No one can really control the possibilities of getting sick. We never know when it is going to happen or how long it will take to fully recover from sickness or injury. But sometimes it adds to the stress when you know that not being able to come to work could mean you will receive less pay and financial problem. Less pay means challenge how you could make ends meet specially when you are living on a paycheck to paycheck.
Is there something else could you do if you already consumed your sick leave?
Hopefully you are active SSS member. Because you can apply for Sickness Benefit and through this you could receive pay for every day you were absent due to sickness
What is 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.
Am I Qualified To Claim Sickness Benefit?
A member is qualified to avail of this benefit if:
A member is unable to work due to sickness or injury and confined either in a hospital or at home for at least four (4) days;
He/she has paid at least three (3) months of contributions within the 12-month period immediately before the semester of sickness or injury;
He/she has used up all current company sick leaves with pay; and
He/she has notified the employer regarding his sickness or injury by filing the sickness benefit application; if he/she is unemployed, voluntary or self-employed member, the sickness notification should be submitted directly to SSS.
How Do I File Claim For SSS Sickness Benefit?
For Employees and Employers:
A member should notify the employer within five (5) calendar days after the start of sickness or injury. The employer, in turn, must notify the SSS of the confinement within (5) calendar days after receipt of the notification from the employee member.
Notification to the employer shall be made within one year from start of confinement if the member’s confinement is in a hospital. If the member got sick or was injured while working or while he was within the company premises, sickness notification shall be made within ten (10) days from the start of confinement. In this case, the employer must notify the SSS within ten (10) calendar days from the start of the employee’s sickness or injury while he was working or while he was within the company premises.
For Unemployed, Self-employed and Voluntary Members:
Unemployed, self-employed or voluntary paying members should notify the SSS directly within five (5) calendar days after the start of confinement, unless such confinement is in a hospital, in which case, notification should be made within one (1) year from start of confinement
Effects of failure or delay in notification
If the employee notifies the employer, or the SSS, in the case of an unemployed, self-employed or voluntarily paying member, beyond the prescribed five-day period, the confinement shall be deemed to have started not earlier than the fifth day immediately preceding the date of notification.
If the employer notifies the SSS beyond five (5) calendar days after receipt of the notification from the employee, the employer shall be reimbursed only for each day of confinement starting from the 10th calendar day immediately preceding the date of notification to the SSS.
If the employee has given the required notification to the employer, but the employer fails to notify the SSS of the confinement within the prescribed period resulting in the reduction of the benefit or denial of the claim, the employer shall have no right to recover the daily sickness allowance advanced to the employee.
The amount of a member’s sickness benefit per day is equivalent to ninety percent (90%) of the member’s average daily salary credit.
For OFWs, they can file their sickness notifications and benefit claims in person, through a representative or via mail to any SSS office in the Philippines or overseas. SSS also gives more time for OFWs to file for Sickness Benefit Claim. OFWs can file their sickness notifications with the agency’s offices abroad within 35 calendar days after start of home confinement.
For the Employee
For the Employer
For Unemployed/Self-Employed/Voluntary member
Certified true copy of medical records
Operating Room Record
X-ray, CT Scan, ECG, Ultrasound Results, if any
Other clinical record/diagnostic procedure results
Proof of Identification
UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth
For Unemployed Members
Certification from last employer showing the effective date of separation from employment or notice of the company’s closure/strike or certification from the Department of Labor and Employment (DOLE) that the employee or employer has pending labor case.
Certification that no advance payment was granted, if the date of separation form employment is within the confinement period being applied for.
For claim filed by Authorized Company Representative
Blue card, representative’s SS card, or two (2) valid IDs both with signature and at least one (1) with photo; and
Photocopy of the member’s SS card or two (2) valid IDs both with signature and at least one (1) with photo and date of birth duly signed by the member and authenticated by the authorized company signatory.
Claims may be filed at the nearest SSS office. However, processing will be done at the branch where the employer and employee records are based.