[7] Statutory Monetary Benefits - Employees’ Compensation Program

From St. Ven's notes

Employees’ Compensation Program

• Government program that provides a package of benefits to all workers and/or their beneficiaries in the event of work-related sickness, injury, disability, or death

• Implemented by Employees’ Compensation Commission (ECC)

Employees’ Compensation Program’s Coverage

• Private sector workers who are compulsory members of SSS including sea-based OFWs and kasambahays (they are covered starting on the first day of employment)

• Government sector employees who are mandatory members of GSIS, including uniformed personnel from AFP, PNP, BJMP, BFP, and Philippine Coast Guard

• Active self-employed members of the SSS

Conditions of Compensability - Compensable Diseases

• If sickness is included in the List of Occupational Diseases and conditions for compensability are met

• If conditions are not met or the claimed ailment is not on the list, proof must be shown that the risk of contracting the disease is increased by the working conditions (increased risk theory)

• COVID-19 compensability conditions:

  • Direct connection between the offending agent or even and the worker based on

  • Epidemiologic criteria and occupational risk (healthcare workers, contact tracing teams, etc.)

  • Tasks assigned to the worker would require frequency face-to-face and close proximity interactions with the public or with confirmed cases for healthcare workers

  • Transmission occurred in the workplace

  • Transmission occurred while commuting to and from work

Conditions of Compensability - Compensable Injuries

• Injury is compensable when it takes place within the period of employment at a place where the employee may reasonably be in the performance of their duties

• Accident may be considered to have risen out of and in the course of employment if it happened:

  • At the workplace

  • While performing official functions

  • Outside of the workplace, but performing an order/instruction of the employer

  • When going to or coming home from work; while ministering to personal comfort

  • While in a company shuttle bus

  • During a company sponsored activity

• No compensation if injury, sickness, disability, or death is due to:

  • Intoxication

  • Willful intention to injure or kill himself or another

  • Notorious negligence

Sickness/disability benefits

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

• Temporary Total Disability (TTD)

• Permanent Total Disability (PTD)

• Permanent Partial Disability (PPD)

Temporary Total Disability (TTD)

EMPLOYEES’ COMPENSATION PROGRAM - SICKNESS/DISABILITY BENEFITS

• Prevents an employee for working for a continuous period not exceeding 120 days

• 90% of employee’s average daily salary credit

Permanent Total Disability (PTD)

EMPLOYEES’ COMPENSATION PROGRAM - SICKNESS/DISABILITY BENEFITS

• Monthly income benefit granted for disabilities, such as, but not limited to:

  • Complete loss of sight for both eyes

  • Loss and function loss of both limbs

  • Brain injury resulting to imbecility or insanity

• Amount of benefit shall be determined by Systems based on average monthly salary credit or average monthly compensation

Permanent Partial Disability (PPD)

EMPLOYEES’ COMPENSATION PROGRAM - SICKNESS/DISABILITY BENEFITS

• Monthly income benefit granted for disabilities that result in physical loss

  (amputation) or functional loss of a body part

• Number of monthly pensions is based on the corresponding body part loss or

  functional loss

Medical benefits

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

Includes reimbursement of the cost of medicines for the illness or injury, payment to providers of medical care, hospital care, surgical expenses, and costs of rehabilitation appliances and supplies

Carers’ allowance

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

• Supplemental pension of P1,000/month

• Granted to pensioners under ECP who suffer from PPD and PTD

Rehabilitation services/KaGabay Program (Katulong at Gabay sa Manggagawang May Kapansanan)

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

• Remedial treatment, vocational assessment, and preparation designed to meet individual needs of handicapped employees to restore them to suitable employment

• Helps each person with work-related disability (PWRD) to develop their mental, vocational, or social potential

• Availed directly at ECC once employee has approved employee compensation claim from systems

• Rehabilitation services:

  • Medical-surgical management

  • Hospitalization

  • Necessary appliances and supplies

  • Physical restoration

  • Psychosocial counseling

  • Psychiatric evaluation

  • Skills training

  • Entrepreneur training

  • Hearing impairment evaluation

  • Visual impairment evaluation

  • Job referral

Death benefit

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

• Beneficiaries of deceased employee are entitled to income benefit if employee died due to work-related injury or sickness

• Benefit paid at the beginning of the month of death and will continue for as long as they are entitled to it

Funeral benefit

EMPLOYEES’ COMPENSATION PROGRAM - BENEFITS

Amount of P30,000 may be granted for the private and public sectors upon the death of an employee who died as a result of work-related accident or disease

Notification and Filing of Claims

• Employer should be notified of employee’s sickness, injury, or death within five days from the occurrence of the contingency

• Notice is not necessary if contingency happened during working hours at the workplace with the knowledge of the employer or representative

• For private sector employees:

  • Claims for EC benefits are filed at any SSS branch office nearest the employee’s residence or workplace

₱10.00

How much is the employers’ contribution based on this range of compensation?

₱1,000.00 - ₱14,749.99

₱30.00

How much is the employers’ contribution based on this range of compensation?

₱14,750.00 and above

Last day of the month

When covered employee dies during employment or is separated, the employer’s obligation to monthly contribute arising from that employment shall cease on the __________ of contingency

Months

When a covered employee becomes disabled during employment, the employer’s obligation to pay monthly contribution shall be suspended during the __________ that the employee is not receiving salary or wages