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Health related Benefits,the GPs role …and the forms we have to fill in.

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Presentation on theme: "Health related Benefits,the GPs role …and the forms we have to fill in."— Presentation transcript:

1 Health related Benefits,the GPs role …and the forms we have to fill in

2 This 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

3 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

4 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

5 Forms for short term sickness SC2 - patient completes, for 1st 7 days Med 3 - after 7 days, when youve 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 dont 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 youve 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 dont always know or keep to the rules so may ask for certificate before 7 days

6 Statutory 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

7 Incapacity 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

8 Forms 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

9 Disability 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)

10 Attendance 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 cant 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 cant apply for mobility but if awarded mobility component of DLA, can go on receiving after 65 if they satisfy criteria

11 Forms 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

12 Patients 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

13 Maternity benefits (Apr 07) Statutory Maternity Pay - paid for 39w from DWP via employer, 90% of wage for 6w, then £ 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 dont 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 £ 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 dont 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

14 Some other Benefits Income support - if people havent paid NI contributions so cant get other benefits but havent enough to live on Job Seekers Allowance Working Tax Credits - for people who earn very little Carers allowance - for people of working age who spend time caring for someone who gets DLA or Attendance Allowance Income support - if people havent paid NI contributions so cant get other benefits but havent enough to live on Job Seekers Allowance Working Tax Credits - for people who earn very little Carers allowance - for people of working age who spend time caring for someone who gets DLA or Attendance Allowance

15 Some other certificates we are asked for Private sick note - e g for school, Court, Probation, employer who wont 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 wont 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

16 Sources of information DWP website Patient.co.uk Many Benefits advice sites for patients DWP website Patient.co.uk Many Benefits advice sites for patients


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