SOCIAL LEGISLATION NOTES (Finals)

Atty. Ian Jerny De Leon

Use at your own risk.

SSS LAW Employer:

- Any person, natural/juridical, who carries on in the
Interpretation: in favor of promoting, developing, and perfecting Philippines any trade, business, industry
a sound and viable tax-exempt social security system (SSS) - Uses the services of another who is under his/her orders
regarding the employment
Policy of the State: - Does not include the Philippine government, and any of its
1. Establish, develop, promote, and perfect a sound and political subdivisions, branches or instrumentalities,
viable tax-exempt SSS suitable to the needs of the people including corporations owned and controlled by the
throughout the Republic; government
2. Promote social justice through savings; and - Self-employed (SE) members shall be deemed an
3. Ensure meaningful social security protection to members employer (ER) and an employee (EE) at the same time
and beneficiaries against disability, sickness, maternity,
old age, death, and other contingencies resulting to loss of Employee:
income. - Performs mental/physical service for an employer,
- Social security protection to Filipino workers, local and provided that there is an ER-EE relationship
overseas, and beneficiaries - SE members shall be deemed an ER and an EE at the
- Work, save, invest, prosper same time

Jurisdiction of the Social Security Commission (SSC): Dependents [SCP]:

[CBCP] a. Legal spouse entitled to support;
- Any dispute arising under the Social Security Act of 2018 b. Legitimate, legitimated, legally adopted, illegitimate child
pertaining to the coverage, benefits, contributions, and who is:
penalties. 1. Unmarried;
2. Unemployed;
Finality of Decision: Fifteen (15) days after notification without 3. Not over 21
appeal XPN: Congenitally/while still a minor been permanently
- Appeal: Questions of law and facts = CA; Law = SC incapacitated of self-support physically/mentally
NOTE: A child below 18 who is in a common-law
Effect of Appeal: does not stay the order of the SSC relationship shall be considered a dependent until the time
XPN: Order from the SSC, CA, SC he reaches the age of 18
c. Parent who is receiving regular support from the member
Definition of Terms
Primary Beneficiaries:
Daverick Pacumio
UST Faculty of Civil Law
 a. Dependent spouse who has not married, cohabited, a. ER contribution to private plan > SSS contributions = ER
entered into a common-law relationship before/after the pays to the SSS only that required of him and deduct the
death of a member; same to the private plan contribution
b. Dependent legitimate, legitimated, legally adopted, and b. ER and EE may agree to adopt plans over and beyond that
illegitimate children in the Social Security Act (SSA)
o NOTE: The share of illegitimate children shall only
be 50% of the chare of the legitimate, legitimated, 2. SE: [SPAPI]
and legally adopted children a. SE professionals;
b. Partners and sole proprietors of businesses;
Secondary Beneficiaries: c. Actors/actresses, directors, scriptwriters, news
a. Dependent parents correspondents who are not EEs;
b. Person designated/reported by the member d. Professional athletes, coaches, trainers, jocks; and
o NOTE: Must have a right to claim support from the e. Individual farmers and fisherfolk.
member under the Family Code
3. Voluntary Coverage: [SOSS]
Contingency: Retirement; Death; Injury/Sickness; Maternity; a. Spouse who devotes full time to managing the household
Unemployment/Involuntary Separation and is NOT engaged in other vocation/employment;
b. OFW terminated from employment;
Average Monthly Salary Credit (AMSC): c. Separated EE who continues to pay; and
- The higher of: d. SE who realizes no income but continues to pay.
a. Sum of the last 60 monthly salary credits (MSC)
immediately preceding the semester of contingency 4. OFW Coverage: Mandatory upon all land-based and sea-
divided by 60 based who are not over 60
b. Sum of the all the MSCs paid prior to the semester of a. Sea-based:
contingency divided by number of monthly Manning Agencies
contributions - Any person, partnership, corporation licensed by DOLE to
recruit and place seafarers
Semester: 2 consecutive quarters ending in the quarter of - Agents of the principal and are considered as ERs of sea-
contingency based OFWs
Quarter: 3 consecutive calendar months ending on the last day - Jointly and severally liable with the principals regarding
of March, June, September, and December civil liabilities from violation of SSA
Principal
Compulsory Coverage: - Employer/foreign placement agency hiring/engaging
1. ER and EE Filipino workers for overseas employment
- All EEs including domestic workers/Kasambahays who b. Land-based: considered as SE until a Bilateral Labor
are not over the age of 60 and their ERs Agreement (BLA) has been entered into
Rules on Private Benefit Plans: shall not be discontinued, MSC for land-based OFW:
and shall be integrated into the SSS, subject to the following - Php 8,000.00
rules: Changes in the MSC:
 1. Initial contribution may be higher/lower than MSC at the Additional Benefit Allowance: Php 1,000.00 and does not
time of registration PROVIDED that the new MSC is not cover dependent’s pension
lower than the minimum (Php 8,000.00)
2. If the land-based OFW member is below 55, he may Dependent’s Pension:
change the MSC without limit - 10% of monthly pension or Php 250.00 whichever is higher
3. If the land-based OFW member is 55 and above, he is - Paid to dependent children not exceeding 5
allowed to change only once a year and by 1 salary - Legitimate children are preferred
bracket
XPN: Retirement Benefit
1. Change in membership type for the first time – - Monthly pension/lump sum
may change without limit Entitlement:
2. Higher maximum MSC 1. Paid 120 monthly contributions prior to semester of
retirement (FULL BENEFIT);
Effectivity of Coverage: 2. 60 years old and is separated from employment or
a. EE: First day of employment ceased to be self-employed; or
b. SE: Upon registration 3. 65 years old.
c. Sea-based OFW: First day of employment Advance pension: First 18 months + additional benefits
d. Land-based OFW: allowance in lump sum
o If covered by a BLA, the provisions of the BLA shall - Conditions:
govern 1. Exercised upon filing of initial retirement claim
o If not covered by a BLA, the applicable month and 2. Excludes dependent’s pension and 13th month pension
year of first contribution payment 3. Increase subject to discounted rate
o NOTE: Voluntary coverage of land-based OFW Lump Sum
shall take effect on the applicable month and year - For a member who has reached retirement age and does
of first contribution payment not qualify for full benefit
- The member must have been separated from employment
Effect of Separation and is not paying SSS contributions on his/her own
1. ER no longer obligated to pay Option to Continue Paying Contributions: for separated
2. For voluntary members (VM): employee with less than 120 monthly contributions – they may
a. For first time VMs, they may choose from existing continue paying as a VM
contributions schedule Suspension of Monthly Benefits:
b. For VMs 60 and above but below 65 with 120 monthly 1. Re-employment;
contributions: may continue paying as VM until 65; 65 2. Resumption of self-employment.
year-old member may continue until he makes 120 NOTE: Upon reaching 65, the member may again claim
monthly contributions retirement benefit
Death:
Monthly Pension: Monthly cash amount given to - Primary beneficiaries receive 100% of the monthly
members/beneficiaries on account of permanent total disability; pension
retirement; death
 - If there are no primary beneficiaries and member dies Permanent Partial Disability (PPD):
within 60 months from the start of the monthly pension, the
secondary beneficiaries receive lump sum (5-year Entitlement for Monthly Pension: 36 monthly contributions paid
guaranteed period) without dependent’s pension and prior to the semester of disability. Less than 36, he is only entitled
additional benefit allowance to lump sum
- If there are no primary and secondary beneficiaries, the Lump Sum: for those who paid less than 36 monthly
lump sum forms part of the estate of the deceased contributions prior to the semester of disability
member a. PTD: higher of the following:
Amount of Monthly Pension for a Retiree After 60 i. Monthly pension x monthly contributions
1. Monthly pension at the earliest time member could have ii. 12 x monthly pension
retired had he/she been separated + all adjustments b. PPD: Percentage of lump sum described in the SSA
2. Monthly pension computed at the time member actually 13th Month Pension: Payable every December
retires Deemed Paid Contributions: Contributions for months where
member received partial disability pension are deemed paid for
Death Benefit purposes of adjudicating retirement, death, and PTD benefits
- Cash benefit either in monthly pension/lump sum Suspension:
Entitlement: 1. Re-employment;
1. Monthly pension: 36 monthly contributions before the 2. Recovery; and
semester of death 3. Failure to report or present oneself for examination at least
o Received by the primary beneficiaries once a year upon notice by the SSS
2. Lump Sum: less than 36 monthly contributions before the Re-employment, Resumption of Self-Employment, Recovery
semester of death from PTD:
o Higher of the following: a. PTD lump sum recipient who was re-employed not earlier
§ Monthly pension x no. of monthly than 1 year from the date of disability shall again be
contributions paid prior to the semester of subject to compulsory coverage
death b. PTD pensioner for 60 months and has recovered loses
§ 12 x monthly pension entitlement to 5-year guaranteed period for retirement
13th Month Pension: given to primary beneficiaries only benefit. The 5-year guaranteed pension payment is
Suspension: Failure of primary beneficiary to report/present granted only once.
himself/herself upon notice by the SSS Death of PTD:
1. Primary beneficiaries are entitled to 100% monthly
Permanent Disability Benefit pension;
2. No primary beneficiaries and dies within 60 months from
Permanent Total Disability (PTD): [CLPBO] the start of the monthly pension = the secondary
1. Complete blindness beneficiaries are entitled to lump sum (5-year guaranteed
2. Loss of 2 limbs at or above the ankle or wrists period) without dependent’s pension, additional benefit
3. Permanent complete paralysis of 2 limbs allowance, and supplemental disability allowance;
4. Brain injury resulting to incurable insanity/imbecility 3. No primary and secondary beneficiaries = lump sum forms
5. Other cases part of the estate
 6. If ER notifies the SSS beyond 5 days from the day the EE
Funeral Benefits notifies him, the ER is reimbursed only for each day of
- Php 20,000.00-Php 40,000.00 depending on no. of confinement starting from the 10th day preceding the date
contributions and AMSC of notification to the SSS
7. If the failure to notify on the part of the ER resulted to
Sickness Benefits reduction of benefit/claim due the EE, the ER shall not be
- Daily cash allowance paid by: entitled to reimbursement
a. ER to member who is unable to work due to sickness; 8. Claim for reimbursement shall be adjudicated within 2
and months from receipt
b. SSS to unemployed, SE, OFW, VM who was - If no payment was received within 1 month after
previously employed/SE/OFW/Non-working spouse adjudication, reimbursement earns 1% interest per month
(NW Spouse) until paid
Entitlement: [3-4-NU] 9. When start of sickness confinement falls on semester
1. 3 monthly contributions within 12-month period where member will not qualify for sickness benefits,
immediately preceding the semester of sickness/injury; confinement period shall be shortened in such a way that
2. Confined for at least 4 days; the 1st day shall be adjusted to period where he/she is
3. Notified the employer/SSS; and qualified
4. Used up all current company sick leave with pay. 10. Sickness & disability benefits may be availed
Notification Requirement: simultaneously PROVIDED:
- Hospital Confinement - not necessary BUT ER must notify a. They are unrelated; and
SSS within 1 year from discharge b. Member is qualified for both
- Confinement elsewhere – EE notifies ER within 5 days
after start of confinement; ER notifies SSS within 5 days Maternity Leave Benefits
- Sickness/injury in workplace – not necessary BUT ER - Daily cash allowance granted to female members who
must notify SSS within 5 days gave birth normally/caesarian/miscarriage, regardless of
- Unemployed/SE/Land-based OFW/VM including NW civil status, legitimacy of the child
Spouse – must notify SSS within 5 days Entitlement:
XPN: Hospital/Confinement elsewhere – 1 year from 1. 3 monthly contributions within 12 moths immediately
discharge preceding childbirth
Amount of Benefit: 90% average daily salary credit (ADSC) 2. Notified the ER of the expected date of delivery which must
Guidelines for grant: be transmitted to SSS
1. Maximum sickness benefit of 120 days/year 3. Unemployed/SE/VM/OFW/NW Spouse must notify SSS
2. 240 days for same illness/confinement NOTE: Failure to notify shall not bar member from receiving
3. Unused portion of 120 days may not be carried over benefit if she confined herself in DOH-accredited/licensed
4. Payment by employer every 15th and last day of the month hospitals/clinics
5. 100% reimbursement to ER provided:
a. ER notified SSS of confinement;
b. SSS reimburses ER/unemployed for 1 year preceding
the date the claim for reimbursement was received
Amount of cash allowance: 100% ADSC for 105 days1 4. Fraudulent alteration, forgery, counterfeiting
Limits: 5. Failure/refusal to register employees/SE
- Benefit is applicable for the first four (4) deliveries only 6. Failure/refusal to deduct contributions
- Member cannot recover Sickness Benefits and Maternity 7. SSS employee’s misappropriation/appropriation of funds
Benefits simultaneously 8. Employer’s misappropriation of contributions
Manner of Payment:
1. Full payment shall be advanced by ER within 30 days from PORTABILITY LAW
the filing of the application
2. SSS shall reimburse ER 100% upon receipt of satisfactory Coverage: All workers of the Government Service Insurance
proof of payment System and/or SSS who transfer from one sector to another, who
3. SSS pays directly the member whose contingency wish to retain their membership in both systems
occurred while she’s employed but who is currently
unemployed, temporarily laid-off, or while her company is Interpretation: Nothing in the law shall be construed to diminish
on lock-out/strike or reduce the benefits being enjoyed by a cover worker arising
4. SSS pays SE/Unemployed/VM/NW Spouse/OFW from existing laws, issuances and company policies or practices
member or agreements between the employer and the employees and any
Prescription: 10 years from delivery/miscarriage conflicting interpretation of the law and the implementing rules
and regulations shall be resolved in favor of the workers.
Unemployment Insurance/Involuntary Separation Benefit
- Monthly cash payment Portability: transfer of funds for the account and benefit of a
- 50% of AMSC for 2 months at the maximum worker who transfers from one system to another
Entitlement:
1. Not over 60 years old; Totalization: adding up the period of creditable services or
2. Has paid 36 monthly contributions, 12 months of which periods of contributions under each of the systems, for purposes
must be paid within 18 months immediately preceding the of eligibility and computation of benefits.
semester of contingency; Applicability. – Totalization shall apply in the following
3. Involuntarily separated from employment. instances:
Limit: Once every 3 years 1. If a worker is not qualified for any benefits from both
Overlapping Benefits: Higher benefit shall prevail systems;
Prescriptive Period: 1 year from separation/unemployment 2. If a worker in the public sector is not qualified for any
benefits in the GSIS;
Punishable Acts 3. If a worker in the private sector is not qualified for any
1. False Statement, Representation, Affidavit/Document benefits in the SSS
2. Fraudulent Acquisition/Receipt of Money/Check
3. Unauthorized purchase, sale, use, transfer, exchange, or
pledge of stamps, coupons, etc.

1
Pursuant to the new Maternity Leave law, the compensable period is 105
days regardless of the manner of delivery.
NOTES: 1. Compulsory life insurance;
1. If after totalization, the worker-member still fails to qualify, 2. Optional life insurance;
the member will get whatever benefits correspond to 3. Retirement benefits;
his/her contributions in either/both systems 4. Disability benefits to work-related contingencies; and
2. If a worker qualifies for benefits in both systems, 5. Death benefits.
totalization shall not apply
3. Overlapping of periods of creditable services or Definitions
contributions in both systems shall be credited only once Employer:
for purposes of totalization a. National government;
b. Political subdivisions, agencies, branches,
Creditable Services: for the public sector, the following shall be instrumentalities;
considered creditable services: c. GOCCs and financial institutions with original charters;
1. All previous services rendered by an official/employee d. Constitutional Commissions and the Judiciary
pursuant to an appointment whether permanent,
provisional or temporary. Employee/Member: any person receiving compensation while in
2. All previous services rendered by an official/employee the service of an ER, whether by election or appointment,
pursuant to a duly approved appointment to a position in irrespective of status and appointment, including barangay and
the Civil Service with compensation or salary; sanggunian officials
3. The period during which an official/employee was on
authorized sick leave of absence without pay not Compensation: basic pay or salary received by EE excluding
exceeding one year; per diems, bonuses, OT pay, honoraria, allowances, and any
4. The period during which an official or employee was out of other emoluments received in addition to basic pay which are not
the service as a result of illegal termination of his service integrated into the basic pay under existing laws
as finally decided by the proper authorities; and
5. All previous services with compensation or salary Reportorial Requirements of ER
rendered by elective officials. - ER must report to the GSIS the names, employment
status, positions, and salaries of EE and such other
Period of Contribution: for the private sector, the periods of matters as determined by the GSIS
contribution shall refer to the periods during which a person
renders services for an employer with compensation or salary Penalty in case of delayed remittance or non-remittance of
and during which contributions were paid to SSS. A self- contributions
employed person shall be considered an employee and employer - Unremitted contributions shall be charged interests which
at the same time. shall not be less than 2% of simple interest per month from
due date to the date of payment
GSIS LAW
Q: May a member enjoy the benefits provided for in the Revised
Purpose for the Enactment of GSIS Law [CORD-D] GSIS Act simultaneous with similar benefits provided under other
- To provide and administer the following benefits to laws for the same contingency?
government EEs, viz:
A: Whenever other laws provide similar benefits for the same c. Contractual employees including casuals and other
contingencies covered by this Act, the member who qualifies to employees with an employee-government agency
the benefits shall have the option to choose which benefits will be relationship are also compulsorily covered, provided they
paid to him. However, if the benefits provided by the law chosen are receiving fixed monthly compensation and
are less than the benefits provided under this Act, the GSIS shall rendering the required number of working hours for
pay only the difference. the month.

Compulsory Coverage Classification of members for purposes of benefit

1. All EEs who have not reached the compulsory retirement entitlement
age, irrespective of employment status 1. Active members
XPNs: - Still in the service and are paying integrated premiums;
1. Uniformed personnel of: Covered for the entire package benefits and privileges
a. The AFP; and being extended by GSIS
b. PNP. 2. Policyholders
2. Contractual EEs who have no ER-EE relationship with - Covered for life insurance only
the agencies they serve. - Can avail of policy loan privilege only
2. Members of the Judiciary and the Constitutional - May also apply for housing loans
Commissions for life insurance policy. - Judiciary and other Constitutional Commissions
3. Retired members
Compulsory Coverage of Life Insurance - Former active members who have retired from the service
General Rule: All EEs receiving compensation who have not and are already enjoying the corresponding retirement
reached the compulsory retirement age, irrespective of benefits applied for
employment status - Not entitled to any loan privilege, except stock purchase
XPN: All members of the Armed Forces of the Philippines (AFP) loan
and the Philippine National Police (PNP).
NOTE: An employee who is already beyond the mandatory Exclusions from coverage [SCAP]
retirement age of 65 shall be compulsorily covered and be 1. EEs who have separate retirement schemes (members of
required to pay both the life and retirement premiums under the the Judiciary, Constitutional Commissions and others who
following situations: are similarly situated);
a. An elective official who at the time of election to public 2. Contractual EEs who have no ER-EE relationship with the
office is below 65 years of age and will be 65 years or agencies they serve;
more at the end of his term of office, including the 3. Uniformed members of the AFP, BJMP; and
period/s of his re-election to public office thereafter 4. Uniformed members of the PNP.
without interruption.
b. Appointive officials who, before reaching the Benefits under the GSIS law [SURP-TS-FLO]
mandatory age of 65, are appointed to government 1. Separation
position by the President of the Republic of the 2. Unemployment or involuntary separation
Philippines and shall remain in government service at 3. Retirement
age beyond 65. 4. Permanent disability
 5. Temporary disability 1. Recipient must be a permanent EE at the time of
6. Survivorship separation;
7. Funeral 2. Separation was involuntary due to the abolition of his office
8. Life Insurance or position resulting from reorganization;
9. Such other benefits and protection as may be extended to 3. Paying the contribution for at least 1 year prior to
them by the GSIS such as loans. separation.

Separation Benefits Retirement Benefits

Entitlement: Entitlement: [15-60-Not]
- Member who has rendered service at a minimum of 3 1. EE must have rendered at least 15 years of service;
years under the following terms: 2. He is at least 60 years of age at the time of retirement; and
1. Member with at least 3 years but less than 15 years – 3. He is not receiving a monthly pension benefit from
cash payment equivalent to 100% average monthly permanent total disability.
compensation for every year of service the member Options to the retiree with regard to his retirement benefits
has paid contributions: 1. Lump sum equivalent to 6 months of the basic
a. Not less than Php 12,000.00; monthly pension (BMP) payable at the time of retirement
b. Payable upon reaching 60 years of age or upon plus old age pension benefit equivalent to BMP payable
separation, whichever comes later for life, starting upon the expiration of the 5 years covered
2. Member with less than 15 years of service and less by the lump sum; or
than 60 years of age at the time of resignation or 2. Cash payment equivalent to 18 times his BMP plus
separation: monthly pension for life payable immediately.
a. Cash payment equivalent to 18 times the basic monthly
pension (BMP), payable at the time of resignation or NOTE: The head of the government agency concerned is vested
separation; with discretionary authority to allow or disallow extension of the
b. An old-age pension benefit equal to the BMP, payable service of an official or EE who has reached 65 years old without
monthly for life upon reaching the age of 60. completing the 15 years of government service.
Effects of separation with regard to membership
- A member separated from service shall continue to be a Permanent Disability Benefits
member and shall be entitled to whatever benefits he has
qualified to (once a member, always a member) Disability: Any loss or impairment of the normal functions of the
physical and/or mental faculty of a member, which reduces or
Unemployment Benefits eliminates his/her capacity to continue with his/her current gainful
- Cash payment equivalent to 50% of the average monthly occupation or engage in any other gainful occupation.
compensation
- NOTE: A member who has rendered at least 15 years of Total Disability: Complete incapacity to continue with present
service shall be entitled to separation benefits instead of employment or engage in any gainful occupation due to the loss
unemployment benefits or impairment of the normal functions of the physical and/or
Entitlement: [PIP] mental faculties of the member.
Types of Permanent Disabilities b. He has paid a total of at least 180 monthly
1. Permanent Total Disability (PTD) - Accrues or arises contribution prior his disability;
when recovery from any loss or impairment of the c. He is not receiving old-age retirement pension
normal functions of the physical and/or mental faculty of a benefits.
member which reduces or eliminates his capacity to NOTE: A member cannot enjoy the monthly income benefit for
continue with his current gainful occupation or engage in permanent disability and the old-age retirement simultaneously.
any other gainful occupation is medically remote. 2. Cash payment equivalent to 100% of average monthly
Examples: [CLPBO] compensation for each year of service he has paid
1. Complete blindness contributions but not less than Php 12,000.00
2. Loss of 2 limbs at or above the ankle or wrists - If he fails to satisfy the abovementioned conditions for
3. Permanent complete paralysis of 2 limbs entitlement
4. Brain injury resulting to incurable insanity/imbecility
5. Other cases Benefits for Permanent Partial Disability
- A member is entitled to cash payment in accordance with
2. Permanent Partial Disability (PPD) - Accrues or arises the schedule of disabilities to be prescribed by GSIS, if he
upon the irrevocable loss or impairment of certain satisfies the given conditions of either (1) or (2) of Sec.
portion/s of the physical faculties, despite which the 16(a).
member is able to pursue a gainful occupation.
Examples: Suspension of Payment of Benefits
1. Complete and permanent loss of the use of: 1. Re-employment;
1. Any finger 2. Recovery; and
2. Any toe 3. Failure to present himself for medical examination when
3. One arm required by the GSIS
4. One hand
5. One foot When recovery is precluded
6. One leg 1. Grave misconduct;
7. One or both ears 2. Notorious negligence;
8. Hearing of one or both ears 3. Habitual intoxication;
9. Sight of one eye 4. Willful intent to kill himself or another
2. Such other cases as may be determined by the GSIS.
Temporary Disability Benefits
Benefits for Permanent Total Disability
1. Monthly income benefit for life equivalent to BMP Temporary total disability: when the impaired physical and/or
Entitlements: mental faculties can be rehabilitated and/or restored to their
1. Member is in the service at the time of disability; or normal functions
2. If separated from service: NOTE: A member cannot enjoy the temporary total disability
a. He has paid at least 36 monthly contributions within benefit and sick leave pay simultaneously.
5 years immediately preceding his disability;
Benefits for Temporary Disability
 1. 75% of his current daily compensation for each day or 3. Cash payment equivalent to 100% of his average
fraction thereof of total disability benefit, to start at the monthly compensation for each year of service he
4th day but not exceeding 120 days in one calendar paid contributions, but not less than Php 12,000.00
year Entitlements:
o In no case shall the benefit be less than Php 70.00 a. Deceased has rendered at least 3 years of service at
a day the time of his death; and
Entitlements: b. Does not qualify under numbers (1) and (2) above
a. Exhausted all sick leaves;
b. CBA sick leave benefits; Secondary Beneficiaries
Provided, that: In the absence of primary beneficiaries, the secondary
o He was in the service at the time of his disability; or beneficiaries shall be entitled to:
o If separated, he has rendered at least 3 years of 1. The cash payment equivalent to 100% of his average
service and has paid at least 6 monthly monthly compensation for each year of service he paid
contributions in the year preceding his disability contributions, but not less than Php 12,000.00 – Provided,
NOTE: An application for disability must be filed with the GSIS That the member is in the service at the time of his death
within 4 years from the date of the occurrence of the and has at least 3 years of service; or
contingency. 2. In the absence of secondary beneficiaries, the benefits
under this paragraph shall be paid to his legal heir.
Survivorship Benefits
- Basic survivorship pension which is 50% of the BMP; and Payment of Survivorship Pension
- Dependent children’s pension not exceeding 50% of the After the end of the guaranteed 30 months, the beneficiaries are
BMP still entitled to survivorship benefits. The survivorship pension
Conditions for primary beneficiaries to be entitled to BMP shall be paid as follows:
1. For Survivorship Pension 1. When the dependent spouse is the only survivor, he/she
Entitlements: shall receive the basic survivorship pension for life or until
a. Was in the service at the time of his death; or he or she remarries;
b. If separated from service, has rendered at least 3 years 2. When only dependent children are the survivors, they shall
of service; and be entitled to the basic survivorship pension for as long as
c. Has paid 36 monthly contributions within the five-year they are qualified, plus the dependent children’s pension
period immediately preceding his death; or has paid a equivalent to 10% of the basic monthly pension for every
total of at least 180 monthly contributions prior to his dependent child not exceeding 5, counted from the
death. youngest and without substitution;
2. For Survivorship Pension plus a cash payment 3. When the survivors are the dependent spouse and the
equivalent to 100% of his average monthly dependent children, the dependent spouse shall receive
compensation for every year of service the basic survivorship pension for life or until he/she
Entitlements: remarries, and the dependent children shall receive the
a. Deceased was in the service at the time of his death; dependent children’s pension.
and
b. Has at least 3 years of service
Benefits that the beneficiaries are entitled to upon the death 1. Those employed after the effectivity of this Act, their
of the pensioner insurance shall take effect on the date of their
1. Upon the death of an old-age pensioner or a permanent employment;
disability pensioner, the qualified beneficiaries shall 2. For those whose insurance will mature after the effectivity
receive the survivorship pension of this Act, their insurance shall be deemed renewed on
2. When the pensioner dies within the period covered by the the day following the maturity or expiry date of their
lump sum, the survivorship pension shall be paid only after insurance;
the expiration of such period 3. For those without any life insurance as of the effectivity of
this Act, their insurance shall take effect following said
Funeral Benefits effectivity.
- Php 20,000.00
Payable to: Optional life insurance coverage
1. Legitimate spouse; 1. A member may at any time apply for himself and/or his
2. Legitimate child who spent for the funeral services; or dependents an insurance and/or pre-need coverage
3. Any other person who can show unquestionable proof that embracing:
he has borne the funeral expenses of the deceased. 1. Life
Payment of Funeral Benefits 2. Memorial plans
Upon the death of: 3. Health
1. An active member; 4. Education
2. A member who has been separated from the service but 5. Hospitalization
is entitled to future separation or retirement benefits; 6. Other plans as maybe designed by GSIS
3. A member who is a pensioner (excluding survivorship 2. Any EE may apply for group insurance coverage for its
pensioners); and EEs.
4. A retiree who is at the time of his retirement was of
pensionable age, at least 60 years old, who opted to retire Beneficiaries
under RA 1616. 1. Primary Beneficiaries
a. Legal and dependent spouse until he/she remarries;
Life Insurance b. Dependent children
Kinds of life insurance: 2. Secondary Beneficiaries
1. Compulsory life insurance; a. Dependent parents;
2. Optional life insurance. b. Legitimate descendants, subject to restrictions on
dependent children
Compulsory life insurance coverage: Dependents
All EEs including the members of the Judiciary and the 1. Legitimate spouse dependent for support upon the
Constitutional Commissioners except for Members of the AFP, member or pensioner;
the PNP, BFP and BJMP, shall, under such terms and conditions 2. Legitimate, legitimated, legally adopted child, including the
as may be promulgated by the GSIS, be compulsorily covered illegitimate child;
with life insurance, which shall automatically take effect as
follows:
 3. An EE over 60 years of age if he had been paying a. For ERs: first day of operation but not earlier than 01
contributions to the System prior to age 60 and has not January 1975;
been compulsory retired. b. For EEs: first day of employment

Prescriptive period to claim benefits Limitation of liability

GR: 4 years from the date of contingency The State Insurance Fund shall be liable for compensation to the
XPN: Life insurance and retirement employee or his dependents, except when the disability or death
was occasioned by:
EMPLOYEES COMPENSATION AND STATE INSURANCE 1. The EEs’ intoxication;
FUND 2. Willful intention to injure or kill himself or another; or
3. Notorious negligence
Philosophy behind workmen’s compensation
- To require the industry to pay for the damage it causes. Compensable Sickness: any illness listed as an occupational
- To secure workmen and their dependents against disease by the Commission or any illness caused by
becoming objects of charity, by making a reasonable employment, subject to proof that the risk of contracting the same
compensation for injuries incident to employment is increased by working conditions. This is known as the theory
Principle of Social Security of increased risk.
- The Employees’ Compensation Commission (the Occupational Disease: one which results from the nature of the
Commission) administers and settles claims from a fund employment and by nature is meant conditions to which all
under its exclusive control. The employer does not employees of a class are subject and which produce the disease
intervene in the compensation process and it has no as a natural incident of a particular occupation.
control over payment of benefits.
Conditions for compensability: [POE]
Definitions 1. The employee must have been injured at the place where
Injury: any harmful change in the human organism from any his work requires him to be;
accident arising out of and in the course of employment 2. The employee must have been performing his official
Sickness: any illness definitely accepted as an occupational functions; and
disease listed by the Commission or any illness caused by 3. If the injury was sustained elsewhere, the employee must
employment, subject to proof that the risk of contracting the same have been executing an order for the employer.
is increased by working conditions. Examples of compensable injuries: [PSMG-ARBE]
(a) Peculiar risks;
Compulsory Coverage: (b) Street perils;
a. Employers: belonging to the public or private sector (c) Acts of ministration (Personal Comfort doctrine);
b. Employees: all employees not over 60 years old. (d) Acts of God;
Employees over 60 years shall be covered if he has been (e) Assaults;
paying contributions prior to the age of 60 and has not (f) Recreational activities;
been compulsorily retired (g) Acts for the benefit of the employer; and
Effectivity date of coverage: (h) Acts during emergency.
 - In case the benefit is paid by the System, the latter is
“Coming and going” rule subrogated to the rights of the injured employee or his
- An injury or accident sustained by an employee while dependents in accordance with the general law.
using the public streets and highways in going to or - Where the System recovers from such third party
returning from the place of employment is not damages in excess of those paid or allowed under Title II,
compensable. Book IV of the Labor Code, such excess shall be delivered
- The rationale for this rule is that the employer is not an to the injured employee or another person entitled thereto,
insurer against all accidental injuries which might happen after deduction of the expenses of the System and the cost
to an employee while in the course of employment of the proceedings.
- XPNs to the rule:
a. Where the employee is proceeding to or from his Employer’s contribution:
work on the premises of the employer; a. For a covered employee in the public sector, his employer
b. Where the employee is about to enter or about to shall remit to the GSIS a monthly contribution equal to 1%
leave the premises of his employer by using the of the actual wages or salary received as of the last day of
customary means of ingress and egress; the month;
c. Where the employee is charged, while on his way b. For a covered employee in the private sector, his employer
to or from his place of employment or at his home, shall remit to the SSS a monthly contribution equal to 1%
or during his employment, with some duty or special of his monthly salary credit as of the last day of the month
errand connected with his employment; and
d. Where the employer, as an incident, provides the Effect of Death/Separation:
means of transportation to and from the place of - Employer’s obligation to pay the monthly contribution shall
employment. cease on the last day of the month of contingency

Exclusiveness of liability of the State Insurance Fund Medical Services

- Whenever other laws provide similar benefits for the same Conditions: [RIN]
contingency, the employee who qualifies for the benefits 1. EE has been duly reported to the System;
shall have the option to choose the law under which the 2. EE sustains an injury or contracts sickness; and
benefits will be paid to him. If the law chosen provides for 3. The System has been duly notified of the injury or
benefits lesser than those provided by the Labor Code, he sickness.
shall be entitled only to the difference.
Temporary Total Disability
Liabilities of third parties Period of entitlement:
- In case the injury or death is caused by circumstances - If caused by an injury or sickness, it shall not be paid
creating a legal liability against a third party other than the longer than 120 consecutive days
employer, the injured employee or his dependents may - Where such injury or sickness still required medical
either claim compensation from the system under the attendance beyond 120 days, such shall not exceed 240
Labor Code, or sue for damages in accordance with law. days from the onset of disability
Suspension of income benefit:
 - If the employee fails to submit a monthly medical report
certified by his attending physician

Permanent Total Disability

Period of entitlement:
- All compensable months of disability
- Guaranteed period: The monthly income benefit is
guaranteed for five (5) years
Suspension of income benefit [EQRE]
1. Failure of the employee to present himself for examination
at least once a year upon notice by the System;
2. Failure to submit a quarterly medical report certified by the
attending physician;
3. Complete or full recovery from his permanent disability; or
4. Upon being gainfully employed.
Amount of benefit for dependent children
- Each dependent child, not exceeding five (5) counted from
the youngest and without substitution, shall be entitled to
10% of the monthly income benefit of the employee

Permanent Partial Disability

Amount of benefit
- If the number of months for payment of income benefit for
permanent partial disability exceeds 12 months, the
income benefit shall be paid in monthly pension.
- If the number of months for payment of income benefit for
permanent partial disability is less than 12 months, the
income benefit shall be in lump sum.