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SICKNESS BENEFIT | |||||||||||||||||||
FOR SELF-EMPLOYED, VOLUNTARY, OVERSEAS FILIPINO WORKER (OFW), NON-WORKING SPOUSE (NWS), AND MEMBER SEPARATED FROM EMPLOYMENT A daily cash allowance paid for the number of days a member is unable to work due to sickness or injury. Qualifying Conditions A member is qualified to avail of this benefit if he/she:
Amount of Benefit The amount of the member’s daily sickness benefit allowance is equivalent to ninety percent (90%) of his/her average daily salary credit (ADSC).
FREQUENTLY ASKED QUESTIONS: How many days in a year can a member be granted sickness benefit? A member can be granted sickness benefit for a maximum of 120 days in one (1) calendar year. Any unused portion cannot be carried forward/added to the total number of allowable compensable days for the following year. The sickness benefit shall not be paid for more than 240 days on account of the same illness. If the sickness or injury persists after 240 days, the claim will be considered a disability claim. What is the prescriptive period in the filing of sickness benefit claim? The following prescriptive periods in filing Sickness Benefit application must be strictly followed:
NOTE: Starting August 18, 2015, OFW-members are given a 30-day grace period beyond the existing five-day prescriptive period in the filing of sickness benefit application. This is to address the concern that due to the distance between their place of work/residence and the nearest SSS foreign branch, their claim for sickness benefit are often penalized for late filing. The additional 30-day grace period shall be applied only to cases that do not require hospital confinement. What are the implications of late filing? Failure to observe the rule on notification shall be a ground for the reduction or denial of the sickness claim application. If the member notifies the SSS beyond the prescribed five-day period, the confinement shall be deemed to have started not earlier than the fifth (5th) day immediately preceding the date of notification.
What if the last day of filing falls on a weekend or a holiday? Whenever the last day to notify the SSS of a member’s sickness or injury falls on a Saturday, Sunday, or holiday, the sickness benefit application may be filed on the immediately succeeding working day without the penalty of delay.
The same rule shall also be applied for hospital confinement, if the deadline of the one-year prescriptive period falls on a Saturday, Sunday, or a holiday. What is the disbursement procedure of sickness benefit payment? The sickness benefit claims shall be mandatorily disbursed through the qualified payee’s Unified Multi-purpose Identification (UMID) card enrolled as Automated Teller Machine (ATM) card. In the absence of this, payment shall be made thru participating banks under the Development Bank of the Philippines (DBP) Disbursement Facility via the Philippine Electronic Fund Transfer System and Operations Network (PESONet), electronic wallets (E-Wallets), or accredited remittance transfer companies (RTCs)/cash payout outlets (CPOs). Hence, self-employed, and voluntary members, including OFWs and those separated from employment, shall be required to enroll the following details in the Disbursement Account Enrollment Module and upload proof of account in the My.SSS Facility in the SSS website:
Members shall be notified by SSS thru email or SMS upon crediting of their sickness benefit claims to their PESONet bank/E-wallet accounts, or if payment is already available through RTCs/CPOs. Crediting of benefit payments shall be made within five (5) banking days from date of settlement. What are the documentary requirements?
NOTE:
What are the additional documentary requirements? For Self-Employed/Voluntary Member (previously employed) If confinement period applied for is within the period of employment or prior to date of separation:
For Member Separated from Employment If confinement period applied for is within the period of employment or prior to date of separation:
If confinement period applied for is after the date of separation:
NOTE: Certificate of separation is not required for self-employed and voluntary members (previously employed) or those separated from employment under any of the following conditions in which other supporting document/s shall be required to be submitted as follows: If company is on strike:
If company has been dissolved or has ceased operation:
If there is a case pending before a court regarding separation of member:
If separated from employment due to absence without leave (AWOL) or with strained relations with the employer:
Where can the member file the sickness claim? The sickness benefit application may be filed by self-employed and voluntary members, and those separated from employment at any SSS branch that is most convenient to them |