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. The amount of sickness benefit per day is equivalent to ninety percent (90%) of the member’s average daily salary credit (ADSC).

A member is qualified to avail of this benefit if:

1. He/She is unable to work due to sickness or injury and confined either in a hospital or at home for at least four (4) days;

2. He/She has paid at least three (3) months of contributions within the 12-month period immediately before the semester of sickness or injury;

3. He/She has used up all current company sick leaves with pay; and

4. He/She has notified the People Operations Team regarding his/her sickness or injury.

1. Exclude the semester (six months) in which the sickness occurred and count backwards one year from the month right before the semester of your sickness.

2. The six highest Monthly Salary Credits (MSC) of the year will determine the amount you will receive, with the maximum fee being P20,000.00 monthly.

3. Continue by dividing the total sum of the six MSC by 180 to get your average daily salary credit, which you will multiply by 90% and get your daily sickness allowance.

4. Lastly, multiply your daily sickness allowance for the amount of days that have been approved for the sickness benefit.

1. A member can be granted sickness benefit for a maximum of 120 days in one (1) calendar year. Any unused portion of the allowable 120 days sickness benefit cannot be carried forward nor added to the total number of allowed compensable days for the following year.

2. The sickness benefit shall be paid for not 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.

1. An Employee 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

2. Notification to the employer shall be made within one (1) 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/she 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 EE’s sickness or injury while he/she was working or while within the company premises.

In filing for Sickness Notification: 

1. If filed personally by member:

• Sickness Notification (SN) Form

• ID card/s and/or document/s

• Medical documents, if any

In case of work-related claims, all the above-listed documents, plus the following:

• Accident/Sickness Report from ER, if work-connected; and

• Police Report (for vehicular accident with third party involvement), if work-related;and

• Photocopy of ER’s logbook In case of prolonged confinements or sickness, original/certified true copy of the following:

  • • • Laboratory, X-ray, ECG and other diagnostic results

      • Operating room/clinical records that will support diagnosis

Note:

-        A Medical Specialist shall determine other required medical documents based on a separate checklist.

In   filing   for   Sickness   Benefit   Reimbursement   Application 

1.  Sickness Benefit Reimbursement Application (SBRA) Form

2.  Approved  SN  Form  or  Certificate  of  Medical  Approval  issued  by  the  SSS  Medical Evaluation Section Copy of page of ER’s Logbook (manual logbook or electronic filing) for approved EC claim

3.  Member or Filer’s SS card or other valid ID cards

1. People Ops Team will log in to the SSS Employer's Account

2. Select the SBRA and encode the SSS Number of the Employee 

3. Select the Claim Reference Number on the list of approved sickness notification and click proceed to continue the application

4. Encode all the needed information such as date of  confinement and sickness computation

5. Once reviewed, click the certification box and submit it to SSS

6. People Ops team will monitor the reimbursement to the nominated bank account