Statutory Sick Pay Record Form (UK)
SSP Employer Record — Social Security Contributions and Benefits Act 1992
STATUTORY SICK PAY (SSP) RECORD FORM
Employer Record — Social Security Contributions and Benefits Act 1992
Statutory Sick Pay (General) Regulations 1982
1. EMPLOYER DETAILS
Employer Name: [Employer Name]
PAYE Reference: [PAYE Reference]
2. EMPLOYEE DETAILS
Full Name: [Employee Name]
National Insurance Number: [NI Number]
Payroll Reference: [Payroll Ref]
Job Title: [Job Title]
Average Weekly Earnings: [Average Weekly Earnings]
SSP Eligibility: To qualify for SSP under the Social Security Contributions and Benefits Act 1992, the employee must: (1) be an employee; (2) have average weekly earnings at or above the Lower Earnings Limit (£123/week in 2024/25); (3) have been sick for at least 4 consecutive days; and (4) not be in the first 3 qualifying days (waiting days).
3. PERIOD OF INCAPACITY FOR WORK (PIW)
PIW Start Date: [PIW Start Date]
PIW End Date: [PIW End Date]
Qualifying Days: [Qualifying Days]
Waiting Days (first 3 qualifying days — no SSP payable): [Waiting Days]
A PIW consists of 4 or more consecutive days of incapacity (including non-working days). If there is a gap of 8 weeks or less between two PIWs, they may be 'linked' and treated as a single PIW — this means no further waiting days apply and SSP continues from where it left off.
4. SSP PAYMENTS
SSP Weekly Rate: [SSP Weekly Rate]
SSP Paid — Pay Period 1: [SSP Period 1 Pay]
SSP Paid — Pay Period 2: [SSP Period 2 Pay]
Cumulative SSP Paid This Tax Year: [Cumulative SSP]
SSP is paid through the employer's payroll and is subject to income tax and National Insurance deductions in the usual way. Employers can no longer reclaim SSP from HMRC (the Percentage Threshold Scheme was abolished in 2014).
5. MEDICAL EVIDENCE AND SSP EXHAUSTION
Medical Evidence / Fit Note: [Medical Evidence]
SSP Exhausted (28 weeks): [SSP Exhausted]
SSP1 Form Issued: [SSP1 Issued Date]
When SSP is exhausted after 28 weeks, the employer must issue form SSP1 to the employee within 7 days of SSP ending. The employee can use the SSP1 to claim Employment and Support Allowance (ESA) from the Department for Work and Pensions.
6. CONTRACTUAL SICK PAY
[Contractual Sick Pay]
7. RECORD-KEEPING
Employers are required by HMRC to retain SSP records for at least 3 years after the end of the tax year to which they relate. Records must include the employee's name, NI number, dates of the PIW, qualifying days, waiting days, and amounts of SSP paid. HMRC may inspect SSP records during a PAYE compliance check.
AUTHORISATION
Completed by: _________________________ Date: _____________
Position: _________________________
On behalf of: [Employer Name]
Payroll / HR Representative
________________
Signature
What Is a Statutory Sick Pay Record Form (UK)?
A Statutory Sick Pay Record Form in the United Kingdom sets out the figures and supporting particulars required for a tax filing or reclaim to the revenue authority, with its requirements set by the Employment Rights Act 1996.
Statutory Sick Pay in the United Kingdom is governed by Part XI of the Social Security Contributions and Benefits Act 1992 and the Statutory Sick Pay (General) Regulations 1982. Employers are legally responsible for paying SSP to eligible employees and for maintaining records sufficient to demonstrate that correct SSP payments have been made. HMRC can inspect SSP records during a PAYE compliance visit and can recover underpayments or impose penalties for record-keeping failures.
To qualify for SSP, an employee must satisfy three conditions under the 1992 Act: they must be an employee (not self-employed); they must have average weekly earnings at or above the lower earnings limit for National Insurance purposes (£123 per week in 2024/25); and they must be sick for at least four consecutive days (including non-working days), constituting a period of incapacity for work. The first three qualifying days are waiting days during which SSP is not payable. SSP is currently payable at £116.75 per week (2024/25 rate) for up to 28 weeks. HM Revenue and Customs (HMRC) publishes the current SSP rate and lower earnings limit in its annual Employer Further Guide to PAYE and National Insurance.
When SSP is exhausted after 28 weeks, the employer must issue the employee with form SSP1, which enables the employee to claim Employment and Support Allowance (ESA) or Universal Credit from the Department for Work and Pensions (DWP). The Employment Rights Act 1996 protects employees from suffering detriment or dismissal for exercising their right to SSP. The Advisory, Conciliation and Arbitration Service (ACAS) publishes guidance on managing sickness absence, which includes advice on the interaction between SSP entitlement and absence management procedures. The Information Commissioner's Office (ICO) regulates the processing of health data (which is special category data under Article 9 of the UK GDPR) held in sickness absence records under the Data Protection Act 2018. Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
When Do You Need a Statutory Sick Pay Record Form (UK)?
A Statutory Sick Pay Record Form in the United Kingdom is needed whenever an employee is absent from work due to illness or injury for four or more consecutive days (including non-working days) and may therefore be entitled to Statutory Sick Pay under the Social Security Contributions and Benefits Act 1992.
Employers must begin a new SSP record at the start of each new period of incapacity for work. Where an employee has multiple separate periods of sickness within a rolling eight-week window, the Statutory Sick Pay (General) Regulations 1982 treat these as linked periods of incapacity for the purposes of calculating waiting days and the 28-week maximum SSP entitlement. Accurate records are essential to identify when linked periods apply and to avoid both underpayment and overpayment of SSP.
The record form is needed throughout the employee's sickness absence period, updated each time SSP payments are made. HMRC requires employers to retain SSP records for at least three years after the end of the tax year to which they relate. During a PAYE compliance check, HMRC inspectors will examine SSP records to verify that eligible employees have been paid the correct amount of SSP, that waiting days have been correctly applied, and that the 28-week maximum has not been exceeded. Errors in SSP records can result in HMRC requiring back-payment of underpaid SSP and may trigger PAYE penalties.
The form is also needed when the employee returns to work, so that the employer can record the return date and calculate the total SSP paid in the period. Where SSP is exhausted at or before 28 weeks, the employer must issue form SSP1 — available from HMRC — to the employee within seven days of the SSP running out. HM Revenue and Customs (HMRC) administers SSP through the PAYE system under the Income Tax (Earnings and Pensions) Act 2003. The Employment Tribunal adjudicates disputes about SSP entitlement under the Employment Rights Act 1996. The Advisory, Conciliation and Arbitration Service (ACAS) provides guidance on managing long-term sickness absence and the interaction between SSP, occupational sick pay, and absence management procedures.
What to Include in Your Statutory Sick Pay Record Form (UK)
A properly maintained Statutory Sick Pay Record Form (UK) should capture the following key elements to satisfy HM Revenue and Customs (HMRC) record-keeping requirements and support accurate SSP calculations under the Social Security Contributions and Benefits Act 1992.
Employee identification: The record must identify the employee by full name, National Insurance number, and payroll or employee reference number. The National Insurance number is the primary identifier used by HMRC to match SSP records to the employee's tax and National Insurance account. HMRC may request employee-level SSP records during a PAYE compliance visit conducted under Schedule 36 to the Finance Act 2008, and will use the National Insurance number to cross-reference records.
Period of incapacity for work (PIW): Each period of four or more consecutive days of sickness (including non-working days) must be recorded as a separate period of incapacity for work under the Statutory Sick Pay (General) Regulations 1982 (SI 1982/894). The start and end date of the PIW must be recorded. Where the employee has had a previous PIW within the previous eight weeks, the two PIWs are treated as linked under the Statutory Sick Pay (General) Regulations 1982, and waiting days do not apply again in the second linked PIW.
Qualifying days: SSP is only payable in respect of qualifying days — the days on which the employee would normally be contracted to work. The employer and employee must agree which days are qualifying days. The record should show the qualifying days in each week of the PIW. Under the Statutory Sick Pay (General) Regulations 1982, the minimum number of qualifying days in a week is one.
Waiting days: The first three qualifying days of each new PIW (or the first three qualifying days of the first PIW in a series of linked PIWs) are waiting days under Part XI of the Social Security Contributions and Benefits Act 1992. SSP is not payable for waiting days. The record must clearly identify the waiting days in each PIW to prevent overpayment.
SSP weekly rate and amounts paid: The current SSP rate (£116.75 per week in 2024/25, set by HMRC each April under the Social Security Benefits Up-rating Order) must be recorded, together with the actual SSP amounts paid in each pay period. Where an employee's qualifying days are fewer than five per week, the daily rate is the weekly rate divided by the number of qualifying days.
Cumulative SSP and 28-week limit: The record must track cumulative SSP paid across all linked PIWs to identify when the 28-week maximum is approached. When SSP is exhausted, the employer must issue form SSP1 (available from HMRC) to the employee within seven days, enabling the employee to claim Employment and Support Allowance (ESA) from the Department for Work and Pensions (DWP) or Universal Credit. The Advisory, Conciliation and Arbitration Service (ACAS) provides guidance on managing long-term sickness absence alongside SSP obligations. The Employment Tribunal adjudicates disputes about SSP entitlement under the Employment Rights Act 1996. Health data in sickness absence records is special category data under Article 9 of the UK GDPR, regulated by the Information Commissioner's Office (ICO) under the Data Protection Act 2018. Employers must retain SSP records for at least three years after the end of the relevant tax year under Regulation 31 of the Social Security (Contributions) Regulations 2001 (SI 2001/1004). Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
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Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Statutory Sick Pay Record Form (UK) (United Kingdom) [Legal document template]. Forms Legal. https://forms-legal.com/uk/employment/forms/statutory-sick-pay-record-form-uk
"Statutory Sick Pay Record Form (UK) (United Kingdom)." Forms Legal, 2026, https://forms-legal.com/uk/employment/forms/statutory-sick-pay-record-form-uk.
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author = {{Forms Legal}},
title = {Statutory Sick Pay Record Form (UK) (United Kingdom)},
year = {2026},
howpublished = {\url{https://forms-legal.com/uk/employment/forms/statutory-sick-pay-record-form-uk}},
note = {Free legal document template. Based on Employment Rights Act 1996}
}Frequently Asked Questions
To qualify for Statutory Sick Pay (SSP) under the Social Security Contributions and Benefits Act 1992 and the Statutory Sick Pay (General) Regulations 1982, an employee must: be classed as an employee (not a self-employed contractor); have average weekly earnings at or above the lower earnings limit for National Insurance purposes (£123 per week in 2024/25); have been sick for at least four or more consecutive days (including non-working days), known as a 'period of incapacity for work'; and not be in their first three days of absence (the 'waiting days'). SSP is payable at the prescribed rate (£116.75 per week in 2024/25) for up to 28 weeks. Agency workers, casual workers and zero-hours contract workers may also qualify if they meet the earnings threshold. Under United Kingdom law, Employment Rights Act 1996, parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Employment Rights Act 1996, the Employment Tribunal adjudicates workplace disputes. Section 94 of the Employment Rights Act 1996 provides the right not to be unfairly dismissed. Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
Yes. Employers are required to keep records of SSP payments and the information needed to calculate them. HMRC may inspect SSP records during a PAYE compliance check. Good practice requires recording: the employee's name, National Insurance number, and payroll reference; the dates of each period of incapacity for work; the qualifying days agreed with the employee; the waiting days in each period; and the SSP amounts paid in each pay period. Although the statutory requirement to give employees form SSP1 (when SSP cannot be paid or is exhausted) remains, the previous requirement to give form SSP2 has been abolished. Employers should retain SSP records for at least three years after the end of the tax year to which they relate. Under United Kingdom law, Employment Rights Act 1996, parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Employment Rights Act 1996, the Employment Tribunal adjudicates workplace disputes. Section 94 of the Employment Rights Act 1996 provides the right not to be unfairly dismissed. Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
SSP is payable for a maximum of 28 weeks. When SSP is exhausted, the employer must provide the employee with form SSP1 (available from HMRC), which the employee may use to claim Employment and Support Allowance (ESA) or Universal Credit from the Department for Work and Pensions. Some employers provide contractual sick pay (occupational sick pay) above the statutory minimum — if so, the terms of the employment contract will govern entitlement. An employee who remains unable to work after SSP is exhausted may be subject to a capability review under the employer's absence management procedure, which could ultimately result in termination of employment on grounds of capability if the employee is unable to return to work within a reasonable period. Under United Kingdom law, Employment Rights Act 1996, parties should seek independent legal advice from a qualified lawyer to confirm compliance with all applicable requirements. Under the Employment Rights Act 1996, the Employment Tribunal adjudicates workplace disputes. Section 94 of the Employment Rights Act 1996 provides the right not to be unfairly dismissed. Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
A Statutory Sick Pay Record Form (UK) does not legally require a lawyer in United Kingdom, and individuals and businesses may draft and execute the document independently. The Employment Rights Act 1996 does not mandate legal representation for the creation or signing of this type of document. However, seeking independent legal advice from a qualified United Kingdom lawyer is recommended for transactions involving substantial financial value, complex regulatory requirements, or cross-border elements where multiple legal jurisdictions may apply. A lawyer can verify that the document complies with all applicable statutory requirements, identify potential risks specific to the transaction, and confirm that the terms adequately protect the interests of all parties involved. The High Court of Justice has jurisdiction over disputes arising from this type of document, and Companies House may impose additional compliance obligations depending on the nature of the underlying transaction. Professional legal review is particularly advisable where the document will be submitted to government agencies or used as evidence in legal proceedings.
A Statutory Sick Pay Record Form (UK) does not legally require a solicitor in the United Kingdom, though legal advice is recommended for complex transactions. Under UK law, individuals may draft and execute this type of document independently. The Consumer Rights Act 2015 provides consumer protections. However, Companies House, HM Revenue and Customs (HMRC), or other regulatory bodies may have specific requirements. For property transactions, the Land Registry requires qualified conveyancers under the Land Registration Act 2002. The UK GDPR and Data Protection Act 2018 impose obligations on parties handling personal data, and legal review confirms compliance. Where disputes arise, the High Court of Justice, County Court, or Employment Tribunal have jurisdiction. Forms-legal.com provides this template as a starting point — always review with a qualified UK solicitor for significant transactions involving substantial value or regulatory complexity.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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