Statutory Sick Pay (SSP) Enhancement Scheme claim form for Personal Assistant paid through direct payments

Before you begin

You'll need to complete this claim form for each absence.

Before you can claim for any absences, you'll need to provide us with an SSP declaration form. You will only need to provide us with a declaration form once.
Have you provided us with an SSP declaration form previously?
YesNo

Declaration form

The employee declaration form is to obtain the employee’s consent to the sharing of their personal data.

Employees only need to submit one form, and this will cover any subsequent periods of absence from work.
Please upload your declaration form

Details of absence being claimed
Please provide us with the details of the absence you would like to claim the SSP enhancement scheme for.
Your name (Name of personal assistant)
Your email address
Your National Insurance Number
Name of direct payment recipient (employer)
Your reasons for absence (select all that apply)
Having symptoms of COVID-19 (you should take a test without delay)Testing positive for COVID-19Self–isolating due to being identified as a contact by NHS Test Trace Protect (TTP)Self-isolating because a member of your household has symptoms of Covid-19 or has tested positive for Covid-19
Date of start of absence
Date at end of absence
Number of hours of absence

Tell us whether you accept cookies