SSS SICKNESS BENEFIT

 

SSS Sickness Benefit is a daily cash allowance paid to a member for the number of days he/she is unable to work due to sickness or injury.

How to qualify?

• Confinement either at home or in the hospital for at least four (4) days
• Paid at least three (3) monthly contributions within the 12-month period preceding the semester of sickness
• Has notified his employer; or if unemployed, has notified SSS
• Has used up all current company sick leave with pay

FIRST STEP:  Sickness Notification

Note: SSS has other advise/notification period during lockdown; ECQ or in case there is still a Covid -19 pandemic which causes the branch to close or stop their operation at their office.

In general, the following rules is being followed:

For Employed Members:

• Employee shall advise employer within 5 calendar days after the start of confinement
• Employer shall notify SSS within 5 calendar days form the receipt of employee notification
• If the employee notifies the employer 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 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.

 If filed through Company Representative, the following documents should be forwarded to SSS:

·       System-generated Transmittal List (TL) or System-generated Acknowledgment Letter, if filed through Electronic Notification (three copies); or Employer TL (three copies)

·       Member’s Sickness Notification Application

·       Member’s identification card/s or document/s (photocopy)

·       All attached medical documents and reports, if any;

​

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

Amount of Benefit

The daily cash allowance is equivalent to 90% of the average daily salary credit

 Computation of Benefit

• Exclude the semester of sickness/contingency
• Select the 3-6 highest Monthly Salary Credits within the last 12 months preceding the semester of contingency to arrive at the Total Monthly Salary Credit (TMSC)
• Divide the TMSC by 180 to get the Average Daily Salary Credit (ADSC)
• Multiply the ADSC by 90%, then further multiply it by the approved number of days (maximum period of entitlement is 120 days in one calendar year)

  Online Sickness Notification via SSS website

• Employer must have a registered My.SSS account ;
• Employer is enrolled in the Sickness and maternity Benefit Payment Thru-the-Bank Program and has a registered bank account;
• Has an approved SSS notification that is included in the SBRA claim; and
• Employer has a certification to advance the sickness benefit of the employee according to their sickness notification

 How to file SBRA for your employees via SSS website

1. Log in to My.SSS account (sss.gov.ph) and click Employer
2. Encode your User ID and Password then tick box for the captcha
3. Under E-Services, click Submit SS Sickness Benefit Reimbursement Application (SBRA)
4. Encode the SS number of the employee. Then select Claim Reference Number button from the list of approved sickness notifications (ex: confinement period, number of days approved) Then click Proceed
5. Enter other needed information then click the certification box. Then click Submit.
6. Confirmation page will be displayed. Make sure to get a copy of your Transaction Reference Number (TRN)
7. Confirmation of successful SBRA will also be sent via the registered email of the employer.

 Manner of Payment & Reimbursement for Employed Members

1. Once employer successfully sent the sickness notification, employer shall advance the benefit every regular payday of the employee
2. The amount advanced will be reimbursed 100% by the SSS thru employer’s depository bank.

 

Reference: SSS website