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Wales Online
Wales Online
National
Ryan O'Neill

Universal Credit: your rights if you get sick while claiming benefits

Millions of people turn to the government for financial help every year.

From universal credit to holder legacy payments like housing benefit, there are several options available to people who are on a low income or who are struggling financially. You can claim universal credit whether you're working or not, although how much you earn in a job will affect how much money you get.

Read more: How to apply for the Welsh Government's £100 Universal Credit winter fuel payment

But the pandemic has thrown up some unexpected situations, it is is entirely understandable to be worried about what will happen to your benefits if you fall ill.

Here's what you need to know about getting sick while claiming benefits, including what you need to do and the money you can still receive.

Statutory sick pay (SSP)

If you fall ill while working, you might be entitled to get statutory sick pay (SSP). You can get £96.35 a week SSP for up to 28 weeks.

To get this, you must:

  • be classed as an employee and have done some work for your employer
  • earn an average of at least £120 per week
  • have been ill or self-isolating for at least four days in a row (including non-working days)

You can get SSP if you're off work because of having tested positive for coronavirus, if you've come into contact with someone who has tested positive for coronavirus, or if you’re self-isolating because someone in your ‘support bubble’ or extended household has symptoms or has tested positive.

If you're off because of coronavirus, you can get SSP for each day you're off sick. If it's for a non-Covid reason, you can get it from the fourth day you're off onwards.

You can also receive it if you're self-isolating before surgery or if you're sick for another reason. To find out more about SSP click here.

What if I'm claiming universal credit?

If you are on universal credit and develop a new health condition or disability, the DWP says this needs to be reported as a change of circumstances.

You can report changes via your online universal credit account. You can find out more about how to use your online account with this guide.

Reasons include becoming too ill to work or meet your work coach. If you have a short-term illness that prevents you working or looking for work, then you can report periods of ill-health of up to 14 days as a temporary period of sickness.

You are able to self-certify for up to the first seven days of your illness without needing a doctor's note by notifying universal credit advisers that you are ill and unable to work.

If you are still ill after seven days, you must give medical evidence to the DWP in the form of a doctor's sick note, now called a fit note. If you are off for reasons related to Covid-19, you might need proof that you are self-isolating. You can find out more about that here.

During this short spell of temporary illness, your universal credit should stay the same. You also may be also to claim SSP and universal credit at the same time. It might be wise to do this if you are struggling financially or need to support several people including children.

What happens if I am ill and haven't claimed universal credit yet?

If you are new to universal credit and making your initial application, you will be asked if you have a health condition or a disability which prevents or limits your ability to work.

If you answer 'yes' you could be asked to attend a work capability assessment (WCA).

In most cases, if you remain unable to work for four weeks, you will be referred for a WCA on the 29th day of your claim.

But you could be asked to go to an assessment on the first day if you are:

  • terminally ill
  • pregnant and there is a serious risk of damage to your health, or to the health of your unborn child if you do not refrain from work or work-related activity
  • receiving or are about to receive treatment for cancer by way of chemotherapy or radiotherapy – or you are recovering from such treatment
  • in hospital or similar institution for 24 hours or longer
  • prevented from working by law
  • receiving treatment such as dialysis, plasmapheresis or total parenteral nutrition for gross impairment of enteric function or are recovering after receiving one of these types of treatment

If you are deemed to be fit for work at your assessment, you have to agree to look for work that is suitable for your health condition, and be prepared to work to keep receiving universal credit.

Limited capability for work (LCW) means you are not expected to look for a job right away but must prepare to go back into employment, such as by writing a CV or undertaking training.

If you have limited capability for work and you started your universal credit claim before April 3, 2017, you get an extra £128.25 on top of the universal credit standard allowance. But if you claimed universal credit on or after that cut-off date, you don't get any extra benefit.

Limited capability for work and work related activity (LCWRA) means you don't have to look for work or prepare for work. You will receive an extra £341.92 in universal credit on top of the standard allowance.

What else should I know?

You’ll still get tax credits when you’re getting sick pay. It's possible that some benefits might even increase while your pay is less than usual. Tell the department that pay you about your illness to see if you are entitled to more.

If you have a long-term illness and your sick pay is ending, you might able to get new style employment and support allowance (ESA). Find out if you're eligible here.

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