A look at the important world of benefits when cancer and its treatments make it very hard to carry on in work. What help is available when you are off sick whether instead of or to top up any sick pay from work. The “sickness benefits” offer a basic income mainly for those of “working age” – as older people will still have their Retirement Pensions , but in this part, we also explore other health related support, beyond the basic “sickness benefit” which makes this very suitable reading for all ages.
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Welcome to the first in a mini-series of blogs , that builds on the general Benefits and Cancer overview – see the links at the end of this blog. Here we look at these key benefits for people after a cancer diagnosis, when both cancer, its impacts and its treatments can limit your ability to work. The benefits we focus on here - collectively known as "sickness benefits" - provide a basic income that may top up or replace earnings from work and any sick pay from an employer.
As such, it may appeal more to readers of “working age” – as older readers have their basic needs met by Retirement Pension, payable in sickness and in health. But this first part puts benefits into the wider scope of support available to people with health conditions like cancer and those other benefits are relevant to all. Meanwhile, Statutory Sick Pay (SSP) has no age limit and remains relevant to people who had carried on working past pension age. So this first part is suitable for readers of all ages...
Older readers may wish to be excused from later parts, although we will be delighted if you choose to stay with us...
This series has five parts:
- in this first part I’ll take a look at these benefits in general, how they fit into the broader scheme of things, other health related support and Statutory Sick Pay in particular
- next time I will take a look at Employment and Support Allowance and Universal credit (for sickness) in more detail.
- I will then move on to look at how these benefits can support you as you ease back into work including work you can do while still claiming them
- For some, “late effects” may mean it may take a lot longer to ease back into work so I take a look at the full Work Capability Assessment, when previous cancer related wave through the assessment run out.
- And finally, I will look at some other issues: work conditionality requirements that may bite more in recovery and why it can still be worth claiming when ESA/UC won’t actually pay you anything.
- Benefits for “sickness”
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1.1 What are the “sickness route” benefits?
These are benefits to give you a basic income to live on while you are off sick from work – whether you were employed, self-employed or looking for work when illness strikes.
A very few people may still be getting older benefits which are being gradually abolished as people switch over to ESA. These included: Incapacity Benefit, Severe Disablement Allowance and Income Support (for sickness). If you are still on one of these benefits, the DWP will be writing to you soon about switching to Employment and Support Allowance. This was meant to have been completed by the end of March 2014, but they didn't quite manage it.
We are now in the midst of another round of changes, as Universal Credit arrives on to the scene. So the current range of “sickness benefits includes:
- Statutory Sick Pay (SSP) is the minimum that an employer must pay in sick pay and applies to most - but not all – employees. You claim this from your employer; and
- Income Support (IS) for sickness: although largely replaced by ESA, IS continues as the means tested top up for SSP if you start a claim before your area switched over to the “full service” version of Universal Credit
- Employment and Support Allowance (ESA) if you don’t have an employer – e.g. if you are unemployed or self-employed - or are one of those employees who can’t get SSP. Or if you were getting SSP but this has now run out. ESA replaced two previous benefits combining them into one with two parts to it, one which is affected by most other income and savings and one which largely is not. You claim both parts of ESA in one claim from Jobcentre Plus, part of the Department for Work and Pensions.
- Universal Credit (UC) for sickness – this is gradually replacing six of the “working age” means tested benefits, rolling them into one. This means that the means tested part of ESA will be separated out and merged into Universal Credit. The tests for sickness largely reproduce those within ESA so moving over should not involve any new health assessment. The non-means tested Contributory ESA will remain as a separate benefit, but it has been affected by Universal Credit and its rather problematic story so far. Being unwell is only one reason for being eligible for UC as you switch horses to being back in work or looking for a new one in recovery.
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1.2 The two parts of ESA
Employment and Support Allowance originally came in two flavours:
- Contributory ESA, which you claim in your own right, is not means tested and is based on your National Insurance contributions, effectively replacing the previous Incapacity Benefit (formerly known as Sickness/Invalidity Benefit). This will remain as a separate benefit during and after the roll out of the new Universal Credit, but will be re-named “ New-style” ESA which will lose the link with:
- Income-related ESA which is a means tested version (i.e. affected by most other income and savings, claimed jointly with any partner. This replaced the former Income Support (for sickness) which was separated out and merged with the former Incapacity Benefit to form the new combined benefit of ESA. This part of ESA will re-unite with five other main working age into the new Universal Credit
The claim and assessment process and criteria for both types of ESA – and largely if you are claiming Universal Credit on grounds of sickness - are the same. In fact, you claimed the two parts of ESA as one benefit, unless you expressly chose not to claim Income-related ESA if you feel certain that you would not qualify for it. Arrangements for claiming under the new Universal Credit regime have got rather confused; more on that later. I will cover this common sickness journey within these blogs these blogs.
I will take a separate look at how the “means test” amounts are calculated for Income-related ESA in a later blog alongside the similar sums for the other “legacy” means tested benefits.
Universal Credit has a different take on means tested sums, the processes and claimant journey and respective responsibilities/duties of claimants and the department. It is to say the least rather struggling with these so definitely deserves its own blog or two.
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1.3 How do benefits for sickness fit in with the rest of the benefits system?
SSP and Contributory ESA are non-means tested benefits that offer a fixed sum to aimed at giving you a rather basic income – in your own right – when not working, but as you will see from the Benefits and Cancer series of blogs, these are by no means the only benefits you can claim.
SSP and ESA both come under Step 1 in my “three steps to maximum entitlement” suggested in the Benefit and Cancer blogs. But you may also get extra amounts:
- from Step 2 means tested benefits: this might be as top ups from Income Support (for SSP) , Income-related ESA (for Contributory ESA) or within Universal Credit. Or it may be help with specific costs to e.g. help with the rent, council tax, health costs and so on
- from Step 3: Extra non-means tested benefits – payable regardless of income and savings because you need extra support with daily living tasks or getting around. These “disability benefits” can be paid on top of all other benefits including sickness route ones like SSP, ESA and UC (for sickness). Step 3 also includes extra amounts for children such as Child Benefit.
For more details of the steps and a wider view of the benefits system for people with cancer please see the links below to the Benefits and Cancer blogs.
In general, you can only get one of the Step 1 benefits at the same time, which means you can’t get paid Carers Allowance or Retirement Pension at the same time as Contributory ESA. The benefits are said to overlap with each other, and while if in you can legitimately claim as many as you might qualify for, the DWP will effectively only pay you one.
The statutory payments are the awkward slight exceptions. They overlap with each other, so you can’t get SSP and say Statutory Maternity Pay at the same time, and with their equivalent benefit, so you can’t get SSP and ESA. But they don’t overlap with the remaining Step 1 benefits. So, if you are a carer who was working or past pension age but still with an employer then you can have any SSP alongside your Carer’s Allowance or Retirement Pension even though you wouldn’t be able to get these with ESA.
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1.4. "Disability" versus "sickness" benefits
There is an important distinction then between benefits for sickness when too unwell to work and benefits for disability. Many people mistakenly believe that they can’t get both.
- benefits for sickness are to give you a basic income - e.g. to cover food bills, ,clothes etc- replace earnings from work. The system seeks to encourage though to keep in touch with the world of work and does allow you to earn some money whilst claiming these benefits. So, the test is not that you would be totally unable to work but rather than you have limited capability for work. More on that in the rest of this series.
- disability benefits are extra amounts to help with additional difficulties with daily living tasks and getting around, regardless of whether this stops you working or not. While many claimants will be also claiming a sickness benefit, many others don’t: they may be claiming basic benefits as carers, lone parents or as a pensioner, but may all face the added costs of living with a disability or long term illness. Some will be actively looking for work as jobseekers while 16% of DLA/PIP claimants are actually in full time work.
The key point of this distinction, is that while both are related to health, each benefit aims to do different things . And that means you can claim both – e.g. ESA for sickness and PIP for disability or SSP for sickness and Attendance Allowance for disability - at the same time .
Sometimes you may just be getting the one: if your period of unwellness is too short for disability benefits or you arenow back in full time work, but still facing with long term difficulties from cancer’s “late effects”. Sometimes you may pass the tests for both ESA/UC (for sickness) and for a disability benefit such as Personal Independence Payment (PIP), but not get the sickness benefit if you have both insufficient National Insurance contributions for Contributory / “New-style” ESA or too much other income for Income-related ESA or Universal Credit. It is worth making the sickness claim, but you may just end up with the PIP “disability benefit”
It is then quite common to come across visitors to our centres, who have thought there is bound to be some immediate help when earnings are hit by sickness, but not that there is additional help for longer term limitations, whether working or not. And often people have been surprised that they can actually receive both a sickness and disability benefit.
The benefits system has traditionally recognised the difference with different benefits for sickness and for disability and still does and will two . However, the two types meet in the means tested sums where extra amounts are allowed both for sickness (for passing the tests for sickness) and via for disability premiums ( based on receiving a disability benefit).
Universal Credit has taken a different direction and merged the two – at least for some people – while abolishing extra amounts for disability for adults and halving them for most children. Some will be better off, others worse off as a result of this novel approach. But conflating and confusing sickness and disability, creates some very harsh cuts for some and does some bizarre things when e.g. people recovering from cancer want to move back into work.
There is and was a far better way to simplify what has undoubtedly become too complicated in the legacy system, but UC is starting to acknowledge they have some problems in achieving their stated aims and they could have avoided the embarrassment of being in the Courts – yet again – for disability discrimination.
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1.5 Who claims which “sickness route” benefit?
- Janet is in her 50s and works for an employer and has been in paid work for some years paying National Insurance. She has a partner who is in a well-paid job and jointly have built up some savings. She receives Statutory Sick Pay within her pay packet from her employers for up to 28 weeks, but when this stops, she can claim Contributory / “New style” ESA, regardless of whether her employers continue to pay her any contractual sick pay
- John is in his 40s and self-employed and has no employer to claim SSP from. He claims Contributory/ “New Style” ESA straight away.
- Zebedee had been unemployed before receiving a cancer diagnosis, so has no employer to claim SSP from and doesn’t have the right National Insurance contributions for Contributory ESA. He can claim either Income-related ESA or Universal Credit instead, depending on whether his area has gone over to the new system yet. All areas are due to do so by December 2018
- Florence does get Contributory ESA but has little other income. She is entitled to some tops ups from Income-related ESA because of: an award of Personal Independence Payment (PIP) from Step 3 and/or.extra amounts for a partner if she moves in with Dougal, affectionately. (NB: if Florence was previously entitled to Contributory ESA before UC came to her area then she remains entitled to have a top up from Income-related ESA added on to her ESA claim. If, however, she claimed “New Style” ESA under the new system, then any top up - and help with the rent - would be via Universal Credit)
- Jack is 66 and has claimed his Retirement Pension. He had carried on working after pension age, but then becomes ill so can still claim Statutory Sick Pay from his employer. However, he won’t be able to move on to Contributory ESA when his SSP ends as ESA overlaps with his State Retirement Pension and also has an age limit of 65. Retirement Pension is paid “in sickness and in health” and does not increase when you are unwell. But Jack may well qualify for additional help from Step 3 Attendance Allowance - regardless of income- based on the impacts of his cancer diagnosis, treatments and other health conditions. And from Step 2 Pension Credit based on both income and health issues.
- Jill is 43 and self-employed and living in an area where the new “full service” Universal Credit arrangements apply. She cannot get SSP from an employer but can claim “New Style” ESA straightaway, regardless of any other income or of any partner’s income . She may have been wrongly advised by DWP not to bother and claim Universal Credit instead. If she is entitled to a top up from Universal Credit, then she should claim both and if not then there is no point in claiming Universal Credit and she should just claim the “New Style ESA. In either case it will be well worth looking at other benefits such as Personal Independence Payment (PIP) as well.
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- Statutory Sick Pay (SSP)
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2.1 What is SSP?
Statutory Sick Pay (SSP) is the legal minimum that an employer must pay. Many employers may pay more as part of your contract with them. For example, some long serving employees might be entitled to e.g. up to 6 months full pay, followed by up to 6 months half pay as contractual sick pay from work However during the first 28 weeks of sickness, your pay will include Statutory Sick Pay, even if the amount on your payslip doesn’t change and you hardly notice that part of your monthly pay y is now SSP.
You claim SSP from your employer, though the system is policed by HM Revenue and Customs, who can resolve disputes
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2.2 Who can claim SSP?
Most – but not all employees can get Statutory Sick Pay. It’s more the legal minimum for an employer to pay rather than benefit, so say being of pension age or receiving most other benefits don’t get in the way of receiving SSP.
You may have only just started with an employer, but once you have turned up on your first day, you are covered by SSP. However, there are some employees who are excluded, so you can’t get SSP if:
- your average earnings - in the 8 weeks before SSP starts – were below the level at which you pay National Insurance (currently £116 gross per week).
- you haven’t yet started work or there’s a strike on.
- you have recently claimed and qualified for ESA in the last 2 to 3 months. You might then go back to those. Get advice.
- you are getting Statutory Maternity Pay, Maternity Allowance or are within your maternity period
- You are in prison or legal custody
If you work part time in two or more jobs you can add earnings together to cross that national insurance threshold if you need to, but can then only get SSP from one employer. If you earn more than £116 a week with more than one employer, then you can get SSP from each.
Your employer cannot dismiss you mainly to get out of paying you SSP. They would still be liable to pay you SSP. But it’s another matter if they can show your dismissal is for other reasons, in which case they don’t have to pay you SSP, but you may get ESA instead.
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2.3 How much is SSP?
SSP is paid at a flat rate of £95.85 a week (for April 2020/21), regardless of other circumstances.
If you just have one lot of SSP coming in and not much other income, then you may be able to get a top up from Income Support or if you are over pension age then Pension Credit. If you are newly sick and you area has gone over to “full service” Universal Credit, then the top up would be from Universal Credit instead.
Whether or not you qualify for a top up you may still help from other benefits for people on a low income. And regardless of your income and savings you may be able to get a disability benefit on top. For more on other benefits see under 1.2 above and have a look at the Benefits and Cancer blog.
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2.4 Who counts as “incapable for work” for SSP?
For SSP this applies if you are incapable of doing work that you could reasonably be expected to do under the terms of your contract because of a specific disease or physical or mental disablement. For the first week you certify yourself and after that by getting a “fitness for work” from your GP. These used to be known as “sick notes” or “sick lines”, but the name changed to emphasise any advice your GP can offer about ways to get back into work more quickly. However, after a cancer diagnosis this may usually be to concentrate on getting through treatment and recovery! You can see what a fitness for work note looks like on page 2 of the guidance for GPs – see under links below
During the coronavirus pandemic you can also claim SSP while "self isolating" for 14 days or "shielding", with evidence based on an NHS letter or an online seld isolation note.
Employers can seek advice from your GP, any occupational medical service or HMRC’s medical service if in doubt, but usually most employers will accept a cancer as a good reason for being off.
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2.5 How long is SSP paid for?
You don’t start getting SSP until the 4th day of incapacity. During these “waiting days” your employer doesn’t have to pay SSP. However, the waiting days are waived if you are self isolating or shielding under coronavirus restrictions. Your employer’s own scheme may cover you from day one.
At its simplest, you can receive SSP for up to 28 weeks. However, any shorter periods of sickness of less than 8 weeks apart are linked together within the same SSP period. The clock does not go back to zero, so you pick up at whatever weeks of sickness you finished last time. On the other hand, you don’t need to serve any “waiting days” at the start of a linked period of sickness.
Many people have been off with problems related to their cancer before the actual diagnosis may mean a longer spell off work to get it sorted, so you may not have 28 weeks of SSP to run when you are diagnosed.
Casual workers on less than 3 month contracts can still get SSP, but this might only last until any assignments of work that have been accepted would have been completed.
In the run up to your SSP running out - or if you can't get SSP - your employer should send you an SSP1 letter telling you when it’s running out or why you can't get SSP. You can see an example of one in the links below.
If you are not ready to return to work at the end of your SSP period, then you may be entitled to Employment and Support Allowance instead from the first day after your SSP ends. You can claim ESA even if your employer continues to pay you some sort of sick pay.
You can claim the ESA in advance so that your ESA is ready for you at the earliest date after your SSP stops and you won’t have to repeat those “waiting days” at the start of your claim.
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In the next blog
Next time we will take a look at Employment and Support Allowance in a bit more detail, which will can help either when SSP finishes or if you can’t get any SSP from the off.
If you have more general questions, or thoughts and experiences you would like to share about these benefits please join our Online forums
For individual face to face advice with a Benefits Advisor please visit your local Maggie’s centre. You can find your nearest centre here
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Useful links and further reading
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External links
- To see what a “fitness for work” certificate looks like see page 2 of the Guidance for GPs - here.
- An example of an SSP1 letter giving you notice of when your SSP is due to stop - here.
- DWP information on SSP - here
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Other blogs in this series
- Benefits when off sick (2) : ESA and UC (for sickness) and their criteria for sickness - here
- Benefits when off sick (3): Easing back into work while on benefits for sickness
- Benefits when off sick (4): Facing the full Work Capability Assessment
- Benefits when off sick (5): Work requirements when claiming for sickness and “credits only” claims
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Other relevant blogs and mini-series you may find useful:
- Benefits and Cancer – a useful overview and how sickness benefits fit in to the grand scheme of the benefits system and getting your full entitlement when affected by cancer – starting here
- Benefits in Pension Age – focussing on the different benefits world after 65-ish and additional help for people affected by cancer – starting here
- Disability Benefits – starting with AA, DLA, PIP and Cancer - here
- Means tested benefits – a look at the traditional “legacy” means tested benefit which remain very important until March 2023 starting here
- Universal Credit - introducing the new replacement for the 6 main means tested benefits for those of working age. UC aims to do things in a very different way from both the benefits it replaces and any other benefit - starting here
- Find out more about.... Benefits and Cancer
- Find out more about benefits for... Difficulties with day to day living and getting around