Free Ssp Form in PDF

Free Ssp Form in PDF

The Statutory Sick Pay (SSP) form is an essential document for employees seeking to claim sickness benefits when they are ill and unable to work for four consecutive days or more. This form serves as an employee's statement of sickness, requiring details such as personal information, the period of sickness, and any relevant dates related to the illness. Interested employees are encouraged to carefully fill out their statement and provide it to their employer to determine their eligibility for SSP. For assistance in filling out the form, click on the button below.

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Navigating sickness while employed can be a daunting process, but understanding the role and requirements of the Statutory Sick Pay (SSP) Employee’s Statement of Sickness can alleviate some of these challenges. This form is integral for employees seeking to claim SSP, a provision meant for those unable to work due to illness. It requires the employee to detail their period of sickness—initiating from the fourth consecutive day of illness—and includes essential personal information, such as surname, first name, national insurance number, and the specifics of the sickness period. Completion of this form and its submission to the employer enables the determination of SSP eligibility. The document outlines additional responsibilities for the employee, including the requirement of a medical 'fit note' for sickness extending beyond seven days, and the process to follow should they disagree with the employer's decision regarding SSP. Furthermore, the form references supports available to those sick and in financial need, directing individuals to valuable resources and benefits that may be of assistance during this period. Understanding the various aspects of this form and the processes it facilitates is pivotal for employees navigating the complexities of sickness within the employment landscape.

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 Specs

Fact Name Fact Detail
Form Purpose The SSP form is used by employees to claim Statutory Sick Pay from their employer when they are ill and unable to work.
Eligibility Requirement Employees must have been sick for four days or more in a row to fill in the "Your statement" section of the form.
Information Required The form requires personal details, National Insurance number, sickness details, and the last workday before sickness began.
Sickness Duration If sick for more than seven days, the employer may request a 'fit note' from a doctor.
Industrial Injury Employees must indicate if the sickness was caused by an accident at work or an industrial disease, which may qualify them for Industrial Injuries Disablement Benefit.
Next Steps After completing the form, it should be given to the employer to decide SSP eligibility.
SSP Payment If eligible, SSP will be paid in the same way as usual wages by the employer.
Disagreements Disagreements with the employer's decision on SSP entitlement can be taken to HM Revenue & Customs within six months for a decision.
Additional Help For further assistance during sickness, resources such as the DWP1026 leaflet and the Benefit Enquiry Line are available.

Instructions on Writing Ssp

After experiencing sickness that keeps you away from work for more days than usual, the process to potentially receive some support during this challenging time involves filling out the Statutory Sick Pay (SSP) form. This is an essential step towards informing your employer officially about your situation, allowing them to process your eligibility for SSP. Make sure to complete this form with care and accuracy to avoid any delays or misunderstandings. Here's how you can do it:

  1. Start by providing your personal information in the ‘Your statement’ section. This includes your surname or family name, first name(s), and title (such as MR, MRS, MISS, MS, or other). This basic information is crucial for your identification within the employer's records.
  2. Enter your National Insurance number and Date of Birth, ensuring the format is correct (DD MM YYYY) for the date fields. These pieces of information are key to linking your health situation with your employment and legal entitlements.
  3. Provide your clock or payroll number if applicable. This further assists in your identification in your employer's payment system.
  4. Move on to the section ‘About your sickness’. Here, you're required to give brief details starting with the date your sickness began and ended. If you're still sick and unsure when you'll return to work, leave the end date blank.
  5. Specify the last date you worked before your sickness began, along with the time you finished work on that day, using the 24-hour clock format. These details help ascertain the duration of your sickness absence.
  6. Answer whether your sickness was caused by an accident at work or an industrial disease. Should your answer be 'Yes', note that you might be eligible for additional benefits like the Industrial Injuries Disablement Benefit.
  7. Sign and date the form at the bottom. Your signature is necessary to validate the information provided. Ensure the date is accurate (DD MM YYYY).
  8. Lastly, include a contact phone number where you can be reached. This is important for any follow-up questions or clarifications needed regarding your SSP claim.

Once the form is fully completed, hand it over to your employer to kickstart the processing of your SSP. Make sure to keep a copy for your record. If your employer determines that you are eligible for SSP, the payments will be made in the same manner as your usual wages. However, if you do not qualify for SSP, you will receive a form SSP1 explaining why and guiding you on how to apply for Employment and Support Allowance instead. Should there be any disagreements on your SSP eligibility, remember that you have the right to request a formal decision from HM Revenue & Customs within six months from your employer's initial decision.

Understanding Ssp

What is Statutory Sick Pay (SSP)?

Statutory Sick Pay (SSP) is a payment made by employers to their employees who are unable to work due to illness. Employees must meet certain conditions to qualify for these payments.

When should I fill out the SSP form?

You should complete this form if you have been sick for four or more consecutive days. This includes days that you do not usually work.

What information do I need to provide in 'Your statement' section?

In the 'Your statement' section, you need to include your personal details like surname, first name(s), title, National Insurance number, date of birth, and clock or payroll number. Additionally, you need to give details about your sickness, including the start and end dates of your sickness, the last day you worked before your sickness began, and whether your sickness was due to an accident at work or an industrial disease.

What if my sickness lasts more than seven days?

If you are sick for more than seven days, your employer may request a medical statement or a 'fit note' from your doctor to confirm your condition.

What should I do after completing the form?

After filling out the SSP form, you should give it to your employer. This will help them determine if you are eligible for SSP. Make sure to keep a copy of the form for your records.

What happens if I'm not eligible for SSP?

If you are not eligible for SSP, your employer must provide you with form SSP1, which explains why. You can use form SSP1 to support a claim for Employment and Support Allowance.

What if I disagree with my employer's decision on SSP?

If you disagree with your employer's decision regarding SSP, and after reviewing the information on the HM Revenue & Customs (HMRC) website, you feel it is incorrect, you can contact HMRC for a decision. You must do this within six months from the first day your employer notified you of their decision. Contact HMRC's Disputes Team for assistance.

Can I get other help while I'm sick?

Yes, additional support may be available if you're ill or disabled. Information can be found in the leaflet DWP1026, which is available from Jobcentre Plus offices, Citizens Advice Bureau, post offices (not in Northern Ireland), or online. If your income is low during your sickness, you might qualify for a Social Security benefit, for which you should contact a Jobcentre Plus office. Also, free phone assistance is available through the Benefit Enquiry Line for people with disabilities.

What are the penalties for providing incorrect information on the SSP form?

Penalties may apply if someone fraudulently or negligently provides incorrect information or makes a false statement or declaration to claim SSP entitlement. It's important to ensure all information provided on the form is accurate and truthful.

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

For more detailed information about SSP and other forms of assistance, visit the official government website at www.gov.uk or contact your local Jobcentre Plus office. Additionally, the Citizens Advice Bureau can provide guidance and help for understanding your rights and the benefits you might be entitled to.

Common mistakes

Filing out the Statutory Sick Pay (SSP) form can seem straightforward, yet many people stumble over common pitfalls that can delay or affect their benefits. It is crucial to be meticulous and aware of these mistakes to ensure a smooth process.

One of the first mistakes is incorrect personal information. Ensuring your surname, first name(s), title, National Insurance number, and date of birth are accurately recorded cannot be overstated. Errors here can result in significant delays.

Another common error is not being precise with the sickness dates. It's important to accurately enter the date your sickness began and, if known, the date it ended. Remember, these dates should match your actual days of illness, regardless of your normal work schedule.

Often overlooked is the detail surrounding the last day worked before sickness. This includes not only the date but the exact time you finished work. Accuracy here helps clarify the onset of your illness in relation to your work schedule.

Many individuals neglect to indicate whether their sickness was caused by an accident at work or an industrial disease. Acknowledging this can open eligibility for additional benefits, such as Industrial Injuries Disablement Benefit.

One crucial step that is frequently missed is signing and dating the form. Without a signature and the correct date, the form is considered incomplete and cannot be processed.

Failure to provide a contact phone number is another common mistake. Although this might seem minor, it can lead to delays if your employer or HMRC needs to clarify any information with you directly.

A significant number of individuals forget to keep a copy of the form for their records. Having a copy is essential for future reference, especially if there are any disputes or if you need to claim other benefits.

Not understanding the next steps, especially if SSP is not granted, leads to confusion. If SSP cannot be paid by your employer, knowing how to use form SSP1 and contacting HM Revenue & Customs for a decision on your entitlement is key.

Last but not least, many miss out on additional support due to a lack of awareness. Information on other help available while you are sick, including contact numbers and websites for relevant services, should be noted and acted upon if needed.

Documents used along the form

When handling Statutory Sick Pay (SSP) matters, several documents and forms often accompany the SSP Employee’s Statement of Sickness, ensuring both employee protections and employer compliance. These documents facilitate a transparent and efficient process for managing sickness absences, allowing for a better understanding of the employee's situation and any subsequent entitlements they may have. Below is a comprehensive list of other key forms and documents typically used alongside the SSP form.

  • Fit Note (Statement of Fitness for Work): Issued by doctors after the first seven days of sickness, the Fit Note provides evidence of the employee's inability to work and any recommendations for phased returns or workplace adjustments.
  • SSP1 Form: If an employee is not eligible for SSP or their entitlement has ended, employers provide this form, which the employee can use to support a claim for Employment and Support Allowance (ESA).
  • Employee Personal Details Form: Collects comprehensive personal and medical information, ensuring accurate record-keeping and facilitating any necessary adjustments or support.
  • Return to Work Form: Completed upon an employee's return, detailing their readiness to resume duties, any on-going health issues, and adjustments or support required.
  • Accident Report Form: In cases where sickness is related to a workplace incident, this form documents the details of the accident or industrial disease, aiding in claims for Industrial Injuries Disablement Benefit.

These documents, used in conjunction with the SSP form, play an instrumental role in the proper management of sickness absence. They ensure that all necessary information is efficiently communicated between the employee, employer, and any relevant third parties. This collection facilitates a more comprehensive understanding of the employee's circumstances, allowing for an informed processing of SSP and any additional support that may be required. Helping to streamline administrative processes and maintaining clear records, these forms and documents contribute to a well-organized and empathetic approach to employee sickness benefits and support.

Similar forms

The Family and Medical Leave Act (FMLA) certification form is similar to the SSP form as it also relates to employee health and time off work. Both forms require details about the health condition impacting the employee's ability to work. However, the FMLA form is used in the United States to certify the need for leave for serious health conditions affecting the employee or their family members, potentially offering up to 12 weeks of unpaid leave, whereas the SSP form is used in the UK specifically for sick pay eligibility.

The Personal Independence Payment (PIP) form, like the SSP form, is concerned with health conditions, but focuses on long-term ill health or disability. Both documents require detailed personal and health information. PIP assists with extra living costs for individuals with long-term ill health or disability, differing from SSP by not being restricted to employment scenarios. The SSP form is primarily for employees to claim sick pay during shorter periods of illness.

The Universal Credit (UC) application shares similarities with the SSP form, as both involve individuals reporting their current circumstances to access financial support. The SSP form is specific to sickness and employment, while UC provides a broader safety net covering aspects like low income, unemployment, and incapacity due to illness, demonstrating a more comprehensive approach to welfare support than SSP.

The Employee's Compensation Declaration Form, akin to the SSP form, is used when an employee is unable to work due to sickness or injury. However, it specifically caters to workplace injuries or occupational diseases, potentially leading to compensation over and above regular salaries or sick pay. Both forms require information about the incident and the resulting absence from work, yet they serve different purposes within the realm of employee health and safety.

The Short-term Disability (STD) claim form also resembles the SSP form, as both involve situations where an employee cannot work due to health issues. STD benefits are usually part of an employer's benefits package or an insurance policy, providing a portion of the employee's salary for a limited time. While the SSP form is a statutory requirement in the UK, STD claims are more common in the U.S., covering a wider range of health-related work absences.

The Workers’ Compensation Claim form, while focusing on employment-related injuries or illnesses like the SSP form, is geared specifically towards incidents that occur at the workplace. Both forms require details of the condition and its impact on the employee's ability to work. Workers’ Compensation, however, also covers medical bills and rehabilitation costs, differing from the SSP’s provision of sick pay alone.

The Employment and Support Allowance (ESA) claim form is related to the SSP form in its focus on health conditions impacting work capability. ESA is aimed at individuals who are unable to work due to illness or disability, offering financial support and personalized help to get back into work if able. Though similar, the SSP form is used for short-term sickness absence, while ESA caters to longer-term incapacity.

The Fit Note, or the Statement of Fitness for Work, is directly related to the process outlined in the SSP form, as it is the document a doctor provides to certify an employee’s fitness for work after seven days of sickness. It advises the employer about the employee’s capabilities and any adjustments that might be needed to facilitate their return to work. While the SSP form initiates the process for claiming sick pay, the Fit Note offers medical evidence to support this claim.

Dos and Don'ts

Filling out the Statutory Sick Pay (SSP) Employee’s statement of sickness requires both attention and honesty. Here are some key dos and don'ts to guide you through the process:

Dos:

  • Read the form carefully before you start filling it out to make sure you understand what's required.

  • Fill in the form as soon as you're eligible (after being sick for four or more days in a row) to avoid delays in payment.

  • Provide accurate information about your sickness, including the correct dates your sickness started and ended.

  • If applicable, include details about whether your sickness was caused by an accident at work or an industrial disease.

  • Keep a copy of the completed form for your records after you’ve given the original to your employer.

  • Sign and date the form – an unsigned form may not be processed.

  • Include your phone number in case your employer or HM Revenue & Customs needs to contact you for further information.

  • Consult with HM Revenue & Customs within six months if you disagree with your employer's decision regarding SSP.

  • Check the HMRC website for additional information if you have any doubts or need further clarification.

  • Explore other support options available while you’re sick, as mentioned in the leaflet DWP1026 and on the DWP website.

Don'ts:

  • Don't leave any required fields blank unless instructed (e.g., the end date of your sickness if unknown).

  • Don't guess dates or times; ensure the information provided, particularly about your sickness period, is accurate.

  • Don't forget to ask for a "fit note" from your doctor if your sickness lasts more than seven days, as your employer may request it.

  • Don't attempt to fill in the form if it is unclear or if you have questions; seek clarification first.

  • Don't provide false or misleading information on the form – penalties may apply for fraudulent or negligent claims.

  • Don't wait longer than six months to consult with HM Revenue & Customs if there’s an issue with your employer's decision.

  • Don't ignore additional support options available to you while you are sick, which can be explored through the DWP or HMRC websites.

  • Don't neglect to give your completed form to your employer or to keep a copy for your personal records.

  • Don't hesitate to contact any Jobcentre Plus office if you're interested in claiming Industrial Injuries Disablement Benefit following a work-related sickness.

  • Don't overlook the availability of social security benefits if your income is significantly affected while you are sick; inquire about your eligibility.

Misconceptions

There are several misconceptions about the Statutory Sick Pay (SSP) form. Clarifying these can help both employers and employees understand their rights and obligations better. Here are seven common misunderstandings:

  • SSP is optional for employers: Some people think that SSP is at the discretion of the employer. However, it's a legal requirement for eligible employees who are ill and unable to work, provided they meet the conditions for payment.
  • Only full-time employees qualify: There's a misconception that part-time or temporary workers aren't eligible for SSP. In reality, most employees, regardless of their working pattern, can qualify for SSP, as long as they meet other eligibility criteria such as their earnings threshold and the number of days they've been sick.
  • A medical note is needed for any period of illness: Employees are often under the impression that they need to provide a doctor's note for any sickness to receive SSP. However, for sicknesses of seven days or fewer, employees can self-certify their illness using the SSP form without needing a medical note.
  • SSP can be claimed for any day missed: Some believe SSP covers all days off due to illness. Actually, there's a waiting period; SSP is not paid for the first three qualifying days, termed 'waiting days,' of sickness.
  • The amount of SSP is determined by the employer: The rate of SSP is set by the government, not at the employer's discretion. This rate can change annually, so it's important to check the current rate each tax year.
  • SSP must be claimed immediately after the sickness: There's often confusion about when to claim SSP. Though it's advantageous to notify the employer as soon as possible, there's a window within which you can still make your claim. Employees should adhere to their employer's notification time frames where possible.
  • If turned down for SSP, there's no further action to take: If an employer decides an employee is not eligible for SSP, they must provide form SSP1, explaining why. This form can be used to apply for Employment and Support Allowance. Furthermore, if an employee disagrees with the decision, they can ask HM Revenue & Customs to review their SSP entitlement.

Understanding these aspects of SSP can ensure both employers and employees handle sickness absence fairly and in compliance with legal requirements. Always refer to the latest government guidance to get the most current information regarding SSP.

Key takeaways

Filling out and utilizing the Statutory Sick Pay (SSP) Employee’s Statement of Sickness form requires attention to detail and understanding of certain key points that ensure compliance and proper claim processing. Here are four critical takeaways:

  • Timing Matters: It’s important to note that the SSP form should be filled out when an employee has been sick for four days or more consecutively. This time frame includes days that the employee may not normally work.
  • Accuracy in Reporting Dates: The form requires accurate information regarding the start and end dates of the sickness. If the end date is unknown, it’s acceptable to leave this blank. Additionally, detailing the last day worked before the onset of sickness and the exact time work ended is crucial for establishing eligibility and the duration of SSP.
  • Supplementary Documentation: In cases where sickness extends beyond seven days, the employer may request a 'fit note' from a doctor. This medical statement is essential for substantiating the claim for SSP and must be presented to continue receiving SSP benefits beyond the initial self-assessment period.
  • Understanding Benefits and Rights: If an employee’s sickness is a result of an accident at work or an industrial disease, there could be eligibility for Industrial Injuries Disablement Benefit. Additionally, if SSP is not granted, the employer must provide an SSP1 form, which is vital for supporting a claim for Employment and Support Allowance. Knowing one's rights and the additional steps to take if SSP eligibility is in question—including contacting HM Revenue & Customs—is imperative for ensuring rightful benefits.

Moreover, the form serves as a gateway to understanding additional supports available during sickness. Information on further help, including financial assistance for those with limited income during their period of illness, is accessible through resources provided by the form. Awareness and pursuit of such support can provide crucial aid during challenging times.

Compliance with providing accurate information and timely submission of the SSP form and any additional required documentation safeguard the employee's rights and ensure the proper handling of their sick pay claim. Each step, from initial submission to possible disputes, is structured to protect both the employer's and employee's interests, making understanding these key takeaways critical.

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