Free SSP record template for UK employers. Track Statutory Sick Pay eligibility, qualifying days, and payment calculations.
Last updated: 30 January 2025
Use this template to track SSP eligibility and payments.
Statutory Sick Pay Record
Employee Details
Field
Information
Employee Name
Employee Number
NI Number
Department
Start Date
Qualifying Days
[e.g., Monday-Friday]
Weekly Earnings
£
Current SSP Rate
Tax Year
Weekly Rate
Daily Rate (5-day week)
2024-25
£116.75
£23.35
Check GOV.UK for current rates
SSP Eligibility Check
Initial Eligibility
Criterion
Met?
Notes
Employee (not contractor/agency)
[ ]
Earning at least LEL (£123/week 2024-25)
[ ]
Off sick for 4+ consecutive days
[ ]
Provided evidence (self-cert/fit note)
[ ]
Not excluded (see below)
[ ]
Exclusions (SSP NOT Payable If)
Exclusion
Applies?
Already received 28 weeks SSP in this PIW
[ ]
Within 8 weeks of receiving certain benefits
[ ]
In legal custody
[ ]
Pregnancy-related exclusion period
[ ]
Industrial dispute at workplace
[ ]
Worked on a qualifying day during the PIW
[ ]
Absence Record
Period of Incapacity for Work (PIW)
PIW Number
Start Date
End Date
Total Calendar Days
Linked?
PIWs separated by 8 weeks or less are linked
Waiting Days and SSP Days
This Absence Period
Day
Date
Qualifying Day?
Waiting Day?
SSP Payable?
SSP Amount
1
[ ]
[ ]
[ ]
£
2
[ ]
[ ]
[ ]
£
3
[ ]
[ ]
[ ]
£
4
[ ]
[ ]
[ ]
£
5
[ ]
[ ]
[ ]
£
6
[ ]
[ ]
[ ]
£
7
[ ]
[ ]
[ ]
£
[Continue as needed]
Total SSP for this period: £_________
Notes on Waiting Days
First 3 qualifying days are waiting days (no SSP)
If linked to previous PIW, waiting days may already be served
Waiting days only apply once per PIW (even if linked periods)
Evidence Received
Period
Type
Covering Dates
Date Received
Notes
Days 1-7
Self-certification
Day 8+
Fit note
Fit note
Fit note
Self-certification acceptable for first 7 calendar daysFit note required from day 8 onwards
SSP Calculation
Weekly SSP Rate
Element
Amount
SSP weekly rate
£116.75
Employee's qualifying days per week
SSP per qualifying day
£
Total SSP Paid This PIW
Week Ending
Qualifying Days Paid
Amount
£
£
£
£
Total
£
28-Week Maximum Tracker
PIW
Start Date
Weeks of SSP
Running Total
1
2
3
Total weeks used
SSP payable for maximum 28 weeks in a PIWIf 28 weeks exhausted, issue SSP1 form
SSP1 Form
Issue SSP1 if SSP not payable or about to end
Issued?
Date
Reason
[ ]
Not enough earnings
[ ]
28 weeks exhausted
[ ]
Other exclusion: _________
Return to Work
Detail
Date/Information
Return to work date
Fit note said "may be fit"
[ ] Yes [ ] No
Adjustments made?
Return to work meeting held
Phased return?
Payroll Processing
Pay Period
SSP Included
Processed By
Date
£
£
£
Notes
[Space for additional notes]
SSP Quick Reference
Who Qualifies
Employees earning ≥£123/week (2024-25 LEL)
Sick for 4+ consecutive days (including non-working days)
Has notified employer of sickness
How Much
£116.75/week (2024-25)
Divide by qualifying days for daily rate
Paid for qualifying days only (not all calendar days)
How Long
Up to 28 weeks in a PIW
3 waiting days (no SSP) at start of each PIW
Linked PIWs share waiting days
Key Forms
Self-certification: Days 1-7
Fit note: From day 8
SSP1: When SSP ends or isn't payable
Record Completed By
Field
Information
Name
Position
Date
Signature
Frequently Asked Questions
How long must I keep SSP records?
You must keep records of SSP payments, dates of sickness, and qualifying days for at least 3 years after the end of the tax year to which they relate.
What records must I keep for SSP?
You must keep records of: dates of absence, qualifying days, SSP paid, why SSP wasn't paid (if applicable), and any evidence of incapacity (self-certification forms, fit notes).
Do I need to report SSP to HMRC?
SSP is reported through Real Time Information (RTI) as part of normal payroll reporting. You report it as part of the employee's pay. You no longer recover SSP from HMRC (the recovery scheme ended in 2014).