SSS SICKNESS BENEFIT (per day)

Self-employed and voluntary paying members should notify the SSS directly within five (5) calendar
days after the start of confinement, unless such confinement is in a hospital, in which case,
notification should be made within one (1) year from start of confinement.

If a self-employed or voluntarily paying member notifies SSS beyond the prescribed five-day period,
the confinement shall be deemed to have started not earlier than the fifth day immediately preceding
the date of notification.

Procedure and Documentary Requirements

The member should submit the following to the SSS:

1. Duly accomplished Sickness Benefit Application (SBA)
2. If filed by Member, present original of any one (1) of the primary ID cards/documents or two (2)
secondary ID cards/documents, both with signature and at least one (1) with photo. See list
3. If filed by Member’s Representative, present the following:
o Original of any one (1) of the Authorized Representative’s primary ID cards/documents
or two (2) secondary ID cards/documents, both with signature and at least one with
photo. See list; and
o Original of any one (1) of the Member’s primary ID cards/documents or two (2)
secondary ID cards/documents, both with signature and at least one (1) with photo. See
list
4. In case of prolonged confinements or sickness, original/certified true copy of the following:
o Laboratory, X-ray, ECG and other diagnostic results
o Operating room/clinical records that will support diagnosis

 Applications may be filed in any SSS branch that is most convenient to the member.
 For hospital confinement, the claim for benefit must be filed within one (1) year from the date of discharge.
For home confinement, the claim must be filed within one (1) year from the start of illness. Failure to file
the claim within the prescribed period will result to denial of the claim.
 Members are also required to enroll in the Sickness and Maternity Benefit Payment thru the Bank
Program and once approved, the Sickness Benefit Payment will be credited directly to the member’s
single savings/current/cash card/prepaid account in the SSS-accredited banks.
 For hospital confinement, the claim for benefit must be filed within one (1) year from the last day of
confinement from the hospital. For home confinement, the claim for reimbursement by the employer must
be filed within one (1) year from the start of illness. Failure to file the claim within the prescribed period
will result to denial of the claim.
 A member can be granted sickness benefit for a maximum of 120 days in one calendar year. Any unused
portion of the allowable 120 days sickness benefit cannot be carried forward and added to the total
number of allowed compensable days for the following year.
 The sickness benefit shall not be paid for more than 240 days on account of the same illness. If the
sickness or injury still persists after 240 days, his claim will be considered a disability claim.
SSS DISABILITY BENEFITS (MONTHLY PENSION OR LUMPSUM AMOUNT)

Application Requirements
1. Disability Claim Application (SSS Form DDR-1);
2. Medical Certificate (SSS Form MMD-102)
3. Member's photo and signature form (for initial claims only)
4. Other documents that may be required to support the disability claim such as clinical and
laboratory tests results, x-ray; and hospital records, among others.
5. UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one
(1) with photo and date of birth
6. Other supporting documents:
a) If for pension - photocopy of either passbook or ATM card with validated deposit slip or
Cash card Enrollment Form
b) If unable to file Disability claim personally:
i. sketch of member's residence or place of confinement (if local resident)
ii. physical examination report describing disabling manifestation, signed by attending
physician (if residing abroad)
c) 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)

Filing Procedure - Applications for disability benefit are filed at any SSS branch or representative
office.

EMPLOYEES' COMPENSATION (EC) PROGRAM

 The Employees' Compensation (EC) program aims to assist workers who suffer work-connected
sickness or injury resulting in disability or death. The benefits under the EC program may be
enjoyed simultaneously with benefits under the social security program effective June 1984.
 To be filed at SSS

What forms are needed to file for EC claims?

For medical expenses:
1. SSS Form B-301 (EC Medical Reimbursement Benefit Application)
For temporary total disability or sickness:
1. EC Form B-309 (Accident/Sickness Report)
2. EC Form B-300 (Employee’s Notification); and
3. SSS Form B-304 (Sickness Benefit Reimbursement Application)
For disability:
1. Claim for Disability Benefit; and
2. SSS Form MMD-102 (Medical Certificate)
OWWA MEDICAL REHABILITATION PROGRAM

The OWWA Medical Rehabilitation Program Per Memorandum Of Instructions NO. 006, Series of 2009,
the Overseas Workers Welfare Administration has established an OFWs Medical Rehabilitation
Program for eligible mentally ill and physically disabled OFW members.

The Medical Rehabilitation Program is in line with the OWWA Board of Trustee’s directive to come-up
with a responsive health program for medically challenged OWWA members, particularly those afflicted
with mental illness and/or suffering from physical impairment that require appropriate medical
intervention.

1. Nature of the Program The OFWs Medical Rehabilitation Program is designed to extend limited but
sustainable medical rehabilitation assistance for returning or repatriated OFWs who manifested either
symptom(s) of mental illness or are suffering from any form of physical disability resulting from injury or
illness contracted at job sites, to facilitate gradual but resolute medical progress to regain functional
capacity.

2. General Objective
The program aims to provide medically challenged OFWs with a support system of clinical programs
to enable them to regain at the very least minimal functional capacity if not maximum level of functional
independence.
2.1Other Objectives
2.1.1 To provide free access to rehabilitation services and benefit after the Philhealth benefits have
been exhausted;
1.1.2 To enable families of concerned OFWs cope with costly rehabilitation expenses;

3. Program Components – the Program has four distinct components.

3.1 Pre-Evaluation Examination – to be undertaken by a competent medical practitioner specialized in

his field of discipline to determine client’s eligibility for rehabilitation and similar services. The OFW has
either to proceed to the next stages of the program or be declared ineligible to the program because
he can not be rehabilitated anymore.

3.2 Rehabilitation Services – this includes necessary confinement (for cases of mental illness) in
identified Philhealth-accredited medical center/hospital/clinic with the end purpose of undergoing
physical and/or mental therapy as required. It shall also cover corrective surgery and giving away
appropriate medical appliances or braces, splints/orthopedic shoes or supplies, and counseling
services as a follow through therapy of his/her rehabilitation.

3.3 OFW Family Value Reorientation – the focus of intervention shall be on enhancing the OFW family
acceptance and coping to sustain the gains of the rehabilitation component. The earning potential of
the family shall also be harnessed to replace the income loss of the OFW.

3.4 Referral Services – this shall be utilized in case the client manifested intention to be referred to
other institutions for further assistance or is seeking local or overseas employment.

4. Medical Coverage The following mental disorder/illness, disabilities, paralysis, etc. are covered under
the program:
4.1 All forms of mental disorder/illness (e.g. acute reactive psychosis and others), regardless of degree
of severity requiring medical attention and/or rehabilitation;
4.2 Physical disability – temporary or permanent – requiring therapy/braces, under the following
categories:
4.2.1 Back pain, all forms of fractures
4.2.2 Slip disc and other spinal disorder
4.2.3 Other forms of dislocation of the bones
4.3 All cases of paralysis, numbness, speech disorder and the like, whether as a result of heart attack
or stroke, accidents, and other illnesses and injuries causing temporary physical incapacity.

Eligibility and Requirements

To be qualified under the program, the OFW applicant:

1. Must be an active OWWA member at the time of application to the program;
2. Must be medically repatriated OFW whose mental illness or physical disability was sustained at
the post;
3. For those already in the country, OFW must have sustained his/her illness/disability within six
(6) months upon arrival from overseas employment;
 4. Must be medically diagnosed to be needing rehabilitation services and/or has clear prospect of
regaining, at the very least, minimum functional capacity, if not entire recovery, through regular
therapy and rehabilitation as may be determined by competent medical practitioners (program
component 3.1); and
5. If currently undergoing therapy, must be personally defraying all attendant rehabilitation
expenses, and is not a recipient of free medical/financial assistance benefit from his company,
Philippine Health Insurance Corporation (PHIC), any medical insurance or from other sources.

2. Documentary Requirements

1. Proof of at least one OWWA contribution;

2. Proof that the OFW applicant was medically repatriated;
3. Copy of Doctor’s medical conclusion/findings with recommendation that OFW need to undergo
rehabilitation and/or therapy program;
4. Copy of passport with stamped arrival date in the country;
5. Notarized Affidavit certifying that the OFW has been defraying personal rehab/therapy expenses
(for those currently undergoing medications at own expenses) and not a recipient of free medical
insurance from any sources; and
6. Copy of medical/police report from the post (with English translation, in case report is written in
local language).
PCSO - INDIVIDUAL MEDICAL ASSISTANCE PROGRAM (IMAP)

DOCUMENTARY REQUIREMENTS
General Requirements:
 Duly accomplished PCSO IMAP Application Form (available for download at www.pcso.gov.ph, or at the
PCSO Lung Center of the Philippines Satellite Office, PCSO Branch Offices and ASAP Partner Hospitals)
 Valid IDs (Patient and Representative), which are any Government Issued Identification cards such as
Passport, Driver’s License, GSIS UMID, SSS ID, PRC ID, NSO Authenticated Birth Certificate, NSO
Authenticated Marriage Certificate, Digitized Voter’s ID, Philippine Health Insurance (PHIC) ID, Senior
Citizen’s ID, Government Issued Office ID, DSWD – 4P’s ID, and Student ID
Specific Requirements:
1. Confinement
o Original Certified True Xerox copy of Medical Abstract with printed name, signature & license
number of the attending physician/ doctor
o Original copy of Statement of Account/Hospital Bill with printed name and signature of the Billing
Officer/Credit Supervisor
 Should reflect PhilHealth deductions, discounts such as Senior Citizen, PWD, etc., private
insurance, deposits and payments
o Endorsement from the Medical Social Services of the hospital for those admitted in the
Charity/Service wards (NOT APPLICABLE FOR ASAP PARTNER HOSPITALS)
o If Discharged: Validly executed Promissory Note (NOT APPLICABLE FOR ASAP PARTNER
HOSPITALS)
o For Medico-Legal Cases: Photocopy of Police Report
2. Medicines
1. Enrolment System for Dialysis (HD/PD) (Epoietin/PD Solution)
Initial Application:
 Original Medical Abstract with printed name, signature & license number of the
nephrologist/attending physician
 Original Prescription with signature, name and license number of nephrologist/attending
physician
 Official quotation from hospital/dialysis center accepting PCSO GL
 Photocopy of relevant Laboratory Results (taken within the last three (3) months)
 Certification of PhilHealth membership and availment status from dialysis center
 PCSO Index Card (if with previous assistance)
Succeeding Applications (For 2nd to 6th tranches):
 Photocopy of the first set of documents (Initial Application)
 Original Prescription with signature, name and license number of nephrologist/attending
physician
 Original Certification of ongoing treatment including date of last treatment from the dialysis
center
 PCSO Index Card
2. Enrolment System for Cancer Drugs (IV or Oral)
Initial Application:
 Original Medical Certificate with printed name, signature & license number of the
oncologist/attending physician
 Original Prescription with signature, name and license number of the oncologist/attending
physician
 Original Treatment Protocol with printed name, signature and license number of the
oncologist/attending physician
 Photocopy of histopathology report/biopsy report)
 If under the Roche, Novartis or other Pharmaceutical Company Access Program: Photocopy
of Tracker
 PCSO Index Card (if with previous assistance)
Succeeding Applications:
 Photocopy of the first set of documents (Initial Application)
 Original Prescription with signature, name and license number of oncologist/attending
physician
 Progress Notes indicating date of last treatment with name, signature and license number of
oncologist/attending physician
 PCSO Index Card
3. Specialty Medicines
 Original Medical Abstract/Medical Certificate with printed name, signature and license
number of the attending physician
  Original Prescription with printed name, signature and license number of the attending
physician
 Photocopy of relevant Laboratory Results (taken within the last three (3) months)
 If under the Roche, Novartis or other Pharmaceutical Company Access Program: Photocopy
of Tracker
 PCSO Index Card (if with previous assistance)
3. Dialysis Procedure – Under Enrolment System for Dialysis
0. For Members of PhilHealth
 Original Medical Abstract with printed name, signature and license number of the attending
physician
 Official quotation from Dialysis Center/ Hospital accepting PCSO GL
 Certification of Exhaustion of PhilHealth benefit for Dialysis Center/ Hospital
 PCSO Index Card (if with previous assistance)
1. For Non-Members of PhilHealth
 Original Medical Abstract with name, signature and license number of the attending
physician/nephrologist
 Official quotation from Dialysis Center/ Hospital accepting PCSO GL
 Certification of Non-Philhealth Member from the Dialysis Center/ Hospital
 PCSO Index Card (if with previous assistance)
4. Implant
0. Orthopedic Implant
 Original Medical Abstract with printed name, signature and license number of the attending
physician with schedule of operation/surgery
 Request from the attending physician with specifications of implant
 Official sealed quotation from three (3) Suppliers accepting PCSO GL
 For implants with only one existing supplier, a certification of sole distributorship is
required
 For Medico-Legal cases: Photocopy of Police Report
1. Cochlear Implant
 Original Medical Certificate with printed name, signature and license number of the attending
physician with schedule of operation/surgery
 Audiological Evaluation (Hearing Test) with name, signature and license number of
audiologist
 Official sealed quotation from a Supplier accepting PCSO GL
5. Laboratory/Diagnostic Procedures
o Original Medical Abstract with name, signature and license number of the attending physician
o Laboratory/Diagnostic Request with name, signature and license number of physician
o Official quotation from the service provider/ hospital indicating PhilHealth deductions and discounts,
if applicable
6. Cobalt/Radiotherapy/Brachytherapy/RAI/Gamma Knife Radiosurgery
o Original Medical Abstract/Certificate with name, signature and license number of the attending
physician
o Official quotation with breakdown of expenses from service provider/hospital accepting PCSO GL,
indicating PhilHealth deduction and discounts, if applicable
o Photocopy of Histopathology/Biopsy report with name, signature and license number of pathologist
7. Assistive Devices
0. Hearing Aid
Original Medical Abstract/Certificate with name, signature and license number of the
attending physician
 Should state the need for and the specifications of the hearing aid
 Audiological Evaluation (Hearing Test) with name, signature and license number of
audiologist from the hearing aid center
 Official sealed quotation from three (3) Suppliers accepting PCSO GL
 For hearing aid with only one existing supplier, a certification of sole distributorship is
required
1. Wheelchair
 Original Medical Abstract/Certificate with name, signature and license number of the
attending physician
 Should state the need for and the specifications of the wheelchair
 Official sealed quotation from three (3) Suppliers accepting PCSO GL (IF SUPPLIER IS NOT
TAHANANG WALANG HAGDAN)
 Whole-body picture of patient
2. Prosthesis
  Original Medical Abstract/Certificate with name, signature and license number of the
attending physician
 Official sealed quotation from three (3) Suppliers accepting PCSO GL
 For prosthesis with only one existing supplier, a certification of sole distributorship is
required
 Request or Prescription from the doctor stating specifications of the needed prosthesis
3. Mechanical Ventilator Rental
 Original Medical Certificate with printed name, signature and license number of the attending
physician with schedule of operation/surgery
 Official sealed quotation from three (3) Suppliers accepting PCSO GL
 Photocopy of Arterial Blood Gas (ABG) result (within the last three (3) months)
8. Medical Devices
o Original Medical Abstract/Certificate with name, signature and license number of the attending
physician
o Request from the attending physician with specifications of medical device
o Official sealed quotation from two (2) Suppliers accepting PCSO GL
 For devices with only one existing supplier, a certification of sole distributorship is required
o Photocopy of relevant Laboratory/Diagnostic Result
9. Non- and Minimally-Invasive Procedures (ESWL, Laparascopic Surgery, Endoscopic Procedures, Cataract
and Eye Surgery)
o Original Medical Abstract with name, signature and license number of the attending physician
o Official quotation with breakdown of expenses and PhilHealth deduction
o Photocopy of relevant laboratory/diagnostic result (taken within the last three (3) months)
10. Transplant
o Original Medical Abstract with name, signature and license number of the attending physician
o Official quotation from the hospital with breakdown of expenses
o Certification from transplant unit of the hospital that the patient is eligible for transplant
o Proof of counterpart from the patient/patient’s family
11. Rehabilitative Therapy (PT/OT/Speech)
o Original Medical Abstract with name, signature and license number of the attending physician
o Official quotation with breakdown of expenses from service provider accepting PCSO GL
12. Surgical Supplies
o Original Medical Abstract with name, signature and license number of the attending physician
o Official quotation with breakdown of expenses from service provider accepting PCSO GL