Stat Sick Pay Fraud

FionaSheila16

Just a couple of final questions if anyone can advise?
1.) Daft question probably but can you claim ESA whilst receiving SSP? I'm assuming it would flag up with HMRC?
2.) How quickly after he resigned, can he then claim ESA and indeed, can he claim ESA if he resigned, ie, his decision to leave? We know his second job is cash in hand and that he has signed a declaration to supply taxes to the HMRC which he of course won't be doing. He could then claim JSA I assume if ESA isn't possible?
Thanks

sangie595

1) no. It's one or the other.

2) Because he told the truth, didn't he? He has a stellar record on honesty. Or did he say that his employer sacked him for being off sick? Or some such thing?

ohreally

FionaSheila16 wrote: »

he has signed a declaration to supply taxes to the HMRC which he of course won't be doing.

This makes no sense, why put yourself on HMRC radar and sign a declaration to supply taxes (I have no idea what this is or its standing) if he, "won't be doing"?

sangie595

ohreally wrote: »

This makes no sense, why put yourself on HMRC radar and sign a declaration to supply taxes (I have no idea what this is or its standing) if he, "won't be doing"?

I'm assuming that the other "employer" claimed he is self employed and responsible for his own taxes. Not that such a thing would be worth the paper it's written on when HMRC find out.

stuartJo1989

I would probably send a letter to all relevant parties like:

- The GP
- HMRC/JSA
- Police
- His current employer

Detail what happened and basically give them all a heads up. You never know but one or more of them might listen and take action

TELLIT01

FionaSheila16 wrote: »

Just a couple of final questions if anyone can advise?
1.) Daft question probably but can you claim ESA whilst receiving SSP? I'm assuming it would flag up with HMRC?
2.) How quickly after he resigned, can he then claim ESA and indeed, can he claim ESA if he resigned, ie, his decision to leave? We know his second job is cash in hand and that he has signed a declaration to supply taxes to the HMRC which he of course won't be doing. He could then claim JSA I assume if ESA isn't possible?
Thanks

Not daft questions at all. ESA can be claimed immediately assuming he has a medical certificate from the GP, which he clearly has or SSP wouldn't have been paid.
JSA is a different matter. If a person resigns or is sacked for misconduct their JSA claim can be sanctioned and there will be a period during which JSA won't be paid.
If you believe he is making fraudulent claims for benefit you can report him anonymously. Search 'reporting benefit fraud'.

System

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?

Just because someone is on SSP doesn't mean they cannot work. You could for example have a problem with your foot which prevents you from doing your job that involves standing for long periods but it wouldn't exclude you from being able to do a job where you were sat down.

From https://www.gov.uk/employers-sick-pay/eligibility-and-form-ssp1
(I've highlighted the below because very few people seem to realise the following is the case)

Employees can qualify for sick pay from more than one job.

They could also qualify in one job but be fit for work in another, for example if one job is physical work that they can’t do while ill but the other is office-based.

So you need to be EXTREMELY CAREFUL about where you go now especially if you're going to start shouting about fraud and misconduct because if what he was signed off for with you didn't prevent him from being able to do something else you could find yourself on the wrong end of a lawsuit or tribunal claim.

sangie595

Tarambor wrote: »

Just because someone is on SSP doesn't mean they cannot work. You could for example have a problem with your foot which prevents you from doing your job that involves standing for long periods but it wouldn't exclude you from being able to do a job where you were sat down.

From https://www.gov.uk/employers-sick-pay/eligibility-and-form-ssp1
(I've highlighted the below because very few people seem to realise the following is the case)

Employees can qualify for sick pay from more than one job.

They could also qualify in one job but be fit for work in another, for example if one job is physical work that they can’t do while ill but the other is office-based.

So you need to be EXTREMELY CAREFUL about where you go now especially if you're going to start shouting about fraud and misconduct because if what he was signed off for with you didn't prevent him from being able to do something else you could find yourself on the wrong end of a lawsuit or tribunal claim.

Did you actually read the posts? The OP was very clear - the person was doing a job that involved the same work, and during the same hours; they took detailed legal advice before acting; they collected full evidence including from the second employer; and the individual resigned rather than attend a disciplinary hearing (so no case of constructive dismissal). So the OP doesn't need to be "VERY CAREFUL" because they have already been very careful, and is therefore quite entitled to shout about fraud and misconduct - because that is what is evident.

System

Yes they do need to be very careful, extremely careful. Their legal advisors told them NOT to dig deeper.]

The hours being the same is irrelevant, the job being in the same field is irrelevant. What is relevant is precisely what they were signed off for, the restrictions placed on them and the EXACT tasks the other role involved.

I was a lorry driver, I have three stuffed discs in my back. I cannot lift anything and have to be very careful about what tasks I can do but I can still drive a lorry. To you it would look like the last job I did was the same as any other job I did but what you would be unaware of is the runs my employer specifically kept me away from because I couldn't do them without causing myself serious problems, hence the reason the word exact was in capital letters in the previous paragraph. Two jobs can look the same from outside observation but can differ significantly.

As for the individual resigning......

All they have to do is to go to a tribunal, claim they were forced to resign by the OP, present evidence of the OP doing what they've posted in here in their first post and frame it as being done in a vindictive manner to force them out of the job as lots of companies illegally sack people by backing them into a corner where they make a threat and also say "if resign and we'll forget about it but if you don't we'll report you to X,Y or Z". Hey presto, person wins case, gets significant 5 figure payout. And that is precisely why their legal advisors told them not to bother digging deeper.

stuartJo1989

Tarambor wrote: »

The hours being the same is irrelevant, the job being in the same field is irrelevant. What is relevant is precisely what they were signed off for, the restrictions placed on them and the EXACT tasks the other role involved.

Well... it would be interesting to first establish whether the OP (employer) was willing to make such reasonable adjustments to support the employee into getting back to work. If OP was willing to make said adjustments then employee could have been supported back into work, because the jobs were similar in hours and field.

So yes, there is at least some relevance....