Health related Benefits,the GP’s role

Health related Benefits,the GP’s role

…and the forms we have to fill in…and the forms we have to fill in

This subject relates to several non clinical areasThis subject relates to several non clinical areas

Ethics Professional responsibility Practice organisation and policies Employment law Social policy How government bodies and agencies work

Ethics Professional responsibility Practice organisation and policies Employment law Social policy How government bodies and agencies work

Main Health Related Benefits which may need evidence from GP

Main Health Related Benefits which may need evidence from GP

Not fit to work - Statutory Sick Pay, Incapacity Benefit

Need help with personal care or mobility - Disability Living Allowance, Attendance Allowance

Maternity Benefits

Not fit to work - Statutory Sick Pay, Incapacity Benefit

Need help with personal care or mobility - Disability Living Allowance, Attendance Allowance

Maternity Benefits

Where do Benefits come from?Where do Benefits come from?

Managed by Department of Work and Pensions (DWP) (formerly Benefits Agency, formerly Department of Social Security (DSS), formerly Department of Health and Social Security (DHSS))

Paid via JobCentre Plus offices

Managed by Department of Work and Pensions (DWP) (formerly Benefits Agency, formerly Department of Social Security (DSS), formerly Department of Health and Social Security (DHSS))

Paid via JobCentre Plus offices

Forms for short term sicknessForms for short term sickness SC2 - patient completes, for 1st 7 days Med 3 - after 7 days, when you’ve just seen

the patient Med 5 - when someone else has seen the

patient, or you saw them but too long ago to do Med 3

NB Employers don’t always know or keep to the rules so may ask for certificate before 7 days

SC2 - patient completes, for 1st 7 days Med 3 - after 7 days, when you’ve just seen

the patient Med 5 - when someone else has seen the

patient, or you saw them but too long ago to do Med 3

NB Employers don’t always know or keep to the rules so may ask for certificate before 7 days

Statutory Sick PayStatutory Sick Pay

Paid via employer to people who are in work, even if only just started work

Rate (Oct 07) is £72.55 per week Paid from 4th day of sickness, lasts up

to 28 weeks Employer may have sick pay scheme to

supplement SSP

Paid via employer to people who are in work, even if only just started work

Rate (Oct 07) is £72.55 per week Paid from 4th day of sickness, lasts up

to 28 weeks Employer may have sick pay scheme to

supplement SSP

Incapacity BenefitIncapacity Benefit

Not eligible for SSP (unemployed, self employed, SSP expired)

Paid adequate NI contributions Short-term (under 28w): if unable to do your

normal job Long term: if unable to do any kind of work Rates (Oct 07): £61.35 for 1st 28w, £72.55

betw 28 and 52w; £81.35 after than

Not eligible for SSP (unemployed, self employed, SSP expired)

Paid adequate NI contributions Short-term (under 28w): if unable to do your

normal job Long term: if unable to do any kind of work Rates (Oct 07): £61.35 for 1st 28w, £72.55

betw 28 and 52w; £81.35 after than

Forms for Incapacity BenefitForms for Incapacity Benefit Short term: Med 3 At change to long term - patient completes

questionnaire and asks GP for Med 4 To assess long term IB, at start and from time

to time, the DWP Sends GP form IB 113 to complete (no fee

payable) Asks patient to attend for medical examination

(done by an outside agency) to assess incapacity for ALL WORK

Short term: Med 3 At change to long term - patient completes

questionnaire and asks GP for Med 4 To assess long term IB, at start and from time

to time, the DWP Sends GP form IB 113 to complete (no fee

payable) Asks patient to attend for medical examination

(done by an outside agency) to assess incapacity for ALL WORK

Disability Living AllowanceDisability Living Allowance

For people under 65 with long term conditions Care component - for personal care

Lower rate £17.10 (some help needed) Middle rate £43.25 (substantial help, either day or

night) Higher rate £64.50 (substantial help, 24h)

Mobility component - Lower rate £17.10 (supervision/guidance on unfamiliar

routes) Higher rate £45 (virtually unable to walk)

(All rates are from Oct 07)

For people under 65 with long term conditions Care component - for personal care

Lower rate £17.10 (some help needed) Middle rate £43.25 (substantial help, either day or

night) Higher rate £64.50 (substantial help, 24h)

Mobility component - Lower rate £17.10 (supervision/guidance on unfamiliar

routes) Higher rate £45 (virtually unable to walk)

(All rates are from Oct 07)

Attendance AllowanceAttendance Allowance

For people over 65 Same criteria as care component of DLA 2 rates (Oct 07)

Lower (<24h) £43.25 Higher (24h) £64.50

No mobililty component - over 65s can’t apply for mobility but if awarded mobility component of DLA, can go on receiving after 65 if they satisfy criteria

For people over 65 Same criteria as care component of DLA 2 rates (Oct 07)

Lower (<24h) £43.25 Higher (24h) £64.50

No mobililty component - over 65s can’t apply for mobility but if awarded mobility component of DLA, can go on receiving after 65 if they satisfy criteria

Forms for DLA and Attendance AllowanceForms for DLA and Attendance Allowance Patient completes v long form which includes

one page for ‘person most involved with your care’

DWP may send GP form DBD 370 (different ones for diff conditions) - fee payable for completing

Fast track DLA application - GP completes DS1500 for patients with prognosis <6m

Patient completes v long form which includes one page for ‘person most involved with your care’

DWP may send GP form DBD 370 (different ones for diff conditions) - fee payable for completing

Fast track DLA application - GP completes DS1500 for patients with prognosis <6m

Patients appealing when Benefits disallowedPatients appealing when Benefits disallowed Refer them to an advice agency (e g

DIAL for physical disability, MIND for mental disability)

You may be asked to provide support letter on goodwill basis

Advice agency can tell you what information will tick the boxes

Refer them to an advice agency (e g DIAL for physical disability, MIND for mental disability)

You may be asked to provide support letter on goodwill basis

Advice agency can tell you what information will tick the boxes

Maternity benefits (Apr 07)Maternity benefits (Apr 07)

Statutory Maternity Pay - paid for 39w from DWP via employer, 90% of wage for 6w, then £112.75 or 90% wage, whichever is less, for 33w - start 11w before EDD or any time up to birth. 52w off work allowed, last 13w unpaid.

Maternity Allowance - same rates as SMP for those who don’t qualify for it

Sure Start Maternity Grant - lump sum £500 for women on low incomes

GP or midwife completes form Mat B1 from 20w before EDD

Statutory Maternity Pay - paid for 39w from DWP via employer, 90% of wage for 6w, then £112.75 or 90% wage, whichever is less, for 33w - start 11w before EDD or any time up to birth. 52w off work allowed, last 13w unpaid.

Maternity Allowance - same rates as SMP for those who don’t qualify for it

Sure Start Maternity Grant - lump sum £500 for women on low incomes

GP or midwife completes form Mat B1 from 20w before EDD

Some other BenefitsSome other Benefits

Income support - if people haven’t paid NI contributions so can’t get other benefits but haven’t enough to live on

Job Seeker’s Allowance Working Tax Credits - for people who earn

very little Carer’s allowance - for people of working

age who spend time caring for someone who gets DLA or Attendance Allowance

Income support - if people haven’t paid NI contributions so can’t get other benefits but haven’t enough to live on

Job Seeker’s Allowance Working Tax Credits - for people who earn

very little Carer’s allowance - for people of working

age who spend time caring for someone who gets DLA or Attendance Allowance

Some other certificates we are asked forSome other certificates we are asked for ‘Private sick note’ - e g for school, Court,

Probation, employer who won’t accept SC2 for 1st 7 days

Evidence of unfitness to travel (on insurance form)

Evidence of fitness for gym, sports, gap year travel etc

Most practices have a scale of fees for these

‘Private sick note’ - e g for school, Court, Probation, employer who won’t accept SC2 for 1st 7 days

Evidence of unfitness to travel (on insurance form)

Evidence of fitness for gym, sports, gap year travel etc

Most practices have a scale of fees for these

Sources of informationSources of information

DWP website Patient.co.uk Many Benefits advice sites for patients

DWP website Patient.co.uk Many Benefits advice sites for patients