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SSS Law

(RA 1161, as amended)


What is the purpose of the SSS
Law?
What is the purpose of the SSS
Law?
to establish, develop, promote and perfect a sound and
viable tax-exempt social security system
suitable to the needs of the people throughout the Philippines
which shall promote social justice and
provide meaningful protection to members and their
beneficiaries against the hazards of
disability,
sickness,
maternity,
old age,
death, and
other contingencies resulting in loss of income or financial burden.
Towards this end, the State shall endeavor to extend social
security protection to workers and their beneficiaries.
What is the purpose of the SSS
Law?
Its purpose is to provide social security, which
means funds for the beneficiary, if the
employee dies, or for the employee himself
and his dependents if he is unable to perform
his task because of illness or disability xxx
(Tecson v. SSS, G.R. No. L-15798, [December
28, 1961], 113 PHIL 703-707)
Who are compulsorily covered
by the SSS?
Who are compulsorily covered by the
SSS?
Employers
Any person, natural or juridical, domestic or foreign

who carries on in the Philippines any trade, business,


industry, undertaking or activity of any kind; and
uses the services of another person who is under his orders
as regards the employment.

EXCEPTthe Government and any of its political subdivisions,


branches or instrumentalities, including corporations owned
or controlled by the Government
Are religious, charitable and
non-profit institutions covered?
Are religious, charitable and non-
profit institutions covered?
the definition of the term "employer" is, we think, sufficiently
comprehensive as to include religious and charitable institutions or
entities not organized for profit, like herein appellant, within its
meaning.

This is made more evident by the fact that it contains an exception


in which said institutions or entities are not included. And, certainly,
had the Legislature really intended to limit the operation of the law
to entities organized for profit or gain, it would not have defined an
"employer" in such a way as to include the Government and yet
make an express exception of it.

(In re Catholic Archbishop of Manila v. Social Security Commission,


G.R. No. L-15045, [January 20, 1961], 110 PHIL 616-622)
Are religious, charitable and non-
profit institutions covered?
It is significant to note that when Republic Act No. 1161 was
enacted, services performed in the employ of institutions organized
for religious or charitable purposes were by express provisions of
said Act excluded from coverage thereof (sec. 8, par. [j], subpars. 7
and 8).

That portion of the law, however, has been deleted by express


provision of Republic Act No. 1792, which took effect in 1957.

This is clear indication that the Legislature intended to include


charitable and religious institutions within the scope of the law.
(In re Catholic Archbishop of Manila v. Social Security Commission,
G.R. No. L-15045, [January 20, 1961], 110 PHIL 616-622)
Who are compulsorily covered by the
SSS?
Employees
All employees not over sixty (60) years of age

Employee -- Any person who performs services for an


employer in which either or both mental and physical efforts
are used and who receives compensation for such services,
where there is an employer-employee relationship

Well-settled is the rule that the mandatory coverage of RA


1161, as amended, is premised on the existence of an
employer-employee relationship. (Co v. People, G.R. No.
160265, [July 13, 2009], 610 PHIL 60-71)
Who are compulsorily covered by the
SSS?
Employees
Domestic helpers earning not less than One thousand pesos
(P1,000.00) a month

The minimum wage of domestic workers is now P1,500 to P2,500


pursuant to Section 24 of RA 10361 (Batas Kasambahay).

Consequently, all domestic workers should be covered.

Per RA 10361, a domestic worker who has rendered at least one (1)
month of service shall be covered by the Social Security System (SSS),
the Philippine Health Insurance Corporation (PhilHealth), and the
Home Development Mutual Fund or Pag-IBIG, and shall be entitled to
all the benefits in accordance with the pertinent provisions provided
by law.
Who are compulsorily covered by the
SSS?
Self Employed Persons
Including, but not limited to the following:

All self-employed professionals;

Partners and single proprietors of businesses;

Actors and actresses, directors, scriptwriters and news correspondents


who do not fall within the definition of the term "employee" in Sec. 8
(d) of this Act;

Professional athletes, coaches, trainers and jockeys; and

Individual farmers and fishermen.


Is this compulsory coverage and
therefore, compulsory contribution,
Constitutional?
Yes.
The Social Security Law is a legitimate exercise
of the police power of the State.

It affords protection to labor, especially to


working women and minors, and is in full accord
with the constitutional provisions on the
"promotion of social justice to insure the well
being and economic security of all the people.

(Roman Catholic Archbishop of Manila v. SSC; GR


L-15045, January 20, 1961.)
Can the parties still agree to a
private benefit plan providing for
greater benefits?
Yes.
Nothing in this Act shall be construed as a
limitation on the right of employers and
employees to agree on and adopt benefits
which are over and above those provided
under this Act. (Section 9)
Who may volunteer for
coverage?
Who may volunteer for coverage?
Spouses who devote full time to managing the
household and family affairs.

Filipinos recruited by foreign-based employers


for employment abroad.
Who are excluded from the
coverage of the law?
Excluded Employees
Purely casual employees; (see alsoViernes case)
Casual means occasional, coming without regularity. The work
is purely casual when it is not a part of the business in which the
employer is engaged. (Mansal v. P.P. Gocheco Lumber Co., G.R.
No. L-8017, [April 30, 1955], 96 PHIL 941-946)
In the case at bar the employment of respondent A to help in
the repair or replacement of the eave of a commercial store
owned by petitioner UC was purely casual because such work
was needed only when the said structure was damaged or
broken. When it would be broken and repaired nobody could
foresee. Work on the eave could not be made at fixed intervals.
The employment of a carpenter and a tinsmith for its repair or
replacement was therefore only occasional, sporadic and for a
short time. (Uy Chao v. Aguilar, G.R. No. L-9069, [March 28,
1958], 103 PHIL 219-223)
Excluded Employees
Employees on an alien vessel employed when
such vessel is outside the Philippines;
Employees of the Philippine Government or
instrumentality or agency thereof;
Employees of a foreign government or
international organization, or their wholly-
owned instrumentality; and
Temporary and other employees excluded by
regulation of the Commission.
What are the effective dates of
coverage of employers and
employees?
Section 10.

Employer = on the 1st day of operation.

Employee = on the day of his employment.

Self-employed = upon registration.


What are the obligations of an
employer under the law?
Reporting of Covered Employees; Section
24(a).

Remittance of Contributions; Sections 18, 19,


19-A, and 22.
What is the employer required
to report?
What is the employer required to
report?
names, ages, civil status, occupations, salaries
and dependents of all his employees who are
subject to compulsory coverage
In case of a legitimate contracting
arrangement, who has the
obligation to report?
In case of a legitimate contracting
arrangement, who has the obligation
to report?
Employees of bona fide independent
contractors shall not be deemed employees of
the employer engaging the services of said
contractors. (Section 8(j))
Principal shall be subsidiarily liable for the civil
liabilities of the contractor under the SSS Law.
What are the consequences of
an employers failure to report?
What are the consequences of an
employers failure to report?
Effect of Failure to Report; Section 24(a)
DAMAGES if the employee subject to
compulsory coverage
Dies;
Becomes sick or disabled; or
Reaches the age of sixty (60)
without the SSS having previously received
any report or written communication about
him from his employer.
What are the consequences of an
employers failure to report?
1. The said employer shall pay to the SSS damages

equivalent to the benefits to which said employee


member would have been entitled had his name
been reported on time by the employer to the SSS,

in case of pension benefits, damages shall be


equivalent to the accumulated pension due as of the
date of settlement of the claim or the five (5) years'
pension, whichever is higher, including dependents'
pension
What are the consequences of an
employers failure to report?

2. The employer shall also be liable for the


payment of the corresponding unremitted
contributions and penalties thereon.
What are the consequences of an
employers failure to report?

3. Section 28(e) -- where the violation consists


in failure or refusal to register employees xxx
the penalty shall be a FINE of not less than
Five thousand pesos (P5,000) nor more than
Twenty thousand pesos (P20,000) AND
IMPRISONMENT for not less than six (6)
years and one (1) day nor more than twelve
(12) years.
When does the employers obligation
to deduct and contribute begin?
The last day of the calendar month when an
employee's compulsory coverage takes effect.
(Sections 18 and 19)

If employee begins work on June 20,


deduction and contribution should be made
by June 30.
What about the obligation to remit?
The contribution imposed in the preceding
section shall be remitted to the SSS within the
first ten (10) days of each calendar month
following the month for which they are
applicable or within such time as the
Commission may prescribe. (Section 22)

June contributions should be remitted by July


10.
Consequences if the employer
fails or refuses to remit?
Consequences if the employer fails or
refuses to remit?
Employer shall be liable for:
Payment of the contributions.
Penalty of 3% per month from due date until paid.
Fine and imprisonment under Section 28(e).
Estafa under Article 315 of the RPC. Misappropriation is presumed if
he deducts but does not remit within 30 days. Section 28(h).
If employer fails to remit prior to date of contingency, resulting in
reduction of benefits, employer shall be liable to pay the SSS damages
equivalent to the difference between the amount of benefit which the
member should have received and the amount payable based on the
contributions actually remitted.
except that in case of pension benefits, the employer shall be liable to pay the
SSS damages equivalent to the accumulated pension due as of the date of
settlement of the claim or the five (5) years' pension, whichever is higher,
including dependents' pension
Consequences if the employer fails or
refuses to remit?

Failure or refusal of the employer to pay or


remit the contributions herein prescribed shall
not prejudice the right of the covered
employee to the benefits of the coverage.
The United Christian Missionary Society is a
religious organization. It believed that it is
not covered by the SSS and therefore, did not
remit any contribution to the System. It filed
a petition for the condonation of penalties.
Decide.
United Christian Missionary Society, et al. v. Social
Security Commission, et al. (G.R. No. L-26712-16,
December 27, 1969).

Good faith or bad faith is rendered irrelevant,


since the law makes no distinction between an
employer who professes good reasons for
delaying the remittance of premiums and
another who deliberately disregards the legal
duty imposed upon him to make such remittance.
From the moment the remittance of premiums
due is delayed, the penalty immediately attaches
to the delayed premium payments by force of
law.
United Christian Missionary Society, et al. v. Social
Security Commission, et al. (G.R. No. L-26712-16,
December 27, 1969).

No discretion or alternative is granted respondent


Commission in the enforcement of the law's mandate that
the employer who fails to comply with his legal obligation
to remit the premiums to the System within the prescribed
period shall pay a penalty of three (3%) per month.
Being a mere trustee of the funds of the System which
actually belong to the members, respondent Commission
cannot legally perform any acts affecting the same,
including condonation of penalties, that would diminish the
property rights of the owners and beneficiaries of such
funds without an express or specific authority therefor.
What is the effect of separation of
employee on the obligation to
contribute and remit?
What is the effect of separation of
employee on the obligation to
contribute and remit?
His employer's contribution on his account and his
obligation to pay contributions arising from that
employment shall cease at the end of the month of
separation,
Said employee shall be credited with all contributions paid on
his behalf and entitled to benefits according to the provisions of
this Act.
He may, however, continue to pay the total contributions to
maintain his right to full benefit. (Section 11)
Any contribution paid in advance by the employer but not
due shall be credited or refunded to his employer. (Section
22)
Benefits
SSS Benefits
1. Sickness Benefits; Section 14
2. Maternity Benefits; Section 14-A.
3. Permanent Disability Benefits; Section 13-A
4. Retirement Benefits; Section 12-B.
5. Death Benefits; Section 13.
6. Funeral Benefits; Section 13-B
7. Member loans; Section 26(e).
On his way home from work, J, a machine
operator in a factory, enters a movie house to
relax. He is stabbed. His claim was denied by
the SSS on the ground that the injury is not
work connected. Is the denial legal?
Sickness Benefit
Sickness Benefit
It is a DAILY ALLOWANCE for each day of
compensable confinement or fraction thereof

Remember, purpose of SSS is to provide


meaningful protection against contingencies
resulting in loss of income or financial burden.
Sickness Benefit
Equivalent to 90% of the employees average
daily salary credit.

Average daily salary credit The result obtained


by dividing the sum of the six (6) highest monthly
salary credits in the twelve-month period
immediately preceding the semester of
contingency by one hundred eighty (180).
Sickness Benefit
the six (6) highest monthly salary credits in
the twelve-month period immediately
preceding the semester of contingency
Sickness Benefit
the six (6) highest monthly salary credits in
the twelve-month period immediately
preceding the semester of contingency

Semester A period of 2 consecutive quarters


ending in the quarter of contingency.

Quarter A period of 3 consecutive calendar months


ending on the last day of March, June, September and
December.
Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015
Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015
Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015
Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014


Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014 Oct Dec 2014


Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014 Oct Dec 2014 Jul Dec 2014


Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014 Oct Dec 2014 Jul Dec 2014

April 1, 2015
Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014 Oct Dec 2014 Jul Dec 2014

April 1, 2015 Apr Jun 2015


Sickness Benefit

Date of Quarter of Semester of


Contingency Contingency Contingency
January 1, 2015 Jan Mar 2015 Oct 2014 Mar 2015

December 31, 2014 Oct Dec 2014 Jul Dec 2014

April 1, 2015 Apr Jun 2015 Jan Jun 2015


Sickness Benefit
Average daily salary credit The result
obtained by dividing the sum of the six (6)
highest monthly salary credits in the twelve-
month period immediately preceding the
semester of contingency by one hundred
eighty (180).
What are the conditions for
entitlement to the sickness benefit?
Sickness Benefit
The member has paid at least 3 monthly
contributions in the twelve-month period
immediately preceding the semester of
sickness.
Sickness Benefit
The member has paid at least 3 monthly
contributions in the twelve-month period
immediately preceding the semester of
sickness.
The member was confined for more than 3
days (whether in a hospital or elsewhere with
the SSCs approval).
Sickness Benefit
The member has paid at least 3 monthly
contributions in the twelve-month period
immediately preceding the semester of
sickness.
The member was confined for more than 3
days (whether in a hospital or elsewhere with
the SSCs approval).
The member has exhausted his company
granted sick leaves with pay, if any.
Sickness Benefit
The member has paid at least 3 monthly
contributions in the twelve-month period
immediately preceding the semester of sickness.
The member was confined for more than 3 days
(whether in a hospital or elsewhere with the
SSCs approval).
The member has exhausted his company granted
sick leaves with pay, if any.
The employee member shall notify his employer
of the fact of his sickness or injury within five (5)
calendar days after the start of his confinement
Sickness Benefit
The member has paid at least 3 monthly contributions in
the twelve-month period immediately preceding the
semester of sickness.
The member was confined for more than 3 days (whether
in a hospital or elsewhere with the SSCs approval).
The member has exhausted his company granted sick
leaves with pay, if any.
The employee member shall notify his employer of the fact
of his sickness or injury within five (5) calendar days after
the start of his confinement
notification to the employer is not necessary where --
confinement is in a hospital; or
the employee became sick or was injured while working or within the
premises of the employer
A began his employment with XYZ Co. on
June 1, 2013. He became sick on June 15,
2013. Prior to being employed by XYZ, he
was employed by ABC from January 1 to May
31, 2012. He made contributions during his
employment with ABC but stopped from the
time he was separated therefrom. Assuming
that he was confined for more than 3 days in
a hospital and has no sick leaves, is he
entitled to a sickness benefit?
Assume that instead of being employed by
ABC from January 1 to May 31, 2012, A was
employed from June 1 to November 30, 2011,
and made no contributions during the
interval that he is unemployed. Is he
entitled?
SECTION 11.Effect of Separation from
Employment. When an employee under
compulsory coverage is separated from
employment xxxsaid employee shall be
credited with all contributions paid on his
behalf and entitled to benefits according to
the provisions of this Act. He may, however,
continue to pay the total contributions to
maintain his right to full benefit.
What if he made monthly contributions from
January to March 2013?
What is the procedure for availment of the
sickness benefit?
If the employee fails to give notice within 5
days from confinement when required, is he
no longer qualified to the sickness benefit?
What happens where the employee member
has given the required notification but the
employer fails to notify the SSS of the
confinement or to file the claim for
reimbursement within the period prescribed
in this section resulting in the reduction of
the benefit or denial of the claim?
Period to File Claim
Hospital confinement: 1 year from last day of
confinement.

Elsewhere: 1 year from start of confinement.

the SSS shall reimburse the employer or pay the


unemployed member only for confinement within the
one-year period immediately preceding the date the
claim for benefit or reimbursement is received by the
SSS, except confinement in a hospital in which case
the claim for benefit or reimbursement must be filed
within one (1) year from the last day of confinement.
How long is the benefit payable?
The compensable confinement shall begin on
the first day of sickness (assuming notification
was given on time if required)
Provided, That such allowance shall begin only
after all sick leaves of absence with full pay to the
credit of the employee member shall have been
exhausted.
120 days max. per year; no carry over
240 days max. per confinement.
When should payments be made?
The payment of such allowances shall be
promptly made by the employer every regular
payday or on the fifteenth and last day of
each month, and similarly in the case of direct
payment by the SSS, for as long as such
allowances are due and payable.
Maternity Benefit
What is the maternity benefit granted
under the SSS law?
DAILY ALLOWANCE given to an employee who
gives birth or suffers a miscarriage.
It is equivalent to 100% of the employees
average daily salary credit.
Normal, miscarriage = 60 days
Caesarean = 78 days
What are the conditions for
entitlement to the maternity benefit?
The female member has given birth or suffers
a miscarriage and such is not yet in excess of
four deliveries or miscarriages;

The female member has paid at least 3


monthly contributions within the 12 month
period immediately preceding the semester of
childbirth or miscarriage.
Same as sickness benefit.
Sample Computation
Delivery: December 2014
The semester of contingency would be __________
The twelve (12)-month period before the semester of
contingency would be ______________
Assume that the six (6) highest monthly salary credits
during this period are P15,000 each. The average daily
allowance would be ______________
The daily maternity allowance would be ___________
The total maternity benefit due would be _______ for
normal delivery or ___________ for caesarian cases.
What is the procedure for availment
of the maternity leave benefit?
The employee notifies the employer of her
pregnancy and the probable date of her delivery
The employer transmits the notice to the SSS
The employer advances the payment of the
benefit within 30 days from the filing of the
maternity leave application; and
The SSS shall reimburse the employer upon
satisfactory proof of such payment and legality
thereof.
What is the effect on the members
entitlement to the maternity benefit in case
she should give birth or suffer miscarriage
without the required contributions having been
remitted for her by her employer to the SSS, or
without the SSS having been previously notified
by the employer of the time of the pregnancy?
The employer shall pay to the SSS damages
equivalent to the benefits which said
employee member would otherwise have
been entitled to.

Remember: Failure or refusal of the employer to


pay or remit the contributions herein prescribed
shall not prejudice the right of the covered
employee to the benefits of the coverage.
(Section 22(b))
2007 Bar
AB, single and living-in with CD (a married
man), is pregnant with her fifth child. She
applied for maternity leave but her employer
refused the application because she is not
married. Who is right? Decide.
2012 Bar
Jennifer, a receptionist at Company X, is
covered by the SSS. She was pregnant with her
fourth child when she slipped in the bathroom
of her home and had a miscarriage.
Meanwhile, Company X neglected to remit the
required contributions to the SSS. Jennifer
claims maternity leave benefits and sickness
benefits. Which of these two may she claim?
Payment of daily maternity benefits shall be a bar
to the recovery of sickness benefits provided by
this Act for the same period for which daily
maternity benefits have been received (Section
14-A)

She may claim sickness benefits beyond the


period covered by the maternity benefits if she
continues to be entitled to sickness benefits.
2012 Bar
H files for a seven-day paternity leave for the
purpose of lending support to his wife, W,
who suffered a miscarriage through
intentional abortion. W also filed for
maternity leave for five weeks. H and W are
legally married but the latter is with her
parents, which is a few blocks away from H's
house. Which of the following statements is
the most accurate?
a) Paternity leave shall be denied because it
does not cover aborted babies;
b) Paternity leave shall be denied because W is
with her parents;
c) Maternity leave shall be denied because it
does not cover aborted babies;
d) Maternity leave shall be denied because
grant of paternity leave bars claim for
maternity leave.
2013 Bar
Because of the stress in caring for her four (4) growing
children, Tammy suffered a miscarriage late in her
pregnancy and had to undergo an operation. In the course
of the operation, her obstetrician further discovered a
suspicious-looking mass that required the subsequent
removal of her uterus (hysterectomy). After surgery, her
physician advised Tammy to be on full bed rest for six (6)
weeks. Meanwhile, the biopsy of the sample tissue taken
from the mass in Tammy's uterus showed a beginning
malignancy that required an immediate series of
chemotherapy once a week for four (4) weeks.

What benefits can Tammy claim under existing social


legislation? (4%)
Disability Benefits
What are the two types of permanent
disability benefits?

Permanent TOTAL disability benefits

Permanent PARTIAL disability benefits


What disabilities are deemed
PERMANENT TOTAL?
Complete loss of sight of both eyes;
Loss of two limbs at or above the ankle or
wrists;
Permanent complete paralysis of two limbs;
Brain injury resulting to incurable imbecility or
insanity; and
Such cases as determined and approved by
the SSS.
What are the PT disability benefits?
If member has paid AT LEAST 36 monthly
contributions prior to the semester of
disability =
MONTHLY PENSION plus
DEPENDENTS PENSION for each dependent child
(up to 5) conceived on or before the date of
contingency
Counting is from youngest, no substitutions
Legitimate children shall be preferred.
Dependents Pension
SECTION 12-A.Dependents' Pension. Where
monthly pension is payable on account of death,
permanent total disability or retirement,
dependents' pension equivalent to ten percent
(10%) of the monthly pension or Two hundred
fifty pesos (P250.00), whichever is higher, shall
also be paid for each dependent child conceived
on or before the date of the contingency but not
exceeding five (5), beginning with the youngest
and without substitution: Provided, That where
there are legitimate and illegitimate children, the
former shall be preferred.
What is the effect of death of a PT
disabled pensioner?
Upon the death of the permanent total disability pensioner,
his primary beneficiaries as of the date of disability shall be
entitled to receive the monthly pension:
Provided, That if he has no primary beneficiaries and he dies
within sixty (60) months from the start of his monthly pension,
his secondary beneficiaries shall be entitled to a lump sum
benefit
equivalent to the total monthly pensions corresponding to the
balance of the five-year guaranteed period excluding the dependents'
pension.

Note: Should a member who is on partial disability pension


retire or die, his disability pension shall cease upon his
retirement or death.
What about --
reemployment (or resumption of self-
employment) or
the recovery of the disabled member from his
permanent total disability or
his failure to present himself for examination
at least once a year upon notice by the SSS?
What are the PT disability benefits?
If member has paid LESS THAN 36 monthly
contributions prior to the semester of
disability = LUMP SUM equivalent to no. of
contributions x monthly pension, or 12
monthly pensions, whichever is higher.
What is effect of re-employment not
earlier than 1 year from PT disability?
A member who --
1. has received a lump sum benefit and
2. is re-employed or has resumed self-employment
not earlier than one (1) year from the date of his
disability

-- shall again be subject to compulsory coverage


and shall be considered a new member.
Question:
X paid 36 monthly contributions from October
2009 to September 2012.

X lost both eyes on January 1, 2013


Pension or lump sum?

What if disability occurred on December 31,


2012?
Pension or lump sum?
What disabilities are deemed PP?
Complete and No. of Months Complete and No. of Months
Permanent Loss of Permanent Loss of
Use of Use of
One thumb 10 One foot 31
One index finger 8 One leg 46
One middle 6 One ear 10
finger
One ring finger 5 Both ears 20
One little finger 3 Hearing of one 10
ear
One big toe 6 Hearing of both 50
ears
One hand 39 Sight of one eye 25
One arm 50
What are the PP disability benefits?
If disability occurs after thirty-six (36) monthly
contributions have been paid prior to the semester of
disability, the benefit shall be the monthly pension for
permanent total disability payable not longer than the
period designated in the foregoing schedule.

The monthly pension benefit shall be given in lump sum if


it is payable for less than twelve months.

For the purpose of adjudicating retirement, death and


permanent total disability pension benefits, contributions
shall be deemed paid for the months during which the
member received partial disability pension
What are the PP disability benefits?
What about dependents pension?
No. It is given only where monthly pension is
payable on account of death, permanent total
disability or retirement.
What are the PP disability benefits?

Should a member who is on partial disability


pension retire or die, his disability pension
shall cease upon his retirement or death.

What if re-employed?
No effect.
What are the PP disability benefits?

If disability occurs before thirty-six (36)


monthly contributions have been paid prior
to the semester of disability, the benefit shall
be such percentage of the lump sum benefit
for PTD with due regard to the degree of
disability as the Commission may determine.
May a PP disability be converted into
a PT disability?
The percentage degree of disability, which is
equivalent to the ratio that the designated
number of months of compensability bears to
seventy-five (75), rounded to the next higher
integer, shall not be additive for distinct, separate
and unrelated permanent partial disabilities, but
shall be additive for deteriorating and related
permanent partial disabilities, to a maximum of
one hundred percent (100%), in which case the
member shall be deemed as permanently totally
disabled.
May a PP disability be converted into
a PT disability?
Yes. If percentage degree of disability
equals or exceed 100%.

Percentage Degree of Disability = [Total no. of


months of deteriorating and related permanent
partial disabilities] 75
Illustration
Suppose that a single disease has resulted in
the disability and deterioration of:
One thumb (10)
One index finger (8)
One middle finger (6)
One ring finger (5)
One little finger (3)
One big toe (6)
One hand (39)
Illustration
PDD = [10 + 8 + 6 + 5 + 3 + 6 + 39] 75

PDD = 77 75

PDD = 102.67% or 103%

PTD even though person lost only 1 thumb, 4


fingers, 1 big toe, and 1 hand.
May a PP disability be converted into
a PT disability?
Yes. See SSC and SSS v. CA; G.R. No. 152058.
September 27, 2004.)
SSC and SSS v. CA
The Court of Appeals correctly observed that
Ragos injury made him unable to perform any
gainful occupation for a continuous period
exceeding 120 days.
The SSS had granted Rago sickness benefit for
120 days and, thereafter, permanent partial
disability for 38 months. Such grant is an
apparent recognition by the SSS that his injury is
permanent and total as we have pronounced in
several cases.
SSC and SSS v. CA
xxx if by reason of the injury or sickness he
sustained, the employee is unable to perform
his customary job for more than 120 days and
he does not come within the coverage of Rule
X of the Amended Rules on Employees
Compensability xxx then the said employee
undoubtedly suffers from 'permanent total
disability' regardless of whether or not he
loses the use of any part of his body.
SSC and SSS v. CA
We further reiterate that disability should be
understood less on its medical significance than
on the loss of earning capacity.
Permanent total disability means disablement of
an employee to earn wages in the same kind of
work, or work of similar nature that he was
trained for or accustomed to perform, or any kind
of work which a person of his mentality and
attainment could do. It does not mean absolute
helplessness.
SSC and SSS v. CA
a person's disability may not manifest fully at
one precise moment in time but rather over a
period of time. It is possible that an injury
which at first was considered to be temporary
may later on become permanent or one who
suffers a partial disability becomes totally and
permanently disabled from the same cause.
Retirement Benefits
Who is entitled to a monthly pension
upon retirement?
A member who has paid at least one hundred
twenty (120) monthly contributions prior to the
semester of retirement and

1. has reached the age of sixty (60) years and is


already separated from employment or has ceased
to be self-employed or
2. has reached the age of sixty-five (65) years

Note: He shall have the option to receive his first eighteen


(18) monthly pensions in lump sum discounted at a
preferential rate of interest to be determined by the SSS.
Dependents Pension also payable?
Yes.
What are the effects of the reemployment
or resumption of self-employment of a
retired member who is less than 65 years
old?
The monthly pension shall be suspended.

ER and EE contributions shall resume.


What is the effect of the death of the
retired member?
His primary beneficiaries as of the date of his
retirement shall be entitled to receive the
monthly pension.
The proviso "as of the date of his retirement" in
Section 12-B(d) is unconstitutional; Dycaico v. SSS,
et al.; GR No. 161357, November 30, 2005.
The proviso infringes the equal protection clause
The proviso infringes the due process clause
Who is entitled to a lump sum only?
A covered member who is sixty (60) years old
at retirement and who does not qualify for
pension benefits xxx shall be entitled to a
lump sum benefit equal to the total
contributions paid by him and on his
behalf. Provided, That he is separated from
employment and is not continuing payment of
contributions to the SSS on his own.
Death Benefits
Pension or Lump sum
Upon the death of a member who has paid at
least thirty-six (36) monthly contributions
prior to the semester of death,

his primary beneficiaries shall be entitled to the


MONTHLY PENSION:

if he has no primary beneficiaries, his secondary


beneficiaries shall be entitled to a LUMP SUM benefit
equivalent to thirty-six (36) times the monthly pension.
Pension or Lump sum
If he has not paid the required thirty-six (36)
monthly contributions,

his primary or secondary beneficiaries shall be


entitled to a LUMP SUM benefit

equivalent to the monthly pension times the number of


monthly contributions paid to the SSS or twelve (12)
times the monthly pension, whichever is higher.
Note: In case of death benefits, if no
beneficiary qualifies under this Act, said
benefits shall be paid to the legal heirs in
accordance with the law of succession.
Funeral Benefits
A funeral grant equivalent to Twelve thousand
pesos (P12,000.00) shall be paid, in cash or in
kind, to help defray the cost of funeral
expenses upon the death of a member,
including, permanently totally disabled
member or retiree.
May the SSS give a coffin worth P12,000?
Yes.

X suffered PTD in 2000. He hasnt paid any


contributions since. He died in 2013. Are his
beneficiaries entitled to the funeral benefit?
Yes.
What are the types of loans available
to members?
Salary
Educational
Livelihood
Marital
Calamity and
Emergency loans
Beneficiaries and Dependents
Primary Beneficiaries.
The dependent spouse until he or she
remarries.

Dependent spouse: The legal spouse entitled by


law to receive support from the member.
Primary Beneficiaries.
The claimant-spouse must therefore establish
two qualifying factors:

1. that she is the legitimate spouse, and

2. that she is dependent upon the member for


support.

a husband and wife are obliged to support each other, but


whether one is actually dependent for support upon the
other is something that has to be shown; it cannot be
presumed from the fact of marriage alone. (SSS v. Aguas;
GR 165546, February 27, 2006.)
Primary Beneficiaries.
The dependent legitimate, legitimated or
legally adopted, and illegitimate children

unmarried, not gainfully employed and has not


reached twenty-one years (21) of age, or

if over twenty-one (21) years of age, he is


congenitally or while still a minor has been
permanently incapacitated and incapable of self-
support, physically or mentally
Legally adopted
Under Section 8 (e) of Republic Act No. 1161,
as amended, only "legally adopted" children
are considered dependent children.
Absent any proof that the family has legally
adopted Janet, the Court cannot consider her
a dependent child of Pablo, hence, not a
primary beneficiary. (SSS v. Aguas; GR
165546, February 27, 2006.)
Note: The dependent illegitimate children shall
be entitled to fifty percent (50%) of the share
of the legitimate, legitimated or legally
adopted children:
In the absence of the dependent legitimate,
legitimated or legally adopted children of the
member, his/her dependent illegitimate children
shall be entitled to one hundred percent (100%) of
the benefits.
Secondary Beneficiaries
The dependent parents.
I.e. parents who are receiving regular support
from the member.
In the absence of all of the foregoing, any other
person designated by the member as his/her
secondary beneficiary.
In short, if there is a named beneficiary and the
designation is not invalid (as it is not so in this case), it
is not the heirs of the employee who are entitled to
receive the benefits (unless they are the designated
beneficiaries themselves).
It is only when there is no designated beneficiaries or
when the designation is void, that the laws of
succession are applicable. And we have already held
that the Social Security Act is not a law of succession.
(SSS v. Davac; GR L-21642, July 30, 1966.)
May a national of a foreign country
be a beneficiary?
Yes, provided that his country extends
benefits to a Filipino beneficiary residing in
the Philippines, or is recognized by the
Philippines.
Provided further, That notwithstanding the
foregoing, where the best interest of the SSS will
be served, the Commission may direct payments
without regard to nationality or country of
residence:
Who may receive benefits for a minor
or incompetent beneficiary?
If the recipient is a minor or a person incapable of
administering his own affairs, the Commission
shall appoint a representative under such terms
and conditions as it may deem proper:
Provided, further, That such appointment shall not be
necessary in case
the recipient is under the custody of or living with the
parents or spouse of the member in which case the benefits
shall be paid to such parents or spouse, as representative
payee of the recipient.
May persons other than the
beneficiary collect under an SPA?
Such benefits are not transferable and no
power of attorney or other document
executed by those entitled thereto, in favor of
any agent, attorney or any other person for
the collection thereof on their behalf shall be
recognized, except when they are physically
unable to collect personally such benefits:
Settlement of Disputes
Who has jurisdiction over disputes arising
under the SSS law with respect to coverage,
benefits, contributions and penalties thereon
or any other matter related thereto?

The SSC.
Who has jurisdiction to review the
decisions of the SSC?
GR: The CA.

XPN: If the decision of the Commission involves only


questions of law, the same shall be reviewed by the
Supreme Court.

No appeal shall act as a supersedeas or a stay of


the order of the Commission unless the
Commission itself, or the Court of Appeals or the
Supreme Court, shall so order.
May fees be charged for the
preparation, filing or pursuing any
claim for benefit under this Act?
No, even as deductions from the benefits.
Any stipulation to the contrary shall be null
and void.
What about attorneys fees?
Any member of the Philippine Bar who appears as
counsel in any case heard by the Commission shall be
entitled to attorney's fees not exceeding ten percent
(10%) of the benefits awarded by the Commission,
which fees shall not be payable before the actual
payment of the benefits, and any stipulation to the
contrary shall be null and void.

What if the lawyer merely prepared the claim documents


and assisted in filing and collecting?
No. He must have appeared as counsel in a case heard by the SSC.
"Any violation of the provisions of this Section
shall be punished by a fine of not less than
five hundred pesos (P500.00) nor more than
five thousand pesos (P5,000.00), or
imprisonment for not less than six (6) months
nor more than one (1) year, or both, at the
discretion of the court.
Exemption from Tax, Legal Process
and Lien
all benefit payments made by the SSS shall
likewise be exempt from all kinds of taxes,
fees or charges and shall not be liable to
attachments, garnishments, levy or seizure by
or under any legal or equitable process
whatsoever, either before or after receipt by
the person or persons entitled thereto, except
to pay any debt of the member to the SSS.