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Labor Law and Social Legislation

SOCIAL AND WELFARE LEGISLATION (P.D. 629) his orders as regards the employment, except the
Government and any of its political subdivisions,
Q: What is Social Legislation? branches or instrumentalities, including corporations
owned or controlled by the Government: Provided,
A: It consists of statutes, regulations and That a self-employed person shall be both Ee and Er
jurisprudence that afford protection to labor, at the same time. (Sec 8[c], R.A. 8282)
especially to working women and minors, and is in
full accord with the constitutional provisions on the Q: Who is an employee?
promotion of social justice to insure the well-being
and economic security of all the people. A: Any person who performs services for an Er in
which either or both mental and physical efforts are
SOCIAL SECURITY SYSTEM LAW (R.A. 8282) used and who receives compensation for such
services, where there is an Er-Ee relationship:
Q: What is the policy objective in the enactment of Provided, That a self-employed person shall be both
the Social Security System Law? Ee and Er at the same time. (Sec. 8[d], R.A. 8282)

A: To establish, develop, promote and perfect a Q: What is employment?


sound and viable tax-exempt social security service
suitable to the needs of the people throughout the A: GR: Any service performed by an Ee for his Er.
Philippines, which shall promote social justice and
provide meaningful protection to members and their XPNs:
beneficiaries against the hazards of disability, 1. Employment purely casual and not for the
sickness, maternity, old age, death, and other purpose of occupation or business of the Er;
contingencies resulting in loss of income or financial 2. Service performed on or in connection with
burden. (Sec. 2, R.A. 8282) an alien vessel by an Ee if he is employed
when such vessel is outside the Phils;
Note: The enactment of SSS law is a legitimate exercise of 3. Service performed in the employ of the Phil.
the police power. It affords protection to labor and is in full Government or instrumentality or agency
accord with the constitutional mandate on the promotion thereof;
of social justice [Roman Catholic Archbishop of Manila vs.
4. Service performed in the employ of a foreign
SSS, G.R. No. 15045, (1961)].
government or international organization, or
their wholly-owned instrumentality:
Q: Are the SSS premiums considered as taxes?
5. Such other services performed by temporary
and other Ees which may be excluded by
A: No. The funds contributed to the System belong to
regulation of the SSC. Ees of bona fide
the members who will receive benefits, as a matter of
independent contractors shall not be deemed
right, whenever the hazards provided by the law
Ees of the Er engaging the services of said
occur [CMS Estate, Inc., vs. SSS, G.R. No. 26298,
contractors. (Sec. 8[j], R.A. 8282)
(1984)].
Q: What is a contingency?
Q: Are benefits received under SSS Law part of the
estate of a member?
A: The retirement, death, disability, injury or sickness
and maternity of the member.
A: No. Benefits receivable under the SSS Law are in
the nature of a special privilege or an arrangement
COVERAGE
secured by the law pursuant to the policy of the State
to provide social security to the workingman. The
Q: Who are covered by SSS?
benefits are specifically declared not transferable and
exempt from tax, legal processes and liens [SSS vs.
A:
Davac, et. al., G.R. No.21642, (1966)].
1. Compulsory Coverage
a. All Ees not over 60 years of age and their Ers;
Q: Who is an employer?
b. Domestic helpers whose income is not less
than P 1000/month and not over 60 years of
A: Any person, natural or juridical, domestic or
age and their Ers;
foreign, who carries into the Phils. any trade,
business, industry, undertaking or activity of any kind
Limitations:
and uses the services of another person who is under

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i. Any benefit earned by the Ees Any foreign government, international


under private benefit plans organization, or their wholly-owned
existing at the time of the approval instrumentality employing workers in the
of the Act shall not be Philippines, may enter into an agreement with
discontinued, reduced or the Philippine government for the inclusion of
otherwise impaired; such Ees in the SSS except those already covered
ii. Existing private plans shall be by their respective civil service retirement
integrated with the SSS but if the systems.
Er under such plan is contributing
more than what is required by this Q: Are seafarers covered by the SSS Law?
Act, he shall pay to the SSS the
amount required to him, and he A: Yes. The result of the Memorandum of Agreement
shall continue with his entered by SSS and DOLE approved by the Social
contributions less the amount paid Security Commission per the Commission's
to SSS; Resolution No. 437, dated July 14, 1988 was that the
iii. Any changes, adjustments, Standard Contract of Employment to be entered into
modifications, eliminations or between foreign shipowners and Filipino seafarers is
improvements in the benefits of the instrument by which the former express their
the remaining private plan after assent to the inclusion of the latter in the coverage of
the integration shall be subject to the Social Security Act. In other words, the extension
agreements between the Ers and of the coverage of the SSS to Filipino seafarers arises
the Ees concerned; and by virtue of the assent given in the contract of
iv. The private benefit plan which the employment signed by Er and seafarer [Ben Sta. Rita
Er shall continue for his Ees shall v. Court of Appeals, G.R. No. 119891, (1995)].
remain under the Ers management
and control unless there is an Note: By extending the benefits of the Social Security Act to
existing agreement to the contrary Filipino seafarers on board foreign vessels, the individual
c. All self-employed considered both an Er employment agreements entered into with the stipulation
for such coverage contemplated in the DOLE-SSS
and Ee
Memorandum of Agreement, merely gives effect to the
d. Professionals;
constitutional mandate to the State to afford protection to
e. Partners and single proprietors of business; labor whether "local or overseas." (Ibid.)
f. Actors and actresses, directors, scriptwriters
and news correspondents who do not fall Q: When is the compulsory coverage deemed
within the definition of the term Ee; effective?
g. Professional athletes, coaches, trainers and
jockeys; AND A:
h. Individual farmers and fisherman. (Sec. 9, 1. Employer on the first day of operation
R.A. 8282) 2. Employee on the day of his employment
3. Compulsory coverage of self-employed upon
2. Voluntary his registration with the SSS
a. Spouses who devote full time to managing
the household and family affairs, unless they Q: What is the effect of separation of an employee
are also engaged in other vocation or from his employment under compulsory coverage?
employment which is subject to mandatory
coverage ; (Sec. 9[b], R.A. 8282) A:
b. Filipinos recruited by foreign-based Ers for 1. His Ers obligation to contribute arising from that
employment abroad may be covered by the employment shall cease at the end of the month
SSS on a voluntary basis; (Sec. 9[c], R.A. of separation,
8282) 2. But said Ee shall be credited with all
c. Ee separated from employment to maintain contributions paid on his behalf and entitled to
his right to full benefits benefits according to the provisions of R.A. 9282.
d. Self-employed who realizes no income for a 3. He may, however, continue to pay the total
certain month contributions to maintain his right to full benefit.
(Sec. 11, R.A. 8282)
3. By agreement

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Note: The above provision recognizes the once a member, A: The contribution shall be determined in
always a member rule. accordance with Sec. 18 of the SSS Law, provided
that:
Q: What is the effect of interruption of business or
professional income? 1. The monthly earnings declared as the time of
registration shall be considered as his monthly
A: If the self-employed member realizes no income in compensation and he shall pay for both Er and Ee
any given month: contributions
2. The monthly earnings declared at the time of
1. He shall not be required to pay contributions for registration shall remain the basis of his monthly
that month. salary credit, unless another declaration of his
2. He may, however, be allowed to continue paying monthly earnings was made, the latter becomes
contributions under the same rules and the new basis of his monthly salary credits. [Sec.
regulations applicable to a separated Ee member: 19-A, R.A. No. 8282]
3. Provided, that no retroactive payment of
contributions shall be allowed other than as Q: How much is the monthly pension?
prescribed under Sec.22-A. (Sec. 11-A, R.A. 8282)
A:
Q: What is a self-employed individual? 1. The monthly pension shall be the highest of the
following amounts:
A: A self-employed person is one whose income is not a. The sum of the following:
derived from employment as well as those i. Php 300.00; plus
mentioned in Sec. 9-A of the law, including: ii. 20% of the average monthly salary credit;
1. All self-employed professionals; plus
2. Partners and single proprietors of business; iii. 2% of the average monthly salary credit
3. Actors and actresses, directors, scriptwriters for each credited year of service in excess
and news correspondents who do not fall of 10 years; or
within the definition of the term Ee in Sec. 8 b. 40% of the average monthly salary credit; or
of this Act; c. Php 1,000.00, provided that the Monthly
4. Professional athletes, coaches, trainers and Pension shall in no case be paid for an
jockeys; and aggregate amount of less than sixty (60)
5. Individual farmers and fishermen. [Sec. 8(s), months (Sec. 12 [a], R.A. 8282)
RA 8282] 2. Minimum Pension
a. Php 1,200.00 - members with at least 10
Q: On her way home from work, Mikaela, a machine credited years of service
operator in a sash factory, decided to watch a movie b. Php 2, 400.00 for those with 20 credited
in a movie house. However, she is stabbed by an years of service. (Sec. [b], R.A. 8282)
unknown assailant. When she filed a claim for
benefits under the SSS Law, it was denied on the Q: What is an average monthly credit?
ground that her injury is not work-connected. Is the
denial legal? Why? A: An average monthly credit is the result obtained
by:
A: No. It is not necessary, for the enjoyment of 1. Dividing the sum of the last 60 monthly salary
benefits under the SSS Law that the injury is work- credits immediately preceding the semester of
connected. What is important is membership in the contingency by 60; or
SSS and not the causal connection of the work of the 2. Dividing the sum of all the monthly salary credits
Ee to his injury or sickness. paid prior to the semester of contingency by the
number of monthly contributions paid in the
Note: Claims based on work-connected injuries or same period, whichever is greater.
occupational diseases are covered by the State Insurance
Fund.
Provided, that the injury or sickness which caused the
disability shall be deemed as the permanent disability
Q: How are contributions of the self-employed to
for the purpose of computing the average monthly
the SSS determined?
salary credit.

Q: What is an average daily salary credit?

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A: An average salary credit is the result obtained by 5. Such other services performed by temporary and
dividing the sum of the 6 highest monthly salary other Ees which may be excluded by regulation
credits in the 12-month period immediately of the Commission. Ees of bona fide independent
preceding the semester of contingency by 180. contractors shall not be deemed Ees of the Er
engaging the service of said contractors.
Q: May the monthly pension be suspended?
Q: A textile company hires 10 carpenters to repair
A: Yes. The monthly pension and dependents the roof of its factory which was destroyed by
pension shall be suspended: typhoon Bening. Are the carpenters subject to
compulsory coverage under the SSS Law? Why?
1. Upon the reemployment or resumption of self-
employment; A: No. the employment is purely casual and not for
2. Recovery of the disabled member from his the purpose of the occupation or business of the Er.
permanent total disability Their engagement is occasioned by the passage of the
3. Failure to present himself for examination at typhoon; they are not hired on a regular basis.
least once a year upon notice by the SSS. [Sec.
13-A (b), RA 8282] BENEFITS

EXCLUSIONS FROM COVERAGE Q: What are the Benefits under the SSS Act?

Q: Enumerate the kinds of employment which are A:


excluded from compulsory coverage under the SSS 1. Sickness Benefits
Law. 2. Permanent Disability Benefits
3. Maternity Leave Benefit
A: Under Section 8(j) of R.A. 1161, as amended, the 4. Retirement Benefit
following services or employments are excluded from 5. Death and funeral Benefits
coverage:
Q: Are the Benefits provided for in the SSS Law
1. Employment purely casual and not for the transferable?
purpose of occupation or business of the Er;
2. Service performed on or in connection with an A: Benefits provided for in the SSS Law are not
alien vessel by an employee if he is employed transferable and no power of attorney or other
when such vessel is outside the Philippines; document executed by those entitled thereto in favor
3. Service performed in the employ of the of any agent, attorney or any other person for the
Philippine Government or instrumentality or collection thereof on their behalf shall be recognized,
agency thereof; except when they are physically unable to collect
4. Service performed in the employ of a foreign personally such benefits. (Sec.15, R.A. 1161, as
government or international organization, or amended)
their wholly-owned instrumentality:
Q: What are the reportorial requirements of the
Provided, however, That this exemption employer and self-employed?
notwithstanding, any foreign government,
international organization or their wholly-owned A:
instrumentality employing workers in the 1. Er - Report immediately to SSS the names, ages,
Philippines or employing Filipinos outside of the civil status, occupations, salaries and dependents
Philippines, may enter into an agreement with of all his covered Ees
the Philippine Government for the inclusion of
such Ees in the SSS except those already covered 2. Self-employed - Report to SSS within 30 days from
by their respective civil service retirement the first day of his operation, his name, age, civil
systems: Provided, further, That the terms of status, occupation, average monthly net income
such agreement shall conform with the and his dependents
provisions of this Act on coverage and amount of
payment of contributions and benefits: Provided, SICKNESS BENEFITS
finally, That the provisions of this Act shall be
supplementary to any such agreement; and
Q: What is sickness benefit?

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A: It is a daily allowance paid to a covered Ee who b. Not paid for more than 240 days on account of
becomes sick and is confined in a hospital for more the same confinement; and
than 3 days or elsewhere with the Commissions c. Ee member shall notify his Er of the fact of his
approval. sickness or injury within 5 calendar days after the
start of his confinement unless such
Q: What are the requirements to be entitled for confinement:
sickness benefit? i. is in a hospital
ii. the Ee became sick or was injured while
A: Under Sec. 14 of the Social Security Law, the working or within the premises of the Er
following are the requisites for the enjoyment by a (notification to the Er not necessary);
covered individual of the sickness benefits:
Note: If the member is unemployed or self-employed, he
1. Payment of at least 3 monthly contributions in shall directly notify the SSS of his confinement within 5
the 12-month period immediately preceding the calendar days after the start thereof unless such
confinement is in a hospital in which case notification is
semester of sickness;
also not necessary;
2. Sickness or injury and confinement for more than
3 days in a hospital or elsewhere with the Where notification is necessary, confinement shall be
Commissions approval; deemed to have started not earlier than the 5th day
3. Notice of the fact of sickness by the Ee to the Er immediately preceding the date of notification. (Sec.14
(or to the SSS in case the member is [b], R.A. 8282)
unemployed) within 5 calendar days after the
start of his confinement; and Note: The law does not require that sickness must be
4. Exhaustion of sick leaves of absence with full pay related to the duties of the beneficiaries.
to the credit of the Ee.
Q: When will compensable confinement commence?
Q: May the requirement of notification be dispensed
with? A:
1. Begins on the 1st day of sickness
A: Yes. Notification is not necessary when: 2. Payment of such allowances shall be promptly
1. Confinement is in a hospital; or made by the Er:
th
2. The employee became sick or was injured a. every regular payday or on the 15 and last
while working or within the premises of the day of each month,
employer. b. in case of direct payment by the SSS - as long
as such allowances are due and payable.
Q: Who will pay the sickness benefits and how much (Sec. 14[b], R.A. 8282)
is the benefit?
Q: What are the requirements in order that Er may
A: claim reimbursement of the sickness benefit?
1. The Er shall pay the Ee for each compensable
confinement or fraction thereof A:
1. 100% of daily benefits shall be reimbursed by SSS
2. The SSS shall pay the member who is unemployed, if the following requirements are satisfied:
self-employed or voluntary members with a daily a. Receipt of SSS of satisfactory proof of such
sickness benefit equivalent to 90% of his average payment and legality thereof;
daily salary credit. b. The Er has notified the SSS of the
confinement within 5 calendar days after
The following requisites must be complied with in receipt of the notification from the Ee
order to avail of sickness benefits: member.

a. In no case shall the daily sickness benefit be paid 2. Er shall be reimbursed only for each day of
th
longer than 120 days in 1 calendar year, nor shall confinement starting from the 10 calendar day
any unused portion of the 120 days of sickness immediately preceding the date of notification to
benefit granted be carried forward and added to the SSS if the notification to the SSS is made
the total number of compensable days allowable beyond 5 calendar days after receipt of the
in the subsequent year; notification from the Ee member. (Sec. 14 [c],
R.A. 8282)

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Q: When will reimbursement be made by SSS? b. Not gainfully employed and has not
reached the age of 21 years of age;
A: GR: SSS shall reimburse the Er or pay the or
unemployed member only for confinement within 1 c. If over 21 years of age, he is
year immediately preceding the date the claim for congenitally or while still a minor
benefit or reimbursement is received by the SSS. has been permanently
incapacitated and incapable of self-
XPN: Confinement in a hospital in which case the support, physically or mentally; and
claim for benefit or reimbursement must be filed 3. The parent who is receiving regular support
within 1 year from the last day of confinement. from the member. [Sec. 8 (e), RA 8282]
(Sec. 14[c], R.A. 8282)
Q: Compare death benefits with permanent total
Q: When is the employer or the unemployed disability benefits
member not entitled to reimbursement?
A:
A: Death Benefits PTD Benefits
1. Where the Er failed to notify the SSS of the Requisite
confinement; at least 36 monthly contributions
2. In the case of the unemployed; where he failed
Benefits payable to whom
to send the notice directly to the SSS except
when the confinement is in a hospital; and Primary Beneficiaries Member
3. Where the claim for reimbursement is made Failure to make 36 monthly payments
after 1 year from the date of confinement. Benefits shall be in lump sum equivalent to the
monthly pension times the number of monthly
PERMANENT DISABILITY BENEFITS contributions paid to SSS or 12 times the monthly
pension, whichever is higher.
Q: What is a permanent disability benefit?
Q: What is the effect of the death of the PTD
A: It is a cash benefit paid to a member who pensioner?
becomes permanently disabled, either partially or
totally. A:
1. Primary beneficiaries are entitled to receive
Q: What disabilities are deemed permanent total monthly pension as of the date of disability.
disability? 2. No primary beneficiaries and he dies within 60
months from the start of his monthly pension -
A: Under Sec. 13-A (d) of the SSS Law, the following secondary beneficiaries shall be entitled to a lump
disabilities are deemed permanent total: sum benefit equivalent to the total monthly
1. Complete loss of sight of both eyes; pensions corresponding to the balance of the 5-
2. Loss of two limbs at or above the ankle or year guaranteed period excluding the dependents
wrists; pension. (Sec. 13-A [c], R.A. 8282)
3. Permanent complete paralysis of two limbs;
4. Brain injury resulting to incurable imbecility or Q: What is the effect of retirement or death to
insanity; and partial disability pension?
5. Such cases as determined and approved by the
SSS. A: Disability pension shall cease upon his retirement
or death. (Sec 13-A [j], R.A. 8282)
Q: Among the persons entitled to permanent
disability benefits are the dependents of the Q: What is the difference of compensability under
covered employee. Who are these dependent? the Labor Law and the Social Security Law?

A: The dependents shall be the following: A: The claims are different as to their nature and
1. The legal spouse entitled by law to receive purpose [Ortega vs. Social Security Commission, G.R.
support from the member; No. 176150, (2008)].
2. The legitimate, legitimated or legally
adopted and illegitimate child who is:
a. Unmarried

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LABOR LAW SOCIAL SECURITY LAW RETIREMENT BENEFIT


Purpose
Governs compensability Benefits are intended to Q: What is a retirement benefit?
of : provide insurance or
1. work-related protection against the A: It is a cash benefit paid to a member who can no
disabilities hazards or risks of longer work due to old age.
2. when there is loss disability, sickness, old
of income due to age or death, inter alia, Q: What are the types of retirement benefits?
work-connected irrespective of whether
or work- they arose from or in the A:
aggravated injury course of the 1. Monthly Pension - Lifetime cash benefit paid to a
or illness. employment. retiree who has paid at least 120 monthly
Nature contributions to the SSS prior to the semester of
A disability is total and Disability may be retirement.
permanent if as a result permanent total or 2. Lump Sum Amount - Granted to a retiree who
of the injury or sickness permanent partial. has not paid the required 120 monthly
the Ee is unable to contributions.
perform any gainful
occupation for a Q: Who are entitled to retirement benefits?
continuous period
exceeding 120 days A:
regardless of whether he 1. A member who
loses the use of any of a. is at least 60 years old
his body parts. b. has paid at least 120 monthly contributions
prior to the semester of retirement; and
MATERNITY LEAVE BENEFIT c. already separated from employment or has
ceased to be self-employed,
Q: What is the maternity benefit?
2. A member who is at least 65 years old, shall be
A: The maternity benefit is a daily cash allowance entitled for as long as he lives to the monthly
granted to a female member who was unable to work pension; (Sec 12-B [a], R.A. 8282)
due to childbirth or miscarriage.
3. A member
Q: What are the qualifications for entitlement to the a. At least 60 years old at retirement; and
maternity benefit? b. Does not qualify for pension benefits under
paragraph (a) above - entitled to a lump
A: sum benefit equal to the total contributions
1. She has paid at least three monthly contributions paid by him and on his behalf;
within the 12-month period immediately c. Must be separated from employment and is
preceding the semester of her childbirth or not continuing payment of contributions to
miscarriage. the SSS on his own. (Sec. 12-B [b], R.A. 8282)
2. She has given the required notification of her
pregnancy through her Er if employed, or to the Q: What happens when the retirement pensioner is
SSS if separated, voluntary or self-employed re-employed or resumes self-employment?
member.
A: The monthly pension of a retirement pensioner
Q: Is the voluntary or self-employed member also who resumes employment and is less than 65 years
entitled to the maternity benefit? old will be suspended. He and his Er will again be
subject to compulsory coverage. (Sec. 12-B [c], R.A.
A: Yes, A voluntary or a self-employed member is 8282)
entitled to the maternity benefit provided that she
meets the qualifying conditions as mentioned in the Q: Are the children of a retiree member entitled to
preceding question. the dependent's pension?

A: Yes (Sec. 12[A], R.A. 8282). However, only 5 minor


children, beginning from the youngest, are entitled to

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the dependents pension. No substitution is allowed. A:


Where there are more than 5 legitimate and 1. Dependent parents
illegitimate children, the legitimate ones will be 2. In the absence of the foregoing, any other person
preferred. designated by the covered employee as
secondary beneficiary. [Sec. 8(k), R.A. 8282]
Q: For how long will the dependent child receive
the pension? Q: Who are considered dependents?

A: Until the child reaches 21 years of age, gets A:


married, gets employed and earns Php 300 a month 1. The legal spouse entitled by law to receive
or more, or dies. support from the member;
2. The legitimate, legitimated, or legally adopted,
However, the dependent's pension is granted for life and illegitimate child who:
to children who are over 21 years old, provided they a. Is unmarried,
are incapacitated and incapable of self-support due b. Not gainfully employed, and
to physical or mental defect which is congenital or c. Has not reached 21 years of age, or if over 21
acquired during minority. years of age, he is congenitally or while still a
minor has been permanently incapacitated
DEATH AND FUNERAL BENEFITS and incapable of self-support, physically or
mentally.
Q: When is a beneficiary entitled to death benefits? 3. The parent who is receiving regular support from
the member.
A:
1. Upon death of a member, if he has paid at least Q: How long shall the primary beneficiaries be
36 monthly contributions prior to the semester entitled to the death benefits consisting of monthly
of death: pension and dependents pension?
a. primary beneficiaries shall be entitled to the
monthly pension; or A:
b. If there are no primary beneficiaries, 1. Dependent spouse entitled until he/she
secondary beneficiaries shall be entitled to a remarries
lump sum benefit equivalent to 36 times the 2. Dependent children entitled until:
monthly pension. a) They get married;
2. Upon death of a member If he has not paid the b) Find gainful employment;
required 36 monthly contributions prior to the c) Reach the age of 21 years; or
semester of death: d) Recover from mental or physical incapacity
a. Primary or secondary beneficiaries shall be and can now support themselves.
entitled to a lump sum benefit equivalent to
the monthly pension multiplied by the Q: What is the funeral benefit?
number of monthly contributions paid to the
SSS: or A: A funeral grant equivalent to Php 12, 000.00 shall
b. 12 times the monthly pension, whichever is be paid, in cash or in kind, to help defray the cost of
higher. (Sec. 13, R.A. 8282) expenses upon the death of a member or retiree.
(Sec. 13-B, R.A. 8282)
Q: Who are primary beneficiaries?
BENEFICIARIES
A:
1. The dependent spouse until he or she remarries Q: What is meant by dependent for support?
2. The dependent legitimate, legitimated or legally
adopted, and illegitimate children: Provided, that A: The entitlement to benefits as a primary
the dependent illegitimate children shall be beneficiary requires not only legitimacy but also
entitled to 50% of the share of the legitimate, dependence upon the member Ee [Gil v. SSC CA- GR
legitimated or legally adopted children. SP. 37150, (1996)].

Q: Who are secondary beneficiaries? If a wife who is already separated de facto from her
husband cannot be said to be "dependent for
support" upon the husband, absent any showing to

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the contrary. Conversely, if it is proved that the renovate its building. The work to be performed by
husband and wife were still living together at the these 50 people is not in connection with the purpose
time of his death, it would be safe to presume that of the business of the factory. Hence, the employment
she was dependent on the husband for support, of these 50 persons is purely casual. They are,
unless it is shown that she is capable of providing for therefore, excepted from the compulsory coverage of
herself [SSS vs. Aguas, G.R. No. 165546, (2006)]. the SSS law.

Q: A, an SSS member was survived by his legal wife, Q: How are disputes settled?
who is not dependent upon him. He was also
survived by two common-law wives with whom he A:
had illegitimate minor children. Who among them is DISPUTE SETTLEMENT
entitled to the benefits? Disputes involving:
1. Coverage
A: The illegitimate minor children shall be entitled to 2. Benefits
the death benefits as primary beneficiaries because 3. Contributions
the legal wife is not dependent upon the member. 4. Penalties
The SSS Law is clear that for a minor child to qualify Social 5. Any other matter related
as a dependent the only requirements are that Security thereto.
he/she must be below 21 yrs. of age, not married nor Commission
gainfully employed [Signey vs. SSS, G.R. No. 173582, (SSC) Note: Disputes within the mandatory
(2008)]. period of 20 days after the submission of
evidence. (Sec. 5a, R.A. 8282)
Q: What is compensation?
Decision, in the absence of appeal, shall be
final and executory 15 days after date of
A: All actual remuneration for employment, including notification. (Sec. 5b, R.A. 8282)
the mandated cost of living allowance, as well as the
Decisions of SSC shall be appealable
cash value of any remuneration paid in any medium
to:
other than cash except that part of the remuneration
1. CA questions of law and fact (Sec.
received during the month in excess of the maximum CA / SC
5c, R.A. 8282)
salary.
2. SC questions of law. (Sec. 5c,
R.A. 8282)
Q: The owners of FALCON Factory, a company
SSC may, motu proprio or on motion
engaged in the assembling of automotive
of any interested party, issue a writ of
components, decided to have their building
Execution execution to enforce any of its
renovated. (50) persons, composed of
of decision decisions or awards, after it has
engineers, architects and other construction
become final and executory. (Sec. 5d
workers, were hired by the company for this
R.A. 8282)
purpose. The work was estimated to be completed
in 3 years. The workers contended that since the
Q: Can the SSC validly re-evaluate the findings of the
work would be completed after more than 1 year,
RTC, and on its own, declare the latters decision to
they should be subject to compulsory coverage
be bereft of any basis?
under the Social Security Law. Do you agree with
their contention? Explain your answer fully. (2000
A: No. It cannot review, much less reverse, decisions
Bar Question)
rendered by courts of law as it did in the case at bar
when it declared that the CFI Order was obtained
A: No. Under Sec. 8 (j) of R.A. 1161, as amended,
through fraud and subsequently disregarded the
employment of purely casual and not for the purpose
same, making its own findings with respect to the
of the occupation or business of the Er is excepted
validity of Bailon and Alices marriage on the one
from compulsory coverage. An employment is purely
hand and the invalidity of Bailon and Teresitas
casual if it is not for the purpose of occupation or
marriage on the other. In interfering with and passing
business of the Er.
upon the CFI Order, the SSC virtually acted as an
appellate court. The law does not give the SSC
In the problem given, Falcon Factory is a company
unfettered discretion to trifle with orders of regular
engaged in the assembly of automotive components.
courts in the exercise of its authority to determine
The 50 persons (engineers, architects and
the beneficiaries of the SSS [SSS vs. Teresita Jarque
construction workers) were hired by Falcon Factory to
Vda. De Bailon, G.R. No. 165545, (2006)].

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Q: Due to the delinquency incurred by ABC Co. 2. Its political subdivisions, branches, agencies,
incurred on its premium and loan amortizations, SSS instrumentalities
suggested settling its obligation either through 3. GOCCs, and financial institutions with original
instalment or through dacion en pago. ABC chose charters
dacion en pago and offered its property situated in 4. Constitutional Commissions and the Judiciary
Baguio City. It was approved by the SSS. However, (Sec. 2[c], R.A. 8291)
SSS refused to accept the payment unless the
interest and charges will be paid. ABC then filed suit Q: Who is an employee or member?
in court. SSS moved for dismissal contending that
the SSC, and not regular courts, has the jurisdiction A: Any person, receiving compensation while in the
to entertain a controversy arising from the non- service of an Er, whether by election or appointment,
implementation of a dacion en pago agreed upon by irrespective of status of appointment, including
the parties as a means of settlement of ABCs barangay and sanggunian officials. (Sec. 2[d], R.A.
liabilities. Resolve. 8291)

A: The law clearly vests upon the Commission Q: What is compensation?


jurisdiction over disputes arising under this Act with
respect to coverage, benefits, contributions and A: The basic pay or salary received by an Ee,
penalties thereon or any matter related pursuant to his or her election or appointment,
thereto... Dispute is defined as a conflict or excluding per diems, bonuses, OT pay, honoraria,
controversy.From the allegations of the complaint, it allowances and any other emoluments received in
readily appears that there is no longer any dispute addition to the basic pay which are not integrated
with respect to ABCs accountability to the SSS. It had, into the basic pay under existing laws. (Sec. 2[i], R.A.
in fact, admitted their delinquency and offered to 8291)
settle them by way of dacion en pago subsequently
approved by the SSS in Resolution No. 270-s. 2001. Q: Baradero is a member of the Sangguniang Bayan
The controversy, instead, lies in the non- of the Municipality of La Castellana, Negros Occ. and
implementation of the approved and agreed dacion is paid on a per diem basis. On the other hand, Belo
en pago on the part of the SSS. As such, ABC filed a a Vice-Governor of Capiz is in a hold over capacity
suit to obtain its enforcement which is, doubtless, a and is paid on a per diem basis. Are the services
suit for specific performance and one incapable of rendered by Baradero and Belo on a per diem basis
pecuniary estimation beyond the competence of the creditable in computing the length of service for
Commission [SSS vs. Atlantic Gulf and Pacific retirement purposes?
Company of Manila, Inc. and Semirara Coal Corp.,
G.R. No. 175952, (2008)]. A: Yes. The traditional meaning of per diem is a
reimbursement for extra expenses incurred by the
GSIS LAW (R.A. 8291) public official in the performance of his duties. Under
this definition the per diem is intended to cover the
Q: What are the purposes behind the enactment of cost of lodging and subsistence of officers and
the GSIS Law? employees when the latter are on a duty outside of
their permanent station. On the other hand, a per
A: To provide and administer the following social diem could rightfully be considered a compensation
security benefits for government Ees: or remuneration attached to an office.

1. Compulsory life insurance The per diems paid to Baradero and Belo were in the
2. Optional life insurance nature of compensation or remuneration for their
3. Retirement benefits services as Sangguniang Bayan and Vice-Governor,
4. Disability benefits to work-related contingencies; respectively, rather than a reimbursement for
and incidental expenses incurred while away from their
5. Death benefits home base.

Q: Who are considered employers under the GSIS If the remuneration received by a public official in the
Act? performance of his duties does not constitute a mere
allowance for expenses but appears to be his actual
A: base pay, then no amount of categorizing the salary
1. National Government as a per diem would take the allowances received

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from the term service with compensation for the EXCLUSIONS FROM COVERAGE
purpose of computing the number of years of service
in government [GSIS v. CSC, G. R. Nos. 98395 and Q: Who are excluded from the coverage of the GSIS
102449, (1995)]. Law?

Q: What is the penalty in case of delayed remittance A:


or non-remittance of contributions? 1. Ees who have separate retirement schemes
(members of the Judiciary, Constitutional
A: The unremitted contributions shall be charged Commissions and others similarly situated)
interests as prescribed by the GSIS Board of Trustees 2. Contractual Ees who have no Er-Ee with the
but shall not be less than 2% simple interest per agencies they serve
month from due date to the date of payment by the 3. Uniformed members of the AFP, BJMP, whose
employers concerned (Sec. 7, R.A. 8291). coverage by the GSIS has ceased effective June
24, 1997
COVERAGE 4. Uniformed members of the PNP whose coverage
by the GSIS has ceased effective February 1,
Q: State briefly the compulsory coverage of the 1996. (Sec. 2.4, Rule II, IRR, R.A. 8291)
GSIS. (2009 Bar Question)
Q: For the purpose of benefit entitlement, how are
A: The following are compulsorily covered by the GSIS the members classified?
pursuant to Sec. 3 of RA 8291:
1. All Ees receiving compensation who have not A:
reached the compulsory retirement age, 1. Active members
irrespective of employment status. a. Still in the service and are paying integrated
2. Members of the judiciary and constitutional premiums.
commissions for life insurance policy. b. Covered for the entire package benefits and
privileges being extended by GSIS.
Q: Who are the government Ees subject to coverage
under the GSIS? 2. Policyholders
a. Covered for life insurance only
A: GR: All Ees receiving compensation who have not b. Can avail of policy loan privilege only
reached the compulsory retirement age, irrespective c. May also apply for housing loans
of employment status. d. Judiciary and Constitutional Commissions

XPNs: 3. Retired Members


1. Uniformed members of the: a. Former active members who have retired
a. AFP; and from the service and are already enjoying
b. PNP. the corresponding retirement benefits
2. Contractuals who have no Er and Ee applied for
relationship with the agencies they serve. b. Not entitled to any loan privilege, except
stock purchase loan (Sec. 2.2, Rules II, IRR,
Q: Who are covered by life insurance, retirement R.A. 8291)
and other social security protection?
BENEFITS
A: GR: All members of the GSIS shall have life
insurance, retirement, and all other social security Q: What are the Benefits provided under the GSIS
protections such as disability, survivorship, Act?
separation, and unemployment benefits. (Sec. 3, R.A.
8291) A:
1. Separation
XPNs: Members of: 2. Unemployment or involuntary separation
1. The judiciary; and 3. Retirement
2. Constitutional commissions 4. Permanent disability
5. Temporary disability
Note: They shall have life insurance only. 6. Survivorship
7. Funeral

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8. Life Insurance In the case of forfeiture, the separated employee shall be


9. Such other benefits and protection as may be entitled to receive only of the cash surrender value of his
extended to them by the GSIS such as loans. insurance.

Q: Who shall be compulsorily covered with life UNEMPLOYMENT BENEFITS


insurance?
Q: What are the conditions for entitlement to
A: G.R.: All Ees unemployment benefits?

XPN: All members of the Armed Forces of the A:


Philippines and the Philippine National Police 1. The recipient must be a permanent Ee at the
(PNP) time of separation;
2. His separation was involuntary due to the
Q: What are the reportorial requirements of the Er? abolition of his office or position resulting from
reorganization; and
A: Er must report to GSIS the names, employment 3. He has been paying the contribution for at least 1
status, positions, salaries of the employee and such year prior to separation.
other matter as determined by the GSIS.
Q: What will consist of an unemployment benefit?
SEPARATION BENEFITS
A: It will consists of cash payment equivalent to 50%
Q: When will a member be entitled to separation of the average monthly compensation
benefits?
Note: A member who has rendered at least 15 years of
service will be entitled to separation benefits instead of
A: A member who has rendered a minimum of 3
unemployment benefits.
years creditable service shall be entitled to separation
benefit upon resignation or separation under the RETIREMENT BENEFITS
following terms:
Q: What are the conditions in order to be entitled to
1. A member with at least 3 years but less than 15 Retirement Benefits?
years: Cash payment equivalent to 100% of the
AMC for every year of service the member has A:
paid contributions: 1. A member has rendered at least 15 years of
a. not less than Php 12,000.00 service;
b. Payable upon reaching 60 years of age or 2. He is at least 60 years of age at the time of
upon separation, whichever comes later. retirement; and
3. He is not receiving a monthly pension benefit
2. A member with less than 15 years of service and from permanent total disability. (Sec. 13-A, R.A.
less than 60 years of age at the time of 8291)
resignation or separation:
a. Cash payment equivalent to 18 times the Q: What is the rule in case of extension of service in
basic monthly pension (BMP), payable at the order to be entitled for Retirement Benefit?
time of resignation or separation
b. An old-age pension benefit equal to the A: Rabor v. CSC (G.R. No. 111812, May 1995), held
basic monthly pension, payable monthly for that the head of the government agency concerned is
life upon reaching the age of 60. vested with discretionary authority to allow or
disallow extension of the service of an official or Ee
Q: What are the effects of separation from service who has reached 65 years old without completing the
with regard to membership? 15 years of government service. However, this
discretion is to be exercise conformably with the
A: A member separated from the service shall provisions of Civil Service Memorandum Circular No.
continue to be a member and shall be entitled to 27, series of 1990 which provides that the extension
whatever benefits he has qualified to. shall not exceed 1 year.
Note: A member separated for a valid cause shall
Q: What is the reason for compulsory retirement?
automatically forfeit his benefits, unless the terms of
resignation or separation provide otherwise.

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A: The compulsory retirement of government officials Q: What are the two types of permanent disability?
and Ees upon their reaching the age of 65 years is
founded on public policy which aims by it to maintain A:
efficiency in the government service and at the same 1. Permanent Total Disability (PTD) - accrues or
time give to the retiring public servants the arises when recovery from any loss or
opportunity to enjoy during the remainder of their impairment of the normal functions of the
lives the recompense, for their long service and physical and/or mental faculty of a member
devotion to the government , in the form of a which reduces or eliminates his capacity to
comparatively easier life, freed from the rigors of civil continue with his current gainful occupation or
service discipline and the exacting demands that the engage in any other gainful occupation is
nature of their work and their relations with their medically remote. [Section 2 (q) and (s) R.A.
superiors as well as the public would impose upon 8291]
them [Beronilla vs. GSIS, G.R. No. 21723, (1970)]. 2. Permanent Partial Disability (PPD) - accrues or
arises upon the irrevocable loss or impairment of
Q: What are the options of the retiree with regard certain portion/s of the physical faculties, despite
to his or her retirement benefits? which the member is able to pursue a gainful
occupation. (Sec. 2[u], R.A. 8291)
A: The retiree may get either of the following:
Q: What are the benefits which an employee is
1. Lump sum equivalent to 6 months of the basic entitled to in case of a PTD?
monthly pension (BMP) payable at the time of
retirement and an old-age pension benefit equal A:
to BMP payable for life, starting upon the 1. A member is entitled to the monthly income
expiration of the 5 years covered by the lump benefit for life equivalent to the BMP when:
sum; or a. He is in the service at the time of the disability
2. Cash payment equivalent to 18 times his BMP and or
monthly pension for life payable immediately. b. If separated from service
(Sec. 13[a], R.A. 8291) c. He has paid at least 36 monthly contributions
within 5 years immediately preceding his
PERMANENT DISABILITY BENEFITS disability
d. He has paid a total of at least 180 monthly
Q: What is disability? contribution prior his disability
e. He is not receiving old-age retirement pension
A: Any loss or impairment of the normal functions of benefits
the physical and/or mental faculty of a member,
which reduces or eliminates his/her capacity to 2. If the member does not satisfy the conditions
continue with his/her current gainful occupation or above but has rendered at least 3- years-service, he
engage in any other gainful occupation. shall be advanced the cash payment equivalent to
100% of his average monthly compensation for each
Q: What is total disability? year of service he has pad contributions but not less
than Php 12,000.00 which should have been his
A: Complete incapacity to continue with present separation benefit (he shall no longer receive
employment or engage in any gainful occupation due separation benefits)
to the loss or impairment of the normal functions of
the physical and/or mental faculties of the member. Q: What are the benefits which an employee is
entitled to in case of a PPD?
Q: What are the conditions in order to be entitled
for permanent disability benefits? A: A member is entitled to cash payment in
accordance with the schedule of disabilities to be
A: The permanent disability was not due to any of the prescribed by GSIS, if he satisfies the given conditions
following: of either (1) or (2) of Sec. 16(a).

1. Grave misconduct Q: When will the payment of these benefits be


2. Notorious negligence suspended?
3. Habitual intoxication
4. Willful intention to kill himself or another

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A: Q: Under what conditions are the primary


1. In case a member is re-employed; or beneficiaries entitled to the basic monthly pension?
2. Member recovers from disability as determined
by the GSIS; or A: Upon the death of a member, the primary
3. Fails to present himself for medical examination beneficiaries shall be entitled to:
when required by the GSIS. (Sec. 16 [c], R.A.
8291) 1. Survivorship pension: Provided, That the
deceased:
TEMPORARY DISABILITY BENEFITS a. was in the service at the time of his death; or
b. if separated from the service, has rendered
Q: When does temporary total disability arise? at least 3 years of service at the time of his
death and has paid 36 monthly contributions
A: It accrues or arises when the impaired physical within the five-year period immediately
and/or mental faculties can be rehabilitated and/or preceding his death; or has paid a total of at
restored to their normal functions. (Sec 2[t], R.A. least 180 monthly contributions prior to his
8291) death; or

Q: What benefits are given for temporary disability? 2. The survivorship pension plus a cash payment
equivalent to 100% of his average monthly
A: compensation for every year of service: Provided,
1. Member is entitled to 75% of his current daily that the deceased was in the service at the time
compensation for each day or fraction thereof of of his death with at least 3 years of service; or
th
total disability benefit, to start at the 4 day but
not exceeding 120 days in one calendar year 3. A cash payment equivalent to 100% of his average
when: monthly compensation for each year of service he
a. He has exhausted all sick leaves paid contributions, but not less than Php
b. CBA sick leave benefits 12,000.00: Provided, that the deceased has
Provided, that: rendered at least 3 years of service prior to his
i. He was in the service at time of disability; death but does not qualify for the benefits under
or item (1) or (2) of this paragraph. [Sec. 21 (a), R.A.
ii. If separated, he has rendered at least 3 8291]
years of service and has paid at least 6
monthly contributions in the year Q: After the end of the guaranteed 30 months, are
preceding his disability the beneficiaries still entitled to any survivorship
2. The temporary total disability benefits shall in no benefits?
case be less than P70 a day.
A: Yes. The survivorship pension shall be paid as
Note: A member cannot enjoy the temporary total follows:
disability benefit and sick leave pay simultaneously.
1. When the dependent spouse is the only survivor,
An application for disability must be filed with the GSIS
he/she shall receive the basic survivorship
within 4 years from the date of the occurrence of the
pension for life or until he or she remarries;
contingency.
2. When only dependent children are the survivors,
SURVIVORSHIP BENEFITS they shall be entitled to the basic survivorship
pension for as long as they are qualified, plus the
Q: Who are entitled to survivorship benefits? dependent childrens pension equivalent to 10%
of the basic monthly pension for every
A: Upon the death of a member or pensioner, his dependent child not exceeding 5, counted from
beneficiaries shall be entitled to survivorship benefits. the youngest and without substitution;
Such benefit shall consist of: 3. When the survivors are the dependent spouse
and the dependent children, the dependent
1. The basic survivorship pension which is 50% of spouse shall receive the basic survivorship
the basic monthly pension; and pension for life or until he/she remarries, and the
2. The dependent childrens pension not exceeding dependent children shall receive the dependent
50% of the basic monthly pension childrens pension. (Sec. 21[b], R.A. 8291)

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133 FACULTY OF CIVIL LAW
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Note: The dependent children shall be entitled to the claim for death benefits with the GSIS? Why? (1991
survivorship pension as long as there are dependent Bar Question)
children and, thereafter, the surviving spouse shall receive
the basic survivorship pension for life or until he or she
A: The beneficiaries of a member of the GSIS are
remarries.
entitled to the benefits arising from the death of
said member. Death benefits are called survivorship
Q: When are secondary beneficiaries entitled to
benefits under the GSIS Law. Not being a beneficiary,
survivorship benefits?
Bella is not entitled to receive survivorship benefits.
She is not a beneficiary because she is a common-
A: In the absence of primary beneficiaries, the
law wife and not a legal dependent spouse.
secondary beneficiaries shall be entitled to:
Q: Is the cause of death of Gary (cardiac arrest due
1. The cash payment equivalent to 100% of his
to accidental electrocution in his house)
average monthly compensation for each year of
compensable? Why?
service he paid contributions, but not less than
Php 12,000.00: Provided, That the member is in
A: Yes. To be compensable under the GSIS Law, the
the service at the time of his death and has at
death need not be work connected.
least 3 years of service; or
2. In the absence of secondary beneficiaries, the
Q: Abraham, a policeman, was on leave for a
benefits under this paragraph shall be paid to his
month. While resting in their house, he heard two
legal heirs. (Sec. 21[c], R.A. 8291)
of his neighbors fighting with each other.
Abraham rushed to the scene intending to pacify
Q: What are the benefits that the beneficiaries are
the protagonists. However, he was shot to death by
entitled to upon the death of the pensioner?
one of the protagonists. Eva Joy, a housemaid, was
Abraham's surviving spouse whom he had
A:
abandoned for another woman years back. When
1. Upon the death of an old-age pensioner or a
she learned of Abraham's death, Eva Joy filed a
member receiving the monthly income benefit
claim with the GSIS for death benefits. However,
for permanent disability, the qualified
her claim was denied because: (a) when Abraham
beneficiaries shall be entitled to the survivorship
was killed, he was on leave; and (b) she was not
pension.
the dependent spouse of Abraham when he died.
2. When the pensioner dies within the period
Resolve with reasons whether GSIS is correct in
covered by the lump sum, the survivorship
denying the claim. (2005 Bar Question)
pension shall be paid only after the expiration of
such period.
A: Yes, because under the law, a dependent is one
who is a legitimate spouse living with the Ee.
Q: Gary Leseng was employed as a public school
(Art. 167 [i], LC) In the problem given, Eva Joy had
teacher at the Marinduque High. On April 27, 1997, a
been abandoned by Abraham who was then living
memorandum was issued by the school principal
already with another woman at the time of his death.
designating Gary to prepare the model dam project,
which will be the official entry of the school in the
Moreover, Abraham was on leave when he was killed.
search for Outstanding Improvised Secondary Science
The 24-hour duty rule does not apply when the
Equipment for Teachers. Gary complied with his
policeman is on vacation leave [ECC v. CA, G.R. No.
superior's instruction and took home the project to
121545, (1996)]. Taking together jurisprudence and
enable him to finish before the deadline. While
the pertinent guidelines of the ECC with respect to
working on the model dam project, he came to
claims for death benefits, namely:
contact with a live wire and was electrocuted. The
death certificate showed that he died of cardiac
1. That the Ee must be at the place where his work
arrest due to accidental electrocution.
requires him to be;
2. That the Ee must have been performing his
Bella (Garys common-law wife) and Jobo (his only
official functions; and
son) filed a claim for death benefits with the GSIS
3. That if the injury is sustained elsewhere, the Ee
which was denied on the ground that Garys death
must have been executing an order for the Er, it is
did not arise out of and in the course of
not difficult to understand then why Eva Joy's
employment and therefore not compensable
claim was denied by the GSIS [Tancinco v. GSIS,
because the accident occurred in his house and not
G.R. No. 132916, (2001)].
in the school premises. Is Bella entitled to file a

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Q: When does compulsory life insurance coverage


In the present case, Abraham was resting at his house take effect?
when the incident happened; thus, he was not at
the place where his work required him to be. A: All Ees including the members of the Judiciary and
Although at the time of his death Abraham was the Constitutional Commissioners except for
performing a police function, it cannot be said that Members of the AFP, the PNP, BFP and BJMP, shall,
his death occurred elsewhere other than the place under such terms and conditions as may be
where he was supposed to be because he was promulgated by the GSIS, be compulsorily covered
executing an order for his Er. with life insurance, which shall automatically take
effect as follows:
FUNERAL BENEFITS
1. Those employed after the effectivity of this Act,
Q: What comprises the Funeral Benefit? their insurance shall take effect on the date of
their employment;
A: The funeral benefit, in the amount Php 20,000, 2. For those whose insurance will mature after the
which is intended to defray the expenses incident to effectivity of this Act, their insurance shall be
the burial and funeral of the deceased member, deemed renewed on the day following the
pensioner, or retiree under R.A. 660, R.A. 1616, P.D. maturity or expiry date of their insurance;
1146, and R.A. 8291. It is payable to the members of 3. For those without any life insurance as of the
the family of the deceased, in the order which they effectivity of this Act, their insurance shall take
appear: effect following said effectivity.
1. Legitimate spouse
2. Legitimate child who spent for the funeral Q: When may a member obtain optional Life
services, or Insurance coverage?
3. any other person who can show unquestionable
proof of his having borne the funeral expenses of A:
the deceased. 1. A member may at any time apply for himself
and/or his dependents an insurance and/or pre-
Q: When will it be paid? need coverage embracing:
a. Life
A: Upon the death of: b. Memorial plans
c. Health
1. An active member d. Education
2. A member who has been separated from the e. Hospitalization
service but is entitled to future separation or f. Other plans as maybe designed by GSIS
retirement benefits
3. A member who is a pensioner (excluding 2. Any Er may apply for group insurance coverage
survivorship pensioners) for its Ees.
4. A retiree who is at the time of his retirement was
of pensionable age, at least 60 years old, who Q: What is the prescriptive period to claim the
opted to retire under RA 1616 (An act further benefits?
amending Sec.12, C.A. 186, as amended, by
prescribing two other modes of retirement and A: GR: 4 years from the date of contingency
for other purposes).
XPNs: Life insurance and retirement (Sec. 28, R.A.
LIFE INSURANCE 8291)

Q: What are the classes of life insurance coverage Q: May a member enjoy the benefits provided for in
under the GSIS Law? the Revised GSIS Act simultaneous with similar
benefits provided under other laws for the same
A: contingency?
1. Compulsory Life Insurance
2. Optional Life Insurance A: Whenever other laws provide similar benefits for
the same contingencies covered by this Act, the
Note: The plans may be endowment or ordinary life. member who qualifies to the benefits shall have the
option to choose which benefits will be paid to him.

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However, if the benefits provided by the law chosen This is advantageous to the SSS and GSIS members for
are less than the benefits provided under this Act, the purposes of death, disability or retirement benefits. In
GSIS shall pay only the difference. (Sec. 55, R.A. 8291) the event the Ees transfer from the private sector to
the public sector, or vice-versa, their creditable
BENEFICIARIES employment services and contributions are carried
over and transferred as well.
Q: Who are the considered beneficiaries?
EMPLOYEES COMPENSATION
A:
1. Primary beneficiaries Q: Discuss briefly the Employees Compensation
a. The legal dependent spouse until he/she Program.
remarries, and
b. The dependent children (Sec. 2[g] , R.A. A: It is the program provided for in Arts. 166 to 208 of
8291) the LC whereby a fund known as the State Insurance
Fund is established through premium payments
2. Secondary beneficiaries exacted from Ers and from which the Ees and their
a. The dependent parents, and dependents in the event of work-connected disability
b. Subject to the restrictions on dependent or death, may promptly secure adequate income
children, the legitimate descendants (Sec. benefit, and medical or related benefits.
2[h] , R.A. 8291)
COVERAGE
Q: Who are considered dependents?
Q: Who are subject to coverage under the
A: Employees Compensation Program?
1. Legitimate spouse dependent for support upon
the member or pensioner; A: Ers and their Ees not over 60 years of age are
2. Legitimate, legitimated, legally adopted child, subject to compulsory coverage under this program.
including the illegitimate child,
a. who is unmarried, The Er may belong to either the:
b. not gainfully employed, 1. Public sector covered by the GSIS, comprising the
c. not over the age of majority, or if over the National Government, including GOCCs,
age of majority, incapacitated and incapable Philippine Tuberculosis Society, the Philippine
of self-support due to a mental or physical National Red Cross, and the Philippine Veterans
defect acquired prior to age of majority; and Bank; and
3. Parents dependent upon the member for 2. Private sector covered by the SSS, comprising all
support. (Sec. 2[f]) Ers other than those defined in the immediately
preceding paragraph.
LIMITED PORTABILITY LAW (R.A. 7699)
The Ee may belong to either the:
Q: What is the Limited Portability Rule? 1. Public sector comprising the employed workers
who are covered by the GSIS, including the
A: A covered worker who transfers employment from members of the AFP, elective officials who are
one sector to another or is employed on both sectors, receiving regular salary and any person
shall have creditable services or contributions on employed as casual emergency, temporary,
both Systems credited to his service or contribution substitute or contractual;
record in each of the Systems and shall be totalized 2. Private sector comprising the employed workers
for purposes of old-age, disability, survivorship, and who are covered by the SSS.
other benefits in either or both Systems. (Sec. 3, R.A.
7699) Q: When does compulsory coverage take effect?

All contributions paid by such member personally, A:


and those that were paid by his employers to both 1. Employer on the first day of operation
Systems shall be considered in the processing of 2. Employee on the day of his employment
benefits which he can claim from either or both
Systems. (Sec. 4, R.A. 7699) Q: What is an occupational disease?

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A: One which results from the nature of the 2. Disability or death was occasioned by the Ees
employment, and by nature is meant conditions intoxication, wilful intention to injure or kill
which all Ees of a class are subject and which produce himself or another, or his notorious negligence
the disease as a natural incident of a particular (Art. 172, LC)
occupation, and attach to that occupation a hazard 3. No notice of sickness, injury or death was given
which distinguishes it from the usual run of to the Er (Art. 206, LC)
occupations and is in excess of the hazard attending 4. Claim was filed beyond 3 years from the time the
the employment in general cause of action accrued (Art. 201, LC, as
amended by P.D. 1921)
To be occupational, the disease must be one wholly
due to causes and conditions which are normal and Note: Notorious negligence is equivalent to gross
constantly present and characteristic of the particular negligence; it is something more than mere carelessness or
occupation. lack of foresight.

Q: What is compensable sickness? Q: Abraham Dino works as a delivery man in a


construction supply establishment owned by
A: It means any illness definitely accepted as an Abraham Julius. One day, while Dino was making
occupational disease listed by the Commission or any reports on his delivery, he had an altercation with
illness caused by employment, subject to proof that Julius; irked by the disrespectful attitude of Dino,
the risk of contracting the same is increased by Julius pulled out his gun and shot Dino, hitting him
working conditions. (Art. 167(l), LC) in the spinal column and paralyzing him completely.
Julius was prosecuted for the act.
Q: Discuss briefly the theory of Increased Risk.
1. Is the disability suffered by Abraham Dino
A: The term sickness as defined in Art. 167(l) of the compensable?
LC is a recognition of the theory of increased risk. To 2. If Abraham Dino recovers compensation from
establish compensability under the same, the the SIF, can he still recover from Abraham Julius
claimant must show substantial proof of work- damages in the criminal case? Why?
connection, but what is required is merely a
reasonable work-connection and not a direct causal A:
relation. Proof of actual cause of the ailment is not 1. Yes. The injury was sustained by Abraham Dino in
necessary. The test of evidence of relation of the his place of work and while in the performance
disease with the employment is probability and not of his official functions.
certainty [Jimenez v. Employees Compensation
Commission, G.R. No. L-58176, (1984); Panotes vs. 2. No. Under Art. 173 of the LC, as amended by P.D.
ECC, G.R. No. L-64802, (1984)]. 1921, the liability of the State Insurance Fund
under the Employees Compensation Program
Q: May an illness not listed by the Employees shall be exclusive and in place of all other
Compensation Commission as an occupational liabilities of the Er to the Ee or his dependents or
disease be compensable? anyone otherwise entitled to recover damages
on behalf of the Ee or his dependents.
A: Where the illness is not listed by the Employees
Compensation Commission as an occupational Q: Wilfredo, a truck driver employed by a local
disease, it must be established that the risk of construction company, was injured in an accident
contracting the same is increased by working while on assignment in one of his employers project
conditions. in Iraq. Considering that his injury was sustained in a
foreign country, is Wilfredo entitled to benefits
Q: What defenses may be interposed by the State under the Employees Compensation Program?
Insurance Fund against a claim for compensation
made by a covered Ee or his dependents? A: Yes. Filipinos working abroad in the service of an
Er, domestic or foreign, who carries on in the
A: The following defenses may be set up: Philippines any trade, business, industry, undertaking
or activity of any kind, are covered by the ECP. (Rule
1. Injury is not work-connected or the sickness is 1, Section 5, ECC Rules; Art.169, LC)
not occupational
Q: What is the Going and Coming Rule? Is this rule
absolute?

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Labor Law and Social Legislation

A: GR: In the absence of special circumstances, an Ee eligible for monthly income benefit. (Art. 167, LC, as
injured while going to or coming from his place of amended by Sec. I, P.D. 1921)
work is excluded from the benefits of Workmens
Compensation Act. Q: What are the benefits which may be enjoyed
under the State Insurance Fund?
XPNs:
1. Where the Ee is proceeding to or from his A:
work on the premises of the Er; 1. Medical Benefits
2. Proximity Rulewhere the Ee is about to 2. Disability Benefits
enter or about to leave the premises of his 3. Death Benefits
Er by way of exclusive or customary means 4. Funeral Benefits
of ingress and egress;
3. Ee is charged, while on his way to or from his MEDICAL BENEFIT (MEDICAL SERVICES)
place of employment or at his home, or
during this employment with some duty or Q: What are the conditions of entitlement to
special errand connected with his medical services?
employment; and
4. Where the Er as an incident of the A: For an Ee to be entitled to medical services, the
employment provides the means of following conditions must be satisfied:
transportation to and from the place of 1. He has been duly reported to the System (SSS or
employment. GSIS);
2. He sustains a permanent disability as a result of
Q: Who are entitled to benefits under the an injury or sickness; and
Employees Compensation Program? 3. The System has been notified of the injury or
sickness which caused his disability.
A: The covered Ee, his dependents, and in case of his
death, his beneficiaries. DISABILITY BENEFIT

Q: Who are the dependents of the employee? Q: What are disability benefits?

A: A: They are income benefits in case of temporary


1. Legitimate, legitimated, legally adopted or total disability, permanent total disability and
acknowledged natural child who is unmarried, not permanent partial disability
gainfully employed, and not over 21 years of age
or over 21 years of age provided he is Q: What are the disabilities that are considered total
incapacitated and incapable of self-support due to and permanent?
a physical or mental defect which is congenital or
acquired during minority; A: The following disabilities shall be deemed total and
2. Legitimate spouse living with the Ee permanent:
3. Parents of said Ee wholly dependent upon him for 1. Temporary total disability lasting continuously
regular support. (Art.167(i), LC, as amended by for more than one hundred twenty days, except
P.D. 1921) as otherwise provided for in the Rules;
2. Complete loss of sight of both eyes;
Q: Who are included in the term beneficiaries? 3. Loss of two limbs at or above the ankle or wrist;
4. Permanent complete paralysis of two limbs;
A: "Beneficiaries" means the dependent spouse until 5. Brain injury resulting in incurable imbecility or
he remarries and dependent children, who are the insanity; and
primary beneficiaries. In their absence, the 6. Such cases as determined by the Medical
dependent parents and subject to the restrictions Director of the System and approved by the
imposed on dependent children, the illegitimate Commission. (Art.192(c), LC)
children and legitimate descendants who are the
secondary beneficiaries: Provided, that the Q: May a permanent partial disability be converted
dependent acknowledged natural child shall be to permanent total disability after the employees
considered as a primary beneficiary when there are retirement? Why?
no other dependent children who are qualified and

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A: Yes. This is in line with the social justice provision 2. If the cause was due to the Ees own notorious
in the Constitution. A persons disability may not negligence, or voluntary act or drunkenness, the
manifest itself fully at one precise moment in time Er shall not be liable.
but rather over a period of time. And disability should 3. If the cause was partly due to the Ees lack of sue
not be understood more on its medical significance care, the compensation shall be inequitably
but on the loss of earning capacity. reduced.
4. If the cause was due to the negligence of a fellow
Q: May permanent total disability arise although the Ee, the Er and the guilty Ee shall be liable
employees does not lose the use of any part of his solidarily.
body? 5. If the cause was due to the intentional or
malicious act of fellow Ee, the fellow Ee and Er
A: Yes. Where the Ee is unable, by reason of the are liable unless the Er exercised due diligence in
injury or sickness, to perform his customary job for selecting and supervising his Ees.
more than 120 days, permanent total disability arises.
[Ijares vs. CA, G.R. No. 105854, (1999)] FUNERAL BENEFIT

DEATH BENEFIT Q: What is the funeral benefit?

Q: What are the conditions for entitlement to death A: A funeral benefit of Php 10, 000.00 shall be paid
benefits? upon the death of a covered Ee or permanently
totally disabled pensioner.
A: The beneficiaries of a deceased Ee shall be entitled
to an income benefit if all of the following conditions Q: Who are required to make contributions to the
are satisfied: State Insurance Fund?
1. The Ee has been duly reported to the System;
2. He died as a result of an injury or sickness; and A: Contributions under this Title shall be paid in their
3. The System has been duly notified of his death, entirety by the Er and any contract or device for the
as well as the injury or sickness which caused his deduction of any portion thereof from the wages or
death. salaries of the Ees shall be null and void. (Art.183(c),
LC)
Q: For how long are the primary beneficiaries
entitled to the death benefits? Q: When does the right to compensation or benefit
for loss or impairment of an employees earning
A: capacity due to work-related illness or injury arise?
1. Dependent Spouseuntil he or she remarries.
2. Dependent Childrenuntil they get married, or A: It arises or accrues upon, and not before, the
find gainful employment, or reach 21 years of happening of the contingency. Hence, an Ee acquires
age. no vested right to a program of compensation
3. Dependent Child suffering from physical or benefits simply because it was operative at the time
mental defectuntil such defect disappears. he became employed [San Miguel Corporation vs.
NLRC, G.R. No. 57473, (1988)].
Q: If an employee suffers disability or dies before he
is duly reported for coverage to the System (SSS or Q: Does recovery from the State Insurance Fund bar
GSIS), who will be liable for the benefits? a claim for benefits under the SSS Law? Why?

A: The Er shall be liable (Sec.1, Rule X; Sec.1, Rule XI; A: No, as expressly provided for in Art. 173 of the LC,
Sec. 1, Rule XII; Sec. 1, Rule XIII; ECC Rules) payment of compensation under the State Insurance
Fund shall not bar the recovery of benefits under the
Q: What are the rules regarding employers liability SSS Law, Republic Act No. 1161, as amended. Benefits
in case of death or injury? under the State Insurance Fund accrue to the Ees
concerned due to hazards involved and are made a
A: burden on the employment itself. On the other hand,
1. If the cause of the death or personal injury arose social security benefits are paid to SSS members by
out of and in the course of employment, the Er is reason of their membership therein for which they
liable. contribute their money to a general fund [Ma-ao
Sugar Central Co., Inc. vs. CA, G.R. No. 83491, (1990)].

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