Sick Pay

[Meli96]

I’m in London. UK. I’ve been off sick for nearly 2 years. First 12 months fit note said stress at work, but changed to Post Covid syndrome (long Covid) Anxiety and depression thereafter. I have income protection as employee benefit but he didn’t help and it was declined (even the appeal). Tried raising grievance but HR declined to even discuss it. What options do I have for income whilst sick?
Sick note resets after 12 months but I haven’t worked in between the sick notes when reasons for illness changed.
Cant find help to prepare for ombudsman or even fight insurer, which my employer should be doing.
any ideas or suggestions appreciated

If you're still too sick to work then apply for Employment and Support Allowance?

www.gov.uk/employment-support-allowance

Can you clarify a few things?

What do you think your employer has done wrong (what was in your grievance?) Have they paid you in line with their policy/your contract? Is it SSP only that has expired? do you get enhanced sick pay from your company? If so how much/for how long?

why do you think your employer should be fighting your insurance? What reason has your insurance given for declining your claim?

Presumably you were paid sick pay by your employer for the length of time stipulated in your terms and conditions. At some point you have ended up with nil pay from them as you have exhausted your sick pay. You have been off sick for nearly two years, and are still on their books? What money are you expecting from them? More details required here.

Do you still actually work there? Do they owe you any money?
You can claim ESA if you're too sick to work. And PIP if you're so unwell you struggle with day to day tasks. Do the forms for both of those.

Do you actually still have a job after 2 years off sick ?

What illness are you off with? I’m confused because you said the first 12 months was ‘stress at work’ …. So is it stress at work, long Covid, anxiety or depression?

What does your sickness policy say…..most have a rolling 12 month period for occupational sick pay and it doesn’t reset if the reason you are off changes. For example my workplace pays 26 weeks full pay and 26 weeks half pay but after that you are only entitled to SSP, so after a year off you’d have to be existing on SSP if you are still too ill to work or look at other benefits that you might qualify for. You also mention income protection that usually has its own conditions around how and when it’s paid so presumably you didn’t meet the conditions for it to pay out?

Wow my last job has two weeks sick pay then straight to SSP

policy outlines sick process and most company’s also have a capability policy - if you are not capable of work they are not obliged to keep you under contract

You sound like you’re taking the piss in my opinion. Surprised they haven’t got rid of you.
Did you change your reasons on your sick notes because your employer tried to engage and make adjustments for you etc?

You sound work shy to me

Are you expecting your employers to continue to support you after two years off work? That's preposterous

its Group Income Protection (GIP) and it’s an employee benefit my employer solely pays for. Employees are the beneficiaries only, since not policy holders to Sue insurer for breach of contract or anything else. Isn’t employer meant to support employees when in need to use any of the benefits employer provides? GIP starts after 6 months of sickness (so after SSP ends) and it’s for a maximum of 2 years. We have enhanced SSP (not sure of the name) where we get 70% salary (top up from sap to 70% salary) and GIP of 70% salary.
Therefore, you could be sick for 2.5 years and get 70% salary. I’ve had no help from employer and they’ve ignored me, lied to me, neglected me in different ways about different matters. Where is the employers duty of care? Insurer has declined saying I’m fine to work full time and declined to share health report. Even after SAR.
Insurer also said that because initial sick notes said stress at work, they don’t pay. Policy doesn’t mention specific illnesses excluded or included, but insurer says stress is not an illness but a symptom.

GIP policy would be applicable if I’m not able to do my job full time.

It’s huge consultancy company, my job is at client’s offices, and or from home. Also, project based and my part nearly done when I felt ill, so no one covering for my role. People moves a lot between projects and clients. Not typical job with employer’s offices or team members, etc. And I had 3 different managers in 7 months.

All sounds correct to me.

You sound like you know very little about many things, in my opinion. I didn’t change fit notes but I was diagnosed with post Covid syndrome, by the long Covid clinic, which triggered the change. Things take a long time in the NHS, specially since Covid. Employer hasn’t tried to make any adjustments at all. They have lied to me in some things and only when I push legally that they suddenly accept my legal rights. I don’t have an office to go to, or a team to work with, until I’m assigned to a project at a clients office. In the meantime you are on the bench, going through interviews. I hope this clarifies a bit.

Please read answers to similar questions. Thanks

Sickness policy is 70% salary for 6 months (including SSP in it). After 6 months you should get GIP (Group Income Protection), employee benefit & paid solely by employer. GIP is 70% salary for 2 years

It sounds like you didn't meet the criteria for the income protection insurance. That's bad luck but probably down to the policy wording. I guess you could sue your employer for breach of contract if you don't believe that they have fulfilled their contractual obligations to you, but I doubt that you'd get very far.

It seems that your best option would be to apply for disability-related benefits and/or seek alternative employment that you can regardless of your health issues.

Have you received payment over the past two years while sick?

After two years, I don’t think it is your employer’s responsibility to be paying you anymore and it sounds as though you are (sadly) no longer capable to fulfil the duties of that role.

As a pp said, it would be wise to consider Employment Support Allowance, PIP or UC at this stage.

please elaborate about “all”

Only for the first 6 months (like enhanced SSP). But I should have had income protection (employee benefit) for 2 years after that

One thing that stands out is that you say you tried to raise a grievance and HR refused to discuss. If you raise a grievance they have to deal with it in line with their grievance policy, so I don’t understand how they could refuse. Do you mean your grievance wasn’t upheld?

Have you tried anything else other than getting paid out on the income protection plan? I’m thinking about reasonable adjustments so that you can return in some capacity. Otherwise your options for income whilst long term sick are the same as everyone else’s. You can claim benefits if eligible, go back to work with adjustments or find another role which you can manage.

I don’t think it’s the employer’s responsibility to fight the insurance company, who will have made a decision based on the terms and conditions of the policy. Given that it has been determined you are not eligible for the insurance payment I’m surprised they haven’t dismissed you on capability grounds.

It sounds as though the providers of the income protection are saying you don’t meet the criteria and you already plan to tackle this through the ombudsmen. What is the plan over the next few months/ year? Are you wanting to return to work with reasonable adjustments? Arranging a meeting with your manager and hr to discuss this would seem reasonable. It has been two years so if you aren’t able to consider going back to work at this point ( even with adjustments), is it a case of accepting that you are no longer able to do your job? You could apply for ESA.

If it's like the policy my old employer had, the company pay for it as a perk of employment but its nothing to do with the employer as to weather the insurance company pays out. So you probably need to take it up directly with the insurance company. But you can probably clarify that with the company first, but they won't have any say as to weather the insurance company pays out.

So it's a bit like if your company never had insurance and you just paid for that sort of insurance for yourself instead. The only difference here is your company has paid into a group scheme (probably got a discount for everyone) and given it as a job perk. They have no control over the payout as it's not their business.

I assuming you where signed off with stress to start with as your doctor hadn't diagnosed the long covid. Maybe it was the wrong thing for them to sign you off with. Weather your GP or clinc can help you with evidence for your claim to the insurance company maybe an option. They do help with PIP claims so worth asking.

Your issue with HR and your job is your return to work and adjustment to your job role.

When did I mention the ombudsman 🤔
My manager hasn’t contacted me even once, besides replying to my email update for the fit note extensions. Wishing me to get well soon. Only HR contacted me. Don’t know what adjustments available for my illnesses and hard to trust those that haven’t been supportive or have lied. I’m exhausted.

Can’t find help to prepare for ombudsman- which led me to believe this was your next step.