SOCSO Act and Benefits: Occupational Health Doctor

SOCSO Act and Benefits
Occupational Health Doctor
1 © 2020 NIOSH Malaysia. All rights reserved.

Learning Objectives
At the end of the session, participant will be
able to:
1. Explain about Social Security Concept and

SOCSO Benefit.
2. Elaborate SOCSO Coverage, Registration and
Contribution.
3. List the roles of panel doctor.

Scope
❖Social Security Concept
❖SOCSO’s Benefit
– Employee Insurance System (EIS)
– Health Screening Program (HSP)
❖SOCSO’s Coverage
❖SOCSO’s Registration and Contribution
❖Promotion of Occupational Safety and
Health
❖Roles of Panel Doctor

ILO Convention 102
Social Security (Minimum Standards) Convention, 1952
Medical Care
Sickness Benefit
Unemployment Benefit
Old Age Benefit
Employment Injury Benefit
Family Benefit
Maternity Benefit
Invalidity Benefit
Survivor’s Benefit

Definition of Social Security
“Social Security may be defined as the protection
furnished by society to its members through a series
of public measures against economic and social
distress that otherwise would be caused by the loss or
substantial reduction of earnings resulting from
sickness, maternity, employment injury,
unemployment, invalidity, old-age and death, and for
the provision of medical care and benefits for the
maintenance of children”

Social Security in Malaysia
Medical Care MOH, SOCSO

Sickness Benefit MOH, SOCSO
Unemployment Benefit Employment Act 1955, SOCSO (EIS)
Old Age Benefit EPF
Employment Injury Benefit SOCSO
Family Benefit JKM
Maternity Benefit Employment Act 1955
Invalidity Benefit SOCSO
Survivor’s Benefit SOCSO

SOCSO is a statutory body with a governing
board under the Ministry of Human
Resources.
The Board is constituted under a tripartite
arrangement with representatives from the
Government, Employers and Employees.
The tripartite composition of the Board,
therefore reflects the social security
programme which is a collaboration of these
three social partners.

SOCSO was established as a government
department on 1st January 1971 to enforce
the Employees’ Social Security Act, 1969
and Employees’ Social Security (General)
Regulations, 1971.

The Principles of Social Security
CORE PRINCIPLES CORE BASIC

• Social Safety Net
• Collection of Contributions Employers and Employees
• Risk Sharing Accident, Disability and Death
• Protection to employees and dependents (Employment

Injury Insurance Scheme and the Invalidity Pension
Scheme)
• Income replacement
• Justice in implementing the principles of Solidarity Fund &

Replacement of Income

Provides comprehensive Social Security
Protection all over Malaysia
Social Security can be defined as protection
furnished by society to its members through a
series of public measures against economic
and social distress.
It can also be defined as fund pooling of
resources and sharing of risk

Collecting low rates of contribution, providing
financial guarantees and protection to the family as a
whole
SOCSO is not a government funded body and not a
charitable organization
Differs from insurance company – SOCSO covers all
working Malaysians with minimum fixed
contribution which varies according to their salary

435, 801 ACTIVE EMPLOYERS 41, 296 RECIPIENTS OF
PERMANENT DISABILITY
6.80 MILLION ACTIVE EMPLOYEES BENEFIT
RM 536.35 MILLION PERMANENT
RM 3,560.97 MILLION CONTRIBUTION DISABLEMENT BENEFIT
REVENUE PAYMENT
568, 204 RECEPIENTS OF 45, 324 RECIPIENT OF
BENEFITS DEPENDANTS BENEFITS
RM 3,271.77 MILLION BENEFITS PAYMENTS 65, 980 RECIPIENTS OF

TEMPORARY
65, 980 RECIPIENTS OF DISABLEMENT BENEFIT
TEMPORARY
RM 206.86 MILLION TEMPORARY
DISABLEMENT
DISABLEMENT BENEFIT
BENEFITS
PAYMENT
RM 206.86 MILLION TEMPORARY 41, 296 RECIPIENTS OF
DISABLEMENT BENEFIT PERMANENTS DISABILITY
PAYMENT BENEFIT

2017 Operations Performance
Achievements Summary
RM 536.35 MILLION PERMANENT RM 43.87 MILLION CONSTANT
DISABLEMENT BENEFIT ATTENDANCE
PAYMENT ALLOWANCE PAYMENT
45, 324 RECEPIENTS OF 17, 556 RECIPIENTS OF FUNERAL
DEPENDANTS BENEFIT BENEFIT
RM 292.94 MILLION DEPENDANTS BENEFIT RM 33.82 MILLION FUNERAL BENEFIT
PAYMENT PAYMENT
63, 822 RECIPIENTS OF 2, 919 RECIPIENTS OF MEDICAL
INVALIDITYPENSION BENEFIT
AND GRANT
RM 3.76 MEDICAL BENEFIT
RM 693. 81 MILLION INVALIDITY IN GRANT MILLION PAYMENT
PAYMENT
7, 076 RECIPIENT OF PHYSICAL
268, 404 RECIPIENTS OF OR VOCATIONAL
SURVIVORS PENSION REHABILITATION
RM 1, 186.00 MILLION SURVIVORS PENSION RM 55.41 PHYSICAL OR
PAYMENT MILLION VOCATIONAL
REHABILITATION
7, 309 RECIPIENTS OF
CONSTANT - 16, 321 RECIPIENTS OF DIALYSIS
ATTENDANCE TREATMENT
ALLOWANCE
RM 215.81 MILLION DIALYSIS TREATMENT
13 © 2020 NIOSH Malaysia. All rights reserved. PAYMENT
Background
Act 4 Act 789 Act 800

Act 4.
Employees' Social Security Act 1969
2 SCHEMES
Employment Injury Invalidity Pension

Applicability
1. The Act is applicable to all establishments
employing one or more employees.
2. Effective from 1 June 2016, it is compulsory for any
employee who is employed for wages under a
contract of service or apprenticeship with an
employer to register and contribute to SOCSO
3. The maximum rate of contribution is based on
monthly wages or salary of RM4,000.00. Notice of
Election is no longer applicable from the date this
Act applies

Benefits

What’s New?

Self Employment Social
Security Act 2017 (Act 789)
❖ Effective since 13 JUN 2017

❖ Taxi driver, e-hailing, bus driver
❖ Currently 45,000 active contributors
❖ Coverage for employment injury Only
❖ ELIGIBILITY
– Malaysian citizen / permanent resident without
age limit;
– Individuals who work for themselves to earn a
living

This Photo by Unknown Author is licensed under CC BY-NC-ND

Effective from 1 January 2020, the scheme is
extended to 19 other sectors as follows:
1. Good and Food Transport 11. Food

2. Online Business 12. Support Services
3. Agriculture 13. Manufacturing
4. Information Technology 14. Arts
5. Livestock 15. Construction
6. Data processing 16. Household Services
7. Forestry 17. Hawkers
8. Agents 18. Beauty and Healthcare
9. Fisheries 19. Accommodation Premises
10. Professional Services

Employment Insurance System (EIS)
ACT800

Coverage and Contribution Rate
• All employers (430 thousand) who have at least one

employee
Coverage • All workers in private sector (6.6m) regardless of wages
• Subject to ceiling insured wages (IW) of RM4,000
• Loss of employment with minimum contribution of

Qualifying 12 months over the period 24 months, except for
Condition voluntary resignation, expiry of fixed-term
contract, misconduct, retirement
Contribution
• Employer (0.2%) RM 1.90 for each RM1,000 wage (*)
Rate
• employee (0.2%) *subject to actual amount in Second Schedule
0.4% of IW

Proposed Benefits
Re-employment Placement Membantu mendapatkan

To assist insured pekerjaan
persons to get suitable
Programme baharu yang sesuai
new employment
Job Search Allowance (JSA) (Rate:slaid

Rujuk 80%,No.
50%, 40%,10
9 dan 40%, 30%,
(EMP dan30%)
EL)
(Kadar: 80%, 50%, 40%, 30%, 30%)
25% from the remaining JSA
Early Re-employment Allowance 25 % daripada baki EMP
(incentive to get new job ASAP)
(ERA)
Minimum RM
Minimum RM 1010 sehari
per day & maximum
dan maksimum
Training Allowance (TA) RM 20
RM 20 sehari
per day (maximum
(maximum 6 months)
6 bulan)
(10% – 15% may require training)
Maksimum RM 4,000
Training Fee (FL) Maximum RM 4,000
Reduced Income Allowance (RIA) Sama seperti faedah EMP, dibayar

For workers working for more than secara pukal
As per JSA, to be paid in lump sum
one employer

Services Provided Job
Matching
&
Placement
Employability
Job Search Programs
SOCSO
Employment
Career Services Vocational
Counselling Training
Individual
Placement
Support

PREVENTION
Accident Disease
Prevention Prevention

The crises from SOCSO’s perspective?
“ • Increase in number of Accidents

o Commuting Accidents represent more
than 50% of total accidents
o More severe injuries
o Longer disability duration
o 2 out of 3 fatalities everyday are from
”
commuting accidents

Number of Accidents Reported
Total Accident Reported

80,000
72,658
69,980
70,000 66,618
63,557 63,331 62,837
59,897 61,552
60,000 56,339 57,639
54,133 55,186
50,000
40,000
30,000
20,000
10,000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018p

SOCSO & OSH
❖Prevention & Promotion Scope:
– Cooperation with NGOs & Government
Agencies
– Commuting Accident Prevention Plan
– Prevention Programme
– Safety Videos
– Safety Guidelines
– Safety Audits
– Research

What About Lifestyle Diseases?
❖Current Prevention activities focuses only on
accidents
❖Less focus on health and lifestyle
❖Changes of lifestyle – need to promote
Healthy Lifestyle
❖Early detection- to prevent disability from
Non-communicable Diseases

Invalidity Pension Benefit Reported for NCD Cases
Year 2009 - 2018
1,600
RM Millions
1,400 1,348
1,186
1,200
1,052
1,000 929
835
762 791
800 704 694
582 584 611
600
551
497
449 454
413
400 346 341
267
200
0
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Pencen Ilat Pencen Penakat
Between 35-49% of claims for Invalidity Pension benefit reported

were due to non-communicable diseases.

Survivors Pension Benefit Reported for
NCD Cases: Year 2009 - 2018
25,000
22,276
19,501
20,000
16,921
15,173
14,466
15,000
13,261
10,769 11,050
10,409 10,497
10,000
5,000
-
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Almost 45% - 50% of claims for Survivors Pension

benefit reported were due to non-communicable diseases.

The SOCSO Health Screening
Programme
❖ Introduced in 2013 for 1.9 million workers above the
age of 40.
❖ Over 3,000 panels clinics, pathological labs and
mammogram centers involved.
❖ Health screening for:
– Cardiovascular Diseases
– Diabetes
– Hypercholesterolemia
– Cancer

RTW and Case Management?
A comprehensive and systematic return

to work plan which consist of collective
agreement between the medical
fraternity, employers, insurance
providers, social networks for the best
possible return to work outcome for a
patient/insured person.
• To be discussed in separated session

The Employment Injury
and
Invalidity Pension Scheme

EMPLOYMENT INJURY SCHEME INVALIDITY PENSION SCHEME
❖ Rate of contribution: 1.25% ❖ Rate of contribution: 1% of
of employee’s monthly monthly wages
wage ❖ Equally shared between
❖ Paid solely by employer employer and employee
❖ Fully Funded ❖ Partially Funded
❖ Coverage : Protection for ❖ Coverage : 24hr protection
work related commuting for Invalidity from illness or
accidents, industrial injury & accident or death
occupational diseases irrespective of cause
❖ Age factor/limit - No ❖ Age factor/limit - Yes
❖ Minimal contribution - No ❖ Minimal contribution - Yes

EMPLOYMENT INJURY INVALIDITY PENSION
SCHEME SCHEME
• Benefits: • Benefits:
• Medical Benefit • Invalidity Pension
• Temporary Disablement • Invalidity Grant
Benefit
• Survivors Pension
• Permanent Disablement
Benefit
• Dependents Benefit
Constant Attendance Allowance

Funeral Benefit
Rehabilitation Benefit
Educational Benefit

During working (Section 2(6))
•a personal injury occurs to an employee caused by an accident

arising out of and in the course of employment
During commuting (Section 24)
•Between residence or stay and the workplace

•Between the workplace and the place where he takes his meal
during any authorized recess
•Travelling activities that required by the job / task
During emergency (Section 25)
•Accidents that occur during an emergency in or near the premises

of the employer during helping, rescuing or protecting those who
suffers in a disaster. Example: fire, robbery
Occupational disease (Section 28)
•The disease caused by an occupation or risk at workplace. The list

of diseases and disease causing agents can be referred to the
FIFTH SCHEDULE, AKSP 1969. Example: Noise induced Hearing Loss

Social Security Benefits
❖Medical Benefit (MB)
a) MB is provided to an insured employee who
suffers from disablement due to an
employment injury.
b) MB is provided through a system of panel
doctors appointed by SOCSO and in all
government hospitals.

❖ Temporary Disablement Benefit(TDB)
a) TDB is paid to an insured employee who suffers
from temporary disablement due to employment
injury and who is certified to be unfit for work for
not less than 4 days( including day of accident)
b) Temporary Disablement is defined as “a condition
resulting from an employment injury which
requires medical treatment and renders an
employee, as a result of such injury, temporarily
incapable of doing the work which he was doing
prior to or at the time of injury.”

❖Permanent Disablement Benefit (PDB)
a) PDB is paid to an insured employee who is
certified by a Medical Board or Special Medical
Board or Appellate Medical Board to be suffering
from permanent disablement due to employment
injury.
b) An insured person is said to be suffering from PTD if
the PD is assessed at 100% loss of earning
capacity. He is said to be suffering from PPD if the
PD is assessed at less than 100% loss of earning
capacity(which can range from 1% to 99% ).

c) Permanent partial disablement is defined as
“such disablement of a permanent nature, as
reduces the earning capacity of an employee
in every employment which he was able to
undertake at the time of the accident resulting
in the disablement.”
d) Permanent total disablement is defined as
“such disablement of a permanent nature, as
disables an employee for all work which he was
capable of performing at the time of the
accident resulting in such disablement.”

❖ Dependant’s Benefit (DB)
a) DB is payable to the dependants of a deceased
insured employee who dies of an employment
injury. The dependants may be either primary or
secondary dependants.
b) Primary dependants are widow and children while
secondary dependants are parents/grandparents
and brothers and sisters.

ELIGIBILITY OF DEPENDENT
1 ➢WIDOW/WIDOWER - 3/5
2
2 ➢CHILDREN - 2/5
THE
DEPENDENT 3 ➢MOTHER - 4/10
4 ➢FATHER - 4/10
Share 5 ➢SIBLINGS - 3/10
6 ➢GRANDPARENT - 4/10
Relations
code

❖Funeral Benefit (FB)
– FB is payable for the funeral of an insured
employee who dies of an employment
injury or while in receipt of disablement
benefit or invalidity pension or who dies
before attaining the age of 60 but has
satisfied the qualifying conditions.

Employment Injury
accidents occur Completed treatment Decease IP
Dependent benefit
Medical benefit
Temporary disablement benefit Funeral benefit
Rehabilitation benefit
Permanent disablement benefit
Constance attendance allowance
Educational benefit

Invalidity Pension
❖Disability is a serious illness, permanent or
may not be recovered, which resulted in an
employee being unable to earn at least
one-third (1/3) of an employee whose
normal capacity
❖24-HOUR PROTECTION to workers against
invalidity or death from any cause

Invalidity
Pension
Invalidity Pension Survivor’s Pension
Section 15. (a) periodical Section 15. (g) periodical

payments to an insured person payments to dependents of an
in case of invalidity certified by insured person who dies while in
a duly appointed medical receipt of invalidity pension, or of
board or by an authority an insured person who has not
specified in this behalf by the attained 60 years of age…
regulations

❖Invalidity Pension(IP)
– IP is payable to an insured employee who
is suffering from permanent invalidity from
whatever cause which renders him
incapable of engaging in any
substantially gainful employment and
who has fulfilled the qualifying
contribution conditions.

Determination of The Invalidity
Question
i. The question whether a claimant is suffering from
“invalidity’ is determined by a medical board or
an appellate medical board.
ii. In determining this question of invalidity, MB or
AMB will consider :-
– Whether he is suffering from a morbid condition of sickness
or infirmity which is incurable or not likely to be cured; and
– Whether he is unable to earn at least 1/3 of the earnings of
what a normally able person could earn by reason of the
morbid condition.

❖ Survivor’s Pension (SP)
– SP is payable to the primary or secondary dependants of an
insured person who dies from whatever cause while in receipt of
invalidity pension or who dies from whatever cause before
attaining the age of 60 but has satisfied the qualifying
contribution conditions.
❖ Constant-Attendance Allowance(CAA)
– CAA is payable to an insured employee who is entitled to PTDB or
IP and who is so severely incapacitated that he requires the
personal attendance and care of another person.
– The question of the existence of the degree of incapacity
qualifying an insured person for CAA is determined by a Medical
Board or the Appellate Medical Board.

ILLNESS INVALIDITY DECEASE INSURED PERSON
Survivor pension
Invalidity Grant Funeral Benefits
Invalidity Pension
Constant Attendance Allowance
Rehabilitation benefits
Education benefits

Eligibility Requirements of Invalidity
Pension Scheme
Before Reaching 55 years

Start / Stop Scheme
After reaching 60 years
AGE ELIGIBILITY
REQUIREMENT Before Reaching 60 years
Invalidity
Invalidity Date (Morbid) before age 60
Last 24/40 month employment , OR

Full entitlement
ELIGIBILITY 2/3 total month of employment
REQUIREMENTS OF
CONTRIBUTION
Reduced entitlement
1/3 total month of employment

AGE ELIGIBILITY REQUIREMENT
Age Achieve / Has Even
60 Years
Invalidity before reaching 60

years of age
Submit Notice of Invalidity after

attaining 60 years of age
Submit Notice of Invalidity before

attaining 60 years of age
Death before 60 years of age
Death after 60 years of age

(Invalidity Pension Recipients)
Start contributing Invalidity

Pension Scheme before
achieved 55 years and stop
contributing when achieve 60
years of age

ELIGIBILITY REQUIREMENTS OF CONTRIBUTIONS
( Full Requirement )
Start
contributing Notice Date
Received FULL ENTITLEMENT
to Scheme
24 months of 24/40
contributions paid
Pensions rates
40 consecutive months (50-65%)
immediately preceding
the month he submitted
a notice of invalidity
2/3
Monthly contributions have been paid not less than 2/3 of complete
months in the period when contributions first become payable by the
month immediately preceding the month submitted a notice of Pensions rates
invalidity (50-65%)

ELIGIBILITY REQUIREMENTS FOR REFERAL TO
THE MEDICAL BOARD
Invalidity
MB / AMB New Invalidity application
Application
Decision After 60 years
Before 60
years
Not Invalidity (when the APPLICATION DENIED

decision was made, IP (DOCUMENTATION
has reached the age of SHOW INVALIDITY HAS
60 years) NOT HAPPENED BEFORE
REACHING 60 YEARS)
NOT REFERRED TO MB

Conclusion
Compensation
before
before
Prevention Rehabilitation

Thank You

SOCSO Act and Benefits: Occupational Health Doctor

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SOCSO Act and Benefits

Occupational Health Doctor

1 © 2020 NIOSH Malaysia. All rights reserved.

1. Explain about Social Security Concept and

2 © 2020 NIOSH Malaysia. All rights reserved.

3 © 2020 NIOSH Malaysia. All rights reserved.

Social Security (Minimum Standards) Convention, 1952

4 © 2020 NIOSH Malaysia. All rights reserved.

5 © 2020 NIOSH Malaysia. All rights reserved.

Medical Care MOH, SOCSO

6 © 2020 NIOSH Malaysia. All rights reserved.

7 © 2020 NIOSH Malaysia. All rights reserved.

8 © 2020 NIOSH Malaysia. All rights reserved.

CORE PRINCIPLES CORE BASIC

• Protection to employees and dependents (Employment

• Justice in implementing the principles of Solidarity Fund &

9 © 2020 NIOSH Malaysia. All rights reserved.

10 © 2020 NIOSH Malaysia. All rights reserved.

11 © 2020 NIOSH Malaysia. All rights reserved.

RM 3,271.77 MILLION BENEFITS PAYMENTS 65, 980 RECIPIENTS OF

12 © 2020 NIOSH Malaysia. All rights reserved.

Act 4 Act 789 Act 800

14 © 2020 NIOSH Malaysia. All rights reserved.

Employment Injury Invalidity Pension

15 © 2020 NIOSH Malaysia. All rights reserved.

16 © 2020 NIOSH Malaysia. All rights reserved.

17 © 2020 NIOSH Malaysia. All rights reserved.

18 © 2020 NIOSH Malaysia. All rights reserved.

❖ Effective since 13 JUN 2017

19 © 2020 NIOSH Malaysia. All rights reserved.

21 © 2020 NIOSH Malaysia. All rights reserved.

1. Good and Food Transport 11. Food

24 © 2020 NIOSH Malaysia. All rights reserved.

25 © 2020 NIOSH Malaysia. All rights reserved.

• All employers (430 thousand) who have at least one

• Loss of employment with minimum contribution of

26 © 2020 NIOSH Malaysia. All rights reserved.

Re-employment Placement Membantu mendapatkan

Job Search Allowance (JSA) (Rate:slaid

Reduced Income Allowance (RIA) Sama seperti faedah EMP, dibayar

27 © 2020 NIOSH Malaysia. All rights reserved.

28 © 2020 NIOSH Malaysia. All rights reserved.

30 © 2020 NIOSH Malaysia. All rights reserved.

“ • Increase in number of Accidents

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Total Accident Reported

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33 © 2020 NIOSH Malaysia. All rights reserved.

34 © 2020 NIOSH Malaysia. All rights reserved.

Pencen Ilat Pencen Penakat

Between 35-49% of claims for Invalidity Pension benefit reported

35 © 2020 NIOSH Malaysia. All rights reserved.

Almost 45% - 50% of claims for Survivors Pension

36 © 2020 NIOSH Malaysia. All rights reserved.

37 © 2020 NIOSH Malaysia. All rights reserved.

A comprehensive and systematic return

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40 © 2020 NIOSH Malaysia. All rights reserved.

41 © 2020 NIOSH Malaysia. All rights reserved.

Constant Attendance Allowance

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•a personal injury occurs to an employee caused by an accident

During commuting (Section 24)