Are you sick within a long period of time and has exhausted all your Sickness Leave in your company? The SSS offers a Sickness Benefit to help people like you.
The sickness benefit is the amount or the daily cash allowance paid for the number of days a member is unable to work due to sickness or injury. It’s equivalent to 90% of the member’s average daily salary credit. Member can file
A member is eligible of this benefit if:
1. He/she is unable to work due to sickness or injury; confined either in a hospital or at home for at least four (4) days;
2. The member was able to pay at least three (3) months of contributions within the 12-month period immediately before the semester of sickness or injury;
3. A member used up all current company sick leaves with pay; and
4. Lastly, if a member was able to notify 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.
1. Sickness Notification (SN) Form
3. Medical and/or Accident related documents such as:
1. Sickness benefit application form for unemployed/self-employed/voluntary member
Remember that a Medical Specialist shall determine other required medical documents. For sickness or injury acquired abroad, documents issued by the foreign country should be in English translation and must be authenticated by the Philippine Embassy or Consulate Office; or duly notarized by a notary public from the host country.
1. Sickness Benefit Reimbursement Application (SBRA) Form
2. Approved SN Form or Certificate of Medical Approval issued by the SSS Medical Evaluation Section
3. Copy of page of ER’s Logbook (manual logbook or electronic filing) for approved EC claim
4. Member or Filer’s SS card or other valid ID cards/documents as listed below:
For the secondary IDs, kindly see the full list here.
The amount of sickness benefit per day is equivalent to ninety percent (90%) of the member’s average daily salary credit (ADSC).
A member can have 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.
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. Exclude the semester of sickness.
2. Count twelve (12) months backwards starting from the month immediately before the semester of sickness.
3. Identify the six (6) highest MSCs within the 12-month period. Monthly salary credit (MSC) means the compensation base for contributions and benefits related to the total earnings for the month. The maximum covered earnings or compensation is P20,000, effective April 2019.
Range of Compensation | Monthly Salary Credit | SS Contribution |
---|---|---|
BELOW – 2,250 | 2,000 | 240.00 |
2,250 – 2,749.99 | 2,500 | 300.00 |
2,750 – 3,249.99 | 3,000 | 360.00 |
3,250 – 3,749.99 | 3,500 | 420.00 |
3,750 – 4,249.99 | 4,000 | 480.00 |
4250 – 4,749.99 | 4,500 | 540.00 |
4,750 – 5249.99 | 5,000 | 600.00 |
5,250 – 5,749.99 | 5,500 | 660.00 |
5,750 – 6,249.99 | 6,000 | 20.00 |
6,250 – 6,749.99 | 6,500 | 780.00 |
6,750 – 7,249.99 | 7,000 | 840.00 |
7,250 – 7,749.99 | 7,500 | 900.00 |
7,750 – 8,249.99 | 8,000 | 960.00 |
8,250 – 8,749.99 | 8,500 | 1,020.00 |
8.750 – 9,249.99 | 9,000 | 1,080.00 |
9,250 – 9,749.99 | 9,500 | 1,140.00 |
9,750 – 10,249.99 | 10,000 | 1,200.00 |
10,250 – 10,749.99 | 10,500 | 1,260.00 |
10,760 – 11,249.99 | 11,000 | 1,320.00 |
11,250 – 11,749.99 | 11,500 | 1,380.00 |
11,750 – 12,249.99 | 12,000 | 1,440.00 |
12,250 – 12,749.99 | 12,500 | 1,500.00 |
12,760 – 13,249.99 | 13,000 | 1,560.00 |
13,250 – 13,749.99 | 13,500 | 1,620.00 |
13,750 – 14,249.99 | 14,000 | 1,680.00 |
14,250 – 14,749.99 | 14,500 | 1,740.00 |
14,750 – 15,249.99 | 15,000 | 1,800.00 |
15,250 – 15,749.99 | 15,500 | 1,860.00 |
15,750 – 16,249.99 | 16,000 | 1,920.00 |
16,250 – 16,749.99 | 16,500 | 1,980.00 |
16,750 – 17,249.99 | 17,000 | 2,040.00 |
17,250 – 17,749.99 | 17,500 | 2,100.00 |
17,750 – 18,249.99 | 18,000 | 2,160.00 |
18,250 – 18,749.99 | 18,500 | 2,220.00 |
18,750 – 19,249.99 | 19,000 | 2,280.00 |
19,250 – 19,749.99 | 19,500 | 2,340.00 |
19,750 and above | 20,000 | 2,400.00 |
4. Add the six (6) highest MSCs to get the total MSC.
5. After doing so, divide the total MSC by 180 days to get the ADSC.
6. Then, multiply the ADSC by ninety percent (90%) to get the daily sickness allowance.
7. Lastly, multiply the daily sickness allowance by the approved number of days to arrive at the amount of benefit due.
The payment of the daily sickness allowance is advanced by the employer every payday. The SSS will then reimburse the employer of the amount legally advanced upon receipt of satisfactory proof of such payment and legality. Since this is the case, all employers are required to enroll in the “Sickness and Maternity Benefits Payment thru-the-Bank Program” (SMB-PTB); wherein SSS reimbursements will be deposited directly to the existing savings/current account of the employer in an SSS-accredited bank.
The payment advice containing the payment details of the Sickness-Maternity reimbursement will be sent to the employer through his/her My.SSS account in the SSS website. The SSS will reimburse the employer only for confinements within the one-year period immediately preceding the date the claim for benefit or reimbursement is received by the SSS; except for confinements in hospital.
To give you an example, the SSS received the employer’s reimbursement claim on October 3, 2015 for the employee’s sickness period of September 23 to October 14, 2014. The employer will be reimbursed for the period October 3 to 14, 2014 only, as September 23 to October 2, 2014 already falls outside the prescribed one-year period for reimbursement claim.
The sickness benefit will be paid directly by the SSS to the member separated from employment, SELF EMPLOYED (SE) and VOLUNTARY MEMBER (VM) through their single savings/current/cash card/prepaid account in SSS-accredited banks under the SMB-PTB.
For this purpose, the member, whose approved benefit amount is more than P1,000 and whose address is within thirty (30) kilometers to the nearest SSS-accredited bank, is required to open a single savings or current account, or to use their existing one with an SSS-accredited bank to which the benefit payment will be remitted. If the member does not have an existing bank account, the SSS shall issue a Letter of Introduction (LOI) form. They need to present that to the SSS-accredited bank chosen by the member for the purposes of opening a single savings account or cash card account. SSS shall then notify the member via email or text of their benefit payment.
For Employed Members
Employees must notify their employer about the sickness/injury within five (5) calendar days after the start of the mishap. The employer must then notify the SSS about the sickness/injury. Actually, notifying or informing your employer is not necessary if you were confined in a hospital or you have acquired the injury while working or if he is aware of your current condition because this will be automatic.
To add to that, the following should be taken into consideration:
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, notification should be made within one (1) year from start of confinement.
If the employee notifies the employer, or the SSS (in the case of a member separated from employment, SE or VM), 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.
To give you a concrete example:
The member is employed – Home confinement period was from March 1 to March 31, 2014 (31 days).
Notifications made:
EE to ER – March 8, 2014 (must be within March 2 to 6) ER to SSS – March 13, 2014 (must be within March 9 to 13) Compensable period: March 3 to March 31, 2014 only (29 days)
SE/VM/Member separated from employment – Home confinement period was from March 1 to March 31, 2014 (31 days).
Notifications made:
Member to SSS – March 8, 2014 (must be within March 2 to 6) Compensable period: March 3 to 31, 2014 only (29 days)
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 SSS.
Member is employed – Home confinement period was from March 1 to March 31, 2014 (31 days).
Notifications made:
EE to ER – March 5, 2014 (must be within March 2 to 6) ER to SSS – March 15, 2014 (must be within March 7 to 11) Compensable period: March 5 to March 31, 2014 only (31 days applied by ER will be reduced to only 27 days for the ER’s reimbursement)
If the employee has given the required notification to the employer, but the latter 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 ER shall have no right to recover the daily sickness allowance advanced to the EE.
Effective November 9, 2016, whenever the last day to either:
A. Notify the employer or SSS of an employee’s/member’s sickness or injury or;
B. File a claim for reimbursement for sickness benefit falls on a Saturday, Sunday or holiday, the sickness notification or claim for reimbursement may be filed on the immediately succeeding working day, without the penalty of delay, under the following guidelines:
For more information about disability benefits and other SSS Sickness Benefit, you may also contact SSS through email (member_relations@sss.gov.ph) or phone (7920-6446 to 55 or 7917-7777) or thru the SSS Official Facebook Page.
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