Now that I need to file several SSS forms to avail both sickness and maternity benefits, I did a lot of research over the net. Below is some information on sickness and disability benefits

(lifted from http://wallis.kezenfogva.iif.hu/eu_konyvtar/projektek/vocational_rehabilitiation
/philippi/phi_rap/comp.htm)

SSS Sickness Benefit

The sickness benefit is a daily cash allowance paid for the number of days a member is unable to work due to sickness or injury.

A member is qualified to avail himself of this benefit if:

  • he is unable to work due to sickness or injury and is thus confined either in the hospital or at home for at least four days;
  • he has paid at least three monthly contributions within the 12-month period immediately before the semester of sickness;
  • he has used up all current company sick leaves with pay for the current year;
  • he has notified his employer or the SSS, if he is a separated, voluntary or self-employed member

Sickness Benefit Computation

The amount of an employee’s sickness benefit is computed as the daily sickness allowance times the approved number of days. Effective May 24, 1997, the daily sickness allowance is 90 per cent of the average daily salary credit.

The sickness benefit is computed by:

  • Excluding the semester of sickness. A semester refers to a period of two consecutive quarters ending in the quarter of sickness. A quarter refers to a period of three consecutive months ending on the last day of March, June, September or December.
  • Counting 12 months backwards starting from the month immediately before the semester of sickness.
  • Identifying the six highest monthly salary credits within the 12-month period. Monthly salary credit means the compensation base for contributions and benefits related to the total earnings for the month. (The maximum covered earnings or compensation increases by P1,000 beginning at P7,000 in 1994 and every January of each year thereafter until the maximum of P12,000 is reached.)
  • Adding the six highest monthly salary credits to get the total monthly salary credit.
  • Dividing the total monthly salary credit by 180 days to get the average daily salary credit.
  • Multiplying the average daily salary credit by 90 per cent to get the daily sickness allowance.
  • Multiplying the daily sickness allowance by the approved number of days to arrive at the amount of benefit due.

Eligibility

A member can be granted sickness benefit for a maximum of 120 days in one calendar year. Any unused portion of the allowable 120 days sickness benefit cannot be carried forward and added to the total number of allowable compensable days in the subsequent year.

The sickness benefit shall not be paid for more than 240 days on account of the same illness. If the sickness or injury still persists after 240 days, the claim will be considered a disability claim

SSS Disability Benefits

Disability benefit is a cash benefit paid to a member who becomes permanently disabled, either partially or totally.

A member who suffer partial or total permanent disability, with at least one monthly contribution paid to the SSS prior to the semester of contingency, is qualified.

The complete and permanent loss of use of any of the following parts of the body fall under permanent partial disability:

  • one thumb one big toe
  • one index finger one hand
  • one middle finger one arm
  • one ring finger one foot
  • one little finger one leg
  • hearing of one ear one ear
  • hearing of both ears both ears
  • sight of one eye

The following fall under permanent total disability:

  • complete loss of sight of both eyes;
  • loss of two limbs at or above the ankle or wrists;
  • permanent complete paralysis of two limbs;
  • brain injury causing insanity; and
  • other cases as determined and approved by the SSS.

There are two types of this benefit. They are:

  • the monthly pension; and
  • the lump sum amount.

The monthly pension is a cash benefit paid to a disabled member who has paid at least 36 monthly contributions to the SSS prior to the semester of disability.

The lump sum amount is granted to those who have not paid the required 36 monthly contributions.

The amount of the monthly pension will be based on the member’s number of paid contributions and his years of membership.

The lowest monthly pension is P1,000 for members with less than 10 calendar years of service (CYS); P1,200 for those with at least 10 CYS and P2,400 for those with at least 20 CYS.

For permanent total disability, the lump sum is equivalent to the monthly pension times the number of monthly contributions paid to the SSS or the monthly pension times 12, whichever is higher.

For permanent partial disability, the lump sum is equivalent to the monthly pension time the number of monthly contributions times the percentage of disability in relation to the whole body or the monthly pension times 12 times the percentage of disability, whichever is higher.

In addition to the monthly pension, a supplemental allowance of P500 is paid to the total or partial disability pensioner. The allowance will provide additional financial assistance to meet his extra needs arising from his disability.

As a disability pensioner, he and his dependents are also entitled to Medicare benefits under the administration of the Philippine Health Insurance Corporation (PhilHealth).

Only totally and permanently disabled members will receive a lifetime monthly pension. However, this pension will be suspended if the pensioner recovers from his illness, resumes employment or fails to report for physical examination when notified by the SSS. The member may request for a domicilliary or a home visit if his disability inhibits his activity.

The monthly pension of a partially disabled member is limited to a certain number of months according to the degree of his disability. If with deteriorating and related permanent partial disability, the percentage degree of disability of the previously granted claim shall be deducted from the percentage degree of disability of the present claim.

The monthly pension is given in a lump sum if it is payable for less than 12 months.

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