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Disability Benefits From Employees Compensation Program Of The Philippines
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In case some of you are searching for topics regarding compensation and benefits related to work injury, this may help.
The Employees' Compensation (EC) program aims to assist workers who suffer work-connected sickness or injury resulting in disability or death. The benefits under the EC program may be enjoyed simultaneously with benefits under the social security program effective June 1984.
Who are covered under the EC program? All SSS-registered employers and their employees are compulsorily covered under the program.
Employers and employees registered in the SSS need not register again under EC.
How much is the monthly EC contribution?
Only the employer is required to remit monthly EC contributions on behalf of the employees, equivalent to one per cent of the employee's monthly salary credit. The required contribution under the current rate is P10.
How long is an employer obliged to pay for the EC contributions of his employee?
For as long as the employee works for him/her employer is obliged to pay EC contributions. The obligation of the employer ceases when an employee is separated from employment or, if the employee dies during employment.
When a covered employee becomes disabled during employment, the employer's obligation to pay the monthly contribution arising from the employment will be suspended during such months that the employee is not receiving salary or wages.
What are the benefits under the EC program?
Benefits under the Employees' Compensation program include:
1.Medical services, appliances and supplies provided to the afflicted member beginning on the first day of injury or sickness, during the subsequent period of disability, and as the progress of recovery may require. These benefits, however, are limited to the ward services only of an accredited hospital and physician.
Ward services, consist of all the services an in-patients would ordinarily receive in a hospital.
2.Rehabilitation services, consisting of medical, surgical and hospital treatment. The SSS also provides as soon as practicable, a balanced program of remedial treatment for handicapped members.
3.Income cash benefit for: a.Temporary total disability or sickness. An income cash benefit equivalent to 90 per cent of the average daily salary credit with a minimum of P10 and a maximum of P200 (effective Nov. 1, 1996).
It is payable for a period not longer than 120 consecutive days. If the injury requires more treatment, the period may be extended up to 240 days. If it persist after this period, the injury will be considered as permanent total disability.
This benefit is advanced by the employer every regular payday. The amount legally paid by the employer is reimbursed 100 per cent by the SSS in the form of cheque or thru the bank.
b.Permanent total disability (loss of two limbs, permanent complete paralysis of two limbs, etc.). This benefit is a monthly pension paid for as long as the injured lives plus 10 per cent for each of the five dependent children beginning with the youngest and without substitution.
The monthly pension is guaranteed for five years but will be suspended if the employee is gainfully employed, recovers from permanent total disability, or fails to present himself/herself for examination at least once a year upon notice by the SSS or fails to submit a quarterly medical report certified by the attending physician as required under Section 5, Rule IV of the EC law. The minimum monthly income benefit is P2,000.
Beginning Jan. 1,1991, a permanent total disability pensioner is also given a supplemental allowance in addition to the monthly pension. This allowance will provide additional financial assistance to meet the extra needs arising from the disability. Effective May 1, 1993, the supplemental allowance is P575 a month. Upon the death of an EC permanent total or permanent partial disability pensioner,the SSS will pay to the primary beneficiaries 100 per cent of the monthly pension. In addition, the dependents will be paid the dependent?s pension. If the deceased pensioner has no primary beneficiaries, the SSS will pay to the secondary beneficiaries the remaining balance of the five-year guaranteed period, excluding the dependent?s pension.
c.Permanent partial disability (such as loss of one thumb, finger, leg). A monthly pension is provided to the member equivalent to the pension for permanent total disability but limited to the number of months designated by law for a particular disability. The minimum monthly pension is P2,000.
However, if the period of permanent partial disability pension is less than a year, the benefit may be paid in lump sum.
d.Death. A monthly pension is provided to the deceased member's primary beneficiaries, plus 10 per cent of such benefit for each of five dependent children, subject to some limitations. In the absence of primary beneficiaries, the secondary beneficiaries are entitled to the monthly pension but not to exceed 60 months. The minimum monthly pension for the death benefit is P2,000.
Under the EC program, a funeral benefit of P10,000 will also be paid to any person who actually shouldered the burial expenses of the deceased member.
What are the qualifications for EC benefits?
1.Employees should be duly reported to the SSS;
2. Employees' sickness, injury or death is work- connected; and
3. The SSS has been duly notified of such sickness, injury or death.
What forms are needed to file for EC claims?
For medical expenses:
1.SSS Form B-301 (EC Medical Reimbursement Benefit Application) For temporary total disability or sickness:
1.EC Form B-309 (Accident/Sickness Report)
2. EC Form B-300 (Employee?s Notification); and
3. SSS Form B-304 (Sickness Benefit Reimbursement Application)
For disability:
1.Claim for Disability Benefit; and
2. SSS Form MMD-102 (Medical Certificate)
For death:
1.BPN-105 (Report of death) and
2. DDR-1 (Death Claim Application)
For funeral expenses:
1.BPN-103 (Claim for funeral expenses);
2. Death certificate of deceased member duly certified by the local Civil Registrar; and
3. Official receipt from the funeral parlor
4. BPN-105 (Report of death)
NOTE: Other documents may be required as they are found to be necessary during the processing of the claim.
What other documents are needed for an EC death claim?
For Primary Beneficiaries:
1.Original or certified true copy (signed by the Local Civil Registrar) of: a. Death certificate of member;
b. Birth certificate(s) of minor children; and
c. Marriage certificate of member
d. For illegitimate children (acknowledged natural children whose parents have no legal impediment to marry)
2.Original or certified true copy (signed by the Local Civil Registrar) of: a.Death certificate of deceased;
b. Birth certificate of the children; and
c. Joint Affidavit of two disinterested persons that parent have no legal impediment to marry.
3. If minor children are orphaned, guardianship will be filed by grandparent, eldest brother or sister or any guardian. The guardian will apply for an appointment as representative payee through a competent court or the System.
NOTE: Other papers may be required as they are found to be necessary during the processing of the claim.
For Secondary Beneficiaries:
1.Parents of deceased: a. Original or certified true copy (signed by the Local Civil Registrar) of : ? Death certificate of deceased;
? Birth certificate of deceased; and
? Marriage certificate of parents
b.SSS Form CLD-1.3A (Affidavit for Death Benefit Claim)
2.For illegitimate children (Parents have legal impediment to marry and claims are to be filed by their guardian) a.Original or certified true copy (signed by the local civil registrar) of: ? Death certificate of deceased;
? Death certificates of parents of deceased, if both are no longer living;
? Birth certificate of the children; and b. SSS Form CLD-1.3A (Affidavit for Death Benefit Claim).
Where are claims for the EC benefit filed?
Claims for EC benefits are filed at any SSS branch or representative office nearest the member's residence or place of work.
The Employees' Compensation (EC) program aims to assist workers who suffer work-connected sickness or injury resulting in disability or death. The benefits under the EC program may be enjoyed simultaneously with benefits under the social security program effective June 1984.
Who are covered under the EC program? All SSS-registered employers and their employees are compulsorily covered under the program.
Employers and employees registered in the SSS need not register again under EC.
How much is the monthly EC contribution?
Only the employer is required to remit monthly EC contributions on behalf of the employees, equivalent to one per cent of the employee's monthly salary credit. The required contribution under the current rate is P10.
How long is an employer obliged to pay for the EC contributions of his employee?
For as long as the employee works for him/her employer is obliged to pay EC contributions. The obligation of the employer ceases when an employee is separated from employment or, if the employee dies during employment.
When a covered employee becomes disabled during employment, the employer's obligation to pay the monthly contribution arising from the employment will be suspended during such months that the employee is not receiving salary or wages.
What are the benefits under the EC program?
Benefits under the Employees' Compensation program include:
1.Medical services, appliances and supplies provided to the afflicted member beginning on the first day of injury or sickness, during the subsequent period of disability, and as the progress of recovery may require. These benefits, however, are limited to the ward services only of an accredited hospital and physician.
Ward services, consist of all the services an in-patients would ordinarily receive in a hospital.
2.Rehabilitation services, consisting of medical, surgical and hospital treatment. The SSS also provides as soon as practicable, a balanced program of remedial treatment for handicapped members.
3.Income cash benefit for: a.Temporary total disability or sickness. An income cash benefit equivalent to 90 per cent of the average daily salary credit with a minimum of P10 and a maximum of P200 (effective Nov. 1, 1996).
It is payable for a period not longer than 120 consecutive days. If the injury requires more treatment, the period may be extended up to 240 days. If it persist after this period, the injury will be considered as permanent total disability.
This benefit is advanced by the employer every regular payday. The amount legally paid by the employer is reimbursed 100 per cent by the SSS in the form of cheque or thru the bank.
b.Permanent total disability (loss of two limbs, permanent complete paralysis of two limbs, etc.). This benefit is a monthly pension paid for as long as the injured lives plus 10 per cent for each of the five dependent children beginning with the youngest and without substitution.
The monthly pension is guaranteed for five years but will be suspended if the employee is gainfully employed, recovers from permanent total disability, or fails to present himself/herself for examination at least once a year upon notice by the SSS or fails to submit a quarterly medical report certified by the attending physician as required under Section 5, Rule IV of the EC law. The minimum monthly income benefit is P2,000.
Beginning Jan. 1,1991, a permanent total disability pensioner is also given a supplemental allowance in addition to the monthly pension. This allowance will provide additional financial assistance to meet the extra needs arising from the disability. Effective May 1, 1993, the supplemental allowance is P575 a month. Upon the death of an EC permanent total or permanent partial disability pensioner,the SSS will pay to the primary beneficiaries 100 per cent of the monthly pension. In addition, the dependents will be paid the dependent?s pension. If the deceased pensioner has no primary beneficiaries, the SSS will pay to the secondary beneficiaries the remaining balance of the five-year guaranteed period, excluding the dependent?s pension.
c.Permanent partial disability (such as loss of one thumb, finger, leg). A monthly pension is provided to the member equivalent to the pension for permanent total disability but limited to the number of months designated by law for a particular disability. The minimum monthly pension is P2,000.
However, if the period of permanent partial disability pension is less than a year, the benefit may be paid in lump sum.
d.Death. A monthly pension is provided to the deceased member's primary beneficiaries, plus 10 per cent of such benefit for each of five dependent children, subject to some limitations. In the absence of primary beneficiaries, the secondary beneficiaries are entitled to the monthly pension but not to exceed 60 months. The minimum monthly pension for the death benefit is P2,000.
Under the EC program, a funeral benefit of P10,000 will also be paid to any person who actually shouldered the burial expenses of the deceased member.
What are the qualifications for EC benefits?
1.Employees should be duly reported to the SSS;
2. Employees' sickness, injury or death is work- connected; and
3. The SSS has been duly notified of such sickness, injury or death.
What forms are needed to file for EC claims?
For medical expenses:
1.SSS Form B-301 (EC Medical Reimbursement Benefit Application) For temporary total disability or sickness:
1.EC Form B-309 (Accident/Sickness Report)
2. EC Form B-300 (Employee?s Notification); and
3. SSS Form B-304 (Sickness Benefit Reimbursement Application)
For disability:
1.Claim for Disability Benefit; and
2. SSS Form MMD-102 (Medical Certificate)
For death:
1.BPN-105 (Report of death) and
2. DDR-1 (Death Claim Application)
For funeral expenses:
1.BPN-103 (Claim for funeral expenses);
2. Death certificate of deceased member duly certified by the local Civil Registrar; and
3. Official receipt from the funeral parlor
4. BPN-105 (Report of death)
NOTE: Other documents may be required as they are found to be necessary during the processing of the claim.
What other documents are needed for an EC death claim?
For Primary Beneficiaries:
1.Original or certified true copy (signed by the Local Civil Registrar) of: a. Death certificate of member;
b. Birth certificate(s) of minor children; and
c. Marriage certificate of member
d. For illegitimate children (acknowledged natural children whose parents have no legal impediment to marry)
2.Original or certified true copy (signed by the Local Civil Registrar) of: a.Death certificate of deceased;
b. Birth certificate of the children; and
c. Joint Affidavit of two disinterested persons that parent have no legal impediment to marry.
3. If minor children are orphaned, guardianship will be filed by grandparent, eldest brother or sister or any guardian. The guardian will apply for an appointment as representative payee through a competent court or the System.
NOTE: Other papers may be required as they are found to be necessary during the processing of the claim.
For Secondary Beneficiaries:
1.Parents of deceased: a. Original or certified true copy (signed by the Local Civil Registrar) of : ? Death certificate of deceased;
? Birth certificate of deceased; and
? Marriage certificate of parents
b.SSS Form CLD-1.3A (Affidavit for Death Benefit Claim)
2.For illegitimate children (Parents have legal impediment to marry and claims are to be filed by their guardian) a.Original or certified true copy (signed by the local civil registrar) of: ? Death certificate of deceased;
? Death certificates of parents of deceased, if both are no longer living;
? Birth certificate of the children; and b. SSS Form CLD-1.3A (Affidavit for Death Benefit Claim).
Where are claims for the EC benefit filed?
Claims for EC benefits are filed at any SSS branch or representative office nearest the member's residence or place of work.
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References
https://www.sss.gov.ph/sss/appmanager/pages.jsp?pa ... ram03
http://www.wisegeek.org/what-is-partial-disability ... y.htm
http://www.wisegeek.org/what-is-partial-disability ... y.htm
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