How to File Sickness and Disability Claims under the Employees’ Compensation Program

The Employees’ Compensation (EC) Program is a state-run social insurance program designed to provide employees and their families with compensation benefits and rehabilitation services in the event of work-related sickness and injuries.

Unlike other social insurance programs of the government, employees’ contribution to the EC program is not deducted from their salaries. Instead, their employers, or the companies they work for, pay for their EC contributions.

In the case of work-contingencies, an employee who works for the private sector may, initially, file an EC benefits’ claim at their Social Security System (SSS) servicing branch. On the other hand, a public sector employee, or a government employee may file an EC benefits’ claim at the Government Service Insurance System (GSIS) branch serving his or her agency.

Covered employees under the EC Program are the compulsory members of the SSS, government workers, uniformed personnel from the Armed Forces of the Philippines (AFP), Philippine National Police (PNP), Bureau of Jail Management and Penology (BJMP), and Bureau of Fire Protection (BFP), and sea-based OFWs.

Employees' Compensation Program

Employees who got sick or injured because of their jobs are entitled to receive the following benefits under the EC Program—loss of income benefits, medical reimbursements, Carer’s allowance, and others.

What you need to prepare

Before proceeding to the SSS or GSIS, an employee who is filing an EC benefits’ claim must have with him or her a Certificate of Employment with the job description and medical records.

In the case of a work-related accident which took place outside the company premises or the employee’s designated workplace or area, he or she needs to secure a Police Report.

The employee should also ask from the company a copy of the page from EC Logbook where his or her sickness or accident has been recorded.

Upon arrival at the SSS or GSIS branch, the employee will have to secure the necessary forms applicable to his or her contingency.

Filing of EC benefits’ claim at the SSS

Social Security System

Photo Credits: SSS

For sickness notification

Fill up the Sickness Notification (SN) and Accident/Sickness Report and submit the required documents at the Member Evaluation Section (MES) or the Member Services Section (MSS).

For sickness/medical reimbursement

Fill up the Sickness Benefit Reimbursement Application (SBRA) and submit it to the MSS, together with the following set of documentary requirements;

  1. Approved SN or Certificate of Medical Approval signed by the Medical Specialist of the MES;
  2. Copy of the EC Logbook page;
  3. Filer’s SS card or other valid identification card or documents

Employees' Compensation Program

For disability claims

Fill up the Disability Claim Application form and the Photo and Signature card and submit it to the MES-Physical Examination Center, together with the following requirements;

  1. A medical certificate signed by the attending physician;
  2. Employment data;
  3. Single Savings Account Passbook;
  4. ATM Card with the account number

Filing of EC benefits’ claims at the GSIS

slogan and logo of GSIS

Photo Credits: GSIS

An employee filing for an EC benefit claim at the GSIS must proceed to the Information Center or the Public Assistance and Complaints Desk to secure a queue number and the prescribed form for EC claims. After filling up the form, it must be submitted to a Frontline Officer together with the complete set of documentary requirements. The Frontline Officer will then validate and ensure the completeness of the presented documents.

For sickness claims

Fill up Income Benefit Claim for Payment and Hospitalization Claim for Payment, Parts I and II, as well as Hospitalization/Clinical Records of Confinement/Consultation Due to Claimed Ailment and submit it to the Frontline Officer together with service record, if the claimant is a uniformed personnel of the AFP, PNP, BJMP, and BFP.

Employees' Compensation Program

For injury claims

Fill up the same set of prescribed forms for sickness claims and submit it to the Frontline Officer together with the following documents;

  1. Certification under oath by the head of the office narrating in detail the circumstances surrounding the accident;
  2. Affidavit of witness to the accident/incident;
  3. Time card/record of attendance;
  4. Police accident/investigation report;
  5. Travel/mission order/personnel pass;
  6. Casualty report/after battle report/line of duty board proceedings for AFP members; and
  7. NAPOLCOM Adjudication Award for PNP employees.

For more information about the EC Program, you may visit the website of the Employees’ Compensation Commission at www.ecc.gov.ph or their official Facebook page, @ecc.offiicial.