SSS Sickness Benefit: What is Covered and How to Avail

SSS Sickness Benefit: What is Covered and How to Avail
SSS Sickness Benefit: What is Covered and How to Avail

The SSS sickness benefit is a daily cash allowance paid to qualified members who cannot work due to sickness or injury. The benefit covers various illnesses, including chronic illnesses such as diabetes, cancer, hypertension, and arthritis. 

Moreover, this SSS benefit covers COVID-infected workers in home confinement. The sickness benefit is 90% of the member’s average daily salary credit. A member can be granted sickness benefits for a maximum of 120 days in one calendar year, and any unused portion cannot be carried forward or added to the total. 

Steps in SSS sickness benefit application?

  1. Go to your nearest SSS branch or download a copy of the SSS Sickness Benefit Application Form.
  2. Fill out the form correctly and accurately. Always add N/A to indicate parts of the form where the information is not available.
  3. Submit the form to SSS within five (5) calendar days after the start of the sickness or confinement.
  4. If you are a COVID-hit member, you can also submit the SS Sickness Benefit Reimbursement Application (SBRA) through the E-Services tab on your SSS account.
  5. Wait for the SSS to process your application. If approved, you will receive your sickness benefit payment through your designated bank account.

It is important to note that the SSS may require additional documents or information to process your application, such as a medical certificate from your attending physician.

What are the requirements?

To support a sickness benefit claim in SSS, the following documents may be needed:

  1. Sickness Benefit Application (SBA) form: This is the main form that needs to be filled out and submitted to the SSS. It can be obtained from the SSS website.
  2. Medical certificate: A medical certificate from the attending physician is usually required to prove the sickness or injury.
  3. Sickness Notification: This form notifies the SSS about the member’s sickness or injury. It needs to be attached to the Sickness Benefit Reimbursement Application.
  4. Bank documents: Photocopies or scanned copies of any documents may be required to prove the member’s bank account for the benefit payment.

For a smoother transaction, check with your nearest SSS branch or refer to their official website for the most up-to-date and accurate information regarding the required documents for a sickness benefit claim.

Who can avail of the SSS sickness benefit?

Under SSS guidelines, the sickness benefits apply to those who meet the following criteria:

  1. Those who cannot work are confined either in the hospital or at home due to sickness or injury for at least four (4) days.
  2. If you have paid for at least three (3) months of contribution within the 12 months before the semester of your sickness or injury.
  3. You have notified SSS directly of your sickness or injury.

How soon do I need to file my application?

In the case of home confinement, you must file your Sickness Benefit Application Form within five calendar days after your confinement date.

Conversely, hospital confinement allows you to file your SBA Form one year from the discharge date.

For Overseas Filipino Workers (OFWs), SSS allows an additional 30-day grace period to file the SBA Form. However, this rule must only apply to cases that do not need hospital confinement.

Late filings of the form may result in adjustments in the compensable period or the days you are supposed to receive the benefits. As a result, you get less than what you were previously qualified to receive.

In cases where the final day for the filing falls on a holiday or weekday, you may still file your application on the next working day without penalty.

Where can I claim my sickness benefits from SSS?

Once your claim has been approved, you may receive your compensation from the following channels:

  • Your qualified Unified Multi-purpose Identification (UMID) card enrolled as an ATM card
  • The Development Bank of the Philippines’ (DBP) participating banks
  • E-Wallets
  • Accredited remittance centers and cash payout outlets

Is there a limit to the sickness benefit claim?

SSS allows up to 120 days of sick leave for each member for every calendar year. Furthermore, unused portions of these claims are carried over to the next year.

However, SSS limits the payment to no more than 240 days for the same illness. Illnesses going over 240 days must be filed as a disability claim.

Who can file the sickness benefit claim?

You may personally file your sickness benefit claim by bringing all the document requirements to your nearest SSS branch. All you need to do is bring a copy of one of your primary or two secondary IDs with a picture and signature.

Alternatively, you may also have an authorized representative transact for you. To do this, the authorized person must bring a copy of both their primary and secondary IDs. They must also come with signatures, and one must have a photo.