of work for six months the same way. And no matter what Nevilles situation - it may be very genuine sickness- employers expect workers to be at work, not off sick all the time. And if they think Neville is taking the proverbial, they want rid of Neville. But to do that they must treat him the same as Jack. So Jack gets dismissed too.

Undervalued

sangie595 wrote: »

I'd have to say that I don't think the employers management was "lacking". Most employers have a tendency to believe fit notes written by doctors! Even a large employer would struggle to be able to evidence that a doctor's opinion was not accurate, and that with the resources of an organisation and occupational health behind them. A small employer doesn't really stand a chance.

Perhaps I didn't phrase it very well (assuming you were replying to my post).

I agree entirely about the difficulty in challenging a doctor's opinion. My point was that few employer's, let alone small ones, would allow 15 to 20 weeks (and continuing) of sick leave without taking formal capability steps or at the least seeking a more detailed medical report.

I infer (maybe I'm wrong) that nothing like that happened and the first action was in response to learning that the employee was working somewhere else whilst getting SSP.

Takeaway_Addict

Undervalued wrote: »

Perhaps I didn't phrase it very well (assuming you were replying to my post).

I agree entirely about the difficulty in challenging a doctor's opinion. My point was that few employer's, let alone small ones, would allow 15 to 20 weeks (and continuing) of sick leave without taking formal capability steps or at the least seeking a more detailed medical report.

I infer (maybe I'm wrong) that nothing like that happened and the first action was in response to learning that the employee was working somewhere else whilst getting SSP.

I don't agree, most would wait till nearer the end of 6 months before starting to take more formal action. Most will maybe ask for a meeting to discuss the issues but no more than that.

FionaSheila16

Having been advised since day 1 by an employment law firm, we have followed instruction by them all the way, sick notes were valid and despite the fact we've known theres absolutely nothing wrong with him, rules are rules and ypu have to follow them, as painful as it has been. We weren't encouraged to 'dig' deeper to find out more (until recently where we've had to intervene). Thank God we did.
And we really CAN'T afford to pay him £90 per week, having to pay that again to replace him, legal fees etc. It's been a big learning curve. And frustrating since 10 years trading and we've never had a blip with any of our staff, so we count ourselves very lucky. Most people are honest, you are right Sangie.
Anyway, thank you all for your advice, will check out the ESA thing if we can which he will undoubtedly be claiming. Would hate him to get away with this and move on to his next target. Which he most definitely will.

sangie595

FionaSheila16 wrote: »

Having been advised since day 1 by an employment law firm, we have followed instruction by them all the way, sick notes were valid and despite the fact we've known theres absolutely nothing wrong with him, rules are rules and ypu have to follow them, as painful as it has been. We weren't encouraged to 'dig' deeper to find out more (until recently where we've had to intervene). Thank God we did.
And we really CAN'T afford to pay him £90 per week, having to pay that again to replace him, legal fees etc. It's been a big learning curve. And frustrating since 10 years trading and we've never had a blip with any of our staff, so we count ourselves very lucky. Most people are honest, you are right Sangie.
Anyway, thank you all for your advice, will check out the ESA thing if we can which he will undoubtedly be claiming. Would hate him to get away with this and move on to his next target. Which he most definitely will.

And since I am badly disabled AND work, I resent paying for him! Don't get me wrong, I'm not complaining. I love my work (i actually retired and my employers begged me to stay on). And my disability could be worse. I'm a positive person overall. But it p.....sses me off no end when the taxes I pay are used to support people like him who think everyone is a mark; or when I see good people trying desperately to maintain their employment in trying circumstances of poor health and disability, battling employers who aren't necessarily bad people, but are simply led by processes introduced to weed out people like him.

sangie595

Takeaway_Addict wrote: »

I don't agree, most would wait till nearer the end of 6 months before starting to take more formal action. Most will maybe ask for a meeting to discuss the issues but no more than that.

I think the truth lies at both ends of this spectrum. We are talking about very small employers here. I agree with you, the good and the not yet jaded would wait and try everything they could to be nice about it. The bad would have sacked him on week two! And the people in between will be stuck in uncertainty, not sure what to do. It's easy to just see employers as the enemy. Actually, they are just people too.