4.
01
EMPLOYEES’ COMPENSATION PROGRAM
3A Group 8 Report
EMPLOYEES’ COMPENSATION PROGRAM (ECP)
 Program designed to provide package of benefits for public and
private sector employees and their dependents in the event of
work-connected contingencies such as sickness, injury, disability or
death.
 It was created under P.D. 626 and became effective on January 1975.
Scope
 every employer shall be covered
 every employee not over 60 years of age shall be covered.
 an employee over 60 years of age shall be covered if he had been
paying contributions to the system prior to age 60 and has not been
compulsorily retired
 an employee who is coverable by both the GSIS and SSS shall be
compulsorily covered by both systems.
Foreign employment
 The Commission shall ensure adequate coverage of Filipino employees
employed abroad, subject to regulations as it may prescribe.
 Filipinos working abroad in the service of an employer shall be
covered by the System, and entitled to the same benefits as are
provided for employees working in the Philippines.
 Medical services, including appliances and supplies for Filipinos
employed abroad rendered or provided in such place of employment,
shall be paid in accordance with, and subject to the limitations fixed in,
these Rules; provided that the Rules on Accreditation shall not apply in
these cases.
 The notice requirement under these Rules shall not be strictly applied.
 Medical certifications of physicians, and statement of accounts of
hospitals, when duly authenticated, are acceptable as basis for
payment, provided that the standard and rates payable by the System
shall be those provided for under these Rules.
Effective Date of Coverage
 Compulsory coverage of the employer during the effectivity of this
Title shall take effect on the first day of his operation, and that of the
employee, on the first day of his employment.
Aim
 To help workers and their dependents in the event of work-related
injury, sickness, disability or death to promptly receive meaningful
and adequate income benefits, medical or related services and
rehabilitation services.
Agencies Involved
 Social Security System (SSS)
 Government Service Insurance System (GSIS)
 Employee’s Compensation Commission (ECC)
EMPLOYEE’S COMPENSATION COMMISSION (ECC)
 DOLE- policy coordination and guidance
 Implement ECP
Main Functions
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 To formulate policies and guidelines for the improvement of the
employees’ compensation program;
 To review and decide on appeal all EC claims disapproved by the
Systems; and
 To initiate policies and programs toward adequate occupational
health and safety and accident prevention in the working
environment
Vision
 A nationally-acclaimed institution in social security promotion that is
in full control of the Employees’ Compensation Program,
managing a sound, strong, and wisely invested State Insurance Fund
and delivering promptly, effectively and efficiently to the Filipino
worker a comprehensive package of services and benefits for work-
connected contingencies through pro-active, humane and dynamic
policies, programs and activities
Mission
The ECC champions the welfare of the Filipino worker. Its mission is
to:
 Build and sustain among employees and employers a culture of
safety and healthful environment in the workplace;
 Ensure at all times that workers are informed of their rights,
benefits and privileges under the Employees’ Compensation
Program (ECP);
 Develop and implement innovative policies, programs and projects
that meet the needs of workers with work-connected contingencies;
 Promptly and fairly resolve all cases brought before it;
 Restore dignity and self-esteem among occupationally disabled
workers; and
 Safeguard the integrity of the State Insurance Fund
Strategic Goals
 To prevent the occurrence of work-connected contingencies among
workers; and
 To promptly provide workers and their dependents with meaningful
benefits and other curative and rehabilitative services in the event of
work-connected contingencies
Composed of
 Secretary of Labor and Employment as Chairman
 GSIS General Manager
 SSS Administrator
 Chairman of the Philippine Medical Care Commission,
 Executive Director of the ECC Secretariat
 Two appointive membersone of whom shall represent the
employees and the other, the employers, to be appointed by the
President of the Philippines for a term of six years
Powers and Duties
 To assess and fix a rate of contribution from all employers
 To determine the rate of contribution payable by an employer whose
records show a high frequency of work accidents or occupational
disease due to failure by the said employer to observe adequate safety
measures
 To approve rules and regulations governing the processing of claims
and the settlement of disputes arising there from as prescribed by the
System;

 To initiate policies and programs toward adequate occupational health
and safety and accident prevention in the working environment,
rehabilitation and other related programs and activities, and to
appropriate funds
 To make the necessary actuarial studies and calculations concerning
the grant of constant help and income benefits for permanent
disability or death, and the rationalization of the benefits for
permanent disability and death the Commission may upgrade
benefits and add new ones subject to approval of the President
 To appoint the personnel of its staff, subject to civil service law and
rules, but exempt from WAPCO law and regulations
 To adopt annually a budget of expenditures of the Commission and its
staff chargeable against the State Insurance Fund  SSS and GSIS shall
advance on a quarterly basis the remittances of allotment of the
loading fund for this Commission's operational expenses based on its
annual budget as duly approved by the Ministry of Budget and
Management.
 To have the power to administer oath and affirmation, and to issue
subpoena and subpoena duces tecum in connection with any question
or issue arising from appealed cases
 To acquire property, real or personal
 To enter into agreements or contracts for such services or aid as may
be needed for the proper, efficient and stable administration of the
program
Six Division of ECC
 Appeals Division (AD) evaluation and decision of EC appealed cases.
 Work Contingency Prevention and Rehabilitation Division
(WCPRD) promotion of occupational health and safety program ;
researches on the list of occupational diseases
 Information and Public Assistance Division (IPAD) comprehensive
communication and information program
 Policy, Programs and Systems Management Division (PPSMD)
initiate planning and programming and continuing review of the
agency programs, projects and activities, and monitor performance of
the agency; researches/special studies on ECP relating to policy
formulation; information communication technology (ICT) service
management and implementation of gender and development
program.
 Administrative Division (AD) human resource management, records
management, supply and building administration.
 Finance Division (FD) effective management of the agency's financial
transactions, financial reports including annual budget in accordance
with the financial plan.
GOVERNMENT SERVICE INSURANCE SYSTEM (GSIS)
 Agency for the PUBLIC SECTOR.
 It provides and administers a pension fund that has the following
social security benefits:
o Compulsory life insurance
o Optional life insurance
o Retirement benefits
o Disability benefits for work-related accidents
o Death benefits
 It provides insurance coverage to assets and properties that have
government insurable interests.
GSIS is authorized to do the following
 Engage in the business and operation of all kinds of insurance and
reinsurance and all other forms of undertakings to indemnify any
person or property against loss, damage, or liability, including third
party liability, arising from unknown or contingent events;
 Reinsure with and accept reinsurance from insurance and reinsurance
companies in the Philippines and abroad;
 Issue policies denominated in any foreign currency;
 Issue surety and/or performance bonds both in Philippine peso
and/or in any foreign currency;
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 Insure all insurable assets serving as collaterals for loans extended by
government financial institutions; and
 Apportion among the governments any disposable surplus that it may
declare from the operations of the Fund.
Functions
 Identify and provide promptly all government property and projects
with the proper risk analysis and adequacy of insurance cover thru
effective strategies and operational tactics;
 Adopt at all times the correct rates, terms and conditions, clauses and
warranties on all tariff and non-tariff business;
 Settle all justifiable claims judiciously and within specified timeframes
and quality standards;
 Reinsure the appropriate amounts with stable and credible reinsurers
at the proper time; and
 Collect all monies due the Government Insurance Fund when these
become due and demandable
Coverage
 Members of the Judiciary and Constitutional Commissions who are
covered by separated retirement laws;
 Contractual employees who have no employee-employer
relationship with their agencies;
 Uniformed members of the Armed Forces of the Philippines and the
Philippine National Police, including the Bureau of Jail
Management and Penology and the Bureau of Fire Protection.
SOCIAL SECURITY SYSTEM (SSS)
 Administering agency for the PRIVATE SECTOR
Vision
 A viable social security institution providing universal and equitable
social protection through world-class service.
Mission
 To manage a sound and viable social security system which shall
promote social justice and provide meaningful protection to
members and their families against the hazards of disability,
sickness, maternity, old age, death and other contingencies
resulting in loss of income or financial burden.
Powers and Duties
 To submit annually a public report to the President and to the
Congress covering its activities in the administration and enforcement
of the Act during the preceding year including information and
recommendations on broad policies for the development and
perfection of the program of the SSS.
 To require the actuary to submit a valuation report on the SSS benefit
program every (4) years, or as may be necessary, to undertake the
necessary actuarial studies and calculations concerning increases in
benefits and to provide for feasible increases in benefits every (4)
years, including the addition of new ones, subject to the approval of
the President : Provided, That the actuarial soundness of the reserve
fund shall be guaranteed: provided, further, that such increases in
benefits shall not require any increase in the rate of contribution;
 To establish offices of the SSS to cover as many provinces, cities and
congressional districts, whenever and wherever it may be expedient,
necessary and feasible, and to inspect or cause to be inspected
periodically such offices;
 To enter into agreements or contracts for such service and aid, as may
be needed for the proper, efficient and stable administration of the
SSS;
 To adopt, from time to time, a budget of expenditures including
salaries of personnel, against all funds available to the SSS under the
Act;
 To set up its accounting system and provide the necessary personnel
 Employees’ Compensation Program

 To require reports, compilations and analyses of statistical and Cardiovascular diseases

economic data and to make investigation as may be needed for the
proper administration and development of the SSS Cerebrovascular accidents
 To acquire and dispose of property, real or personal, which may be Malaria and Schistosomiasis
necessary or expedient for the attainment of the purposes of this Act
 To acquire, receive, or hold, by way of purchase, expropriation or Pneumonia
otherwise, public or private property for the purpose of undertaking
Hernia
housing projects preferably for the benefit of low‐income members
and for the maintenance of hospitals and institutions for the sick, aged Bronchial Asthma
and disabled, as well as schools for the members and their immediate
families; Osteoarthritis
 To sue and be sued in court; and Viral Encephalitis
 To perform such other corporate acts as it may deem appropriate for
the proper enforcement of the Act. Peptic Ulcer
Pulmonary Tuberculosis
ECC, GSIS, and SSS
Essential hypertension
 May disburse each year not more than twelve percent of the
contributions and investment earnings collected for operational Asbestosis
expenses, including occupational health and safety programs.
 All revenues as are not needed to meet current operational expenses
shall be accumulated in a fund known as the State Insurance Fund,  Cardiovascular Disease
which shall be used exclusively for payment of the benefits and no o Strain of work of an acute attack must be of sufficient severity
amount shall be used for any other purpose. and must be followed within 24hrs by clinical signs
 All amounts accruing to the State Insurance Fund shall be deposited o Person was apparently asymptomatic before showing
with any authorized depository bank approved by the Commission, or persistent signs and symptoms during performance of his/her
invested with due and prudent regard for the liquidity needs of the work
System.  Cerebrovascular Accidents
 The System shall have original and exclusive jurisdiction to settle any o History of trauma at work
dispute with respect to coverage, entitlement to benefits, collection o Direct connection between the trauma and in the course of
and payment of contributions and penalties or any other matter collapse
related. o If trauma caused a brain hemorrhage, injury may be considered
 Decisions, orders or resolutions of the Commission may be arising from work
reviewed on certiorari by the Supreme Court on questions of law  Pneumonia
upon petition of an aggrieved party within ten days from notice. o Definite history of wetting and chilling during course of
employment
o Direct connection between offending agent and illness
ANNEX A OF PD No. 626, o Signs of consolidation should appear soon and symptoms of
Employee’s Compensation Program initial chills and fever should be at least 24 hours after injury
or exposure
ANNEX A DISEASES o Patient must manifest any of the ff within a few days of the
Cancer of the epithelial lining of the bladder accident:
 severe chills and fever
Cancer, epithellomatous or ulceration of the skin or of the corneal surface
 headache and pain in the side of the body
Cataract produced by exposure to the glare of, or rays from molten glass or  short, dry, painful cough with blood tinged expectoration
molten or red hot metal  PE signs of consolidation and rales
Deafness  Hernia
o Should be of recent origin
Decompression sickness o Appearance was accompanied by pain, discoloration
o Preceded by severe straining out of and in the course of
Dermatitis due to irritants and sensitizers employment
Infections o Protrusion of mass should appear immediately following the
alleged strain
Ionizing radiation disease, inflammation, ulceration or malignant disease  Bronchial Asthma
o No history of asthma before employment
Poisoning and its sequelae
o Allergen is present in working environment
Pneumoconiosis o Sensitivity test to allergen is positive in working environment
o Positive provocative test
Diseases cause by abnormalities in temperature and humidity  Asbestosis
Vascular disturbances in the upper extremities due to continuous o Employee must have been exposed to asbestos dust in workplace
vibration o Chest x-ray report must show findings of asbestos, or asbestos
related disease
Viral hepatitis o If the ailment is discovered after retirement/separation, claim
Poisoning by cadmium must be filed with the system within 3 years from discovery

Leukemia and lymphoma

ANNEX B OF PD No. 626,
Cancer of stomach and other lymphatic and blood forming vessels; nasal Employee’s Compensation Program
cavity and sinuses
*See addendum for the Table of Annex B. =)*
Cancer of the lungs, liver and brain

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 Employees’ Compensation Program

Medical Services
 Conditions to Entitlement * Surgical procedure done in OR/ Diagnostic complex shall be paid*
o He has been duly reported to the System
o He sustains an injury or contracts sickness Rehabilitation Services
o The System has been duly notified of the injury or sickness. • Coverage is voluntary.
 Period of Entitlement • Entitlement shall be upon approval of the EC claim for disability
o First day of the injury or sickness benefits.
o During the period of his disability • Period of entitlement:
o As the recovery may require • During disability until period determined by rehabilitation
 Extent of Services experts.
• Skills training
 Benefits only for the ward services
• Tuition fee
 Ward services during confinement in an accredited hospital; • Cost of training materials
 The follow-up care by an accredited physician • Meal and transportation allowance(P2,500).
 Medicines. • Limitations of liability
 Ambulatory services in an accredited hospital shall be allowed • Intoxication
only in case of injury. • Willful intent to injure oneself or another;
• Notorious negligence
Ward Services
PERMANENT PARTIAL DISABILITY
Amount of Benefit
 Monthly income benefit for the number of months indicated
 If the indicated number of months exceed 12, the income benefit shall
be paid in monthly pension
 20% increase in benefits for contingencies after may 1, 1978
o Before : P12, 000 or 5 years

Unlisted Injuries and Illnesses

 In cases of injuries or illnesses not listed in the schedule under section
2, the benefit shall be an income benefit equivalent to the percentage
of the permanent loss of the capacity for work

• Ward services do not include:
• The extra charge for more comfortable accommodations.
Except:
• Patient has contagious disease or his condition requires
him to be isolated
• No available ward bed and the emergency nature of the
injury or disease requires him to be immediately
accommodated,
• Objects/ services for personal comfort or convenience.
• Private duty nurses.
• If the patient will receives treatment which are more expensive
than ward services, only the ward services will be paid for.
Professional Fees
• First visit
• General Practitioner: P100
• Specialist: P150
• Succeeding visits
• General Practitioner: P80
• Specialist: P100
Surgical Benefits
• Surgeon's fee according to the ECC Relative Value Study
• Anesthesiologist's fee, not exceeding one-third of the surgeon's
fee.
• Only one surgeon shall be paid for each operation
• Only one anesthesiologist shall be paid for each operation
• Local anesthesia shall not be compensable.
• Except for regional nerve block anesthesia.
CONTRIBUTION
Employer’s Contribution
 < php 14,500 monthly salary - 10 pesos/month/employee
 > php 15,000 monthly salary – 0.2% of monthly salary
 Contribution ceases in case of employee’s death
 Contribution is suspended until the employee is able again in case
of employee’s disability
COMPENSABILE CONTINGENCIES
 Work-connected injury or accident
o The injury must be a result of an accident that should arise
within the course of the employment
o Increased Risk Theory
 For a certain sickness and its resulting disability or death
to be compensable, it has to be a result of an occupational
disease listed under the provided Annex A
 Otherwise, a proof must be presented that the risk of
contracting the disease is increased by the working
conditions
 Work-connected sickness
o The employer shall require pre-employment examination of all
prospective employees
o Provide periodic medical examination to employees who are
exposed to occupational diseases and take such other measures
as may be necessary
 The periodic medical examination for the early detection of
occupational diseases must be in accordance to the set
minimum standards as prescribed in the provided Annex
B.
 Any disability or death resulting from any work-connected accident or
work-connected sickness
LIABILITY

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 No compensation shall be allowed to the employee or his dependents
when the injury, sickness, disability or death was occasioned by any of
the following:
o Intoxication
o Willful intention to injure or kill
o Notorious negligence
DEATH BENEFITS
 All of the following conditions should be satisfied:
o The employee has been duly reported to the system
o He died as a result of an injury or sickness
o The system has been duly notified of his death, as well as the
injury or sickness which caused his death
 His employer shall be liable for the benefit if such death
occurred before the employee is duly reported for coverage
to the system
Primary Beneficiaries
 For each topic header, use the following option:
 The income benefit shall be paid beginning at the month of death and
shall continue to be paid for as long as the beneficiaries are entitled
thereto.
 The monthly income benefit shall be guaranteed for five years, and
shall not be <P15,000.00
 Surviving legitimate spouse – qualified as long as he/she has not
remarried
 Dependent children’s qualifications are:
o Unmarried
o Not gainfully employed
o Over 21 years of age provided he/she is incapable of self-support
due to a physical or mental defect which is congenital or acquired
during minority
Secondary Beneficiaries
 The income benefit shall be sixty (60) times the monthly income
benefit of a primary beneficiary which in no case be less than
P15,000.00, which shall likewise be paid in monthly pension
FUNERAL BENEFITS
 A funeral benefit of twenty thousand pesos (P20,000.00) shall be
paid upon the death of a covered employee or permanently totally
disabled pensioner to one of the following:
o The surviving spouse
o The legitimate child who spent for the funeral services
o Any other person who can show incontrovertible proof or proof
of his having borne the funeral expenses.
 EC funeral benefits shall be granted after the SSS or the GSIS has
declared the following in the evaluation of claims for EC death
benefits:
o Death due to sickness - causal relationship between the death
and the working conditions of the covered member
o Death due to injury - causal relationship between the death and
the work-related accident
 Death of EC permanent partial disability (PPD) or permanent total
disability (PTD) pensioner - the cause of death is a complication or
natural consequence of previously compensated PPD or PTD
PROVISIONS COMMON TO INCOME BENEFITS
Delinquent Contributions
 An employer who is delinquent in his contributions shall be liable to
the system for the benefits which may have been paid by the system to
his employees or their dependents
 The payment by the employer of the lump sum equivalent of such
liability shall absolve him from the payment of the delinquent
contributions and penalty
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 Failure or refusal of the employer to pay or remit the contributions
herein prescribed shall not prejudice the right of the employee or his
dependents to the benefit
Second Injuries
 If any employee under permanent partial disability suffers another
injury which results in a compensable disability greater than the
previous injury, the state insurance fund shall be liable for the income
benefit of the new disability:
o Provided, that if the new disability is related to the previous
disability, the system shall be liable only for the difference in
income benefits
Assignment of Benefits
 No claim for compensation is transferable, or liable to tax, attachment,
garnishment, levy or seizure by or any under legal process whatsoever
except to pay any debt of the employee to the system
Earned Benefits
 Income benefits shall be payable to an employee who is entitled to
receive wages, salaries or allowance for holidays, sick leaves or any
award of benefit
Safety Devices
 In case the employee’s injury or death was due to the failure of the
employer to comply with any law, or to install and maintain safety
devices, or take other precautions for the prevention of injury, the
employer shall pay the state insurance fund a penalty of 25% of the
lump sum equivalent of the income benefit payable by the system to
the employee
Prescriptive Period
 No claim for the compensation shall be given due course unless said
claim is filed with the system within three years from the time the
cause of action occurred
Erroneous Payment
 If the system pays income benefit to a dependent who is inferior in
right to another dependent or with whom another dependent is
entitled to share, such payment will discharge the system of any
liability, unless and until such other dependent notifies the system of
his claim prior to the payments
 In case of doubt in right of claims, the system is empowered to
determine as to whose payments should be made in accordance with
such regulations as the commission approves
Prohibition
 No agent, attorney or any other person pursuing or in charge of the
preparation or filing of any claim for benefit shall demand or charge
for his services any fee, and any stipulation to the contrary shall be
null and void.
 Retention or deduction of any amount from any benefit granted is
prohibited.
 Violation of this article shall be punished by fine of p50,000, or
imprisonment for not less than six months nor more than one year,
or both.
RECORDS, REPORTS, AND PENAL PROVISIONS
Record of Death or Disability
 All employers should keep a logbook with a chronological record of
o Sickness
o Injury or death of their employees
o Names
o Dates and place of contingency
o Absences
 Entries should be made within five days from notice/knowledge of
the occurrence of the contingency
 Employees’ Compensation Program

 Only work-related contingencies are to be reported

 All entries must be written down by the employer or any of his
authorized officials
 Failure to record or giving false information or withholding
information entitles the employer to be liable for 50% of the lump sum
equivalent of the income benefit to which the employee may be found
to be entitled with
 In case of payment of benefits for any claim which is later determined
to be fraudulent and the employer is found to be a party to the fraud,
such employer shall reimburse to the system the full amount of the
compensation paid

Notice of Sickness, Injury or Death

 Notice should be given to the employer by the employee or by his
dependents or anybody on his behalf within five days from the
occurrence of contingency
 Notice is not required if contingency is known to the employer

Penal Provisions
 The penal provisions are to be distributed, paid to or collected by the
system
 Any person, who for the purpose of claiming or securing entitlement of
the provision, whether for him or for some other person, commits
fraud, collusion, falsification, misinterpretation of facts or any other
kind of anomaly
o Shall be punished by fine of not less than P500 and not more than
P5,000 and an imprisonment for not less than 6 months nor more -FAI =)
than 1 year.
 If the act penalized is committed by a/the:
o Employee of the system- imprisonment of >1 year
o Lawyer, physician or other professional- in addition to the
penalty, the professional is disqualified from practice
o Government official - in addition to the penalty, be dismissed
with prejudice to reemployment in government services

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ADDENDUM

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