DWP Investigation

kaMelo

On a slight tangent but I think relevant is holiday entitlement, certainly in light of the Stringer vs HMRC case. 
As most Health/sickness insurance policies don't usually cover holiday pay, if he is still employed then his employer is liable for at least twelve months holiday entitlement or payment in lieu, maybe more depending on the company wide policy.

I'm not sure how this would fit into the whole picture of what you are dealing with or whether his employer is even aware of this.

Targaryan

Thanks for that.
Never thought about holiday pay entitlement, certainly worth thinking about once we have the current situation dealt with.

calcotti

Targaryan said:

Thanks for that.
Never thought about holiday pay entitlement, certainly worth thinking about once we have the current situation dealt with.

If there is generous occupational sick pay available indefinitely, regardless of the legal position in respect of holiday pay, would you really want to rock the boat? Holiday pay would possibly not be covered by the insurance and therefore cost the employer in which case they then have a financial incentive to end the employment. 

kaMelo

calcotti said:

Targaryan said:

Thanks for that.
Never thought about holiday pay entitlement, certainly worth thinking about once we have the current situation dealt with.

If there is generous occupational sick pay available indefinitely, regardless of the legal position in respect of holiday pay, would you really want to rock the boat? Holiday pay would possibly not be covered by the insurance and therefore cost the employer in which case they then have a financial incentive to end the employment. 

Which was exactly the debate regarding the outcome of the case. The headline would appear to protect employees however employers were more likely to have and implement strict return to work policies and in cases where return was unlikely, terminate employment at the earliest opportunity to limit liability.  This is not only important for holiday pay but for things like redundancy pay and severance pay where length of service matters. The sickness insurance payments are independent of employer and will continue whether employed or not.  
This is a highly unusual situation to have kept someone employed for so long as it only incurs liability with no benefit for the employer which is why I wondered whether they were even aware.
Having said all that I would probably come to a similar conclusion of not "poking the tiger"

Targaryan

calcotti said:

Targaryan said:

Thanks for that.
Never thought about holiday pay entitlement, certainly worth thinking about once we have the current situation dealt with.

If there is generous occupational sick pay available indefinitely, regardless of the legal position in respect of holiday pay, would you really want to rock the boat? Holiday pay would possibly not be covered by the insurance and therefore cost the employer in which case they then have a financial incentive to end the employment. 

No, to be perfectly honest we wouldn’t. We have been very grateful for what hubby has received, and truly appreciate how fortunate he has been to benefit from such a generous scheme. At this stage we just want to get the DWP off our back

Have moved a bit further on....
The DWP have been waiting for four months for hubby’s employer to confirm he is still an employee. I emailed the company on Friday, and today received email confirmation that he is. Did hope that might be it, but the DWP aren’t satisfied with that. They want to know the exact nature of the sick pay and whether it not it’s a health insurance. Hubby really doesn’t remember so I’ve contacted Unum and they are going to help. It just seems to go on and on..

calcotti

Targaryan said: They want to know the exact nature of the sick pay and whether it not it’s a health insurance. 

I really don't understand why they are asking that. If he is an employee, as I understand it, it makes no difference.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/932377/dmgch51.pdf

Pension payments
51768 Pension payments are periodical payments (see DMG 51770 et seq) paid to or for a person 
1. under a personal pension scheme (see DMG 51772 et seq) or
2. in connection with the ending of the person’s employment as an earner (see DMG 51790) under
2.1 an occupational pension scheme (see DMG 51778) or
2.2 a public service pension scheme (see DMG 51779 et seq)
3. under an insurance policy providing benefits in connection with physical or mental illness or disability (see DMG 51798).

Insurance policy providing benefits in connection with physical or mental illness or disability 
51798 A payment under a permanent health insurance policy is a pension payment for the purposes of ESA (Cont). It means any periodical payment 
1. made to a former employee and 
2. which was arranged by an employer under an insurance policy and
3. which provides benefits to the former employee in connection with physical or mental illness or disability and
4. is payable on the termination of employment. 

As he is not a former employee (because he is still employed) the insurance policy does not fall to be treated as a pension and therefore does not come under the rules governing the treatment of pension for contribution based ESA.

Targaryan

calcotti said:

Targaryan said: They want to know the exact nature of the sick pay and whether it not it’s a health insurance. 

I really don't understand why they are asking that. If he is an employee, as I understand it, it makes no difference.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/932377/dmgch51.pdf

Pension payments
51768 Pension payments are periodical payments (see DMG 51770 et seq) paid to or for a person 
1. under a personal pension scheme (see DMG 51772 et seq) or
2. in connection with the ending of the person’s employment as an earner (see DMG 51790) under
2.1 an occupational pension scheme (see DMG 51778) or
2.2 a public service pension scheme (see DMG 51779 et seq)
3. under an insurance policy providing benefits in connection with physical or mental illness or disability (see DMG 51798).

Insurance policy providing benefits in connection with physical or mental illness or disability 
51798 A payment under a permanent health insurance policy is a pension payment for the purposes of ESA (Cont). It means any periodical payment 
1. made to a former employee and 
2. which was arranged by an employer under an insurance policy and
3. which provides benefits to the former employee in connection with physical or mental illness or disability and
4. is payable on the termination of employment. 

As he is not a former employee (because he is still employed) the insurance policy does not fall to be treated as a pension and therefore does not come under the rules governing the treatment of pension for contribution based ESA.

They haven’t mentioned pensions yet......
The lady I deal with is very nice, and has said this is a very unusual case. But I’m really struggling to see where they are going with this. We’ve sent them P60’s going back a few years. Payslips all saying long term sickness benefit, and have now confirmed that he’s still employed. I honestly don’t know what else they want.

calcotti

Targaryan said:

calcotti said:

Targaryan said: They want to know the exact nature of the sick pay and whether it not it’s a health insurance. 

I really don't understand why they are asking that. If he is an employee, as I understand it, it makes no difference.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/932377/dmgch51.pdf

Pension payments
51768 Pension payments are periodical payments (see DMG 51770 et seq) paid to or for a person 
1. under a personal pension scheme (see DMG 51772 et seq) or
2. in connection with the ending of the person’s employment as an earner (see DMG 51790) under
2.1 an occupational pension scheme (see DMG 51778) or
2.2 a public service pension scheme (see DMG 51779 et seq)
3. under an insurance policy providing benefits in connection with physical or mental illness or disability (see DMG 51798).

Insurance policy providing benefits in connection with physical or mental illness or disability 
51798 A payment under a permanent health insurance policy is a pension payment for the purposes of ESA (Cont). It means any periodical payment 
1. made to a former employee and 
2. which was arranged by an employer under an insurance policy and
3. which provides benefits to the former employee in connection with physical or mental illness or disability and
4. is payable on the termination of employment. 

As he is not a former employee (because he is still employed) the insurance policy does not fall to be treated as a pension and therefore does not come under the rules governing the treatment of pension for contribution based ESA.

They haven’t mentioned pensions yet......
The lady I deal with is very nice, and has said this is a very unusual case. But I’m really struggling to see where they are going with this. We’ve sent them P60’s going back a few years. Payslips all saying long term sickness benefit, and have now confirmed that he’s still employed. I honestly don’t know what else they want.

The reference is because the rules do mean that for contribution based ESA pension income can reduce the amount payable. The bit I quoted says that a health insurance policy paid to a former employee is treated as a pension (unless the claimant paid more than 50% of the premium) which means that it could reduce the ESA payable. The point I am making is that this is irrelevant because he is still an employee.

I’m surprised they are saying it is very unusual. It’s not common but is far from unique.

Targaryan

calcotti said:

Targaryan said:

calcotti said:

Targaryan said: They want to know the exact nature of the sick pay and whether it not it’s a health insurance. 

I really don't understand why they are asking that. If he is an employee, as I understand it, it makes no difference.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/932377/dmgch51.pdf

Pension payments
51768 Pension payments are periodical payments (see DMG 51770 et seq) paid to or for a person 
1. under a personal pension scheme (see DMG 51772 et seq) or
2. in connection with the ending of the person’s employment as an earner (see DMG 51790) under
2.1 an occupational pension scheme (see DMG 51778) or
2.2 a public service pension scheme (see DMG 51779 et seq)
3. under an insurance policy providing benefits in connection with physical or mental illness or disability (see DMG 51798).

Insurance policy providing benefits in connection with physical or mental illness or disability 
51798 A payment under a permanent health insurance policy is a pension payment for the purposes of ESA (Cont). It means any periodical payment 
1. made to a former employee and 
2. which was arranged by an employer under an insurance policy and
3. which provides benefits to the former employee in connection with physical or mental illness or disability and
4. is payable on the termination of employment. 

As he is not a former employee (because he is still employed) the insurance policy does not fall to be treated as a pension and therefore does not come under the rules governing the treatment of pension for contribution based ESA.

They haven’t mentioned pensions yet......
The lady I deal with is very nice, and has said this is a very unusual case. But I’m really struggling to see where they are going with this. We’ve sent them P60’s going back a few years. Payslips all saying long term sickness benefit, and have now confirmed that he’s still employed. I honestly don’t know what else they want.

The reference is because the rules do mean that for contribution based ESA pension income can reduce the amount payable. The bit I quoted says that a health insurance policy paid to a former employee is treated as a pension (unless the claimant paid more than 50% of the premium) which means that it could reduce the ESA payable. The point I am making is that this is irrelevant because he is still an employee.

I’m surprised they are saying it is very unusual. It’s not common but is far from unique.

Yes I understand that, and thank you for the document.
I had hoped once they had the evidence that he is still employed and receiving long term sickness pay that would be the end of it. 

Maybe the lady dealing with us hasn’t come across a similar situation.

Targaryan

Update

Weve just had a phone call to say the DM have finally accepted that the money hubby receives is long term sickness pay, as he is still employed by the company! Only took 13 months!

We did contact our MP two weeks ago, so I suspect this may have moved things along....

It’s a massive weight off our shoulders, and I’m truly grateful for all the advice and assistance I received from this forum