An overview of benefits and cancer

Monday 25 June 2018


A condensed overview and summary in one blog of the more detailed four-part series  "Benefits and cancer"

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The aim of this blog is to give you a whistle stop at a glance summary of the points covered in the fuller, four part series of  Benefits and Cancer blogs . These run through, in a little more detail. - the main benefits that are likely to be relevant to people affected by cancer, whether as a person who has received a diagnosis or a carer.  Beyond that further blogs explore each of those benefits - and other benefit issues -  in more detail.

This blog is more of a "see the woods for the trees" quick overview,  with only brief thumbnail sketches of these important benefits. It's more to give  you a feel as to what they might be about and how they fit together.

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The importance of benefits

Living with cancer can bring with it a number of extra costs: travel to hospital, keeping warm, adapting/tempting diet when if appetite is suppressed, changing clothes sizes or some very important treats and breaks to reward yourself for things endured.

At the same, time there may be a drop in income, depending on sickness pay / insurance arrangements at work, when taking time out whether fo treatments or to act as carer. For others a fixed retirement income may not be directly affected but is just a bit more stretched and any additional help might be welcome. 

Whatever you may have picked up from coverage of changes and cuts, the benefits system is still largely there, both as a safety net for lower incomes and an insurance system regardless of savings and incomes.  The real issue with benefits is less the problem of fraud presented in media - which at official estimates of 0.5% is rather lower than most people think - but rather people simply not claiming their entitlement. 

Official estimates suggest up to £30 billion goes unclaimed each year - some 15% of the total spend. And that is often down to people simply not knowing what benefits might apply and some common myths we tell ourselves as to why we don’t like to ask.

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Common myths that stop people enquiring further

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"We are feeling the extra costs but still have a modest income and savings so we won’t get benefits"

You still very well might. Some benefits will assess your income and savings but some of these are payable further up the income scale than you might think. But others are payable entirely regardless of any other income or savings

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"Others may need it more than me"

They might. And others less, but still meeting the criteria. Benefits do not come out of a fixed pot, so that you selflessly not claiming will do nothing to enhance the chances for others

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I don’t like to receive handouts and charity and lose my independence

The modern social security system was based on a concept of mutual insurance to promote and maintain independence and avoid “the stink of charity”. Think of it like a home or car insurance: you pay the premiums in the hopes of never needing to claim, but knowing it is there should you need it. It’s the same principle as behind the National Health Service, as modern social security came out of the same Beveridge Report

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"Ok, Ok.. I’ll think about it. But isn’t it terribly complicated?

That’s where we hope this and other blogs can help. Yes it can look a bit like a maze with many entrances, routes and exits. Depending on how you count them there are some 45 different benefits and staring at a list of them may not be that helpful. So below we group the key ones in what we hope will feel a more sensible order.

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Some unavoidable jargon

But first there are some terms that are unavoidable and may be worth pinning down:

"Means tested" v. “Non-means tested” benefits:  

Some benefits are “means tested” - aka income related” - and others are not  Means testing is an extra financial assessment, so that as well as meeting criteria for say being too unwell to work or being a carer, you also need to have income and savings low enough to qualify. This may rule out some benefits for you but by no means all - many useful benefits remain available regardless of your finances

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“Contributory” v “non-contributory”: 

Some benefits will depend on having the right National Insurance contributions whether in recent years or over your working life.; others will not. The distinction is more important within non-means tested benefits as you may miss out on some because of gaps in your NI record, but others are totally unaffected. The means tested benefits are all non-contributory 

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Working age v. pension age : 

Increasingly it feels there are two separating systems depending on whether you have come of pension age. The age for that dividing line is becoming clearer as men and women’s pension age are almost equalised and will be - at 65 by the end of 2018. Some benefits have different equivalents on either side of the line and some - such as housing benefit or carers allowance - co-exist on both sides of the line. 

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“Sickness" v. "disability”  benefits

Less official jargon and more an important distinction within benefits related to your health.  Some benefits - for “sickness” - are there to offer a basic income when you are too unwell to work. Those over pension age would already be covered by a Retirement Pension . Others - for “disability” - are there to help with extra costs of living with a disability or long term health condition and are always payable on top of any other benefits, whether you are able to work or not. While often the two may go together and people may claim one of each, disability benefits might top up wages from full time work or a retirement income

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Three steps to ensuring maximum entitlement

Knowing the jargon may make the list of benefits seem a bit less daunting, but still… I would like to suggest taking it in steps, with the key benefits being usefully -  but entirely unofficially- grouped into three main categories. Working out your entitlement may then be helped by visiting each step in turn. 

And after getting to Step 3, it can always be worth revisiting Step 2 . Think tho the “do-re-mi” scene in the Sound of Music if that might help . 

The three steps are:

  • Step 1: Earnings Replacement Benefits 
  • Step 2: Means Tested Benefits and Tax Credits
  • Step 3: Extra non-means tested benefits to to help with additional costs. 

The rest of this blog follows this three steps approach, explaining a little bit more about each step and offering the briefest thumbnail sketch of the key benefits under each one

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Step 1 Earnings replacement benefits

These - together with statutory payments from employers are the original foundations of the post World War II concept of “social security from the cradle to the grave”. It was all part of making real the sprit of “we are all in this together”  that gave rise to education and housing reform, full employment policies and the NHS. The new compulsory National Insurance contributions were to fund both these benefits and the new NHS. 

The idea was we all pay in -as with any insurance policy - against adversity during our working life. It also acts as a basic long term savings provision for  retirement too. That’s why most other income or savings are is ignored completely in working out your entitlement, why you claim as an individual . Step 1 then is non-means tested with benefits available to anyone who meets the criteria, whether these end up as your main - if rather basic - income or as a very useful part of other household income. 

There are number of different reasons why your normal income from earnings may be interrupted - sickness, caring, maternity, retirement etc - and you can claim as many Step 1 benefits as apply.  But you will usually only be paid the one - whichever is the highest, so these are also known as the “overlapping benefits”

Where you do have a choice, then you might want to look at: which pays the most? which comes with the least hassle? which feels the most secure? which feels right for you? 

Statutory payments are amounts that an employer must pay as a legal minimum to qualifying employees when either sick or expecting a new child coming into the home (maternity, paternity or adoption) They also overlap with each other and their equivalent earnings replacement benefit, but not the others. So it is possible for an older worker to get Say Statutory Sick Pay from an employer and their Retirement Pension. 

Carers Allowance can be one that can be worth claiming even when you can’t receive it because of another overlapping benefit. The is because it can generate extra amounts in Step 2 . 

The key Step 1 benefits for people affected by cancer are likely to be:

  • Retirement Pension - entirely unaffected by the arrival of cancer but simply because it may be there already as more people affected by cancer will be of pension age than not
  • Statutory Sick Pay - if you receive a cancer diagnosis while working for an employer
  • Contributory Employment and Support Allowance - the latest version of “sickness benefit”  if you are not covered by SSP or after this has come to an end. 
  • Carers Allowance - for those of any age who are acting as a carerhether of working or pension age acting as carers.

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Step 1 benefits in brief:

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Retirement Pension 

This is the biggest benefit of all, but with some of the least problems: almost everyone entitled claim it and while how the total is arrived at can seem interesting, on the whole people get the right amounts. Basically it’s have come of pension age and how do your contributions stack up over your working life.  

Pension age for men and women will be equalised at 65 come November 2018 before another phased increase to 66 begins. There is a new Retirement Pension Scheme applying for those who have retired since April 2016, but in practise for many  much of their pension will be determined under the old rules.

You don’t have to stop work at pension age: you can opt to start claiming Pension and earn as much as you like on top. Or you can delay claiming your pension for up to  5 years in exchange for a higher amount later. 

Your Retirement Pension is fixed in sickness or in health. Other benefits can come into play if you are unwell or acting as a carer, so do still check out any extra help.

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Works and private pensions

Not a state benefit, and so a bit outside of these Steps,  but it here, as it can be an important part of your planned provision for replacing earnings from work in retirement. 

A key /difference is that you might need or want to access this at a younger age, eg as part of an early retirement on health grounds. 

Just retiring early out of choice is often possible but often at some cost in terms of the amount you can expect in salary linked pension or in simply needing to make your pension pot stretch further.  But where health is forcing the pace, then there may be partial or full top ups or different Pension Choices to be made for “pension pots” . Health issues then can have a bearing on income from private and occupational pensions, especially if these enforce retirement. 

Making any additional provision is encouraged by the non-means tested approach - your State Retirement Pension is the platform on which you can build additional income. There is no reduction or overlapping between state and private pensions. There is though a special provision that does - rather unfairly - lead to the main Step 1 benefit for sickness being affected by work or private pension. 

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Statutory Sick Pay

This is the minimum that an employer must pay most employees when they are too unwell to work. It is a single set amount - £92.05 a week  for 2018/19 - and lasts for up to 28 weeks. 

Many employers may pay more than this under your contractual sick pay schemes. eg some months full sick pay, followed by some months part sick pay. You may notice though that part of your sick pay from work is SSP.  

It is the payment of some SSP that prevents you claiming a sickness benefit from the Department of Work and Pension (DWP), rather than the fact that your employer pays you anything. So once SSP drops out of any sick pay from work, you are free to claim Contributory ESA - see below, even if your employer continues to pay something. 

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Contributory / “New Style” Employment and Support Allowance

This is what was once called “Sickness, Invalidity  or Incapacity Benefit” benefit and is the earnings replacement benefit when you are too unwell to work. You might claim this straightaway if you are not covered by SSP when you become ill or it may be that you claim it when SSP comes to an end

You claim it from the DWP. Contributory ESA remains entirely outside of the new Universal Credit scheme which we will come to in Step 2, but the name - and the way you claim it - changes in areas where Full Service Universal Credit is in operation. In those areas, new claims will be for “New Style ESA instead.  

Initially - as with SSP - the evidence of your unwellness is a GP’s “sick note/line” officially called a Fitness for Work Statement. However, during the first 3 months of your ESA claim the DWP will carry out their own Work Capability Assessment, but many people affected by cancer may bypass the full process.  That involves first a detailed questionnaire the ESA50 and then in most cases a face to face assessment with a Health Professional. Two important exceptions can make this a quicker and easier process: 

  • anyone “awaiting, receiving or recovering from major treatments like chemo or radiotherapy is treated as passing the test, whatever the nature, staging or prognosis for their cancer.  You still get the ESA50 form but need only fill in a few pages . You status will be confirmed quickly, but the additional payment that comes with it will still only kick in from week 14 of your ESA claim. 
  • if you have a more advanced diagnosis which may be life limiting, then you can bypass the assessment entirely with a DS1500 certificate issued by a GP or consultant . You do not then get sent an ESA50 and you get the maximum ESA from the start of the claim. 

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Carers Allowance

This can be claimed by anyone over 16 who is spending 35 hours a week with someone who is living with cancer or any other illness. The two main conditions are that:

  • the person you support is receiving one of the “disability” benefits from Step 3
  • you are spending 35 hours or more a week with them

That is not 35 hours as in a full working week for a social services home carer, giving physical help with day to day tasks. Rather it is 35 hours in the person’s company, whether you are physically helping, reminding and encouraging or just being there on hand if needed, even asleep. No diaries nor timesheet need be kept and 35 hours could be done over a weekend.

Being entitled to Carers Allowance - even if it can’t be paid e.g. if you get another overlapping benefit - can still be worth doing as it entitles you to extra amounts over at Step 2: Means Tested Benefits

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Step 2 Means tested benefits

Despite the ambition to go for a mainly non-means tested system based on Step 1 benefits, there was a need from the start for a back up “safety net” for people that slipped through Step 1 or who did get something from Step 1, but needed a top up to meet basic needs, if Step 1 was there only income.  

Since then, Step 2 benefits have grown for a number of reasons: 

  • gaps emerging in the Step 1 benefits - eg for lone parents or former residents in carer institutions now living more independently. 
  • the erosion of Step 1 benefits over the years through freezes, time limiting and removal of additional amounts for partners and children, 
  • Step 2 being seen as the best way to make the most of increases in resources to tackle child or pensioner poverty. 
  • the real rise in rents, meaning more people needing additional help from Housing benefit

The result  then, is that means testing is a much greater part of the system than envisaged in the 1940s. Modern means testing, though  is much less harsh than the 1930s approach and is a simple calculation of your household income and savings. There is in many -  but by no means all - cases a £16,000 capital limit. 

You claim Step 2 benefits jointly with any partner and it will be your combined household income that will be considered. So while you might be entitled to Step 1 Contributory ESA regardless of what a partner is doing financially, you may be ineligible for Step 2 Income-related ESA because of a partners income or joint savings. 

Step 2 benefits, then  do a number of things :

  • provide a safety net income - payable either instead of Step 1 benefits (eg because of not having enough National Insurance contributions for the Step 1 benefit ) or as a top up because Step 2 has extra amounts for a partner, age, caring, or for disability that are not there in Step 1) 
  • provide additional support to those in work, especially low income working families or workers with long term health problems through Working Tax credit
  • help with the costs of children. some help is available for all under Step 3, but extra amounts under Step2 have been brought together separately under Child Tax Credit available to parents whether they are in work or not in work
  • help with certain specific costs - the rent, council tax or health costs

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Means tested safety net benefits

Some of these are direct Step 2 equivalents of benefits in Step 1. They are there to ensure that your income does not fall below “the amount the law says you need to live on”, set at quite a basic minimal poverty line. 

Step 1 benefits on their own might not do that if you have little else coming in, The safety net benefits are there to catch you if you either can’t get a help from Step 1 or as a top up to Step 1 if you are left with only a minimal income from Step 1 and have extra needs, mouths to feed etc.

Once this all came under Income Support - which still remains at the top up benefit for many: lone parents, carers, those needing a top up to SSP and a variety of small groups

However, some of the “routes” to benefit have off from Income Support, so as to better connect with their Step 1 equivalents. This includes:

  • Income-based Jobseekers Allowance: for those fully fit and active jobseekers or able to do so with some allowances for lesser  health, caring and parental limitations
  • Income-related Employment and Support Allowance - for those too unwell to work on exactly the same grounds as for Contributory ESA in Step 1
  • Pension Credit - once for men and women over 60, but the age is rising alongside women’s Retirement Pension Age. This significantly increased the amounts for means tested top ups for older people, but some 40% of those entitled don’t claim iPC

They all work by a similar calculation:

  • adding up the maximum amount you could get - with extra amounts for non working partners sickness, disability, caring to get to the applicable or appropriate - amount for your household
  • looking at your assesable income - important amounts such as many Step 3 benefits and some earnings are ignored
  • Taking one form t’other to get to the amount needed to top your income up to the Applicable amount”

The basic amounts can be very low subsistence levels - except in the case of Pension Credit -  but with the recognition of additional costs for carers and those with long term health issues,  the amounts rise across the board. So you may be entitled to some support at higher incomes than you might first think; don’t discount help here, especially if you are of pension age or have children. 

There are big changes ahead as the three “working age” benefits for supporting income are merged into Universal Credit (see below).  

Tax Credits

These come about in 2004 from the merging of :

  • in work benefits to provide additional income for families on low incomes and those working with long term health or disability issues
  • additional means tested help for children and young people

There are two  parts to your tax credit claim:

  • Working Tax Credit that tops up low - or temporarily reduced earnings - in paid work and helps with child care costs while in work.  WTC can be useful for people whose earnings take a hit following a cancer diagnosis or in easing back into work in recovery.
  • Child Tax Credit deals separately with amounts for children, not just for those claiming WTC but for all parents on a low income. The idea of putting it all together was to act as a bridge for parents moving from out of work to in work benefits. CTC can be paid separately to main carer of children in a couple., as overall evidence shows it reaches children more effectively. 

The sums works a little differently than the per week calculations of means tested benefits . Things are more aligned to the “light touch” means test of the income tax systems, so your P60 or self assessment sums can be used for tax credits.  Tax Credit forms are much shorter as a result

This sums are bypassed altogether for anyone getting one of the means tested benefits who will automatically get the maximum amount of Child Tax Credit. 

Both tax credits then can go rather higher up the income scale than you may think, especially if you have children so it is definitely worth a look. There are also no savings limits 

There is no upper age limit on either tax credit, so they can be of interest to older people carrying on in work or to grandparents looking after their grandchildren.

Housing Benefit and help with the council tax

Both of these are claimed from your local council and are payable separately and on top of any means tested benefits or tax credits above.

Housing Benefit (HB ) helps with paying the rent, something which has always been left out of Step 1 and other Step 2 benefits., mainly because it can vary so much depending on area. So if you get help in Step 1 and don’t qualify for any income top ups here in Step 2, you might still need some help with say your rent.

Council Tax Support (CTS) varies a little according to where you live but for older people and those living in Scotland and Wales operates vey much like the previous national Council Tax Benefit scheme.  from your local council and are payable on top of any means tested benefits or tax credit above.

Both start from the same similar sums as the means tested benefits, which means that one of the bonuses of say claiming Pension Credit is that you don’t have to go through a similar means test all over again with your council. In fact this also gets you round the normal savings limit too. 

The big difference is what happens if your assessed income gets  is more than your “applicable amount”:

  • for the other means tested benefits the nearer your income gets to the set amount the smaller the top you get and once you get past that level you get nothing.
  • with HB and CTS any income below the set amount means that you simply get the maximum amount of help with rent and council tax the scheme allows. If your income is greater than the set amount rather than getting nothing, you see the amount of help you get start to taper off.

So in higher rent areas, people may be in full time work and not necessarily on the lowest wage rates and still receive at least some help with the rent or council tax. Overall some 50% of those claiming HB are in paid work.

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Universal Credit (UC)

This aims to replace the six main “working age” means tested benefits and tax credits entirely by the most recently revised date of March 2023.  The benefits merging into Universal Credit are: Income Support, Income-based JSA, Income-related ESA, Housing Benefit , Working Tax credit and Child Tax Credit. 

All other benefits stay outside UC. 

  • within Step 2, that means: Pension Credit , Council Tax Support, passport benefits and the regulated Social Fund remain outside of UC
  • all the non-means tested benefits - all of Step 1 and Step 3 - remain as they are, with some small changes for the contributory versions of ESA and JSA. 

UC aims to do far more than join up and rationalise the 6 benefits it replaces. It wants to do benefits very differently and make it much more like being in work.: monthly all in payments to encourage budgeting skills, online claiming and managing accounts to develop IT skills,  more “claimant responsibility” , more personal supervision and support and greater emphasis on work requirements and UC work coach discretion. 

UC experience so far has largely been with a piloting with jobseekers, so the move to the full range of potential claimants is exposing some gaps in the design and processes of UC. The focus on “tough love” and transforming pathways into work may not be appropriate to someone who just needs some support to get through cancer treatments.  

Before you get to the issues involved in claiming UC, there is a lot of added complication by the slow switchover, and differences in the way you might switch from a legacy benefit to UC. You may need advice to avoid losing out in any switch - or “migration” to UC. 

If you currently get a legacy benefit, nothing changes on the day your area switches over to Full Service UC and it may not be until as late as March 2022 that you may switch. The first effects will be more for those making a new claim for UC from Step 2 i who would usually claim UC rather than a legacy benefit. 

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Health costs

The NHS is free at the point of delivery, but there can be a number of costs at the edges that can build up especially when you are a frequent visitor : prescription charges (in England only), travel to hospitals (especially more distant regional cancer centres)  and charges for dental treatment , optical items or wigs and fabric supports. The extent of such charges vary across the home nations, but where they apply there are exemptions for those on a low income:

  • those on a means tested benefit will be exempt / get maximum available help
  • those on Working Tax Credit or Universal Credit may or may not get help. HMRC will provide an annual exemption certificate, while for the more variable UC it may be showing your last UC monthly statement
  • others may still get some/all help by applying separately rough the NHS Low Income Scheme and getting an HC2 certificate giving full help or an HC3 offering more limited help. 

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Step 3 Extra non-means tested benefits

This step is about additional non-means tested benefits to help with the extra costs for children and disability /long term health issues. These are different from Step 1 in that they are not there to replace earnings and can be paid in or out of paid work. 

So while Contributory ESA or Retirement Pension from Step 1 might - with some top ups from Step 2- aim to cover the basic costs of living - an award of Personal Independence (for someone of working age) or Attendance Allowance ( for those over 65) will be on top aimed at helping with some of the extra costs that living with cancer can bring. 

Bereavement Benefits have made a switch from being another Step 1 earnings replacement benefit to being more of a top up to other benefits under Step 3

Step three then includes:

  • for children - Child Benefit and Guardians Allowance  
  • for disability and long term health issues: the three “disability benefits” of: Attendance AllowanceDisability Living Allowance and Personal Independence Payment
  • industrial and war disablement compensation schemes: small mini benefits systems of their own
  • for bereavement:  Bereavement Support Payment.

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For children:

  • Child Benefit offers an entirely non-means tested support that most parents - or people acting as parents will claim for children under 16 and young people up to age 20 who are still in non-advanced education or approved training.  This is unlikely to be affected by a cancer diagnosis, except that if income has fallen it may well be worth exploring new / increased entitlements to Child Tax Credit or Universal Credit in Step 2
  • Guardian’s Allowance is an additional amount of Child Benefit for looking after children whose parents have both died or one has died and the other’s whereabouts are unknown or who are away in prison.

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The three main disability benefits

These may be very relevant to someone who receives a cancer diagnosis. Which one you claim depends on your age when you claim

  • Disability Living Allowance (DLA) is only open to new claims in relation to children under 16 . Those who were on DLA as adults will either be transferring over to PIP (some 2 minion will have to re-apply for PIP)  or if they were over 65 in April 2013, stick with their DLA in retirement (some 1 million will be doing this).  It offers help based on daily living tasks and getting around.
  • Personal Independence Payment (PIP) is the replacement for DLA for new claims in “working age between 16 and 64. Those who were on DLA are being re-assessed with the aim of a 30% cut over what the DLA budget would have been. PIP too offers help with both extra daily living costs and help with getting around. 
  • Attendance Allowance (AA) remains the benefit for new claims first made after 65 - those who were on DLA before aged 65 remained on it through their 65th birthday as will those on PIP as they reach their 65th.

All three benefits are highly relevant to people affected by cancer but are significantly under claimed. That doesn’t mean having cancer will necessarily entitle you but it could well do. There are two main ways in:

  • some people with more advanced and life limiting cancers may bypass the assessments just as in ESA - with a DS1500 certficate from a GP or consultant. The claim is fast tracked and people get the top rate for daily living and any Mobility help too. Others can make the claim for you and you don't need to get into discussions of prognosis and the DS1500 does not contain one. 
  • others will not qualify that way, but may very well do so via the normal assessment of difficulties around daily living and getting around. But many people count themselves out because they sort of, somehow manage most of the activities considered.

The criteria are slightly different between the closely related AA and DLA and the rather more points based PIP. But in all cases, the key issues is the difficulty and help you ideally could do with - and which would make such a difference if it were available 

Taking your time, not doing it too often, restricting your activities, picking your best moments may be how you manage in practise. However, in AA and DLA terms, you could still do with help to manage tasks so as to "live as normal a life as possible. For PIP the points system is meant to look at how you manage reliably: safely, repeatedly and to a reasonable standard. The PIP points system is meant to look not just at whether you manage an activity but whether you can do so reliably.

So don’t discount the possibility that often vague - but still really limiting - effects of cancer and its treatments, might well qualify you for this valuable extra amount.  Not only is it always paid on top of any other income, is non taxable and is never counted in the sums for other benefits, an award of one of the “disability benefits” can actually increase your entitlements under Step 2.

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Industrial injuries and war disablement benefits.

The main benefit in these schemes is more of a compensation for health problems rather than either a payment for being too unwell to work or to help with extra costs. So you could have Industrial Injuries Disablement Benefit based on % age disability and both Contributory ESA and PIP. 

There are a number of additional allowances, some of which mirror the the main disability benefits. and may pay more or less. Others only exist within these schemes. Overall these can be well worth exploring as they can be more generous if there is a connection between your health difficulties and work in particular industries or while in service with the Forces. 

There are certain cancers that come under “prescribed occupational diseases” most notably in the case of asbestos related conditions such as mesothelioma.

Bereavement Support Payment

Previously Bereavement Allowance and Widowed Parents Allowances were mainly an earnings replacement benefit time limited either for a year or until all children connected with your deceased partner had grown up. 

The new Bereavement Support Payment focusses mainly on a lump sum payout, with smaller income payments for 18 months designed to give a small top up rather than a weekly benefit that might replace earnings. So that’s why in the entirely unofficial Steps approach they move from Step 1 to Step 3. 

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Examples of working through the Steps

So what might the mix of claims look like in some common scenarios for people affected by cancer?

Do take a look at some of the examples in Part 4 of the more extensive Benefits and Cancer blogs to see some specific examples. But likely common combinations include:

Angus, is of pension age and receives a cancer diagnosis

  • Step 1 Retirement Pension is unchanged. He might get SSP if he was with an employer
  • Step 2 Pension Credit is worth exploring as a potential top up. He might also get help with rent and council tax and health costs.
  • Step 3 Attendance Allowance (AA) is work checking out as it can be paid on top of the others
  • Back to Step 2: an award of AA might increase - or enable - an award of Pension Credit back at Step 2 

Bethan is of “working age” when she gets a breast cancer diagnosis: 

  • Step 1 SSP would be part of any sick pay from an employer for the first 28 weeks. After that or if not entitled to SSP - then Bethan can claim Contributory ESA 
  • Step 2 depends on whether she claims in a Full Service UC area or not. Under legacy benefits, Bethan claims Income-related ESA for an income top up, Housing Benefit for rent. Under Full Service, UC she claims UC instead of these two. Either way she can claims Council Tax Support and help with health costs separately
  • Step 3: She can claim Personal Independence Payment (PIP) for extra difficulties with daily living and getting around. 
  • Return to Step 2. An award of PIP might have an effect on her Income-related ESA, but not sadly if she is on Universal Credit. 

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Christopher is a carer of working age and a lone parent.

  • Step 1 : Carers Allowance
  • Step 2: -an income top up from Income Support, Child Tax Credit and help for rent from Housing Benefit . Or a claim for Universal Credit instead of these three . Again new or old systems it would be separate claims for Council Tax Support and any health costs he might have
  • Step 3: Child Benefit . If he had his own long term health issues there is no contradiction in claiming PIP for these while still being a carer for someone else. 
  • Return to Step 2 ?: only if a PIP award might lead to extra counts in his Income Support.

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Getting further advice and Support

For individual sessions to identify the benefits that will relate to your specific circumstances and help in making those applications:

  • Call into your nearest Maggies Centre and arrange to see the Benefits Advisor there. You can enter your town or postcode into Find your nearest Maggie's Centre here
  • You can do the same to see if there is a Macmillan Advice Service here
  • Or to find your nearest Citizen Advice - In England and Wales here   and in Scotland here

There may be a range of other sources of advice susch as local cancer support groups, local welfare rights services and so on. Your local council may well have a guide as to what is available in your area.

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Links and further reading 

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Stepping back to something simpler:

Step back a bit and see the two double sided Maggies Find Out More About leaflets - just a couple of sides each: 

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Going into more detail:

A more detailed overview in the four part Benefits and Cancer series, 

  • Benefits and Cancer 1:  An Introduction: Costs and benefits, myths, basic jargon and three steps to full entitlement - here
  • Benefits and Cancer 2:  Step 1 - The non-means tested earnings replacement benefits and statutory payments - here
  • Benefits and Cancer 3 : Step 2 - Means tested benefits and tax credits - here
  • Benefits and Cancer 4:  Step 3  - Extra non-means tesed benefits for children and disability - here

Further reading

From these blogs links will take you into further blogs around individual benefits in more details and other blogs exploring other benefit issues and blogs from different perspectives e.g. for carers, for older people  

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Getting face to face help from a benefits advisor:

  • Visit your local Maggie's Centre  and talk with one of our benefits advisors. Find your local centre here
  • See if there is a Macmillan advice service near you here
  • Find your local Citizens Advice office: in England & Wales - here. In Scotland - here


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