The SSS Sickness Benefit is one of the financial assistance programs offered by the Social Security System (SSS) in the Philippines. This benefit provides a daily cash allowance to qualified members who are unable to work due to illness or injury, offering much-needed financial relief during recovery.
In this detailed guide, we’ll walk you through the eligibility requirements, computation process, filing steps, and other important details you need to know about applying for the SSS Sickness Benefit.
Program Overview
The SSS Sickness Benefit is a financial assistance program that provides daily cash allowances to qualified members unable to work due to illness or injury. It offers a daily benefit equivalent to 90% of the member’s average daily salary credit (ADSC) and is computed based on the member’s six highest monthly salary credits within a 12-month period before the semester of illness.
The program covers up to 120 days of sickness benefit per calendar year, with a maximum of 240 days for the same illness before it is considered a disability claim. Applications must be submitted promptly, as late filing may result in reduced benefits or denial. Payments are disbursed through the member’s enrolled bank account, e-wallet, or other approved channels within five banking days after claim approval. Members can file their applications online or through SSS branches for special cases, ensuring quick access to this critical support during periods of financial difficulty caused by illness.
Benefit Amount and Computation
The daily sickness allowance is equivalent to 90% of your ADSC. These are the steps if you wish to manually calculate how much benefit you are entitled to.
Step 1. Exclude the Semester of Contingency: The semester includes two consecutive quarters ending in the quarter of your sickness or injury.
Step 2. Count 12 Months Backward: From the month before the semester of contingency, count backward 12 months.
Step 3. Select the Six Highest MSC: Identify the six highest MSCs within the 12-month period.
Step 4. Compute the ADSC:
- Divide the total MSC by 180 days.
- Multiply the ADSC by 90% to get the daily sickness allowance.
Step 5. Calculate the Total Benefit: Multiply the daily sickness allowance by the approved number of sick days.
Sample Computation
Let’s say your six highest MSCs total ₱120,000. Here’s how the computation works:
- ADSC: ₱120,000 ÷ 180 days = ₱666.67
- Daily Sickness Allowance: ₱666.67 × 90% = ₱600
- If you’re approved for 10 sick days, your benefit would be ₱600 × 10 = ₱6,000.
Note: Contributions paid after the semester of contingency are not included in the computation.
Target Beneficiaries
The SSS Sickness Benefit is designed to provide financial assistance to SSS members who are unable to work due to illness or injury. If you’re considering applying for the SSS sickness benefit, the bare minimum requirement is to at least be one of these:
- SSS Members Unable to Work Due to Sickness or Injury
- SSS Members with Sufficient Contributions
- Members Who Have Properly Notified SSS
- Self-Employed, Voluntary Members, and OFWs
- Legal Heirs of Deceased Members
- Inactive or Retired Members with Unclaimed Benefits
- Company Representatives or Authorized Individuals
Qualifying Conditions
To qualify for the lifeline we call the SSS Sickness Benefit, then just being an eligible applicant won’t cut it. You also need to meet the following qualifying conditions:
- Must be confined at home or in a hospital for at least four (4) days.
- Must have at least three (3) months of contributions within the 12-month period immediately preceding the semester of illness or injury.
- Must have notified the SSS about their sickness or injury in a timely manner. Notification must be submitted within five (5) calendar days, unless hospitalized, in which case the employer has one (1) year from the discharge date to file the claim.
- Must have submitted their Sickness Benefit Application (SBA) through the My.SSS portal or in-person at SSS branches, depending on their situation.
- Must be eligible to claim unclaimed sickness benefits of a deceased member.
- Must be SSS members who are no longer employed but have previously accumulated sufficient contributions may file for unclaimed sickness benefits.
- Must be authorized representatives who are filing claims on behalf of the member, and can provide the necessary authorization documents, such as a Letter of Authority (LOA) or Special Power of Attorney (SPA).
Required Documents
When applying for the SSS Sickness Benefit, here are the documentary requirements you need to prepare:
Basic Requirements
- Duly Accomplished SBA Form
- Valid ID: Examples include:
- Unified Multi-Purpose ID (UMID)
- Passport
- Driver’s License
- Postal ID
For Representatives
- Letter of Authority (LOA) or Special Power of Attorney (SPA)
- Valid IDs of both the member and representative.
Filing Your SSS Sickness Benefit Application
To easily file for the SSS Sickness Benefit, here’s a detailed guide you can follow:
Online Filing via My.SSS Portal
For self-employed, voluntary members, and separated employees, the My.SSS portal is the easiest way to submit your Sickness Benefit Application (SBA).
Step 1. Log in to your My.SSS account on the SSS website, https://www.sss.gov.ph.
Step 2. Go to the Benefits tab and select “Submit Sickness Benefit Application.”
Step 3. Fill out the required information and upload supporting documents.
Step 4. Review your details and click “I certify and submit.”
Step 5. Take note of the transaction number for tracking purposes.
You will receive an email notification regarding the status of your application.
Filing Through SSS Branches
For special cases (e.g., denied claims for reconsideration or unclaimed benefits), members must file directly at an SSS branch.
Step 1. Visit your preferred SSS branch on the scheduled day according to the last digit of your SSS number.
Step 2. Get a queue number at the SSS branch.
Step 3. Submit the completed SBA form and supporting documents, including a valid ID.
Step 4. Wait for the acknowledgment stub, which indicates successful filing.
Note: Processing time may take up to 20 days for special cases.
Filing Deadlines and Notifications
For hassle-free filing of the SSS Sickness Benefit, make sure to take note of the following deadlines and notification schedules:
Prescriptive Period
- For Claims During ECQ/GCQ: The SSS allows members to file their claims within 60 days after the lifting of quarantine restrictions.
- Late Filing: If you notify SSS beyond the prescribed period, the claim will be reduced. The confinement will be considered to have started five (5) days before the date of notification.
Special Cases
- If the last day for filing falls on a weekend or holiday, you can file on the next working day.
Payment and Disbursement
SSS disburses sickness benefits through the following channels:
- UMID Card Linked to an ATM
- PESONet-Participating Banks
- E-Wallets (e.g., GCash)
- Remittance Transfer Companies (RTCs) or Cash Payout Outlets (CPOs)
Note that members are required to enroll their disbursement account in the Disbursement Account Enrollment Module (DAEM) in their My.SSS account.
Limitations of the SSS Sickness Benefit
The SSS sickness benefit is not unlimited. Though getting sick may not be something one can plan, not every instance can be used as a ticket to claim the SSS sickness benefit. Here are some limitations:
- Maximum Days: You can claim up to 120 days of sickness benefits in a calendar year.
- Chronic Illness: If the sickness or injury persists beyond 240 days, it will be considered a disability claim.
- Unused Days: Unused benefit days cannot be carried over to the next year.
Tips for a Smooth Application
To ensure a smooth and hassle-free application for SSS Sickness benefit, make sure to keep these reminders in mind:
- Notify Early: Ensure you notify the SSS within the prescribed period to avoid reductions or denial of your claim.
- Complete Requirements: Double-check your documents before submission.
- Track Your Claim: Use your transaction number to monitor your application status via My.SSS.
Video: Required Documents for SSS Sickness Benefit Application
For a detailed guide on the required documents when applying for SSS Sickness Benefit Application, you may check out this video from MySSSPH:
Summary
The SSS Sickness Benefit provides valuable financial assistance to members unable to work due to illness or injury. By understanding the requirements, computation, and application process, you can efficiently file your claim and receive the benefits you’re entitled to. Visit the official SSS website or your nearest branch for additional information. Take advantage of this SSS program and secure your financial stability during recovery.