SPM60110 - Disputes Decisions and Appeals - An overview

How disputes arise

The most common type of dispute are where:

• an employer refuses to pay a statutory payment and either the employee or DWP/SSA think that they should have paid it, or
• an ECO finds than an employer has made an error in the operation of statutory payments or recovery schemes.

Time limit for a request for a decision by employee or the Secretary of State

An employee must request a decision no later than 6 months from the first day for which SSP entitlement is disputed.

Form SSP14, SMP14, SAP14 or SPP14, Request for a Decision, is normally issued when the employee contacts HMRC about their dispute with the employer. So long as they have contacted HMRC within the time limit and have signed and returned this form to the SPDT within 6 months of its issue

If they have contacted HMRC to investigate their entitlement to an SP within the 6 month time limit and ask for a decision in a letter as part of that correspondence about their entitlement, they have satisfied this condition.

Regulation 2 & 3 of the Statutory Sick Pay and Statutory Maternity Pay (decisions)Regulations 1999

Direct contact from the employee

An employee may contact any HMRC office directly if they disagree with their employer’s decision. However, all disputes and requests for a decision are dealt with by the Statutory Payments Dispute Team, Room BP 3202, Benton Park View, Longbenton, Newcastle upon Tyne. NE98 1YS.

The employer should have given the employee Form SSP1, SMP1, SPP1 or SAP1 explaining why they are not entitled to be paid the SP. If the employer has refused to issue the appropriate form they must give the employee a written statement instead.

Although the employee may ask for a decision in writing or by completing Form SSP14, SMP14, SMP56, SPP14 or SAP14 it may be possible to resolve the dispute informally by issuing an opinion without the need for the formal decision. This is often referred to as an “informal decision”.

If there are medical issues involved in the dispute it may be necessary to refer the case to Medical Services for an independent medical opinion based on either an examination or information from the employee's medical practitioner. See SPM50000.

If it is not possible to resolve the dispute informally or by giving a written opinion, a Nominated Officer can give a formal decision under section 8 of SSCTOFA1999/article 7 ofSSCTOFO(NI)1999. See SPM60300.

DWP/SSA referral for a decision in "benefit involved" cases under section 10A(1)(2)(a)(b) of the Social Security Act 1998

If an employee tries to claim a state benefit such as IB, ESA or MA, their local Jobcentre Plus or Jobs and Benefits Office may query the employer’s reasons for not paying SSP or SMP. In these cases, a decision maker acting on behalf of the Secretary of State for Work and Pensions, or the Department of Social Development, will send a “benefit involved” case to the Statutory Payments Disputes Team (SPDT). A member of the disputes team will then consider entitlement and give a decision. This type of case should be given high priority as the employee’s benefit entitlement cannot be decided until the matter is finally resolved.

Error in payroll identified at review

If an ECO discovers an error in the payroll they should action the case themselves. These cases may not always involve the employee, for example if the issue involves the amount an employer may recover from the NI Fund.

Should the employer fail to pay their employee a statutory payment following a decision by the ECO, the case must be transferred to the SPDT to arrange for a payment to be made to the employee. See SPM70000 and SPD17000.

The six month time limit for requesting a decision does not apply in these cases.