Ending SSP, what can be claimed next?

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airliner said:

I realise this thread has moved on but I wanted to make a point about SSP. 

SSP is paid from the 4th day of a period of sickness. It has no relevance whether a person gets full pay at he start of their sickness....it just means the first £96.35 per week is SSP and the rest is company sick pay and the total equals their full pay....for however long their company sick pay policy lasts for.

SSP cannot just be tacked onto the end of a period of full pay or half pay, and have the 28 weeks start from that point.

Therefore SSP should have ended 28 weeks from the date your BIL signed off as sick, so long as there were no previous linked periods of incapacity for work.

Employers get this wrong all of the time. Sometimes the mistake is beneficial to the employee, sometimes not.

The mistake certainly dictates when a person can claim NSESA.

And therefore BIL  should have correctly claimed NSESA from 14/12/20  at the very latest  and probably earlier than that.  

He cannot backdate a claim to  NSESA more than 3 months 

So he maybe should write a letter to ESA and call them to request that he is allowed to backdate the claim that he did make by 3 months from the date the claim was originally submitted.      and so as not to put all his eggs in one basket he could also do another NSESA New Claim Online backdated 3 months from today to 24/01/2021 

He should then set about asking his employer for a corrected SSP1 with the SSP ending in December 2020.  

HOWEVER, if the employer continued to pay him £95 per week through Dec Jan Feb  that mistake would have him better off than if he were to pay it back and try to get ESA at £74 per week.  

So maybe it is not a good idea to open this can of  worms.


He also has at least 6 weeks to get them his new fitnote.   The letter means that his benefit cannot be paid while they wait for him to send in his new fit note but when he does send a new one in as long as there is no gap, the ESA will be backdated ...his claim will not close for a late fitnote,  it has to be late by more then 6 weeks for that to happen but even then it is rare to result in claim closure. 

Boohoo

Just to update this and more advice please.

My BIL went onto ESA last year and he had his assesment in October 2021 and they said he did not get enough points so they will stop his claim. He was advised to claim UC.

We started that UC claim and he was told to send in Fit To Work notes to get his money. Due to his savings he gets £150 a month and the UC started early November 2021.

He got a letter/form asking him to fill in about his illness and it was the same as the ESA assesment form he got earlier in the year.

The assesment was done over the phone a week ago and they called back to ask a few more questions and later that day he gets a text asking to check his UC journal and the have made an appointment to see his work coach ay the JC in 2 days.

He went there and the work coach said he has to look for any job. He explained that he is still off work and the GP has signed him off for another 8 weeks this Monday but he said look for work.

He contacted his work HR and as they are paying him holiday pay they said that they will have see him at some point to see what state he is in but that will be an outside OH team. The said that they cant take him back if the GP says he is not fit to work as their insurance will not cover him for any injuries to himself or other employee's.

The HR did mention PIP as so far since the UC he has only got £182 as his firm has paid him his holiday pay at Xmas and again this month but can he claim PIP and still be off work or does he have to look for work and go to interviews as he and i are unsure?

Thanks for any advice you may have.

poppy12345

The work capability assessment for ESA and UC are exactly the same, the forms are identical.

For the ESA claim did he request the Mandatory Reconsideration (MR) for that decision? If he didn't, was there any reason why?

He's still within the timescale to request this, with good reason you have 13 months.

For the ESA payments to continue past 1 year then he would need to be placed into the Support Group and it's not about scoring points. You need to satisfy at least one of the descriptors. See them here. It says LCWRA but Support Group is the same. https://www.benefitsandwork.co.uk/universal-credit-uc/uc-faq/limited-capability-for-work-related-activity

It also sounds like he was found fit for work for the UC assessment too.

MR request details here https://www.gov.uk/mandatory-reconsideration/how-to-ask-for-mandatory-reconsideration

calcotti

If the Work Capability Assessment finds him For for Work it doesn't matter what his GP is willing to say unless there is a new health condition or a worsening of an existing health condition.

As poppy says, if he disagrees with the decision he needs to challenge it.

Robbie64

Out of interest, if someone is sick from work but is being told by UC to look for any employment (as above) could that not cause a potential problem between employer and employee? As above, the brother in law is saying he cannot attend work due to illness but UC are telling the person to look elsewhere for work.

I do wonder in this case if the WCA for UC is yet to be decided but the work coach is not prepared to turn off jobsearch requirements. As 3 months have elapsed since he claimed UC he is now in the "look for any job" group (which has also been reduced to a month for new claims from January). It may just bea coincidence that the UC WCA took place on the same day that the work coach sent a message via the UC journal.

Boohoo

poppy12345 said:

The work capability assessment for ESA and UC are exactly the same, the forms are identical.

For the ESA claim did he request the Mandatory Reconsideration (MR) for that decision? If he didn't, was there any reason why?

He's still within the timescale to request this, with good reason you have 13 months.

For the ESA payments to continue past 1 year then he would need to be placed into the Support Group and it's not about scoring points. You need to satisfy at least one of the descriptors. See them here. It says LCWRA but Support Group is the same. https://www.benefitsandwork.co.uk/universal-credit-uc/uc-faq/limited-capability-for-work-related-activity

It also sounds like he was found fit for work for the UC assessment too.

MR request details here https://www.gov.uk/mandatory-reconsideration/how-to-ask-for-mandatory-reconsideration

The ESA WCA called him to say that his claim will be stopped as he did not get enough points. He was told that he can make a UC claim if he wants to.

As for MR he and his dad were told that if he does that then his ESA claim would be halted/pending the outcome and if won then the money would be back dated but if he lost then he gets nothing and she told them that she can not tell him how long it would take if he did a MR and he would be without any ESA payment so i think he just accepted that.

Boohoo

Robbie64 said:

Out of interest, if someone is sick from work but is being told by UC to look for any employment (as above) could that not cause a potential problem between employer and employee? As above, the brother in law is saying he cannot attend work due to illness but UC are telling the person to look elsewhere for work.

I do wonder in this case if the WCA for UC is yet to be decided but the work coach is not prepared to turn off jobsearch requirements. As 3 months have elapsed since he claimed UC he is now in the "look for any job" group (which has also been reduced to a month for new claims from January). It may just bea coincidence that the UC WCA took place on the same day that the work coach sent a message via the UC journal.

When my BIL told his HR dept about this they said as they are still paying him his annual leave entitlement and also paying into his company pension they may have to let him go but they are going to talk to their legal team and then get back to him.

His GP says he is not fit to work and his employer will not take him back until the GP says he is fit for work as their insurance and duty of care for their staff needs it but the WCA  team seem to know best.

He was thinking of claiming PIP but maybe the same result and he is know thinking of stopping his UC JSA claim as his £150 a month he gets is reduced to £0 when he gets his 2days annual leave from his works(if they pay him monthly) and to get to his JC costs £18-£20 return taxi, the JC is one of the new ones opened up during COVID in a out of city/town industrial park. Getting a bus is £4.80 return from 1 company and then £3.80 return from another company and then he has to walk about a mile from the bus stop to the JC.

Last week he was told that his work coach will need to se him every 2 weeks. There is a JC in the town centre but he was told that his claim is with the out of town/city JC and they will not transfer him.

Spoonie_Turtle

Boohoo said:

poppy12345 said:

The work capability assessment for ESA and UC are exactly the same, the forms are identical.

For the ESA claim did he request the Mandatory Reconsideration (MR) for that decision? If he didn't, was there any reason why?

He's still within the timescale to request this, with good reason you have 13 months.

For the ESA payments to continue past 1 year then he would need to be placed into the Support Group and it's not about scoring points. You need to satisfy at least one of the descriptors. See them here. It says LCWRA but Support Group is the same. https://www.benefitsandwork.co.uk/universal-credit-uc/uc-faq/limited-capability-for-work-related-activity

It also sounds like he was found fit for work for the UC assessment too.

MR request details here https://www.gov.uk/mandatory-reconsideration/how-to-ask-for-mandatory-reconsideration

The ESA WCA called him to say that his claim will be stopped as he did not get enough points. He was told that he can make a UC claim if he wants to.

As for MR he and his dad were told that if he does that then his ESA claim would be halted/pending the outcome and if won then the money would be back dated but if he lost then he gets nothing and she told them that she can not tell him how long it would take if he did a MR and he would be without any ESA payment so i think he just accepted that.

If his claim is stopping/has stopped anyway then he has absolutely nothing to lose by doing an MR.

If being made to do work-search acitivity or work-relayed activity would pose a substantial risk to his health for any reason, that is also an angle that can be pursued.  https://wcainfo.net/issues/substantial-risk-lcw  (see also the LCWRA version https://wcainfo.net/issues/substantial-risk-lcwra)

Substantial risk (LCW)

A claimant can be treated as having limited capability for work (LCW) after failing to score sufficient points under the WCA if, by reason of their health condition or disability, there would be a substantial risk to the health of the claimant or others were they found not to have LCW. Substantial risk that can be avoided through reasonable adjustments to the claimant’s workplace or by taking prescribed medication or treatment will not count.

Regarding the location of the Jobcentre, I think he might be able to request higher up to consider to be transferred.  My own claim started a couple of years ago now so I can't remember what the advice was, I think they don't normally transfer people but he has what any reasonable person would deem to be a good reason, especially if his GP still says he's not well, and two buses plus a mile each way is no good for someone unwell.  (I wonder whether a letter from his GP would carry any weight here.)

Who and how he'd have to raise the request hopefully someone else will know.