Hello Mike,
Last week, I attended your very informative session on UC and PIP.
I work with a woman who is 54 and is married, lives with her husband.
She’s severely ill, which is being managed by drugs. Currently she has been diagnosed with more complications and has been signed off from work.
Her employer will finish paying her salary at end of this month and she will have to claim SSP.
The question is would she be able to claim Universal credit? Her husband works full time. And when can she apply?
Nefertari
Hello Nefertari,
I’m going to over-answer your question (because that is what I do)
The first thing to think about with this lady’s situation is PIP:
As you know, PIP is a benefit for people who need help to look after themselves, or people who have difficulties getting around.
Something that didn’t get a mention the other day is the special rules for PIP.
If you have a health condition from which your death could reasonably be expected in the next 12 months then you automatically qualify for the high rate of PIP’s Daily Living Component, under the special rules.
Note the way that this is phrased, it’s not that your doctor thinks you will die in the next year, it’s that your death would not be a surprise.
If this is so, she can ask her doctor to submit a form SR1 to the DWP.
Here is the DWP web-page about special rules claims.
If she does not come under the special rules than she could claim PIP in the normal way – explaining that she needs aids, or prompting, or physical help, or supervision, in order to do the PIP tasks in a reasonable time, without too much pain/discomfort, whenever she needs/wants to do them.
Next, I’m going to ponder on sick-pay:
Statutory Sick-Pay is the legal minimum that an employer must provide during the first 28 weeks of sickness. From 6 April 2026, it’s £123.25pw.
Good employers often make that up to the normal level of wage (or some other higher amount).
The extra amount is called occupational sick pay or contractual sick pay (because it depends on your contract for your occupation)
So, I would expect that she has already been getting SSP made up to the normal wage, rather than getting normal wage, then moving onto SSP.
Also, some good employers continue to pay contractual sick-pay even after the SSP has ended.
This is worth checking.
ESA when the SSP ends
ESA is another thing that didn’t get a mention during our training day.
ESA stands for new-style-contributory-Employment and Support Allowance (ffs!).
This is an instead-of-a wage-benefit for people who have Limited Capability for Work You will remember from the training: LCW means you’re ill, LCWRA means you’re very ill.
To get ESA, you must have worked and paid national insurance in one of the two tax years before the year in which you make the ESA claim.
To start the claim you should submit a sicknote from your GP practice, to show that you have Limited Capability for Work.
The DWP then does a Work Capability Assessment (the health journey) to confirm this.
If she has submitted an SR1 form in relation to her PIP claim, DWP will not do the full Work Capability Assessment, and will automatically treat her as having both LCW and LCWRA.
You get:
£95.55 for the first 13 weeks
£95.55 from week 14 onwards if you have LCW only – Maximum one year.
£145.90 from week 14 onwards if you have both LCW and LCWRA – Indefinite payments
ESA is non-means-tested so it is paid regardless of saving and almost all income – though it may be reduced if you have a private pension.
At last, I’m (not) answering your question – Can she get UC, and when should she claim it?
It may be that even with her sick pay and her husband’s wage they are currently entitled to UC – so claim now.
It may be that at the moment they are too rich for UC, but they will become entitled once her sick-pay ends – so claim then.
It may be that even once her sick pay ends, they will still be too rich for UC because of the husband’s wage – so no point claiming.
To throw some spanners-in-the-works:
It might be that claiming ESA (which UC counts as income) might make them too rich for UC – in which case she might be better off not claiming the ESA, so that she gets the UC, because UC passports her to things like free prescriptions.
It might be that they are not currently entitled to UC, but once the LCWRA element kicks in (after a three month waiting period) they will become entitled; in which case they can claim now, to start the clock ticking on this.
If you claim too early, DWP can treat it as a claim on the right day (within a month), but there is no way of being sure they will do this, or making them do it.
So! Right now, it’s impossible to know when/whether they should claim UC. However, if you can find out:
- Does she already get PIP? if so, amount?
- What’s going on with her sick pay?
- How much the husband earns – take-home?
- What’s their housing situation? Owner or renter? If renter, social or private? Amount of rent? How many bedrooms? Does anyone else live with them?
Then I will be able to give you a clear and specific answer.
🙂
Mike
Mike Bolton
07949 525371