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The Statutory Sick Pay (SSP) form serves as a crucial document for employees who find themselves unable to work due to illness. When an employee has been sick for four consecutive days or more, they must complete this form to claim their SSP entitlement. The form requires basic personal information, including the employee's name, National Insurance number, and date of birth. It also asks for specific details about the illness, such as the start and end dates of the sickness, the last day worked, and whether the sickness was caused by a workplace accident or an industrial disease. Employees need to provide this information accurately, as it helps employers determine eligibility for SSP payments. If the illness extends beyond seven days, a medical statement from a doctor, often referred to as a 'fit note,' may be required. Once completed, the form should be submitted to the employer, who will then process the claim. If the employer denies the claim, they are obligated to provide a form SSP1, explaining the decision. This form can be used to support claims for other benefits, such as Employment and Support Allowance. Moreover, the SSP form includes guidance on additional support available for those who are ill, ensuring that employees are aware of their rights and options during a challenging time.

Preview - Ssp Form

Statutory Sick Pay (SSP)

Employee’s statement of sickness

About this form

Statutory Sick Pay (SSP) is money paid by employers to their employees who satisfy the conditions for payments when they are ill and unable to work.

Please fill in ‘Your statement’ below when you have been sick for four days or more in a row.

Your statement

About you

Surname or family name

First name(s)

Title – enter MR, MRS, MISS, MS, or other title

National Insurance number

Date of birth DD MM YYYY

Clock or payroll number

About your sickness. Please give brief details

What date did your sickness begin? DD MM YYYY

What date did your sickness end?

If you do not know, please leave this blank.

DD MM YYYY

The dates you put in these two boxes may be days you do not normally work. If you are sick for more than seven days, your employer may ask you for a medical statement of fitness for work ‘fit note’ from your doctor.

What date did you last work before your sickness began?

DD MM YYYY

What time did you finish work on that date? (enter time in 24 hours)

Was your sickness caused by an accident at work or an industrial disease?

No

 

Yes

If you answered ‘Yes’, you may be able to get Industrial Injuries Disablement Benefit. If you want information about claiming this benefit, ask at any Jobcentre Plus office or go to www.dwp.gov.uk

Signature

Date DD MM YYYY

Phone number

What to do next

Please:

give your completed form to your employer. It will help them to decide if you can get SSP

keep a copy for your own information.

If you can get SSP, your employer will pay you in the same way they usually pay your wages.

If you cannot get SSP, your employer must give you form SSP1 to tell you why. You can use form SSP1 to support a claim for Employment and Support Allowance.

If you disagree with your employer’s decision and you have also looked at the further information on the HMRC website, you can ask HM Revenue & Customs for a decision about your entitlement. You must do this

within six months of the first day that you are notified of your employer’s decision. Phone our DisputesPlease turn over Team on 0191 225 5221.

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HMRC 10/12

Other help while you are sick

You can get more information about other help while you are sick in leaflet DWP1026 Help if you’re ill or disabled.

You can get leaflet DWP1026 from:

any Jobcentre Plus office

most advice centres like the Citizens Advice Bureau, or

any post office (except in Northern Ireland), or

go to www.dwp.gov.uk

If you do not have much money coming in while you are sick, you may be able to get a Social Security benefit. You should contact any Jobcentre Plus office or, go to www.dwp.gov.uk

You can also phone the Benefit Enquiry Line for people with disabilities. The phone call is free. The number is 0800 882 200 or in Northern Ireland 0800 220 674.

If you have any problems with hearing or speaking and use a textphone, phone 0800 243 355. The phone call is free.

If you do not have your own textphone system, they are available to use at the Citizens Advice Bureau and main libraries.

If you want to know more about SSP go to www.gov.uk

Penalties

We may charge penalties where a person, either fraudulently or negligently, gives incorrect information or makes a false statement or declaration for the purpose of claiming entitlement to Statutory Sick Pay.

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Document Specifics

Fact Name Description
Purpose of SSP Statutory Sick Pay (SSP) provides financial support to employees who are unable to work due to illness, ensuring they receive compensation during their recovery period.
Eligibility Criteria To qualify for SSP, employees must be sick for four consecutive days or more and meet specific employment conditions set by their employer.
Medical Documentation If an employee is sick for more than seven days, their employer may request a 'fit note' from a doctor to confirm the illness.
Accident at Work If the sickness is a result of an accident at work or an industrial disease, employees may be eligible for additional benefits, such as the Industrial Injuries Disablement Benefit.
Submission Process Employees must submit the completed SSP form to their employer, who will then determine eligibility for payments.
Employer's Responsibilities If an employee is not eligible for SSP, the employer must provide form SSP1, explaining the reasons for the decision.
Dispute Resolution Employees can challenge their employer’s decision regarding SSP by contacting HM Revenue & Customs within six months of the notification.
Additional Support Employees seeking further assistance while ill can access various resources, including social security benefits and informational leaflets available at Jobcentre Plus offices.

Ssp: Usage Instruction

Filling out the SSP form is a straightforward process. This form helps your employer understand your situation when you have been sick for four days or more. After completing it, you will submit it to your employer, who will determine your eligibility for Statutory Sick Pay (SSP).

  1. Start by entering your surname or family name in the first field.
  2. Next, fill in your first name(s).
  3. Indicate your title by selecting MR, MRS, MISS, MS, or another title.
  4. Provide your National Insurance number.
  5. Enter your date of birth in the format DD MM YYYY.
  6. Fill in your clock or payroll number.
  7. In the section about your sickness, briefly describe your condition.
  8. Record the start date of your sickness in DD MM YYYY format.
  9. If applicable, enter the end date of your sickness in DD MM YYYY format. If you are unsure, leave this blank.
  10. Provide the date you last worked before your sickness began in DD MM YYYY format.
  11. Indicate what time you finished work on that date using 24-hour format.
  12. Answer whether your sickness was caused by an accident at work or an industrial disease by selecting Yes or No.
  13. Sign the form and enter the date of your signature in DD MM YYYY format.
  14. Lastly, provide your phone number.

After completing the form, give it to your employer. They will review it to decide if you qualify for SSP. Keep a copy for your records. If you do not qualify, your employer must provide you with form SSP1, which explains the reasons for the decision. This form can help if you wish to claim Employment and Support Allowance.

Learn More on Ssp

What is the Statutory Sick Pay (SSP) form?

The Statutory Sick Pay (SSP) form is a document that employees fill out to claim sick pay from their employers when they are unable to work due to illness. To qualify, employees must have been sick for four consecutive days or more. This form helps employers determine eligibility for SSP payments.

Who needs to fill out the SSP form?

Employees who have been ill for four or more consecutive days and wish to claim Statutory Sick Pay must complete the SSP form. This includes providing personal details, information about the sickness, and dates relevant to the absence from work.

What information do I need to provide on the SSP form?

When filling out the SSP form, you will need to provide the following information:

  • Your surname and first name(s)
  • Your National Insurance number
  • Your date of birth
  • Your clock or payroll number
  • The start and end dates of your sickness
  • The date you last worked before your sickness
  • Whether your sickness was caused by an accident at work or an industrial disease

What should I do after completing the SSP form?

After you have completed the SSP form, you should give it to your employer. It is important to keep a copy for your own records. Your employer will use this information to decide if you are eligible for SSP payments.

What happens if I am not eligible for SSP?

If you are not eligible for SSP, your employer is required to provide you with form SSP1. This form explains the reasons for the denial. You can use it to support a claim for Employment and Support Allowance if needed.

Can I dispute my employer's decision regarding SSP?

Yes, if you disagree with your employer's decision about your SSP eligibility, you can ask HM Revenue & Customs (HMRC) for a review. You must do this within six months of being notified of your employer’s decision. For assistance, you can contact the Disputes Team at 0191 225 5221.

Where can I find more information about SSP and other benefits?

For more information about Statutory Sick Pay and other support while you are sick, you can visit the following resources:

  • The official government website at www.gov.uk
  • Your local Jobcentre Plus office
  • Advice centres like the Citizens Advice Bureau

Common mistakes

Filling out the Statutory Sick Pay (SSP) form can seem straightforward, but many people make common mistakes that can lead to delays or complications in receiving their benefits. Understanding these pitfalls can help ensure that your application is processed smoothly.

One frequent mistake is failing to provide complete personal information. When filling out the section about yourself, it's crucial to include your full name, National Insurance number, and date of birth accurately. Omitting any of these details can create confusion and may result in your form being returned for corrections.

Another common error occurs in the sickness dates section. Some individuals mistakenly enter dates that do not align with their actual period of illness. It’s important to accurately indicate the date your sickness began and, if applicable, when it ended. Leaving these fields blank can lead to complications, especially if your absence exceeds seven days.

Many people also forget to mention whether their sickness was caused by an accident at work or an industrial disease. This information is vital because it can affect your eligibility for additional benefits. If you experienced a work-related injury, be sure to check "Yes" and provide any necessary details.

In addition, not signing the form is a common oversight. A signature is required to validate your statement. Without it, your employer cannot process your claim, which can lead to unnecessary delays in receiving your SSP.

Another mistake involves not keeping a copy of the completed form. This can be detrimental if you need to reference your submission later or if there are any disputes regarding your claim. Always retain a copy for your records.

Some individuals misunderstand the instructions regarding the medical statement of fitness for work, commonly known as a "fit note." If your sickness lasts more than seven days, your employer may request this document. Failing to obtain it when required can jeopardize your claim.

Lastly, many people overlook the importance of checking for any updates or changes to the SSP process. Regulations can change, and staying informed ensures that you are providing the most accurate and relevant information. Regularly visiting the official website can help you stay up to date.

Documents used along the form

When dealing with Statutory Sick Pay (SSP), there are several other forms and documents that may be needed. Each of these documents serves a specific purpose and can help streamline the process of claiming benefits. Below is a list of commonly used forms alongside the SSP form.

  • SSP1 Form: This form is provided by the employer if an employee is not eligible for SSP. It explains the reasons for the decision and can be used to support a claim for Employment and Support Allowance.
  • Fit Note: Also known as a medical statement of fitness for work, this document is issued by a doctor. It is required if an employee is sick for more than seven days and can support a claim for SSP.
  • DWP1026 Leaflet: This leaflet provides information on additional help available for individuals who are ill or disabled. It can be obtained from Jobcentre Plus offices or online.
  • Employment and Support Allowance (ESA) Claim Form: This form is used to apply for ESA, which provides financial support to those unable to work due to illness or disability.
  • National Insurance Number Application: If an employee does not have a National Insurance number, this application form is necessary for obtaining one, which is essential for SSP claims.
  • Social Security Benefit Application: This form is used to apply for various social security benefits if an employee is struggling financially while sick.
  • Dispute Form: If an employee disagrees with their employer's decision regarding SSP, this form can be submitted to HM Revenue & Customs to request a review.
  • Accident Report Form: If the sickness is due to a workplace accident, this form documents the details of the incident and may be required for certain claims.
  • Payroll Information Form: This document helps employers track employee payroll information, which is necessary for processing SSP payments.
  • Medical Records Release Form: This form allows healthcare providers to share medical records with employers or relevant authorities, which may be needed for SSP verification.

Understanding these forms can help ensure that the process of claiming SSP is as smooth as possible. Each document plays a vital role in supporting the employee's claim and ensuring they receive the necessary benefits during their time of illness.

Similar forms

The Statutory Sick Pay (SSP) form shares similarities with the Employee Leave Request form. Both documents require employees to provide personal details, including their name and identification numbers. They also ask for specific dates related to the leave, whether for illness or other personal reasons. The structure of both forms aims to gather necessary information that helps employers process requests efficiently. Ultimately, both forms serve to communicate an employee's need for time away from work.

Another document similar to the SSP form is the Family Medical Leave Act (FMLA) request form. Like the SSP, the FMLA form requires employees to state the reason for their leave and provide dates. Both forms emphasize the importance of notifying the employer in advance, whenever possible. They also help ensure that employees receive the appropriate benefits or protections while they are away from work, whether due to illness or family responsibilities.

The Medical Certification form also parallels the SSP form in its purpose. Both documents require information about the employee's health condition. While the SSP form focuses on sickness that prevents work, the Medical Certification form may require a healthcare provider's input. This ensures that the employer has the necessary documentation to support the employee's claim for benefits or leave. Both forms aim to provide clarity and support for the employee's situation.

Similar to the SSP form is the Occupational Health Referral form. This document is used when an employee's health condition impacts their ability to perform their job. Both forms require details about the employee's illness or condition. They also facilitate communication between the employee, employer, and healthcare professionals, ensuring that the employee receives the necessary support and accommodations. The goal of both forms is to protect the employee's rights while maintaining workplace efficiency.

The Sick Leave Notification form also shares characteristics with the SSP form. Both documents require employees to inform their employers about their absence due to illness. They typically ask for the dates of absence and may request a brief description of the illness. Both forms are essential for maintaining accurate records and ensuring that employees receive the appropriate pay or benefits during their time away from work.

Lastly, the Short-Term Disability Claim form resembles the SSP form in that it addresses situations where employees cannot work due to health issues. Both forms require personal information and details about the condition affecting the employee's ability to work. They also serve to initiate the process for receiving financial support during the period of absence. The focus of both documents is on ensuring that employees receive the necessary assistance while they recover.

Dos and Don'ts

When filling out the Statutory Sick Pay (SSP) form, it’s essential to be careful and thorough. Here are four important things to keep in mind:

  • Do ensure all personal details are accurate, including your name, National Insurance number, and date of birth.
  • Don’t leave out any required dates, especially the start date of your sickness. Incomplete information may delay your claim.
  • Do provide a brief but clear description of your sickness. This helps your employer understand your situation better.
  • Don’t forget to sign and date the form before submitting it. An unsigned form may be considered invalid.

Taking these steps can significantly impact your ability to receive the support you need during your illness. Act promptly and ensure your form is completed correctly.

Misconceptions

Here are seven common misconceptions about the Statutory Sick Pay (SSP) form:

  1. SSP is automatic and does not require a form. Many believe that they will receive SSP without submitting any paperwork. However, completing the SSP form is necessary to initiate the process.
  2. You can only claim SSP if you are off work for more than seven days. Some think that SSP is only available after a week of absence. In reality, you must fill out the form if you are sick for four consecutive days or more.
  3. Your employer decides if you qualify for SSP without any input from you. While employers assess eligibility, your completed form provides essential information that influences their decision.
  4. You must have a fit note from a doctor to claim SSP. This is not true for all cases. A fit note is only required if your sickness lasts longer than seven days.
  5. SSP is the same as regular pay. Some assume that SSP is paid at the same rate as their usual wages. In fact, SSP is a fixed amount set by the government and may be lower than your normal earnings.
  6. You cannot appeal if your SSP claim is denied. Many believe that a denial is final. However, you can dispute the decision with HM Revenue & Customs within six months of notification.
  7. SSP is only for full-time employees. This misconception overlooks that part-time workers can also qualify for SSP, provided they meet the necessary conditions.

Key takeaways

When filling out and using the Statutory Sick Pay (SSP) form, keep the following key takeaways in mind:

  • Eligibility: You must be sick for four consecutive days to qualify for SSP.
  • Personal Information: Provide accurate details such as your name, National Insurance number, and date of birth.
  • Sickness Dates: Clearly state the start date of your sickness. If you are unsure of the end date, you can leave that section blank.
  • Work Details: Include the last date you worked before your illness and the time you finished work on that day.
  • Accident Reporting: Indicate if your sickness was caused by a work-related accident or industrial disease. This could open up additional benefits.
  • Medical Evidence: If your sickness lasts more than seven days, your employer may request a ‘fit note’ from your doctor.
  • Submission: Submit the completed form to your employer promptly to facilitate their decision on your SSP eligibility.
  • Keep a Copy: Retain a copy of the completed form for your records.
  • Employer's Decision: If you are denied SSP, your employer must provide you with form SSP1, explaining the reason for the denial.
  • Dispute Process: If you disagree with your employer's decision, you can appeal to HM Revenue & Customs within six months.

Additional resources and support are available if you need help while you are sick. Consider reaching out to Jobcentre Plus or visiting the government website for more information.