How to File SSS Disability Benefit and how much will you get?

My mother-in-law had her left leg amputated last year due to diabetes. When she heard about the SSS Disability Benefit, she asked me to assist her in filing her benefit. We went to the nearest SSS branch and we inquired about the SSS Disability Benefit and they gave us the Application Form and the list of requirements.

What is SSS Disability Benefit

The SSS Disability Benefit is one of the benefits that SSS provides to its deserving members. It is a cash benefit given to the SSS member who lacks the ability to perform an activity or his work in the manner or within the range considered normal for a human being. The member’s disability could have been a result of either an illness or an accident.

Who can avail of the SSS Disability Benefit?

Under the redesigned disability program of the Social Security System, a member who suffers partial or total permanent disability, is qualified to avail of this program or benefit provided that he has paid at least 1 monthly contribution to the SSS prior to the semester of contingency.

2 Types of Disability Benefits

1. Monthly pension

– It is a cash benefit that is granted to a disabled SSS member who has paid at least 36 monthly SSS contributions prior to the semester of disability.

2. Lump sum amount

– It is a cash benefit that is granted to a disabled SSS member who has not met the required 36 monthly SSS contributions.

– It is a cash benefit that is granted to a disabled SSS member whose approved disability period is payable for less than 12 months.

What you need to know about the Monthly Pension

1. The amount of the disabled member’s monthly pension will be based on:

• the number of paid SSS contributions and
• the years of membership prior to the semester of disability
  • below 10 CYS (Credited Years of Service) – P1,000 monthly pension
  • at least 10 CYS – P1,200 monthly pension
  • at least 20 CYS – P2,400 monthly pension

2. A lifetime monthly pension can be granted only to an SSS member with a total permanent disability.

When can the monthly pension be suspended? 

• If the disabled member recovers from the disability or resumes employment
• If the disabled member fails to report for annual physical examination when notified by the SSS.

An annual re-examination is required to assess the medical situation of the disabled member. If he cannot report to the SSS branch for the annual medical exam due to his disability, the member may request for a domiciliary or a home visit or re-examination by the SSS physician at any SSS branch office.

3. Depending on the degree of disability, the monthly pension of a partially disabled member is paid up to a certain number of months only. It’s not a lifetime benefit.

• If the member’s condition deteriorates due to the same illness or injury, he may be entitled to claim additional disability benefit.

How much is the additional disability benefit? 

• This is calculated based on the remaining percentage of disability after deducting from the percentage of disability in the current claim, the percentage of disability granted in the previous claim.

 

Other Benefits for the Disabled Member

A. Supplemental Allowance

A supplemental allowance of P500.00 per month is paid to the SSS member with total or partial disability. This allowance is given to provide additional financial assistance to meet the extra needs that may arise due to the member’s disability.

B. 13th Month Pension

For the totally disabled member, you will receive a 13th month pension every December.

For the partially disabled member, you will receive a 13th month pension every December, PROVIDED, that the
pension duration is at least 12 months.

C. Dependent’s Allowance

Who are the qualified dependents of the totally disabled pensioner?

• The totally disabled pensioner’s dependent children (including the legitimate, legitimated, legally adopted and illegitimate children), who were conceived on or before the date of contingency will each receive a dependent’s allowance equivalent to 10% of the member’s pension or P250 (whichever is higher).
• Only 5 minor children (beginning from the youngest) are entitled to the dependent’s allowance. Substitution is NOT allowed.
• The dependent’s allowance is granted for life to children who are over 21 years old, provided, they are incapacitated and incapable of self-support due to a physical or mental defect which is congenital or acquired during minority.

The dependent’s allowance stops when the child reaches 21 years old, or when he gets married, or when he gets employed, or when he dies. Incapacitated dependent children are exempted of this.

Who are not entitled to dependent’s allowance?

• The partially disabled pensioner’s children, even if they are minors, are not entitled to the dependent’s allowance.

Who will claim the monthly pension of a disability pensioner when he dies?

For Totally Disabled Pensioner

• The primary beneficiaries of the totally disabled pensioner shall be entitled to 100% of the monthly pension, and the dependents to the dependent’s pension, except for the supplemental allowance which will not be included.
• If the totally disabled pensioner has no primary beneficiaries and if he dies within 60 months from the start of his monthly pension, the secondary beneficiaries shall be entitled to a lump sum benefit. This benefit is equivalent to the total monthly pensions corresponding to the balance of the 5-year guaranteed period. This is also excluding the supplemental allowance.

For Partially Disabled Pensioner

• If the partially disabled pensioner retires or dies, his monthly pension will stop. Though his monthly pension is limited only to a certain number of months according to the degree of his disability.

What types of illnesses or injuries are considered as a disability?

Partial Permanent Disability

It refers to a complete and permanent loss or use of any of the following body parts, but which does not totally prevent a member from engaging in any activity or gainful occupation.

• one thumb
• one index finger
• one middle finger
• one ring finger
• one little finger
• hearing of one ear
• hearing of both ears
• sight of one eye
• one big toe
• one hand
• one arm
• one foot
• one leg
• one ear
• both ears

Total Permanent Disability

It refers to a complete and permanent loss or use of any of the following body parts that may totally prevent a member from engaging in any activity or gainful occupation.

• complete loss of sight of both eyes
• loss of two limbs at or above the ankles or wrists
• permanent complete paralysis of two limbs
• brain injury resulting to incurable imbecility or insanity
• such cases as determined and approved by the SSS

How to Compute the Lump Sum Amount

1. For TOTAL permanent disability

The lump sum amount that a totally disabled member can get is computed in 2 ways but whichever is higher will be the final lump sum amount.

• The lump sum benefit is equivalent to the monthly pension times the number of monthly contributions paid to the Social Security System. –OR–
• The lump sum benefit is equivalent to 12 times the monthly pension.

Example Scenario: 

Alfred is an SSS member who applied for SSS Disability Benefit after both of his feet were amputated and he also has other existing illnesses. Upon assessment by the SSS, the degree of his disability was determined to be 100% (total disability) and the number of his SSS contributions was equivalent to 30 months only. How much lump sum amount can he possibly receive from SSS? 

Remember that if the member has below 10 credited years of service (CYS), his monthly pension would be P1,000. Also, if the member did not meet the required 36 monthly contributions, he is eligible to get a lump sum amount.

a. P1,000 (monthly pension) x 30 (monthly contributions) x 100% (percentage of disability) = P30,000; –OR–
b. 12  x P1,000 (monthly pension) x = P12,000

Therefore, Aflred’s lump sum pension is P30,000.

2. For PARTIAL permanent disability

The lump sum amount that a partially disabled member can get is also computed in 2 ways but whichever is higher will be the final lump sum amount.

A. The lump sum is equivalent to the monthly pension times the number of monthly contributions times the percentage of disability in relation to the whole body. –OR–

B. The lump sum is equivalent to the monthly pension times 12 times the percentage of disability.

Example Scenario: 

Mario is an SSS member who applied for SSS Disability Benefit after meeting an accident. Upon assessment by the SSS, the degree of his disability was determined to be 20% (partial disability) and the number of his SSS contributions was equivalent to 24 months only. How much lump sum amount can he possibly receive from SSS? 

Remember that if the member has below 10 credited years of service (CYS), his monthly pension would be P1,000. Also, if the member did not meet the required 36 monthly contributions, he is eligible to get a lump sum amount.

a. P1,000 (monthly pension) x 24 (monthly contributions) x 20% (percentage of disability) = P4,800; –OR–
b. P1,000 (monthly pension) x 12 x 20% (percentage of disability) = P2,400

Therefore, Mario’s lump sum pension is P4,800.

How to Claim or Receive the SSS Disability Benefit Pension? 

The SSS pays your pension directly through your existing single savings bank account.

If you don’t have an existing single savings account, the SSS will issue an LOI form (attached to the SSS Disability Benefit Application form) to be presented to your chosen SSS-accredited bank so that you can open a single
savings account.

Upon the filing of the SSS Disability Benefit application, the disabled member must submit a photocopy of any of the following documents and present the original copy for authentication purposes.

• the savings account passbook
• the ATM card bearing the member’s name and account number
• a validated initial deposit slip
• Visa Cash Card Enrollment Form

Once your benefit application claim is approved by SSS, you will receive a notice-voucher from SSS through mail with the information as to when you can withdraw your SSS benefit or pension from the bank.

How to File SSS Disability Benefit Application

1. Obtain the Disability Application Form from the SSS office or download it here: Disability Claim Application (DisCA) Form. Fill out the form with all the required information.

2. Accomplish all the required documents

• Member’s/Claimant’s Photo and Signature Form (for initial claims only)
• SSS Medical Certificate Form, accomplished by attending physician within six (6) months
  from the date of filing
• Supporting medical records (certified true copy)
• Member or Filer’s SS card or other valid ID cards or documents
• Other Required Documents
  • In my mother-in-law’s case, since she was amputated, she was required to submit a certified true copy of Hospital Abstract/Discharge Summary and Operation Records.
• If for pension – photocopy of either passbook or ATM card with validated deposit slip or Cash card Enrollment Form
• If for total disability pension, with dependent children:
  • certified true copy of marriage certificate registered with LCR/NSO
  • certified true copy of birth certificate of legitimate or legitimated dependent children
  • legal adoption papers for legally adopted children (date of adoption must be prior to date of disability)
  • any proof of filiation for illegitimate dependent children
  • claim for Dependent’s Allowance (SS Form BPN-106)

Click here to see the SSS Disability Benefit Guidebook with the complete list of valid IDs and documents that you need to submit for your SSS Disability Benefit Claim.

3. Submit your SSS Disability Benefit Application and requirements to the nearest SSS branch.

If the disabled member is unable to file Disability claim personally, he may authorize a representative to submit his documents together with a sketch of the member’s residence or place of confinement (if local resident) and a physical examination report describing disabling manifestation, signed by attending physician (if residing abroad).

F.A.Q.

• Can I still file for my SSS Disability Benefit even if it has been 3 years since I got disabled? 

Answer: Yes, as long as you submit all the required documents including medical records to prove your illness and disability, you can still file for your SSS Disability Benefit. The prescriptive period for the filing of the disability benefit claim should be 10 years from the date of occurrence of your disability.

• What if I don’t qualify for the SSS Disability Benefit or I’m not a member of the SSS, can I avail of other disability benefits? 

Answer: If your disability was connected to your work or job and that it incapacitates you from performing your work for more than 120 days, then you are likely entitled to the permanent total disability benefit provided under the Labor Code. To claim, you may file an application with the SSS, which is the agency that receives the application for Employee Compensation (EC) benefits. Make sure to submit all pertinent documents. (Source)

Aside from SSS Disability Benefit and Employee Compensation Benefits, you may also avail of the benefits from your Insurance Company if you have any. Your benefits will depend on the insurance plan that you signed up for.

Click here to read: My Mother-In-Law’s SSS Disability Benefit Application

Click here to read: 7 Steps for SSS Online Registration