DWP (Department for Work and Pensions) & HMRC, United Kingdom · United Kingdom

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Form SSP1: Statutory Sick Pay and an Employee's Claim for Benefit

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JustFill is an independent PDF form-filling tool and is not affiliated with DWP, HMRC, or GOV.UK. We prepare the SSP1 PDF; we do not process benefit claims or submit forms to your employer or DWP.JustFill is not affiliated with DWP (Department for Work and Pensions) & HMRC, United Kingdom. This is an independent third-party tool to help you complete Form SSP1. Always download the current blank form from the official source and verify your completed copy before signing or submitting. Official Form SSP1 from DWP (Department for Work and Pensions) & HMRC, United Kingdom

Quick answer

UK Form SSP1, Statutory Sick Pay and an Employee's Claim for Benefit, is the official DWP and HMRC form an employer must give an employee when Statutory Sick Pay (SSP) cannot be paid or is coming to an end (for example at the 28-week maximum). The employer completes Part A (employer details, dates of sickness, reason SSP is not payable or ending, and linking periods), and the employee keeps or submits the form to DWP to support a claim for New Style Employment and Support Allowance (ESA) or Universal Credit. Because the official GOV.UK SSP1 PDF is often distributed as a flat PDF or payroll scan, JustFill detects every box so employers and employees can complete it in any browser and download a clean PDF at no charge for the first export.

Form
Form SSP1
Issued by
DWP (Department for Work and Pensions) & HMRC, United Kingdom
Country
United Kingdom
Free allowance
First clean download (up to 15 pages, filled by hand)
Official edition
DWP Form SSP1 (Statutory Sick Pay and an employee's claim for benefit — GOV.UK current April 2026 edition)
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What is Form SSP1?

Received a flat SSP1 PDF from GOV.UK or your employer, or preparing SSP1 forms for employees whose Statutory Sick Pay is ending or not payable? Form SSP1 bridges UK employer payroll (administered under HMRC SSP rules, alongside employee self-certification on Form SC2) and DWP benefit claims (New Style ESA and Universal Credit). Employers must issue Form SSP1 within 7 days of determining that SSP is not payable, or on or before the beginning of the 23rd week of SSP when an employee's illness is expected to last to the 28-week SSP limit. JustFill turns any flat GOV.UK SSP1 PDF or employer sickness sheet into an interactive browser form — and lets UK payroll bureaus and HR teams batch-fill SSP1 forms from Excel or CSV.

Download the Form SSP1 form PDF — free

DWP publishes Form SSP1 on GOV.UK at gov.uk/government/publications/statutory-sick-pay-and-an-employees-claim-for-benefit-form-ssp1. Because employers and employees frequently download a flat PDF or scanned copy that cannot be typed into cleanly in browser viewers, click "Fill the blank Form SSP1 now" above to open an interactive SSP1 worksheet in JustFill, or upload your GOV.UK SSP1 PDF to detect every field and download your first completed PDF at no charge.

Get the official Form SSP1 PDF from DWP (Department for Work and Pensions) & HMRC, United Kingdom

Who fills out Form SSP1?

  • UK employers, HR managers, and payroll bureaus completing Part A when an employee does not qualify for Statutory Sick Pay or is reaching the 28-week SSP limit
  • UK employees completing employee details or reviewing Part A before claiming New Style Employment and Support Allowance (ESA) or Universal Credit from DWP
  • Accountants and outsourced payroll providers issuing SSP1 statements across client payroll runs
  • Workers who previously self-certified sickness on HMRC Form SC2 and now need an SSP1 because their statutory sick pay entitlement has ended or does not apply

Field-by-field breakdown

What each section of Form SSP1 asks for. JustFill’s AI will detect these fields automatically when you upload the PDF — review the breakdown below so you know what to enter.

Employee identification — Name, National Insurance number & address

Employee's surname, first name(s), title, date of birth, UK National Insurance number (required to match DWP and HMRC PAYE records), home address, postcode, and telephone number.

Part A (Completed by Employer) — Employer & PAYE details

Employer name, payroll or clock number, business address, postcode, contact telephone number, and authorised person's name and job title.

Part A — Dates of sickness & qualifying days

First day of the current spell of sickness, last day of sickness (if known), normal qualifying working days of the week (Sunday through Saturday checkboxes), and any linked periods of incapacity for work (PIW) within 8 weeks.

Part A — Why SSP is not payable or why SSP is ending

Tick-box reasons why SSP is not payable (e.g. SSP has been paid for the maximum 28 weeks, fixed-term contract ended, employee is receiving Statutory Maternity Pay / Maternity Allowance, or other statutory exclusions) and the exact date the last SSP payment will be made.

Part A — Employer declaration, signature & stamp

Signature of the employer or payroll representative, printed name, position in the business, date signed, and optional company stamp.

Part B / Employee handover — Claiming New Style ESA or Universal Credit

Instructions and reference details for the employee to submit the completed SSP1 to the Department for Work and Pensions (DWP) alongside their benefit application.

Common mistakes to avoid

  • 1Confusing Form SSP1 with Form SC2 — Form SC2 is the employee's self-certification of sickness given to the employer to claim SSP; Form SSP1 is the statement the employer gives the employee when SSP cannot be paid or is ending after 28 weeks.
  • 2Issuing Form SSP1 late when SSP is ending — UK employers must send Form SSP1 on or before the start of the 23rd week of SSP if the employee's absence is expected to reach the 28-week limit, or within 7 days of SSP ending unexpectedly.
  • 3Applying old pre-April 2026 Lower Earnings Limit (LEL) or 3-day waiting-day rules — from 6 April 2026 under the Employment Rights Act reforms, SSP is payable from the first full qualifying day of sickness without the old Lower Earnings Limit exclusion.
  • 4Sending Form SSP1 to HMRC — the employer gives the completed SSP1 directly to the employee, who sends it to DWP (Jobcentre Plus) only if claiming New Style ESA or Universal Credit.

Form SSP1 example — what a filled-out form looks like

A fictional UK employer, Sample Manufacturing Ltd in Leeds, completes Part A of Form SSP1 in October 2026 for an employee whose Statutory Sick Pay is reaching the 28-week maximum entitlement so the employee can claim New Style ESA from DWP. All identifiers are fictional.

Employee Details — Name, DOB & National Insurance Number

EXAMPLE, DAVID ARTHUR · DOB: 14 06 1984 · NI No: QQ 12 34 56 C · 24 Sample Lane, Leeds, ZZ99 9ZZ

Uses HMRC's fictional QQ prefix and ZZ99 9ZZ placeholder postcode so the record is unmistakably illustrative.

Part A — Employer Name, Address & Payroll Reference

Sample Manufacturing Ltd · Payroll Ref: EMP-0842 · 100 Sample Park, Leeds, ZZ99 9ZA · Tel: 0113 496 0100

Identifies the employer and payroll reference for DWP verification.

Part A — Qualifying Days & Sickness Period

Qualifying days: Monday to Friday · Sickness started: 08 04 2026 · Still sick

Shows the normal working days of the week and the start of the incapacity period.

Part A — Reason SSP Is Ending & Final Payment Date

☑ Statutory Sick Pay is ending (28 weeks reached) · Last date SSP paid up to: 20 10 2026

Issued by the 23rd week of SSP so the employee can apply for New Style ESA before SSP stops.

Part A — Employer Signature & Date

H. SAMPLE (Payroll Manager) — Signed and dated 08 09 2026

Signed by the employer and handed to the employee, who retains a copy and submits it to DWP if claiming benefit.

These values are made up. They are here to show what belongs on each line, not to be copied — every name, number, and address on your own Form SSP1 has to be your own.

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Related forms

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Frequently asked questions

Form SC2 is completed by the employee to self-certify up to 7 days of sickness and ask the employer for Statutory Sick Pay (SSP). Form SSP1 is completed by the employer and given to the employee when SSP cannot be paid or is coming to an end after 28 weeks, so the employee can claim New Style ESA or Universal Credit from DWP.
If the employee does not qualify for SSP from the start of an absence, the employer must send Form SSP1 within 7 days of them going off sick. If the employee is receiving SSP and the illness is expected to last until the 28-week maximum, the employer must issue Form SSP1 on or before the beginning of the 23rd week (or within 7 days if SSP ends unexpectedly).
Many SSP1 copies circulated by employers, payroll systems, or downloaded from GOV.UK are flat PDFs or scanned sheets without interactive AcroForm fields. Uploading the file (or clicking "Fill the blank Form SSP1 now") in JustFill detects every checkbox and text box so you can type cleanly and export a finished PDF.
Never send Form SSP1 to HMRC. The employer gives the completed SSP1 to the employee. The employee then uses it to support a claim for New Style Employment and Support Allowance (ESA) or Universal Credit with the Department for Work and Pensions (DWP).
Yes. Payroll bureaus and HR teams can upload an Excel or CSV absence report in JustFill to map employee names, NI numbers, qualifying days, and SSP end dates into multiple SSP1 PDFs at once.

Official source: Form SSP1 on DWP (Department for Work and Pensions) & HMRC, United Kingdom’s website

Edition checked: DWP Form SSP1 (Statutory Sick Pay and an employee's claim for benefit — GOV.UK current April 2026 edition). Verified against the official source on · Verified in our Government Forms Fillability Study.

Contains public sector information licensed under the Open Government Licence v3.0.

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