Taking time off work

Cancer and the side effects of treatment can be intense. Some people may be able to continue working through treatment. Other people may have to stop. Taking time off work can leave you feeling angry, lonely and worried about your finances.

Under equality laws your employer should give you a reasonable amount of time off to attend hospital appointments. This may not be paid time off unless your employment contract states so.

If you’re an employee and cancer treatment makes you unable to work, you will usually get Statutory Sick Pay. Your employment contract may also allow you to claim Occupational or Company Sick Pay.

If you are temporarily unable to work, other benefits you may be eligible for include:

  • Employment and Support Allowance
  • Universal Credit.

If you have care needs, you may apply for:

  • Personal Independence Payment
  • Disability Living Allowance
  • Attendance Allowance.

Benefits and social services change over time. Call the Macmillan Support Line (0808 808 00 00) to talk to a welfare rights adviser or simply for someone to talk to.

Taking time off work during treatment

How much work you feel you’re able to do during cancer treatment might depend on a number of factors. These may include the type of treatment you’re having, the stage of your cancer, your overall health and the type of work you do.  

You may find that you’re able to – and possibly want to – keep working during cancer treatment. Or you may find that you need to stop working to cope with the effects of the cancer and its treatment.

You’ll probably need to take time off for appointments, treatment and follow-up. In most cases, under equality laws your employer will give you a reasonable amount of time off work to attend necessary hospital appointments.

Your employer may be able to make reasonable adjustments to allow you to go to hospital appointments. However, there’s no absolute right to paid time off unless your contract of employment specifically states this. You should discuss the issue of appointments with your employer at an early stage to agree how they should be dealt with.

It will help to give your employer as much warning as possible if you need time off, because if you give very short notice they may be unable to agree to the request. If possible, it can help to arrange appointments for the start or end of the day to keep time away from work to a minimum.

If you need to take time off work during your treatment, it may be taken as sickness absence, or an agreed reduction in working hours or days per week. We have more information about taking time off, sick pay and other financial issues.

Talking to your employer about your need for time off will mean they can support you in the best way possible.

Your feelings

Being diagnosed with cancer and having to take time off can cause a range of emotions. You may feel angry that you can’t be at work when you have a lot to do. You may also feel guilty if others have to take on some of your work when you’re not there.

When dealing with a cancer diagnosis, people often say that they feel lonely and isolated. These feelings can affect people at different times in their illness. If you’re unable to work for periods of time, this may add to a sense of isolation.

Having cancer can also make you feel very vulnerable. You may feel as though you’ve lost your independence. You can feel tired and stressed, and it may seem as though things you used to find easy are now much more difficult.

Taking a lot of time off can make you feel out of touch with what’s going on at your workplace. You may lose confidence in your ability to do your job well, or you may think your colleagues are annoyed with you or feel you’re not doing enough. Some people lose a sense of normality when they’re not working, and some find that they lose self-esteem.

All these things can be hard to cope with, but you may find ways of adapting to your illness and treatment that will give you a new focus and sense of control. This can take some time, and your confidence and self-esteem will need to be built up again gradually.

Getting support

Talking through your feelings can often help. Some people worry that by asking for help they’re being a burden. However, people are usually pleased to be involved and to be able to support you. It can be difficult to know who to talk to and what to say – it’s important to speak to someone you feel comfortable with and can trust.

You may wish to speak to a partner, family member or friend, a health professional involved in your care, or a trained professional not directly involved in your care, for example a counsellor. Counselling can help people cope with their feelings and help them find ways of talking to colleagues. It can also help restore self-confidence. Some GP surgeries provide counselling. Some companies and organisations have employee assistance programmes (EAPs), which are there to help employees dealing with personal issues.

You may find our information about the emotional effects of cancer helpful.


Statutory Sick Pay (Non-means-tested/non-contribution-based)

You may be able to get Statutory Sick Pay (SSP) if you are employed but unable to work because of illness. You can claim it if you meet both of these conditions:

  • You’re unwell and off work for at least four days in a row (including weekends, bank holidays and days that you don’t normally work).
  • Your average weekly earnings are at least £112.

SSP is paid by your employer for up to 28 weeks of sickness.

The standard rate is currently £88.45 a week. Employers cannot pay you less than this if you qualify for SSP.

Before your SSP is due to end, you should check whether you can get a benefit called Employment and Support Allowance.

How to claim

Ask your employer, as they are responsible for making these payments.


Statement of fitness for work (fit note)

If you’re ill and not able to work for more than a few days, remember to ask your GP for a statement of fitness for work (often called a fit note) to cover the period of your illness.

If you’re in hospital, ask your doctor or nurse for a fit note to cover the time that you’re an inpatient. This will be necessary if you need to claim a benefit. You may need to have a medical assessment to see whether you’re eligible to claim.


Help if you’re unable to work or on a low income

Employment and Support Allowance

This benefit provides financial help to people who are unable to work because of their illness or disability. It also provides personalised support to those who are able to work. There are two different types of Employment and Support Allowance: contribution-based and income-related (means-tested). People may get either or both, depending on their national insurance contribution record and their income and savings.

Between October 2013 and 2017, income-related Employment and Support Allowance will be replaced by Universal Credit (see below). Contribution-based Employment and Support Allowance will stay the same.

Employment and Support Allowance may be paid at a basic rate of up to £71.70 for the first 13 weeks of the claim. During this time, unless you’re terminally ill or have claimed before in the previous 12 weeks, you may need to take part in a work capability assessment. This involves filling in and sending back a questionnaire about how your illness or disability affects your ability to complete everyday tasks.

Your doctor may also be asked to complete a report. This evidence will be considered by an approved healthcare professional, who may recommend you attend a face-to-face assessment if more information is needed about your condition.

If the work capability assessment shows that your illness or disability limits your ability to work, you’ll be placed into one of two groups: the support group or the work-related activity group.

If you’re receiving, waiting for, or recovering from any kind of chemotherapy or radiotherapy, you’ll be treated as unable to work or to undertake any work-related activity. You’ll therefore satisfy the work capability assessment for entitlement to Employment and Support Allowance and be placed in the support group.

If you still qualify for Employment and Support Allowance after 13 weeks, you’ll enter the main phase of the benefit. If your illness or disability has a severe effect on your ability to work, you’ll be placed in the support group and you won’t have to undertake work-related activities. An additional payment of £34.80 will be paid to anyone in the support group.

If your ability to work is limited, but not severely so, you’ll be placed in the work-related activity group, and you’ll have to attend six work-focused interviews. A smaller additional payment of £28.45 will be paid to anyone in this group.

The amount of time a person can receive contributory-based Employment and Support Allowance in the work-related activity group is limited to 12 months. After 12 months, the benefit will stop unless you claim and qualify for income-related Employment and Support Allowance (Universal Credit since October 2013) or you request to be placed in, and are accepted for, the support group.

If you think this may affect you, speak to a welfare rights adviser as soon as possible.

If you’re self-employed, you can claim contributory-based Employment and Support Allowance as long as you’ve paid the correct level of national insurance contributions.

You may be able to get more money if you qualify for income-related Employment and Support Allowance (Universal Credit since October 2013), depending on your circumstances.

To claim in England, Scotland or Wales, call Jobcentre Plus on 0800 055 6688, textphone 0800 023 4888. To claim in Northern Ireland, call the Department for Social Development on 0800 085 6318.

Universal Credit

Universal Credit is a new single payment for people who are looking for work or on a low income. It’s expected that Universal Credit will be introduced in Northern Ireland, but not until spring 2014. In England, Scotland and Wales, it will gradually replace the following benefits between October 2013 and 2017:

  • Income Support
  • Housing Benefit
  • Child Tax Credit
  • Working Tax Credit
  • Income-based Jobseeker’s Allowance.

To claim Universal Credit, you need to:

  • be 18 or over (or 16 or 17 in certain cases)
  • be under State Pension age
  • live in the UK
  • not be in education
  • accept a claimant commitment.

If you have a partner, you’ll need to make a joint claim for Universal Credit. If one of you doesn’t meet the requirements, they won’t be included in the amount of Universal Credit you get, but both of your savings, income and earnings will be taken into account.

The claimant commitment sets out your responsibilities in terms of your Universal Credit award. It includes work-related requirements. However, there are groups who won’t be required to demonstrate that they’re working, preparing for work or looking for work.

Universal Credit is made up of a standard allowance and five additional elements, which may be paid monthly depending on your circumstances.

Contact a Macmillan welfare rights adviser for more information about Universal Credit and the five additional elements.


Help if you have care needs

Personal Independence Payment

This is a benefit for people aged 16–64 who have care or mobility needs. It replaces Disability Living Allowance (see below).

In England, Scotland and Wales, this change has already started to happen. In Northern Ireland, Personal Independence Payment won’t be introduced until at least spring 2014.

There are many similarities between the two benefits. In particular, Personal Independence Payment has two components: a daily living component and a mobility component.

There are some key differences though. New claims will normally be started over the phone, and then a personalised form will be posted to you to complete. Personal Independence Payment claims will include an assessment of individual needs by a health professional – most people will have a face-to-face consultation as part of their claim. Awards will also be reviewed regularly, based on how likely it is that your condition or disability will change.

Personal Independence Payment provides help towards some of the extra costs arising from a health condition or disability. It’s based on how a person’s condition affects them, not on the condition they have.

To get Personal Independence Payment, you must be 16–64 and satisfy a daily living and/or mobility activities test for three months before claiming, and be likely to continue to satisfy this test for at least another nine months. The test includes activities such as how well you can move around, and your ability to prepare food, wash, bathe and dress yourself.

You can receive Personal Independence Payment whether you’re in or out of work, and receiving it doesn’t normally reduce other benefits – in some cases your other benefits may actually increase.

Disability Living Allowance

This benefit is for people under 65 who have difficulty walking or looking after themselves (or both). In England, Scotland and Wales, it started to be replaced by Personal Independence Payment in 2013. People who claimed Disability Living Allowance before this point may still be receiving the benefit, but will gradually be reassessed for Personal Independence Payment.

This won’t affect most people until 2015 or later. (Reassessment started in October 2013.) In Northern Ireland, you’ll still be able to claim Disability Living Allowance as a new claimant until at least spring 2014.

Attendance Allowance

This benefit is for people aged 65 or over who have difficulty looking after themselves. You may qualify if you need help with personal care, for example getting out of bed, having a bath or dressing yourself. It’s based on the amount of care you need, not the care you receive. You must have needed care for at least six months prior to making a claim, unless you’ve been diagnosed with terminal cancer. You don’t need to have a carer to qualify for this benefit.

If you’re terminally ill, you can apply for Personal Independence Payment, Disability Living Allowance or Attendance Allowance under the special rules. Under these rules, you don’t need to meet the three- and six-month qualifying conditions mentioned above. Your claim will be dealt with quickly and you’ll receive the benefit at the highest rate.


Appealing against an unsuccessful benefit application

If you’ve been turned down for a benefit or tax credit, you may be able to appeal against that decision or ask for a review. You must do this within a certain time frame. As this can be a complicated process, it’s a good idea to ask a welfare rights adviser for help as soon as possible. You can speak to a welfare rights adviser by calling us.


Free prescriptions

Prescriptions are free in Scotland, Wales and Northern Ireland.

People with cancer in England are eligible for free prescriptions. All people undergoing treatment for cancer, or the effects of cancer or its treatment, can apply for an exemption certificate by collecting form FP92A from their GP surgery or oncology clinic.

We have more information about prescription charges available.


Council tax reduction

You may be able to claim a reduction of your council tax if:

  • you pay council tax
  • you’re on a low income or claiming benefits.

To find out more or to apply for a reduction, contact your local council.


Getting information about financial issues

For more information about benefits and financial support, call the Macmillan Support Line. You can also find out more about benefits from Citizens Advice. You’ll usually need to make an appointment. Or you can get information from gov.uk if you live in England, Scotland or Wales, or from nidirect.gov.uk if you live in Northern Ireland.

Remember that a change in your circumstances (such as a reduction or increase in your salary or in the number of hours you work) can mean you’re entitled to more or less benefit.

You need to find out in detail the regulations and conditions that apply to your benefits.

Whatever you decide to do, it may help to contact Macmillan’s Financial Guidance Service. They can help you understand the options available to you through any insurance policies you hold. For example, you may have policies that cover you for income replacement, life and critical illness cover, or loan and mortgage payments.

They can also give you information about other conditions that might apply to any insurance policies you hold. For example, Waiver of Premium benefit allows you to take a break from payments until you’re fit to return to work.

It may also help to contact a financial adviser to get advice on your financial options. Financial advisers can assess your individual situation and recommend the best course of action. Ask family and friends if they can recommend someone, or try the Personal Finance Society or Unbiased.

If you’d like help finding a suitable independent financial adviser or understanding the information you might need to provide to your insurance company, then our Financial Guidance Service can help you.


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