Dizon, May Ann B.
Module 6 (Social Legislation)
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SOCIAL LEGISLATION
RULES ON COMPENSATION FOR ILLNESS, ACCIDENT
OR DEATH OF THE WORKER
1. Illness should be included in the list
of occupational disease. Does it
mean that if the illness incurred by
the worker during the period of
employment is not included in the
list, he/she cannot anymore claim
compensation?
When EE suffers in illness and not included in the
list occupational disease, there will arise a
disputable presumption that illness is
compensable. EE has to present substantial
evidence. ER has to refute that.
Duty on the part of EE to connect the illness to
the duty or environment that he has in
(connectivity rule or increased risk theory).
Work connection – duty and environment vis a
vis the illness that EE has suffered. Example: EE
subjected to lung cancer due to asbestos,
produce evidence that he is suffering to illness
and connected to the asbestos and that the
environment he is working in he may inhale
asbestos.
Increased risk – Driver will incur heart/kidney
related diseases. They are usually pressed in
time. They cannot relieved themselves and
answer the call of nature most especially if may
hinahabol sila ng oras. Pinipigalan nila nag pag-
ihi kaya may problema sa kidney.
Truck driver will have to prove by substantial
evidence that because of work he is required to
perform there is an increased risk for him to incur
the illness.
A worker who incurred illness during the period
of employment may still claim compensation
despite that such illness is not included in the list
of occupational disease.
Sickness, as defined under Article 167(1) Chapter
I, Title II, Book IV of the Labor Code of the
Philippines refers to "any illness definitely
accepted as an occupational disease listed by the
Employees Compensation Commission, or any
illness caused by employment, subject to
proof that the risk of contracting the same
is increased by working conditions.”
Section 1(b), Rule III of the Rules Implementing
P.D. No. 626, as amended, requires that for the
sickness and the resulting disability or death to be
compensable, the claimant must show:
(1) that it is the result of an occupational
disease listed under Annex "A" of the
Amended Rules on Employees Compensation
with the conditions set therein satisfied; or
(2) that the risk of contracting the disease is
increased by the working conditions.
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
2. What is the amount of proof
required for worker compensation
cases?
The law requires proof by substantial
evidence, or such relevant evidence which a
reasonable mind might accept as adequate to
justify a conclusion, that the nature of his
employment or working conditions increased the
risk of contracting the ailment or that its
progression or aggravation was brought about
thereby.
3. The burden of proof is upon the
claimant to prove by substantial
evidence. Will it suffice to merely
provide evidence that the worker
probably contracted the illness for
that worker to successfully claim for
compensation?
NO. Although strict rules of evidence are not
applicable, yet the basic rules that mere
allegations are not evidence cannot be
disregarded.
4. Are all injuries, including those
arising from accidents resulting to
disability, incurred or sustained
during the period of employment,
compensable?
No. Not all injuries or accidents resulting to
disability that are incurred or sustained during the
period of employment is compensable.
Rule III of the Amended Rules on Employees
Compensation provides:
SECTION 1. Grounds—(a) For the injury and the
resulting disability or death to be compensable,
the injury must be the result of an employment
accident satisfying all of the following conditions:
(1) The employee must have been injured
at the place where his work requires
him to be;
(2) The employee must have been
performing his official functions; and
(3) If the injury is sustained elsewhere, the
employee must have been executing an
order for the employer.
5. Explain how employees may be
compensated while ministering to
his/her own personal need/s?
Ministering to personal needs w/c an EE cannot
be denied from attending to. Whenever an EE
encountered accident/injury while ministering to
their personal needs it is compensable. OSH will
always relate to the personal needs of EEs.
In the case of Luzon Stevedoring Corporation vs.
Workmen's Compensation Commission, the Court
held that acts reasonably necessary to health and
comfort of an employee while at work, such as
satisfaction of his thirst, hunger, or other physical
demands, or protecting himself from excessive
cold, are incidental to the employment and
Dizon, May Ann B.
Module 6 (Social Legislation)
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injuries sustained in the performance of such acts
are compensable as arising out of and in the
course of employment.
6. Explain the concept of going to-
coming from rule including its
exception.
GR: EE encountered accident going to office from
home and coming from office to home, is
compensable. Exception: there is deviation to
the normal route. Exception to exception:
deviation due to reasonable instruction by ER.
EE went to friend’s home before going to office.
There was a deviation to her normal route then
he met accident, it is not compensable.
EE was instructed to go to client before going to
office. Accident is compensable.
“Going to and coming from work” rule of
the “street peril” principle
General Rule: "in the absence of special
circumstances, an employee injured, in going to,
or coming from his place of work is excluded from
the benefits of workmen's compensation acts."
The reason given is that accidents do not arise
out of and in the course of employment.
Exceptions: The very case of Afable says that
"we do not of course mean to imply that an
employee can never recover for injuries suffered
while on his way to and from work. That depends
on the nature of his employment." The case
of Iloilo Dock Engineering Co. even enumerates
four well-recognized exceptions, to wit:
(1) where the employee is proceeding to
or from his work on the premises of
his employer;
(2) where the employee is about to enter
or about to leave the premises of his
employer by way of the exclusive or
customary means of ingress and
egress;
(3) where the employee is charged,
while on his way to or from his place
of employment or at his home, or
during his employment, with some
duty or special errand connected
with his employment; and
(4) where the employer, as an incident
of the employment, provides the
means of transportation to and from
his place of employment.
7. May all members/heirs of members
of the military or police force
automatically claim compensation
for injury/disability/death under
the 24/hour doctrine?
Military and PNP are always on 24-hour duty.
Anytime they may be called to report for work
and address certain emergencies.
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
If there is an indication that they are not
performing work but sidelining or moonlighting,
then 24-hour doctrine.
Police was shot while flying a trike, the SC held
said no because the police is moonlighting.
Military asked for permission to attend the
wedding of his cousins he brought along w/ him
his friends. May military pass. OTW home there
was incident, friend accidentally pulled the trigger
namatay yung nag ask ng military pass. Is that
compensable? GSIS initially denied the claim. SC
held, under the 24-hour duty doctrine the military
here was still on-call. EEs were allowed to carry
their firearms when they attended the wedding.
The community they will going is heavily
surrounded by NPAs. Even if attending to
personal concerns, they can be called by
superiors to call for emerging situations.
- Not applicable to BFP. You can argue
favorably for BFP and jail guards but it
will depend to attendant circumstances.
Pag sinabi ng superior na rest day siya
but anytime they may be called, then 24-
hour rule can be applied. Meaning nasa
waiting list siya. On-call, WFH anytime
pwede ka pumunta sa office to do work.
- Shifting pa rin kasi si BFP.
No. Members/heirs of military or police force
cannot automatically claim compensation for
injury/disability/death under the 24-hour
doctrine.
In Tancinco vs. GSIS, the Court ruled that at any
rate, the 24-hour duty doctrine, as applied to
policemen and soldiers, serves more as an
after-the-fact validation of their acts to place
them within the scope of the guidelines rather
than a blanket license to benefit them in all
situations that may give rise to their
deaths. In other words, the 24-hour duty
doctrine should not be sweepingly applied to all
acts and circumstances causing the death of a
police officer but only to those which, although
not on official line of duty, are nonetheless
basically police service in character.
Moreover, in GSIS vs CA, the Court clarified that
not all deaths of policemen are compensable.
Thus,
Taking together jurisprudence and the pertinent
guidelines of the ECC with respect to claims for
death benefits, namely: (a) that the employee
must be at the place where his work
requires him to be; (b) that the employee must
have been performing his official functions;
and (c) that if the injury is sustained
elsewhere, the employee must have been
executing an order for the employer,
8. Explain the increased risk doctrine
in compensation cases.
Increased Risk Theory – to establish
compensability, the claimant must show proof of
reasonable work-connection, not necessarily
direct causal relation. Thedegree of proof
Dizon, May Ann B.
Module 6 (Social Legislation)
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required is merely substantial evidence which
means such relevant evidence as will support a
decision, or clear and convincing evidence.
Although strict rules of evidence are not
applicable, yet the basic rules that mere
allegations are not evidence cannot be
disregarded.
SOCIAL SECURITY SYSTEM
Dependents
A. The legal spouse entitled by law to
receive support from the member;
B. The legitimate, legitimated or
legally adopted. and illegitimate
child who is unmarried, not gainfully
employed, and has not reached twenty-
one (21) years of age, or if over twenty-
one (21) years of age, he is congenitally
or while still a minor has been
permanently incapacitated and
incapable of self-support, physically or
mentally: and
C. The parent who is receiving regular
support from the member.
Beneficiaries
1. PRIMARY BENEFICIARIES
a) The dependent spouse until he or she
remarries;
b) The dependent legitimate, legitimated or
legally adopted, and illegitimate children;
The dependent illegitimate children shall
be entitled to 50% of the share of the
legitimate, legitimated or legally adopted
children. However, in the absence of the
dependent legitimate, legitimated
children of the member, his/her
dependent illegitimate children shall be
entitled to 100% of the benefits.
2. SECONDARY BENEFICIARIES
a) The dependent parents, in the absence
of the primary beneficiaries.
b) Any other person designated by the
member as his/her secondary
beneficiary, in the absence of all the
foregoing primary beneficiaries and
dependent parents.
Coverage (Employees and employers)
1. COMPULSORY COVERAGE
Coverage in the SSS shall be compulsory upon all
employees, including kasambahay or domestic
workers not over sixty (60) years of age and their
employers.
2. COMPULSORY COVERAGE OF SELF-
EMPLOYED PERSONS
Coverage in the SSS shall also be compulsory
upon such self-employed persons as may be
determined by the Commission under such rules
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
and regulations as it may prescribe, including, but
not limited to, the following:
(a) All self-employed professionals;
(b) Partners and single proprietors of
businesses;
(c) Actors and actresses, directors,
scriptwriters and news correspondents who
do not fall within the definition of the term
"employee";
(d) Professional athletes, coaches, trainers
and jockeys; and
(e) Individual farmers and fishermen.
Unless otherwise specified in the law, all
provisions thereof applicable to covered
employees shall also be applicable to the covered
self-employed persons.
3. COMPULSORY COVERAGE OF OFWs
a. Coverage of all OFWs.
Coverage in the SSS shall be compulsory upon all
sea-based and landbased OFWs, Provided, that
they are not over sixty (60) years of age.
All benefit provisions under this Act shall apply to
all covered OFWs. The benefits include, among
others, retirement, death, disability, funeral,
sickness and maternity.
b. Sea-based OFWs.
Manning agencies are agents of their principals
and are considered as employers of sea-based
OFWs.
For purposes of the implementation of R.A. No.
11199, any law to the contrary notwithstanding
manning agencies are jointly and severally or
solidarily liable with their principals with respect
to the civil liabilities incurred for any violation
thereof.
The persons having direct control management or
direction of the manning agencies shall be held
criminally liable for any act or omission penalized
under R.A. No. 11199 notwithstanding Section
28(f) thereof.
c. Land-based OFWs.
Land-based OFWs are compulsory members of
the SSS and considered in the same manner as
self-employed persons under such rules and
regulations that the Commission shall prescribe.
The Department of Foreign Affairs (DFA), the
Department of Labor and Employment (DOLE)
and all its agencies involved in deploying OFWs
for employment abroad are mandated to
negotiate bilateral labor agreements with
the OFWs' host countries to ensure that the
employers of land-based OFWs, similar to the
principals of sea-based OFWs, pay the required
SSS contributions, in which case, these land-
based OFWs shall no longer be considered in the
same manner as self-employed persons. Instead
they shall be considered as compulsorily covered
Dizon, May Ann B.
Module 6 (Social Legislation)
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employees with employer and employee shares in
contributions that shall be provided for in the
bilateral labor agreements and their
implementing administrative agreements:
Provided, That in countries which already extend
social security coverage to OFWs, the DFA
through the Philippine embassies and the DOLE
shall negotiate further agreements to serve the
best interests of the OFWs.
The DFA, the DOLE and, the SSS shall ensure
compulsory coverage of OFWs through bilateral
social security and labor agreements and other
measures for enforcement.
4. VOLUNTARY COVERAGE
In addition to the foregoing OFWs who are
eligible for voluntary coverage, the following may
be cited:
a) Non-working spouses of SSS members
Spouses who devote full time to managing the
household and family affairs unless they are also
engaged in other vocation or employment which
is subject to mandatory coverage, may be
covered by the SSS on a voluntary basis.
b) OFWs
Upon the termination of their employment
overseas, OFWs may continue to pay
contributions on a voluntary basis to maintain
their rights to full benefits.
c) Filipino permanent migrants, including
Filipino immigrants, permanent residents
and naturalized citizens of their host
countries
Filipino permanent migrants, including Filipino
immigrants, permanent residents and naturalized
citizens of their host countries may be covered by
the SSS on a voluntary basis.
Benefits and requirements before a 3. RETIREMENT BENEFITS
beneficiary may avail them
1. SICKNESS BENEFIT
The sickness benefit is a daily cash allowance paid
for the number of days a member is unable to
work due to sickness or injury.
A member who has paid at least three (3)
monthly contributions in the 12-month
period immediately preceding the semester of
sickness or injury and is confined therefor for
more than three (3) days in a hospital or
elsewhere with the approval of the SSS, shall, for
each day of compensable confinement or a
fraction thereof, be paid by his employer, or the
SSS, if such person is unemployed or self-
employed, a daily sickness benefit equivalent
to ninety percent (90%) of his average daily
salary credit, subject to the following
conditions:
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
(1) In no case shall the daily sickness
benefit be paid longer than one hundred
twenty (120) days in one (1) calendar
year, nor shall any unused portion of the
one hundred twenty (120) days of
sickness benefit granted under this
section be carried forward and added to
the total number of compensable days
allowable in the subsequent year;
(2) The daily sickness benefit shall not
be paid for more than two hundred
forty (240) days on account of the
same confinement; and
(3) The employee member shall notify
his employer of the fact of his sickness
or injury within five (5) calendar days
after the start of his confinement
unless such confinement is in a hospital
or the employee became sick or was
injured while working or within the
premises of the employer, in which case,
notification to the employer is not
necessary: Provided, - That if the
member is unemployed or self-employed,
be shall directly notify the SSS of his
confinement within five (5) calendar days
after the start thereof unless such
confinement is in a hospital, in which
case, notification is also not necessary:
Provided, further, That in cases where
notification is necessary, the confinement
shall be deemed to have started not
earlier than the fifth day immediately
preceding the date of notification.
Compensable Confinement
That such allowance shall begin only after all
sick leaves of absence with full pay to the credit
of the employee member shall have been
exhausted.
2. 105-DAY MATERNITY LEAVE
Two types of retirement benefits
Retirement benefit is a cash benefit either in
monthly pension or lump sum paid to a
member who can no longer worker due to old
age.
1. Monthly pension; and
2. Lump sum amount
The monthly pension is a lifetime cash benefit
paid to a retiree who has paid at least one
hundred twenty (120) monthly contributions prior
to the semester of retirement. The lump sum is
granted to a retiree who has not paid the
required 120 monthly contributions. It is equal to
the total contribution paid by the member and
by the employer including interest.
Who are qualified (Sec. 12-B, RA 1199)
Dizon, May Ann B.
Module 6 (Social Legislation)
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A member who has paid at least one hundred
twenty (120) monthly contributions prior to the
semester of retirement and who:
1. has reached the age of sixty (60)
years and is already separated from
employment or has ceased to be self-
employed; or
2. has reached the age of sixty-five
(65) years, shall be entitled for as long
as he lives to the monthly pension.
Provided, that he shall have the option to receive
his first eighteen (18) monthly pensions in lump
sum discounted at a preferential rate of interest
to be determined by the SSS.
A covered member who is sixty (60) years old at
retirement and who does not qualify for
pension benefits under paragraph (a) above, shall
be entitled to a lump sum benefit equal to the
total contributions paid by him and on his behalf:
Provided, that he is separated from employment
and is not continuing payment of contributions to
the SSS on his own.
Reemployment or resumption of self-
employment
The monthly pension shall be suspended
upon the reemployment or resumption of
self-employment of a retired member who is
less than sixty-five (65) years old
Death of retired member
Upon the death of the retired member, his
primary beneficiaries as of the date of his
retirement shall be entitled to receive the monthly
pension: Provided, That if he has no primary
beneficiaries and he dies within sixty (60) months
from the start of his monthly pension, his
secondary beneficiaries shall be entitled to a lump
sum benefit equivalent to the total monthly
pensions corresponding to the balance of the five-
year guaranteed period, excluding the
dependents’ pension.
Retirement of member after reaching 60
The monthly pension of a member who retires
after reaching age sixty (60) shall be the higher
of either: (1) the monthly pension computed at
the earliest time he could; have retired had he
been separated from employment or ceased to be
self-employed plus all adjustments thereto; or (2)
the monthly pension computed at the time when
he actually retires.
4. UNEMPLOYMENT INSURANCE OR
INVOLUNTARY SEPARATION BENEFITS
A member who is not over sixty (60) years of age
who has paid at least thirty-six (36) months
contributions twelve (12) months of which should
be in the eighteen-month period immediately
preceding the involuntary unemployment or
separation shall be paid benefits in the form of
monthly cash payments equivalent to fifty
percent (50%) of the average monthly salary
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
credit for a maximum of two (2) months:
Provided, That an employee who is involuntarily
unemployed can only claim unemployment
benefits once every three (3) years: Provided,
further, That in case of concurrence of two or
more compensable contingencies, only the
highest benefit shall be paid, subject to the rules
and regulations that the Commission may
prescribe.
5. DISABILITY BENEFITS
6. DEATH BENEFITS
7. FUNERAL BENEFITS
GOVERNMENT SOCIAL INSURANCE SYSTEM
1. Who are the beneficiaries and dependents?
2. Enumerate the benefits and the requirements
before they may be availed by the
member/beneficiaries
MEMORIZE PROVISIONS (SSS AND GSIS)
SSS
COMPULSORY MEMBERS – OFWs (JOINT SHIP
MANNING GRP CASE)
Voluntary
Beneficiaries and Dependents
SSS AND GSIS: Parents of the member of
SSS/GSIS are 2ndary beneficiaries. Will only be
entitled to the proceeds if there are no primary
beneficiaries available.
Primary: Spouse, minor dependents, not fully
depended bec of mental incapacity.
Benefits that may be availed. Wag magmemorize
na ng number of contribution. Know what are
these benefits.
Compare the SSS and GSIS benefits, mas madami
GSIS benefits.
In case EE used to be a member of SSS and
transferred to GSIS or vis a vis, EE claim benefit
under specific system but not yet entitled yet bec
of req premium contribution. System shall apply
limited portability rule. System should consider
the premium payment made on another section.
There is a totalization. Magkaiba ang amount na
kini-claim ng SSS sa GSIS. Malaki contribution sa
GSIS kesa SSS. Kaya mag-government ka na!
System wil not consider the number of
contribution they have to abide to the formula. IT
CAN BE DONE ONLY ONCE.
- After totalizing, still short of the req
number of contribution. Will it be denied?
NO. System has to compute for whatever
amount the EE is entitled based on the
contribution.
UHC
How it operates?
All working EEs will contribute to Healthcare
system. All workings EEs shall shoulder the
payment of premiums of indigent community.
We all contribute to the system. All of us are
paying for every member of the society to avail
the UHC.
Dizon, May Ann B.
Module 6 (Social Legislation)
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Nature of the funds of SSS, GSIS, Philhealth are
highly fiduciary. They should exercise highest
degree of diligence in managing our funds.
SSS invested several million of pesos sa stocks ng
ABS-CBN. Congress denied the franchise of ABS-
CBN. Ang laki nawala sa SSS. By 2025, SSS will
be running out of funds na daw huhu. Ayoko na
mag private company.
INTEGRATION
LABOR CODE provides min standard benefits that
may be accorded to the EE. EE-ER are still free to
enter into agreements to provide more benefits
to EE. No agreements should be done providing
lesser benefit that the LC.
Before claiming benefits, there should be EE-ER
relationship.
Test of EE-ER relationship. 1) four-fold test
(control by ER over EE). Control as to means and
methods.
Control exercised by ER by requiring certain
amount of work or over the equipment or manner
how the work will be performed by EE.
2) ECONOMIC independent reality test – if four
fold test is not conclusive and there is some
badges in some test. Economic dependence of
the EE to the perpetrated ER if we will cut off the
economic ties, the EE has no other source of
livelihood.
Applied if may claim that EE is contractor or
consultant.
ER decide to hire maintain compensate disciple
and in all aspects of operation of establishment
inc closing – protected right of ER (management
prerogatives)
GR: State will not interfere
EXC: ER will violate law, policy, customs, unfair
or oppressive to the EEs.
Forms ER would exercise MR.
Treatment in favor of EE pursuant to Social
Justice.
Memorise meaning of SJ. Applied whether a
validly dismissed EE can claim SP
PLDT vs NLRC – 2 guidelines
Toyota – aside from the 2 guidelines, SP is
withheld based on the JUST GROUNDS provided
in LC.
Mitigating/aggravating circumstancs may still be
taken into consideration in entitlement to SP
despite the validity of dismissal.
LC – applicable to private EEs.
GOCCs w/ charter – CSC
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
GOCCs w/o charter – LC
Diff GOCCs that we have. How are they created?
**benefits title 1 book iii of LC – MEAT OF LAB
STANDARDS.
Know how limits of MR in req EE to report to work
in rest days, holidays, working during night time
rest day holiday
SIL how provided. How It may be availed
SERVICE CHARGE
Wages RTBP would fixed min wage rate in every
region may factors!
RB has issue Wage order tat would fix min wage
of MWE
If WO is implemented resulring to Wage
distortion
REMEDIes WD depends if organized or not
Wages include facility
Faci vs supplements – test? Effect if ER would
unilaterally withdraw? Er do where it will
withdraw benefits categorized as facility
ER may have remedies to challenge a WO. Know
remedies.
OHS – art 128, 129
Test is whether the RD or repre of DOLE went to
the premises of ER – visitorial and enforcement
(Art 128) NO 5,000 limitation
ART 129 – 5K limit will not apply EE claiming
reinstatement (proper complain of ID, LA may
jurisdiction). Complainant is DH, all matters will
be under the jurisdiction of RD w/c will include
benefits under 129 regardless of amounts.
Apprentices vs learners – sino? Periods>?
Disabled person – how can be hired?
Acts of discrimination gender, age, disability
Sexual harassment, GENDER based harrasment
Anti trafficking recruitment under MWA
Labor only and independent contractors.
LO prohibited, IC allowed.
Extent of liabilities: BOTH contractor solidarily
liable to principle to unpaid wages. Difference.
Hired worker under LO may claim regularization
under trilateral rel, principal is considered the
direct er contractor ay agent lang ni principal.
Under IC, principal ay indirect ER, contractor is
still the ER of EE. Solidarily liability on the
principal, contractor afailed to pay, EE can go
after the princioal for unpaid wages during the
extent of contract no more no less.
Dizon, May Ann B.
Module 6 (Social Legislation)
7|Page

All other beenfits accorded to regular afforded sa SIL – ER providing for at least 5 days of VL,
EE hired by LO. establishment is no longer req to observe SIL
under LC.
TEST sa LO, negate lang sa IC.
No offsetting rule –EE on a half day or late siya
CONTROL TEST GINAGAMIT YAN SA LO tas babawiin the ff day. Maextend ang 8 hrs na
CONTRACT. dapat mag work siya. Under LC, entitled na sa OT
pay for work rendered beyond 8 hrs. That will
SERNANDE CASE – SC IDENTIFIED 2 TYPES LO circumvent the OT pay in LC. Mas malaki ang OT
1) control 2) substantial capitalization kasi.

1) LO no substantial capitalization auto LO na BPO offsetting of holiday ng US sa holiday ng PH

- DOLE should take note when they conduct
2) LO no control over hired workers. May visitation in BPO.
substantial pero no control sa workers.

Recruirment and placement elements of IR,

types of IR, PREscription period, def of IR,
how MWA differs from R AND P in LC.

Just cause and authorized cause

EE entitled to security of tenure. All ees cannot
be terminated except for just and authorized
cause.

Finding of ID: 1) Reinstatement 2) backwages 3)

all benefits accrue during unlawful termination

How to validly terminate the EEs?

Just – based on the act of EEs

- Serious misconduct insubordination

gross and habitual neglect of duty,
willful disobedience, commission of the
crime against ER or rep of ER.

Authorized – depends on prero of ER

- Labor saving (Automation),

retrenchment due to serious business
losses or prevent closure of business,
redundancy (amt of manpower is no
longer required by the demand of ER),
disease/illness of EE (somehow
attributable to EE)

RELEVANCE OF DISTINCTION

Authorized cause – pay EE with SP.

(provided by law talaga not under SJ)

- SJ vis a vis SP will only apply in case the

EE has been validly dismissed based on
JUST ground.
- SJ is equitable, applicable if no provision
in LC.

Clarification:

ER in its discretion may adopt policies that

would affect the benefits of the EEs.

ER may be allowed to give VL and SL – based on

the prerogative yan ng ER wala yan sa LC e.

As to how they may avail based yan sa policy ng

ER. DOLE will only interfere if ER would renege
to the policy on how those leave will be claimed
bec it is not a valid exercise of MR.

* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
Dizon, May Ann B.
Module 6 (Social Legislation)
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LIMITED PORTABILITY
How may members of the SSS and the
GSIS benefit from this scheme?
RA No. 7699 was enacted to enable those from
the private sector who transfer to the government
service or from the government sector to the
private sector to combine their years of
service and contributions which have been
credited with the GSIS or SSS, as the case
may be, to satisfy the required number of
years of service for entitlement to the
benefits under the applicable laws.
This is advantageous to the SSS and GSIS
members for purposes of death, disability or
retirement benefits.
Totalization
Process of adding up the periods of creditable
services or contributions under each of the
System, SSS or GSIS, for the purpose of
eligibility and computation of benefits.
Totalization shall not apply to following
instances:
1. Worker is not qualified for any benefits
from both Systems; or
2. Worker in the public sector is not
qualified for any benefits from the GSIS;
or
3. Worker in the private sector is not
qualified for any benefits from the SSS.
Is portability absolute?
PORTABILITY – refers to the transfer of funds for
the account and benefit of a worker who transfers
from one system to the other.
UNIVERSAL HEALTH CARE
State the policy/ies under the law.
It is the policy of the State to protect and
promote the right to health of all Filipinos and
instill health consciousness among them.
Towards this end, the State shall adopt:
1. An integrated and comprehensive
approach to ensure that all Filipinos are
health literate, provided with healthy
living conditions, and protected from
hazards and risks that could affect their
health;
2. A health care model that provides all
Filipinos access to a comprehensive set
of quality and cost-effective, promotive,
preventive, curative, rehabilitative and
palliative health services without causing
financial hardship and prioritizes the
needs of the population who cannot
afford such services;
3. A framework that fosters a whole-of-
system, whole-of-government, and
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
whole-of-society approach in the
development, implementation,
monitoring, and evaluation of health
policies, programs and plans; and
4. A people-oriented approach for the
delivery of health services that is
centered on people’s needs and well-
being, and cognizant of the differences in
culture, values, and beliefs.
Who are direct contributors?
Refer to those who have the capacity to pay
premiums, are gainfully employed and are
bound by an employer-employee
relationship, or are self-earning,
professional practitioners, migrant
workers, including their qualified dependents,
and lifetime members.
Direct contributors, including their qualified
dependents shall be composed of, but not
limited to, the following:
1. Employees with formal employment
characterized by the existence of an
employer-employee relationship, which
include workers in the government and
private sector, whether regular, casual,
or contractual, are occupying either an
elective or appointive position, regardless
of the status of appointment, whose
premium contribution payments are
equally shared by the employee and the
employer;
2. Kasambahays
3. All other workers who are not covered by
formal contracts or agreements or who
have no employee-employer relationship
and whose premium contributions are
self-paid, and with capacity to pay
premiums, such as the following:
a) Self-earning individuals; and
b) Professional practitioners;
4. Overseas Filipino Workers, such as, but
not limited to:
a) Sea-based Filipino workers or
seafarers; and,
b) Land-based overseas Filipino
workers;
5. Filipinos living abroad;
6. Filipinos with dual citizenship;
7. Lifetime members as defined in RA 10606
(National Health Insurance Act); and
8. All Filipinos aged 21 years and above who
have the capacity to pay premiums.
Who are indirect contributors?
Refer to all others not included as direct
contributors, as well as their qualified
dependents, whose premium shall be subsidized
by the national government including those who
are subsidized as a result of special laws.
Indirect contributors, including their qualified
dependents shall be composed of, but not limited
to, the following:
1. Indigents identified by the DSWD;
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Module 6 (Social Legislation)
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2. Beneficiaries of Pantawid Pamilyang
Filipino Program/Modified Conditional
Cash Transfer (4Ps/MCCT);
3. Senior citizens who are not currently
covered by the Program;
4. Persons with disability;
5. All Filipinos aged 21 years old and
above without the capacity to pay
premiums;
6. Sangguniang Kabataan officials
7. Those previously identified at point-
of-service (POS) or during registration,
members previously sponsored by LGUs
and those who are not yet in the
PhilHealth database and are financially
incapable to pay premiums.
Is PHILHEALTH contribution required
before a Filipino may avail of the health
care benefits under the law?
No.
Section 9. Entitlement to Benefits. - Every
member shall be granted immediate eligibility for
health benefit package under the Program:
Provided, That PhilHealth Identification Card
shall not be required in the availment of
any health service: Provided, further, That no
co-payment shall be charged for services
rendered in basic or ward accommodation:
Provided, furthermore, That co-payments and co-
insurance for amenities in public hospitals shall be
regulated by the DOH and PhilHealth: Provided,
finally, That the current PhilHealth package for
members shall not be reduced.
PhilHealth shall provide additional Program
benefits for direct contributors, where applicable:
Provided, That failure to pay premiums shall
not prevent the enjoyment of any Program
benefits: Provided, further, That employers and
self-employed direct contributors shall be
required to pay all missed contributions with an
interest, compounded monthly, of at least three
percent (3%) for employers and not exceeding
one and one-half percent (1.5%) for self-earning,
professional practitioners, and migrant workers.
Who are covered by the Universal Health
Care Program?
1. Population Coverage - Every Filipino
citizen shall be automatically included
into the National Health Insurance
Program, hereinafter referred to as the
Program.
2. Service Coverage –
3. Financial Coverage –
a) Population-based health services
shall be financed by the national
government through the DOH
and provided free of charge at
point of service for all Filipinos.
b) The national government shall
support LGUs in the financing of
capital investments and
provision of population-based
health services.
* By Nolasco, C.I. for SY 2021-2022 PUP Labor Law 1 Students, November 2021.
c) Individual-based health services
shall be financed primarily
through prepayment
mechanisms such as social
health insurance, private health
insurance, and HMO plans to
ensure predictability of health
expenditures
How will the program be funded?
1. For population-based health
services – it shall be financed by the
National Government through the DOH
and provide free of charge at point of
service for all Filipinos.
2. For individual-based health services
– it shall be financed primarily through
prepayment mechanisms such as social
health insurance, private health
insurance and HMO plans.
What is a health care provider?
Refers to any of the following:
1. A health facility which may be public or
private, devoted primarily to the
provision of services for health
promotion, prevention, diagnosis,
treatment, rehabilitation and palliation of
individuals suffering from illness, disease,
injury, disability, or deformity, or in need
of obstetrical or other medical and
nursing care.
2. A health care professional who may be a
doctor of medicine, nurse, midwife,
dentist, or other allied professional or
practitioner duly licensed to practice in
the Philippines.
3. Community-based health care
organization - Refers to an association of
members of the community organized for
the purpose of improving the health
status of that community
4. Pharmacies or drug outlets- Refer to
establishments licensed under RA 9711
(Food and Drug Administration Act of
2009) which sell or offer to sell any health
product directly to the general public or
entities licensed by appropriate
government agencies, and which are
involved in compounding and/or
dispensing and selling of pharmaceutical
products directly to patients or end users
as defined under RA 10918 (Philippine
Pharmacy Act).
5. Laboratories and diagnostic clinics - Refer
to licensed facilities where tests are done
on the human body or on specimens
thereof to obtain information about the
health status of a patient for the
prevention, diagnosis and treatment of
diseases.
LECTURE:
- EE on account of illness may claim for
compensation there is existing list of
compensable disease. If the illness is
already included in that list, EE has to
prove the fact of his illness.