Employees’ Compensation Program Flashcards
Employees’ Compensation Program
•government program that provides a package of benefits to all workers and/or their beneficiaris in the event of work-related sickness, injury, disability, or death
•implemented by Employees’ Compensation Commission (ECC)
Coverage
ECP covers the ff:
•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
GSIS – Government Service Insurance System
AFP – Armed Forces of the Philippines
PNP – Philippine National Police
BJMP – Bureau of Jail Management and Penology
BFP – Bureau of Fire Protection
Philippine Coast Guard – The branch of the Philippine government responsible for maritime law enforcement and search and rescue operations.
These are all government agencies and sectors involved in the public service and employee benefits system in the Philippines.
SSS - Social Security System
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 mus 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 frequeny face-to-face and close
proximity interactions with the public or with confirmed cases for healthcare
workers
•transmission occured in the workplace
•transmission occured while commuting to and from work
•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 homr 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
•Temporary total disability (TTD)
-prevents an employee for working for a continuous period not exceeding 120 days
-90% of employee’s average daily salary credit
Benefits
Sickness/disability benefits
Permanent total disability (PTD)
-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
Benefits
Sickness/disability benefits
PTD stands for Permanent Total Disability.
The statement means that when an employee becomes permanently and totally disabled, the amount of their disability benefit will be determined by the system (likely referring to the governing agency like the SSS or GSIS) based on the person’s average monthly salary credit or average monthly compensation.
Here’s how it works:
- Average Monthly Salary Credit: This is the average amount the employee has been contributing to the system (e.g., SSS or GSIS) over a certain period.
- Average Monthly Compensation: This refers to the average salary the employee was earning over a period before becoming disabled.
The benefit amount will be calculated based on these averages, and this is what the disabled employee will receive as compensation for their permanent total disability.
Permanent partial disability (PPD)
-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 correspoinding body part loss or
functional loss
Benefits
Sickness/disability benefits
Medical 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
-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)
•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 approve 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
-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
If the death benefit is ₱5,000 per month, the family will receive ₱5,000 for the month of March (even though Juan passed away in the middle of the month) and continue to receive ₱5,000 every month for the next 12 months, depending on the eligibility.
Funeral benefit
-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
Contribution
-employers pay for the EC contributions
-for every covered employee in the private sector, their employer shall remit to SS a
monthly contribution in accordance with the following schedule:
Range of Employer’s
compensation Contribution
1k-14,749.99. ₽10.00
14,750 and above. ₽30.00
-when covered employee dies during employment or is separated, the employer’s obligation to monthly contribute arising from that employment shall cease on the last day of the month of contingency
-when a covered employee becomes disabled during employment, the employer’s obligation to pay monthly contribution shall be suspended during the months that the employee is not receiving salary or wages
Here’s a simpler explanation of the contribution system:
- Employer’s Responsibility: Employers are required to pay EC (Employees’ Compensation) contributions for every covered employee in the private sector. This contribution is paid monthly to the Social Security System (SSS).
-
Contribution Amount: The amount the employer has to pay depends on the employee’s salary:
- If the employee’s monthly salary is between ₱1,000 and ₱14,749.99, the employer pays ₱10 per month.
- If the employee’s salary is ₱14,750 or more, the employer pays ₱30 per month.
- When the Employee Dies or is Separated: If the employee dies or is separated from the company, the employer stops contributing to the EC starting from the last day of the month the employee passed away or left the job.
- When the Employee Becomes Disabled: If the employee becomes disabled and is not receiving salary or wages during this period, the employer does not need to contribute for the months the employee is not working and not getting paid.
In short, the employer pays a small contribution for each employee, which stops when the employee passes away, leaves the job, or is disabled and not earning a salary.
