Breast Cancer Care

Summary of benefits

Statutory Sick Pay (SSP)

If you are working and are sick for four or more days in a row, you are probably entitled to Statutory Sick Pay from your employer for up to 28 weeks in any period of sickness or series of linked periods of sickness. You will be entitled to SSP only if, before your period of sickness, your average weekly earnings started at or above the lower earnings limit at which NI contributions become payable.

SSP is the legal minimum that your employer has to pay, but your work contract may provide better conditions, so do check your company’s sick pay arrangements. You need to tell your employer that you are sick immediately and produce a doctor’s certificate after seven days. Your employer will then pay your SSP to you in the same way as your salary. Working tax credits can be paid to you throughout this period. If you are still sick after 28 weeks, you can claim Incapacity Benefit.

Incapacity Benefit (IB)

You may be unable to work because of your breast cancer or your treatment, or you may not have a job. You can claim Incapacity Benefit if:

• you are incapable of work and
• you are under pension age and
• you have paid enough NI contributions and
• you are not entitled to SSP, or your SSP has run out after 28 weeks.

Even if you are not sure whether you have paid sufficient NI contributions, you should still make a claim as Jobcentre Plus will check your records. Young people who have been incapable of work since before age 20 (or 25 if they have been in education or training) can claim IB without needing to satisfy the NI contribution conditions. As part of the process Jobcentre Plus will assess the level of your incapacity. There are two different tests depending on how long you have been sick: the ‘own occupation test’ and the ‘personal capability assessment’.

Criteria for eligability

For the first 28 weeks of your incapacity for work you will be assessed under the ‘own occupation test’ (as long as you have worked at least 16 hours a week in eight out of the last 21 weeks immediately before the claim). For this period it will normally be enough to provide medical certificates from your GP to confirm that you can’t do your usual job.

After 28 weeks of incapacity, or sooner if you haven’t worked recently, Jobcentre Plus will want to do a ‘personal capability assessment’ to decide if you are still incapable of work. This assesses your ability to do any sort of work, not just your usual job. It looks at your ability to carry out a range of activities such as walking, standing and sitting, and, if appropriate, includes an assessment of your mental health.

Payment

IB is paid at three rates.

• The short-term lower rate is paid for the first 28 weeks (unless you are entitled to SSP from your employer).
• The short-term higher rate is paid from your 29th week of incapacity.
• The long-term rate is paid from your 53rd week of incapacity.

Special circumstances

If your cancer is incurable and it is likely that you will not live for longer than six months, or you receive the high-rate care component of Disability Living Allowance, you should receive IB paid at the long-term rate after 28 weeks instead of 52 weeks.

The Employment and Support Allowance (ESA)

This benefit will be introduced in October 2008 for people whose ability to work is limited by ill health or disability. It will replace income support (IS) that is paid on the grounds of incapacity, and incapacity benefit. ESA will initially only be for new claimants. Those already receiving IS for incapacity or IB will be unaffected at present, although the government plans to move them onto ESA eventually.

People claiming ESA will have to undergo a 13-week Personal Capability Assessment (PCA) unless they are terminally ill
or achieve one of the following:

1. pass a contributory test (to make sure they have paid enough national insurance in specific tax years)
2. be under 20 years old (or 25 if they have been in education or training)
3. pass a low-income test.
    

The ESA PCA is a test carried out by a healthcare professional on behalf of the Department for Work and Pensions. If you take this test, it should:

• find out whether you have a limited capacity for either work or work-related activity
• involve a work-focussed health-related assessment.

If you are eligible for benefits, the amount that you receive will depend on whether it has been decided that you do or do not have a limited capacity for work-related activity. If you do not have a limited capacity for work-related activity, you will need to attend five further work-focussed interviews with the long-term goal of helping you back into work.

During the assessment phase for ESA, you can only be paid the benefit at a reduced rate (subject to a means-tested top-up). After the assessment phase is over, you will receive an additional payment. The rate of this will be determined by whether or not you have a limited capacity for work.

You can get up-to-date information about ESA from the Department for Work and Pensions website at www.dwp.gov.uk/esa

Disability Living Allowance (DLA)

If you are under 65 and you need help with your personal care (including supervision) and/or getting around, you may be entitled to Disability Living Allowance (tax-free). If you were over 65 when you started to need help, see Attendance Allowance section.

DLA is not dependent on your NI contributions, any savings or any income you or your partner may have. DLA can act as a gateway to certain other types of help, so if you are eligible it is an important benefit to receive. To be eligible for DLA you should normally have needed help for at least three months and be likely to need it for at least a further six months. It is important to be realistic and not underestimate the help that you need. DLA is divided into two components.

• The care component (paid at one of three rates). Entitlement depends on needing help with activities such as washing, using the toilet, dressing, eating and communicating. You are eligible for the allowance even if no one is giving you the care you need. You only have to show that you need the care
• The mobility component (paid at one of two rates). Entitlement depends on being unable or virtually unable to walk or needing guidance and supervision when outdoors.

Special circumstances

If your breast cancer is incurable and it is likely that you will not live for longer than six months, special rules apply so that you can get your benefit more easily and quickly. You don’t need to wait until you have needed help for three months and you receive the highest rate of the care component whether or not you need any help with this care.

If you have mobility difficulties, you can receive the mobility component immediately. Your Macmillan nurse, cancer specialist or GP can help you claim this benefit, or a welfare adviser will be able to help.

Attendance Allowance (AA)

Attendance Allowance is a tax-free allowance for people aged 65 or over when they claim, who need help with their personal care. You can claim the benefit even if no one is giving you the care you need. It is not dependent on NI contributions, savings or income that you or your partner may have. To claim AA you should normally have needed help with care for six months. The allowance is paid at two rates.

Special circumstances

If your breast cancer is incurable and it is likely that you will not live for longer than six months, special rules apply so that you can claim your benefits easily and quickly. (If you are caring for someone you can claim on their behalf.) Your Macmillan nurse, cancer specialist or GP can help you to claim this benefit, or you can get help from a welfare adviser.

Note

The Disability Living Allowance and Attendance Allowance claim forms are long and complex, so it is a good idea to get help with filling in the claim forms from a welfare adviser. You can also fill in the claim forms online at www.direct.gov.uk/disabledpeople

Carer’s Allowance (CA)

Carer’s Allowance is a weekly taxable benefit for people who are caring for a severely disabled person for at least 35 hours a week. The earnings limit is normally updated every April and is currently £95 per week from employment, after allowable deductions, and expenses or certain other benefits. It is not dependent on NI contributions. The person you are looking after must be receiving DLA at the middle or highest rate of the care component or AA at either rate.