How to Avail of SSS Sickness Benefit

Are you sick? Did you get injured recently? Are you reading this from your hospital bed? 

Are you a member of SSS? Are you here because you heard of the SSS Sickness Benefit? 

Do you wish to avail of this benefit?

Well, you are in luck because this article will discuss the SSS Sickness Benefit, how to know if you qualify, how to apply and how much you will get.

I’m sorry to hear that you are ill or injured. But on the bright side, there is a compensation for your hard work given by the government. I hope and pray for your fast recovery.

How would I know if I am qualified to avail of SSS Sickness Benefit?

The first step to approaching this benefit is to know if you satisfy the qualifying conditions.

Do not easily trust what you hear from friends because as we know, we, Filipinos have a tendency of twisting information especially if they are passed by mouth.

It is better to check the official qualifications than being denied access to the benefit later.

Below are the qualifications:

1. YOU ARE A MEMBER OF SSS.
2. You are unable to work because of sickness and/or injury and you are confined in the hospital or at home for at least four (4) days
3. You have paid at least three (3) months of monthly contributions prior to being sick/injured
4. You have used all company sick leaves with pay; and
5. You have notified the employer or SSS, if unemployed, voluntary, or self-employed member about the sickness or injury

If you qualify with the five (5) qualifications mentioned above, you can then proceed to applying for the particular benefit.

If you haven’t done Qualification #5, don’t fret because I will teach you how to notify your employer or the SSS.

How will I notify the SSS about my sickness or injury?

FOR EMPLOYED MEMBERS

You MUST notify your employer about the sickness/injury within five (5) calendar days after the start of the sickness or the injury. Your employer must then notify the SSS about the sickness/injury.

*Notifying your employer is not necessary if you got confined in a hospital or you have acquired the injury while working or if he is aware of your current condition.

Important notes to take note of:

• Do take note that if you fail to notify your employer within the five-day rule, then, your confinement will be considered to have started five days before you notified him.
• If your employer fails to notify the SSS within the five-day rule, then, your employer will be reimbursed only for each day of confinement from the 10^th calendar day before he notified SSS.
• If you had successfully notified your employer but he fails to notify the SSS causing the denial of the benefit claim, your employer will have NO RIGHT to recover your daily sickness allowance.

Filing Requirements:

You may file through a company representative or personally. Do prepare the following documents needed for the filing of the notification.

1. Duly accomplished sickness notification
2. Identification card/s and/or document/s
3. Medical documents if any

Plus the following documents, if needed:

In case of work-related claims:

• Accident/Sickness Report from employer, if work-connected; and
• Police Report (for vehicular accident with third party involvement), if work-related; and
• Photocopy of employer’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

In case of sickness that occurred while on strike/shutdown/and member will file to SSS personally, submit the above-mentioned requirements together with the following:

• Certificate of Notice of Strike issued by DOLE
• Certificate of Foreclosure
• Certification from the DOLE that the employee or employer has a pending labor case
• Certificate of Non-advancement of Payment from Employer

FOR SELF-EMPLOYED MEMBERS

You MUST notify the SSS within five (5) days after the start of the sickness/injury. If you are confined in a hospital, notifying the SSS should be within one (1) year after the confinement.

Filing Requirements

Prepare the following requirements in order to move on with the application process for the benefit.

1. Duly accomplished Sickness Benefit Application (SBA)

If filed by member:

2. Present original of any one (1) of the primary ID cards/documents or two (2) secondary ID cards/documents, both with signature and at least one (1) with photo.

If filed by member’s representative:

3. present the following:
   1. Original of any one (1) of the Authorized Representative’s primary ID cards/documents or two (2) secondary ID cards/documents, both with signature and at least one with photo. See list ; and
   2. Original of any one (1) of the Member’s primary ID cards/documents or two (2) secondary ID cards/documents, both with signature and at least one (1) with photo. See list
4. In case of prolonged confinements or sickness, original/certified true copy of the following:
   1. Laboratory, X-ray, ECG and other diagnostic results
   2. Operating room/clinical records that will support diagnosis

*For a detailed list of requirements, do check the official list given out by the SSS website.

How much will I get?

The amount that you will receive will be equal to 90% of the your SSS average daily credit.

Please take note that as of this writing, the highest monthly salary credit is capped at ₱16,000. This means that if you divide that to 30 days, your average daily salary credit is capped at ₱533.33.

90% of that amount would be equal to ₱479.99. 

To compute the amount of your SSS sickness benefit, you must how much your SSS monthly contributions are.

How to compute SSS Sickness Benefit? 

1. Determine the semester of sickness.

There are 4 quarters of the year and each quarter is composed of 3 consecutive months.

• 1st Quarter: January, February and March
• 2nd Quarter: April, May and June
• 3rd Quarter: July, August and September
• 4th Quarter: October, November and December

There are 4 semesters of the year. The semester refers to 2 consecutive quarters, therefore, each semester consists of 6 consecutive months.

• 1st Semester: 1st and 2nd Quarter
• 2nd Semester: 2nd and 3rd Quarter
• 3rd Semester: 3rd and 4th Quarter
• 4th Semester: 4th and 1st Quarter

To determine the semester of your sickness, meaning you have to check the quarter where it belongs, then followed by the semester.

Example: 

You got sick on July 2018. July belongs to the 3rd Quarter. The 3rd Quarter belongs to the 2nd Semester.

The semester of sickness are the months of September, August, July, June, May and April. 

2. Count 12 months backward starting from the month before the semester of sickness.

Now that you know the semester of sickness, you need to count 12 months before that and check your contributions.

Example: 

Since you got sick on July 2018, the semester of sickness is the 2nd Semester and the first month of the semester is April. Count 12 months from before April.

• March 2018
• February 2018
• January 2018
• December 2017
• November 2017
• October 2017
• September 2017
• August 2017
• July 2017
• June 2017
• May 2017
• April 2017

3. Check the 6 highest monthly salary credits of those 12 months.

Since you have 12 months above to choose from, just choose the 6 highest salary credit. 

Example:

• March 2018 – ₱16,000
• February 2018 – ₱16,000
• January 2018 – ₱8,000
• December 2017 – ₱8,000
• November 2017 – ₱8,000
• October 2017 – ₱8,000
• September 2017 – ₱16,000
• August 2017 – ₱16,000
• July 2017 – ₱16,000
• June 2017 – ₱16,000
• May 2017 – ₱15,000
• April 2017 – ₱15,000

4. Add the 6 highest monthly salary credits and divide those by 180 days to get the average daily salary credit.

Example: 

Considering the example above, 6 months have a salary credit of ₱16,000 which is the highest. We then need to multiply ₱16,000 by 6 or simply add all the 6 highest monthly salary. 

• ₱16,000 x 6
• OR
• ₱16,000 (March)+ ₱16,000 (February) + ₱16,000 (September) + ₱16,000 (August) + ₱16,000 (July) + ₱16,000 (June)

TOTAL = ₱96,000

To get the Average Daily Salary Credit, divide the total 6-month salary credit by 180 days.

= ₱96,000 / 180 days

= ₱533.33 per day

5. Multiply the daily salary credit by 90% to get the sickness benefit amount.

90% of Average Daily Salary Credit:

= ₱533.33 * 90%

= ₱479.99 sickness benefit amount

6. Multiply the sickness benefit amount to the number of days you are sick.

If for example, you have 5 days of sickness, that would be:

= 5 days x ₱479.99 per day

= ₱2,399.95 SSS sickness benefit

Not that much, but I’m sure it would somehow help in your finances or medical expenses.

Isn’t it wonderful that even if we are sick, we still get compensation pay from the government? This will essentially be helpful for paying those hospital bills and buying those medicine. As we all know, it is not easy when one gets sick or suffers from an injury.

I hope that you learned something after reading this article. Share this on your Facebook or Twitter and you might help a friend out who is in need! Hoping for your fast recovery and for good health. 

Click the link to read more about SSS Maternity Benefit, SSS Retirement Benefit, SSS Disability Benefit, SSS Death and Funeral Benefit or visit the SSS website for more info.