SSS Sickness Benefit for Employed: Guide for Employers

Introduction

Due to the pandemic, most of the employees might have been hospitalized for having tested positive of Covid or even under quarantine for being a close contact of a positive patient. Did you know that you can claim for a sickness benefit from SSS? If you are the employee, just comply the Sickness Notification form then submit to your employer.

Qualifying Conditions

An employed member is qualified to avail of this benefit if he/she:

• Is unable to work due to sickness or injury and is confined either in a hospital or at home for at least four (4) days;
• Has paid at least three (3) months of contributions within the 12-month period immediately preceding the semester of sickness or injury;
• Has duly notified the SSS directly of the fact of sickness or injury.

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).

SSS Sickness Notification

EMPLOYEE

1. Fill out the Sickness Notification form. You may ask from the branch or print online. Complete the following fields:

• Part I: A Personal Data (SSS Number, Date of Birth, Name, Address, Mobile Number, Country, Zip Code)
  
• Part I B. Certification (Printed Name, Signature and Date)
• Part III. Medical Certification (Your attending physician's certification)

2. After filling out the form with physician's doctor, attach Medical Certificate and your valid ID (for Co-Vid cases: swab result, quarantine clearance and valid ID). Submit it to your employer so they can process.

3. The employer will be the one to submit the form to the branch for SSS doctor's screening (Part IV and V)

4. Follow up your employer after one (1) week. Ask if the notification form is already approved by SSS doctor. This is to ensure that the in-charge has submitted it to the branch. 

Note: Employer should give the benefit to the employee once the sickness notification form is approved by the SSS doctor but unfortunately most employers do not follow this rule so just coordinate your employer for the release of your benefit.

EMPLOYER

Once you received the sickness notification from your employee, immediately submit e-notification. Then submit the documents to the branch for SSS doctor's screening (Part IV A and B). After you have received the approved notification form, you can immediately proceed to submit reimbursement application online.

How to do Sickness E-notification?

1. Log in to your employer account on the sss portal. Go to E-services  then Submit Sickness Notification.

2. Input SSS Number (-Member Name will automatically appear) and Start of Sick Leave.

3. Select Claim Type and Confinement Location

4. Input No of Days and Attending Physician's PRC No.

5. Click Add. Then Submit Sickness Notification List then OK

6. A confirmation Message will prompt click OK. You will then get the Transaction Number

7. Make sure to submit the documents within thirty (30) days to the nearest branch for Medical evaluation.

How to Compute Sickness Benefit?

1. Count twelve (12) months backwards starting from the month immediately before the semester of contingency.
2. Select the six (6) highest monthly salary credits within the 12-month period to arrive at the total monthly salary credit.
3. Divide the total monthly salary credit by 180 days to get the average daily salary credit (ADSC)
4. Multiply the ADSC by ninety percent (90%) to get the daily sickness allowance.
5. Multiply the daily sickness allowance by the approved number of days to arrive at the amount of benefit due.

How to Submit Sickness Benefit Reimbursement?

Since SSS has mandated using their E-services, filing for reimbursement has now become so convenient. Employers just need to access their sss account and do the filing online.

If you already have with you the sickness notification form with SSS doctor's medical evaluation (Part IV and V are already filled out, you can immediately submit your SBRA.

1.Log in to your SSS employer account

2. Go to E-services>Submit Sickness Benefit Reimbursement Application (SBRA

3. Input SSS number

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 Notification must be strictly followed:

EMPLOYEE

The employee must submit to employer within five (5) calendar days after start of confinement except:

• if confinement is in a hospital - deadline for notification is one (1) year from date of dischardge
• if sickness/injury occured while at work or within company premises - EMployer is deemed notifed

EMPLOYERS

• Employers must file the SN form at SSS within five (5) calendar days after its receipt from employee including cases where sickness/injury occurred while at work or within company premises or
• Notify the system through the web and submit the SN form within thirty (30) calendar days after web notification

Glossary

• Sickness benefit is a daily cash allowance paid for the number of days a member is unable to work due to sickness or injury.
• SBRA refers to Sickness Benefit Reimbursement Application
• Semester refers to two (2) consecutive quarters ending in the quarter of sickness.
• Quarter refers to three (3) consecutive months ending in March, June, September, or December
• Monthly salary credit (MSC) refers to the compensation base for contributions and benefits related to the total earnings for the month.
• ADSC refers to Average Daily Salary Credit