The Government Service Insurance System (GSIS) provides financial assistance to its members through various benefits, including disability claims. Whether you are applying for Temporary Total Disability (TTD), Permanent Partial Disability (PPD), or Permanent Total Disability (PTD), understanding the process ensures that eligible members can access the support they need.
This guide provides a detailed walkthrough of the GSIS disability claim application process. It covers eligibility, required documents, submission methods, and processing timelines to help you efficiently apply for this GSIS benefit.
Program Overview
The GSIS Disability Benefits Program provides financial assistance to government employees who experience a temporary or permanent loss of physical or mental function categorized under three types of disability: Permanent Total Disability (PTD), Permanent Partial Disability (PPD), and Temporary Total Disability (TTD). This loss, whether partial or total, affects their ability to work or earn income, making it necessary for them to seek support. The program is designed to compensate members for the actual loss of income resulting from disability, based on the severity of the condition, the member’s ability to work, and the number of days they incurred leave without pay (LWOP). Applications are assessed through established medical standards and must be filed within four years from the date of disability to qualify as a valid claim.
The GSIS Disability Benefits Program operates under RA 8291, which outlines the rights and benefits of government employees, including those affected by illness, injury, or organ loss. This applies to all active government employees and separated members who meet the required contribution criteria and includes compensation for members who experience a disability that leads to a reduced ability to work or complete loss of earning capacity. Whether the condition is permanent or temporary, the program provides financial support through monthly income benefits, cash payments, or both, depending on the severity of the disability and the member’s contribution history.
Benefits
The GSIS Disability Benefit provides financial assistance and compensation to eligible members experiencing temporary or permanent disabilities due to non-work-related conditions, which includes:
- Permanent Total Disability (PTD)
- Lifetime monthly income equivalent to the Basic Monthly Pension (BMP)
- Cash benefit equivalent to 18 times the BMP for members with 180 paid contributions
- Separated members with at least three years of service and fewer than 180 contributions receive a lump sum equivalent to 100% of their Average Monthly Compensation (AMC) per year of service, with a minimum of ₱12,000
- Permanent Partial Disability (PPD)
- Cash benefit for loss of function in specific body parts or senses, such as an eye, ear, arm, or leg
- The benefit is calculated by dividing the BMP by 30 days and multiplying it by the compensable days of Leave Without Pay (LWOP)
- The entitlement period does not exceed 12 months
- Temporary Total Disability (TTD)
- Compensation for temporary inability to work, starting from the fourth day of incapacity
- Computed at 75% of the daily salary, with a minimum of ₱70 and a maximum of ₱340 per day
- Entitlement period is up to 120 days, extendable to a maximum of 240 days based on medical evaluation.
These benefits aim to assist GSIS members in managing income loss during periods of disability.
Target Beneficiaries
The program is designed to provide assistance to specific groups of members who experience disabilities due to non-work-related conditions such as:
- Active GSIS Members: Individuals who are currently employed in government service and contributing to GSIS
- Separated GSIS Members: Former government employees who have at least three years of service but are no longer in active service
- Retired GSIS Members: Retirees receiving pension benefits who later develop a disability
- Members with PTD: Those who are permanently unable to work due to a severe and lasting disability
- Members with PPD: Individuals with disabilities that partially impair their ability to perform tasks but do not completely prevent them from working
- Members with TTD: Members who temporarily cannot work due to an injury or illness but are expected to recover
Qualifications
To apply for the benefit, claimants must meet the following qualifications to ensure eligibility:
- Government Service Record: Must have been a government employee and a contributing member of GSIS
- Contribution Requirement: At least three years of service and paid premiums if the disability is not work-related
- Certification of Disability: Must be officially certified by a licensed physician as suffering from temporary, permanent partial, or permanent total disability
- Non-Work-Related Disability: The disability must not be caused by injuries or illnesses incurred during official duties
- Separation or Retirement Condition: For separated members, they must not have received any other permanent benefit from GSIS
- Age Limit: If applicable, the applicant should not exceed the age limit for claiming specific benefits
- Active or Separated Member Status: Must be an active contributor, separated member with enough service years, or a retiree depending on the benefit being claimed
- Leave: Must have incurred leave without pay (LWOP) during the period covered by the claim
Required Documents
To process your disability claim, you need to prepare the following documents nd prove your eligibility:
For Disability under PPD and TTD (Sickness/ Injury/ Organ Loss) Claims
- Application for Disability Retirement (original, 1 copy): Available at any GSIS Members’ Assistance Counter or downloadable from the GSIS website.
- Proof of Disability Forms (Parts I, II, and III) (original, 1 copy): Also available at GSIS offices or online.
- Updated Service Record (original, 1 copy): Provided by your agency.
- Approved Sick Leave Application (original, 1 copy): Signed by your employer, indicating the dates of sick leave (with and without pay).
- Additional documents: Other proof of income loss or disability, as required by GSIS provided by the claimant’s agency
For PTD claims
- Duly accomplished Application Form for Disability Benefit (1 copy, original), secured from any GSIS Members’ Assistance Counter or downloaded from the GSIS website (under the tabs: Quick Link – Downloadable Forms)
- Proof of Disability Forms (Parts I, II, and III) (original, 1 copy): Also available at GSIS offices or online.
- Service Record with Certification (indicating the specific dates and time of sick leave with or without pay) signed by authorized officer (1 copy, original or authenticated copy) from the Claimant’s Agency
- Declaration of Pendency / Non-pendency of Case (DPNPC) Form (date administered / notarized should be on or after receipt of notification of claim approval from GSIS) to be submitted upon receipt of notice from GSIS (1 copy, original): Available at any GSIS Members’ Assistance Counter or downloadable from the GSIS website.
- Photocopy of GSIS UMID/eCard, valid passport, PhilID/ePhilID, or two (2) valid government-issued IDs (if Retirement Claim is filed by the claimant)
Application Procedures
The GSIS offers three ways to file your disability claim: in person, via email, or through postal mail.
1. Filing In-Person
If you prefer a face-to-face process, follow these steps:
Step 1: Visit a GSIS office, proceed to the Information Center or Public Assistance and Complaints Desk (PACD), and get a queue number.
Step 2: Submit all required documents at the designated counter and receive an acknowledgment receipt.
Step 3: Upon submission, GSIS will verify your documents and log them into the Transaction Monitoring System (TMS).
Step 4: The submitted documents will then be scanned and routed to the Claims Unit.
Processing Time: 1 working day.
Step 5: Once your application is filed, the next step involves medical evaluation to verify your condition.
- GSIS will assess your claim and schedule a physical exam or home visit.
- A medical officer evaluates the clinical abstract and notifies you of the schedule.
- During the physical exam or home visit, your condition is assessed to determine eligibility.
Timeline: Medical evaluations take up to 20 working days, including reviews by multiple medical officers and final approval by the Senior Vice President.
Step 6: After medical evaluation, your application is forwarded for final processing:
- Claims processors review medical resolutions and reconcile accounts.
- The claim is forwarded to team leaders for review and voucher approval.
Step 7: Wait as the approved claims are either credited to your GSIS eCard/UMID account or released as a check.
Processing Time: 20 working days.
Note: Members with eCards can expect funds credited within 3 banking days after posting, while those receiving checks should allow up to 20 working days.
2. Filing via Email
Members can also submit their application electronically.
Step 1: Email scanned copies of the required documents to the GSIS office handling your claim. Ensure the email subject follows this format: GSIS(Type of Claim)_(BP Number)_(Last Name)_(First Name)_(Agency Name).
Step 2: Include a clear photo of yourself holding your completed application form and two government-issued IDs.
Step 3: GSIS will review your documents and validate your identity against your GSIS records.
Step 4: Wait while the person-in-charge logs the documents into the TMS, assigns a reference number, and informs you if your claim is under process or needs additional requirements.
Processing Time: 3 working days.
Note: Original documents must be submitted within 10 working days of emailing your application.
Step 5: Once your application is filed, the next step involves medical evaluation to verify your condition.
- GSIS will assess your claim and schedule a physical exam or home visit.
- A medical officer evaluates the clinical abstract and notifies you of the schedule.
- During the physical exam or home visit, your condition is assessed to determine eligibility.
Timeline: Medical evaluations take up to 20 working days, including reviews by multiple medical officers and final approval by the Senior Vice President.
Step 6: After medical evaluation, your application is forwarded for final processing:
- Claims processors review medical resolutions and reconcile accounts.
- The claim is forwarded to team leaders for review and voucher approval.
Step 7: Wait as the approved claims are either credited to your GSIS eCard/UMID account or released as a check.
Processing Time: 20 working days.
Note: Members with eCards can expect funds credited within 3 banking days after posting, while those receiving checks should allow up to 20 working days.
3. Filing via Postal Mail or Courier
Applications can also be sent through postal services or couriers.
Step 1: Secure all required documents in a sealed brown envelope and mail them to the GSIS office.
Step 2: Clearly indicate your full name, address, and contact details in the application.
Step 3: Wait while the GSIS staff logs your documents into the TMS and verify the claimant information using GSIS records.
Step 4: You will receive a notification of your application status via email or SMS, including any deficiencies or next steps.
Processing Time: 3 working days.
Note: Original documents are required for claim payment.
Step 5: Once your application is filed, the next step involves medical evaluation to verify your condition.
- GSIS will assess your claim and schedule a physical exam or home visit.
- A medical officer evaluates the clinical abstract and notifies you of the schedule.
- During the physical exam or home visit, your condition is assessed to determine eligibility.
Timeline: Medical evaluations take up to 20 working days, including reviews by multiple medical officers and final approval by the Senior Vice President.
Step 6: After medical evaluation, your application is forwarded for final processing:
- Claims processors review medical resolutions and reconcile accounts.
- The claim is forwarded to team leaders for review and voucher approval.
Step 7: Wait as the approved claims are either credited to your GSIS eCard/UMID account or released as a check.
Processing Time: 20 working days.
Note: Members with eCards can expect funds credited within 3 banking days after posting, while those receiving checks should allow up to 20 working days.
Where to Secure the Application Form
The application form for GSIS disability claims can be obtained from any GSIS Member Assistance Counter. It is also available for download on the GSIS official website under the “Quick Links” section in the “Downloadable Forms” tab. Make sure to complete and submit the form along with the other required documents for your application.
Additional Notes for Claimants
For those who are filing disability claims for PTD, you may want to take note of the following:
- For PTD claims: Members must submit a Declaration of Pendency/Non-Pendency of Case (DPNPC). This document must be notarized and submitted in original form.
- If submitted via email: Make sure to include a photo of yourself holding the notarized DPNPC. Original documents must be provided within five calendar days of email submission.
Video: Benefits of GSIS Disability Claim
To learn more about what it means to successfully process a GSIS Disability Claim, watch this video from Prof. Allan Noguerra MBA, LPT:
Summary
Applying for a GSIS disability claim involves preparing required documents, choosing a submission method, undergoing medical evaluation, and waiting for claim processing. Whether applying for TTD, PPD, or PTD, members can file applications in person, via email, or by mail. Each method has specific steps and timelines to follow. With this financial assistance from the GSIS disability claim, government employees can now manage non-work-related disabilities more effectively. For more information, you may also visit the GSIS website or contact your nearest GSIS office.