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Guide to SOCIAL SECURITY ORGANIZATION (Malaysia

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Source: Lawyerment.com.my (Malaysia Online Legal Resources)

http://www.lawyerment.com.my/library/doc/empl/socso/

Abstract

The Social Security Organization (SOCSO) is an organization set up to administer, enforce and implement the Employees' Social Security Act, 1969 and the Employees' Social Security (General) Regulations 1971. It provides social security protection by social insurance including medical and cash benefits, provision of artificial aids and rehabilitation to employees to reduce the sufferings and to provide financial guarantees and protection to the family.It is commonly known in the Malay term as PERKESO or Pertubuhan Keselamatan Sosial. This section informs on who should compulsorily contribute to SOCSO, coverage provided to an insured person by SOCSO under ESSA 1969, coverage and benefits of invalidity pension scheme, employment injury insurance scheme, employer’s SOCSO responsibilities and procedures on how to report accidents, demand claims and appeals.

WHO IS COMPULSORY TO CONTRIBUTE TO SOCSO ?

An employee employed under a contract of service or apprenticeship and earning a monthly wages of RM2,000 and below must compulsorily register and contribute to SOCSO regardless of the employment status whether it is permanent, temporary or casual in nature.

An employee must be registered with the SOCSO irrespective of the age.

SOCSO only covers Malaysian workers and permanent residents. As a result, foreign workers are protected under the Workmen's Compensation Act 1952.

Nevertheless, SOCSO does not cover the following categories of persons :

A person whose wages exceed RM2,000 a month and has never been covered before.

Government employees.

 Self-employed persons. maternity and others  allowances. food.  Foreign workers. washer woman and driver. gardeners. shift.  Employees who have attained the age of 55 only for purposes of invalidity but if they continue to work they should be covered under the Employment Injuries Scheme. wages mean all remuneration payable in money to an employee. Domestic servants employed to work in a private dwelling house which includes a cook. public holidays. sick. cost of living and others. annual. daily rate. weekly rate. The following payments are considered as wages :  salary  overtime payment  commissions and service charge  payment for leave. incentive. WHAT DO WAGES MEAN FOR THE PURPOSE OF SOCSO CONTRIBUTION ? For the purpose of SOCSO contribution. the following payments are not considered as wages :  payments by an employer to any statutory fund for employees  mileage claims  gratuity payments or payments for dismissal or retrenchment . However. Payments made to an employee paid at an hourly rate. housing. rest day. watchman. house servants. task or piece rate are also considered as wages.

The contribution payment is made by both the employer and employee . These schemes are classified into 2 categories :  First Category . annual bonus. WHAT IS THE COVERAGE PROVIDED TO AN INSURED PERSON BY SOCSO UNDER ESSA 1969 ? An insured person or dependants will be entitled to the following benefits :  Periodical payments in the case of invalidity  Periodical payments in the case of disablement suffered as a result of an employment injury  Periodical payments to the dependants of an insured person who dies as a result of an employment injury  Payments for funeral benefit or expense on the death of an insured person as a result of an employment injury  Periodical payments to an insured person who is in receipt of invalidity pension or disablement benefit and is so severely incapacitated or disabled as to require the personal attendance of another person  Medical treatments for the attendance on insured persons suffering from disablement  Periodical payments to dependants of an insured person who dies while in receipt of invalidity pension SOCSO provides coverage to eligible employees through 2 schemes namely  Employment Injury Insurance Scheme  Invalidity Pension Scheme.Employment Injury Insurance Scheme and Invalidity Pension Scheme.

invalidity means a serious disease or disablement of a permanent nature that is either incurable or not likely to be cured. Funeral Benefit. The benefits provided under this scheme are Invalidity Pension. the employee has not completed the age of 55 years • if the employee has completed the age of 55 years when the notice of invalidity is received. The contribution is paid by the employer only. Second Category . • certified as an invalid by a Medical Board or Appellate Medical Board • has fulfilled the contribution qualifying conditions. constant attendance allowance and educational loan. survivors pension. funeral benefit. An employee who is not eligible for coverage under the Invalidity Pension Scheme is protected under this category. kidney failure. chronic asthma and other similar conditions are chronic ailments or diseases that could be considered for invalidity. . cancer. mental illness. Survivors Pension.Employment Injury Insurance Scheme Only. invalidity grant. Rehabilitation and Educational Loan. Invalidity Grant. These schemes provide the benefits of invalidity pension. The following conditions must be fulfilled by an employee to be eligible for Invalidity Pension : • at the time the notice of invalidity is received. Constant Attendance Allowance. Heart attack. as a result of which an employee is unable to earn at least 1/3 of what a normally able person could earn. WHAT DOES THE INVALIDITY PENSION SCHEME COVER AND THE BENEFITS PROVIDED ? Invalidity Pension Scheme provides a 24-hours coverage to employees against invalidity and death due to any cause not connected with employment before the age of 55 years. rehabilitation. such employee has to provide proof that the invalidity occurred before 55 years and he had ceased employment at that time.  Invalidity Pension For the purpose of Invalidity Pension.

is at least 24.  Invalidity Grant This is an outright payment paid to worker or employee who does not qualify for the Invalidity Pension. but has made at least 12 monthly contributions. irrespective of the cause of death.There are 2 contribution qualifying conditions : • full qualifying condition • reduced qualifying condition. as he does not meet any of the contribution qualifying conditions stated. an employee's monthly contributions within a period of 40 consecutive months must be at least 24 months. The Medical Board or an Appellate Medical Board will decide on the eligibility to receive this allowance and will pay the recipient of the benefit directly. the benefit is 40% of the rate of Invalidity Pension.  Survivors Pension Where an employee dies in any of the following situations. The Invalidity Grant is equivalent to the total amount of contributions paid by the employee and the employer for the Invalidity Pension Scheme including the interest thereof. This is subject to the condition that the total number of monthly contributions made during the stated period. Subject to a maximum of RM500 per month. An employee is deemed to have fulfilled the conditions of full contribution qualification if • before the month in which the notice of invalidity is received. • an employee has made monthly contributions for at least 2/3 of the number of full months in the period between the date of first coverage under the Invalidity Pension Scheme and the date the notice of invalidity is received by SOCSO. the dependants will be paid Survivors Pension : . the recipient of Invalidity Pension is also entitled to Constant Attendance Allowance. If an employee is severely incapacitated and requires constant personal attendance.

The rate of Survivors Pension will be 50% of the average monthly wage for an employee who meets the reduced contribution qualifying condition.• while an employee is receiving invalidity pension irrespective of his age • an employee who is not a recipient of the invalidity pension and has not reached the age of 55 years but met either the full contribution qualifying condition or the reduced contribution qualifying condition. The amount and the persons qualified to receive this benefit are the same as those under the Employment Injury Scheme  Rehabilitation Benefit An employer who suffers invalidity is also entitled to receive Rehabilitation Benefit as provided under the Employment Insurance Injury Scheme . Where the deceased is not a recipient of the Invalidity Pension and has met the full contribution qualifying conditions. the rate of the Survivors Pension is equivalent to the rate of the Invalidity Pension received by him.  Funeral Benefit This benefit is paid to the eligible next-of-kind if an employee dies : • while receiving Invalidity Pension • before reaching the age of 55 but meets the full or reduced qualifying contribution conditions. the full rate of the Survivor's Pension is between 50% to 65% of the average monthly wage depending on the number of contributions made in his behalf. Dependants who are entitled for the pension are the same as those under the Dependent Benefit of Employment Injury Scheme. Where the deceased is a recipient of Invalidity Pension.

Several benefits are provided under the Employment Injury Insurance Scheme :  Medical Benefit . WHAT DOES THE EMPLOYMENT INJURY INSURANCE SCHEME COVERS ? The Employment Injury Scheme provides coverage for accidents that occur while :  Traveling (Commuting accident) • while traveling on a route between the place of residence or stay and the work place • while traveling between the work place and the place where the employee takes meals during any authorized recess • while traveling on a journey directly connected to work Except for accident that occurs during a stoppage or deviation done for personal reasons.  Occupational diseases An employee contracting a disease to which he is exposed to various hazards by the nature of his duty. The list of occupational diseases is found in the Fifth Schedule of the Employees' Social Security Act 1969.The total contribution for the Invalidity Pension Scheme is about 1% of the wages of an employee and is shared by the employer and the employee equally. all commuting accidents are considered as employment related.  Arising out of and in the course of employment Accident that happens while performing official duty at the work place which arise out of the employment.

such treatment can also be provided at a government hospital. Where an employee requires specialist treatment. However. This benefit will be paid for the period the employee is on medical leave.Where an employee contracts any occupational disease or meets with an accident. Reimbursement for medical expenditure incurred at a non SOCSO Panel Clinic may only be submitted for consideration. he is entitled to treatment at a SOCSO Panel Clinic or any government hospital or clinic. he is eligible for second class ward treatment at the hospital. the treatment should be at the nearest government hospital. the employee will be paid a minimum rate of RM10 if the daily rate is below RM10.  Permanent Disablement Benefit . To be eligible for free treatment. treatment must be continued at the same clinic until recovery or unless he is referred to a Government Hospital.  Temporary Disablement Benefit An employee who has been certified by a doctor to be unfit for work for not less than 4 days including the day of the accident is eligible for this benefit. Where an employee requires in-patient treatment. a employee or his representative is required to bring along an • Accident Report (Form 21) or an Identification • Letter from his employer or Report of Occupational Diseases Form 68 & Form 69 (whichever is relevant) SOCSO will settle his medical bill on behalf by paying the medical treatment provider directly. Where the employee initially receives treatment in a SOCSO Panel Clinic. In the event of serious injury. An employee whose wage exceeds RM1.900 per month will be paid a maximum rate of RM52 per day. The daily rate of this benefit is equivalent to 80% of the average assumed daily wage.

While receiving this benefit. the employee is given an option to exchange 1/5 of the daily rate of permanent disablement benefit into a lump sum payment while the balance will be paid as a monthly pension for life.  Rehabilitation Benefit SOCSO provides facilities for vocational and physical rehabilitation to employee who suffers from permanent disablement. However. subject to a minimum daily rate of RM10. where the assessment of the loss of earnings capacity exceeds 20%. Subject to a maximum of RM500.500 whichever is lower.  Funeral Benefits Where an employee dies as a result of an employment injury or while receiving disablement benefit. Where the permanent disablement is assessed to be 100%. an amount of RM1. the person who incurred the funeral expenditure will be paid the benefit. eye and . hand. and is so severely incapacitated that he constantly requires the personal attendance of another person. occupational therapy.An employee who has been certified by a Medical Board or an Appellate Medical Board to be suffering from permanent disablement as a result of an employment injury is eligible for this benefit.  Constant Attendance Allowance This allowance is paid to an employee who is suffering from permanent total disablement or 100% loss of earnings capacity. an employee may continue to work. Where there are no next-of-kin.500 will be paid. the allowance is equivalent to 40% of the rate of permanent total disablement benefit. Payment will be made to the eligible next-of-kin. an employee will be paid a daily rate equivalent to 90% of the average assumed daily wage. Physical rehabilitation includes physiotherapy. The maximum amount for the benefit is the actual amount incurred or RM1. An employee can claim the benefit to be paid as a lump sum if the permanent disablement is assessed to be 20% or less. The Medical Board or the Appellate Medical Board will determine the eligibility for this allowance and the payment will be paid directly to the recipient of the benefit. as well as the supply of artificial limps such as artificial leg. reconstructive surgery.

crutches. the following persons can receive the benefits if they depend wholly or partially on the employee's income at the time of his death. whichever occurs earlier Receive benefit up to age 21 or marriage. hearing aids. adopted child or a child out of wedlock will receive the benefit If receiving higher education. repairs of refrigerator and air-conditioner. An employee who is unable to find a suitable job due to his permanent disablement. plumbing. whichever occurs earlier For a mentally retarded or physically handicapped child who is unable to support himself the benefit is paid as long as the child is unable to support himself On condition that he is wholly or mainly dependant on the earning of his wife at the time of her death Receives benefits until remarriage or as long as he is not earning enough to support himself In the event the widower is not eligible for the benefit. Dependants Parents Share of full daily rate 4/10 Conditions Payment of benefit will be made for life . electrical wiring. Dependants Widow Share of full daily rate 3/5 Conditions Receives benefit for life or until remarriage. can apply to undergo vocational training in courses such as radio or television repairs. the full daily rate of dependants' benefit is 90% of the average assumed daily wage.dentures and other prosthetic appliances such as wheelchairs. typing and secretarial work. Subject to a minimum rate of RM10 per day. Children including natural. the children are entitled to receive the benefit (rate of the benefit is 3/5) 2/5 Widower 3/5 Where there is no widow. whichever occurs earlier. tailoring. dependant stepchild. widower or an eligible child.  Dependant's Benefit Where an employee dies as a result of an employment injury. SOCSO will bear all expenses incurred for the purpose of vocational and physical rehabilitation based on rates and conditions determined by SOCSO. including their repair and replacement. the dependants are entitled to this benefit. SOCSO may continue paying the benefit up to completion of the first Degree or marriage. metal trade. spectacles. calipers and orthopedics shoes.

10 0.75 7.90 4.35 1.90 9.10 6.10 5.50 0.10 4.40 0.90 1.25 19. The employer pays 1.40 0.75% for the Employment Injury Insurance Scheme and the Invalidity Pension Scheme while the employee's share of 0.60 9.60 2.35 3.60 3.30 1.30 0.25 10.75 16.60 .25 5.60 8.Grandparents (if parents have passed away) Brothers and sisters 4/10 4/10 Payment of benefit will be made for life Payment of benefit will be made up to age 21 or marriage whichever occurs earlier WHAT IS THE RATE OF SOCSO CONTRIBUTION ? The principal employer must make a monthly contribution for each eligible employee according to the rates specified under the Act.20 0.50 0.95 0.85 2.70 0.40 7.80 2.40 6.65 2. (First Category) Employment Injury & Invalidity Employer Employee's Total Share Share (RM) 0.10 0.5% of wages should be paid for coverage under the Invalidity Pension Scheme.80 1.10 13. The rate of contribution is based on the monthly wage of the employee in accordance to 24 categories.90 11.70 1.90 (Second Category) Employment Injury Only Employer Contribution Only 0.50 2.85 3.10 2.50 Wage Up to RM30 Exceeds RM30 but does not exceed RM50 Exceeds RM50 but does not exceed RM70 Exceeds RM70 but does not exceed RM100 Exceeds RM100 but does not exceed RM140 Exceeds RM140 but does not exceed RM200 Exceeds RM200 but does not exceed RM300 Exceeds RM300 but does not exceed RM400 Exceeds RM400 but does not exceed RM500 Exceeds RM500 but does not exceed RM600 Exceeds RM600 but does not exceed RM700 Exceeds RM700 but does not exceed RM800 Exceeds RM800 but does not exceed RM900 1.25 14.15 1.15 3.40 14.75 12.10 0.10 10.40 1.85 4.

10 24.40 16.75 34.35 32.200 but does not exceed RM1.10 27. it is the duty of an employer to make contribution to the SOCSO on behalf of the employees to insure them against employment injury and the contingencies of invalidity.Exceeds RM900 but does not exceed RM1.35 34.75 25.90 23.500 Exceeds RM1.25 23.000 a month has to register with SOCSO.25 37.10 20.60 18.25 28.60 43.40 11.90 32. It is the liability of the principal employer to ensure all employees employed by the immediate employer have been registered and their contributions have been paid.40 28.500 but does not exceed RM1.700 Exceeds RM1.65 8.60 30. the principal employer will be liable.200 Exceeds RM1.100 Exceeds RM1.15 9.700 but does not exceed RM1.10 15.35 7.65 6.600 Exceeds RM1.000 but does not exceed RM1.40 21.40 WHAT ARE THE RESPONSIBILITIES OF AN EMPLOYER ? An employer must cover their employees even if the employees have other private insurance coverage.10 20. Under the Employees' Social Security Act 1969.35 5.300 but does not exceed RM1.15 7.400 Exceeds RM1.75 30.75 41.900 Exceeds RM1.600 but does not exceed RM1.800 but does not exceed RM1.000 Exceeds RM1.100 but does not exceed RM1.900 16.90 19.300 Exceeds RM1.90 25.400 but does not exceed RM1.40 21.90 14.85 6.800 Exceeds RM1. in the event the employees have not been registered and the immediate employer cannot be located.60 23. Where an employee reached the age of 55 and continues to be employed after that age. Under the Employees' Social Security Act 1969. . A company or firm with one or more employees whose individual earnings do not exceed RM1. only the employer shall contribute to SOCSO for such employees.85 8. The contributions for such employees are borne solely by the employer.90 18.15 5.65 4.25 9.75 39.75 21.60 13.

000. A copy of the trading. The detail records of contributions to SOCSO can be sent using  Computer tapes and diskettes  Electronic data transfers  Preprinted Form 8A IS THERE ANY INTEREST ON CONTRIBUTIONS DUE AND NOT PAID ON TIME BY EMPLOYER ? Where an employer fails to pay contributions within the required period. Both the new and old Identity Card numbers of the employee have to be entered. Contributions can be made through appointed banks or through post offices in Sabah and Sarawak only. Thereafter. subject to a minimum payment of RM5.000 ? Where an employee's monthly wages exceed RM2. such employee will falls into either of the situation : . the duly filled forms and relevant documents should be sent to the SOCSO local Office which will then issue the employer with an employer's Code Number within 1 month. Interest payable will be calculated at the rate of 6% per annum in respect of each day of default or delay beyond the end of such period. The name of an employee has to be as per Identity Card. Employer must fill both forms neatly providing complete details in a legible manner.HOW DOES AN EMPLOYER REGISTER AN EMPLOYEE WITH SOCSO ? Employers are required to fill Employer Registration Form 1 and Employee Registration Form 2 for registration with SOCSO. business or company license has to be enclosed. such employer shall be liable to pay interest as specified under regulation 33 of the Employees Social Security (General) Regulations 1971. Contributions should be made from the first month an employee is employed. This number will be used in all correspondence with SOCSO. WHAT ABOUT AN EMPLOYEE WITH MONTHLY WAGES EXCEEDING RM2.

Claim Form 10 and sick leave certificates should be attached to the completed Form 21. This will be in line with the principle of "once covered always covered" to preserve the employee's rights accumulated under the Invalidity Pension Scheme. the following action should be taken : o The employer of the insured person must be notified verbally or in writing about the accident as soon as possible either by the insured or another person acting on his behalf. Where an employee has not been registered previously and has been receiving a monthly wage exceeding RM2. If an employee opts to be covered.  To claim for Temporary Disablement Benefit. Form 69 should be used instead.  Where an employee is still in employment and contracted with Occupational diseases. report can be made using Form 68. such employee may opt to be covered under the Act. However. A police report. attendance records and a sketch map of the route indicating the place of the accident are additional requirements to report commuting accidents. the victim or the representative has to submit the following documents : • Claim Form 10 • Doctor's Certificate (Form 13) or the original copy of a Medical Certificate • In the event of commuting accident. The information regarding the accidents and injuries has to be written clearly with full details. if the employee has ceased employment. both the employer and employee have to consent to the coverage by filling the necessary form.000 per month. such employee must compulsorily continue to contribute even though the present wage exceeds RM2.Where an employee has been registered previously and contributed to SOCSO. .000. HOW DO I REPORT AN ACCIDENT AND MAKE MY CLAIM ? Under the Employment Injury Insurance Scheme :  All commuting and work related accidents have to be reported by completing and submitting the Accident Report Form 21. which involves the payment of Temporary Disablement Benefit or Permanent Disablement Benefit. An employer's statement.

o A police report of the accident must be made either by the insured or anyone on his behalf. o The employer of the insured person should submit the police report.  To claim for Dependants Benefit. the employee or worker must submit Claim Form 10 and a written application to the SOCSO local office for reference to the Medical Board. the claimant should submit Claim Form 24 and certified copies of the following documents : • birth certificate of the deceased • birth certificate of all the younger brothers and sisters where applicable . the claimant should submit Claim Form 24 and certified copies of the following documents • death certificate • post-mortem report (if any) • birth certificate of all the children • marriage certificate • widow's identity card (if relevant) If there is no widow. widower or an eligible child.  To claim for Permanent Disablement Benefit. o A copy of the police report must then be obtained and submitted to the employer either by the insured or any other person. sketch map of place of accident. attendance record and other documents together with the Accident Report in form 21 to SOCSO local office. A Medical Report from the hospital or clinic which the employee is treated must also be submitted.

(F)41 (Notice of Invalidity) Form and medical report together with a certified copy of identity card or birth certificate. birth certificate of younger brothers and sisters. birth certificate of all children. If you fulfill the necessary requirements and the application forms and supporting documents are complete. . marriage certificate and the widow or widower identity card where applicable.  To claim for Survivor Pension of the Invalidity Pension Scheme. if relevant. the claimant must submit Claim Form 24 and certified copies of death and birth certificate of the deceased employee. Under the Invalidity Pension Scheme :  To claim for Invalidity Grant. HOW LONG DOES IT TAKES TO PROCESS A CLAIM ? Incomplete application form results in late withdrawals payment. the claimant should submit Claim Form 26 and return it to the SOCSO local office together with a certified copy of the death certificate. identity card of parents or guardian or grandparents. SOCSO will undertake to :  pay temporary disablement benefit (first payment) to injured employees within a month.• identity card of parents or guardian or grandparents (if relevant) • death certificate • statement of dependency  To claim for Funeral Benefit. if relevant. The completed application should be sent to the nearest SOCSO local office for processing. widower or children. the claimant should submit the PKS. Where there is no eligible widow. the claimant should submit the Claim Form 24 and certified copies of the death certificate.

 pay survivor's pension (first payment) to dependants within a period of 3 months. Employees who are not satisfied with a decision of a Medical Board regarding assessment of permanent loss of earnings capacity or the determination of invalidity can appeal to this board.  Appellate Medical Board The Appellate Medical Board reviews the decision of the Medical Board. within 90 days of the date on the letter informing the decision of the Medical Board. State offices of the SOCSO are now empowered to process and settle compensation claims of less than RM20.  Social Security Appellate Board . I AM NOT SATISFIED WITH THE COMPENSATION CLAIM FROM SOCSO.000. General compensation claims can be settled within 3 days. have been set up to review cases or decide on appeals relating to approvals and claims for benefits. CAN I APPEAL ? Two types of appeal boards. The decision made by this board is final. pay permanent disablement benefit (first payment) and constant attendance allowance to all injured employees within 3 months. You can appeal by filling the PKS(P) 12 Form and returning to the SOCSO local office. except for the specific ones which requires longer time to be finalized.  pay invalidity pension (first payment) or invalidity grant or constant attendance allowance to employees who qualify within a period of 3 months.  pay dependant's benefit (first payment) to dependants within 3 months.  pay funeral benefits to eligible dependants of deceased persons within 15 days. namely Appellate Medical Board and Social Security Appellate Board.

a trade union representative or any person authorized by the Board. Employees or dependants who are not satisfied with a decision made by SOCSO can appeal to this board. An appellant can be represented by a lawyer.The Social Security Appellate Board reviews the decision of the SOCSO. . An appeal can be made by completing Form A and sending it to the relevant board at any of the Social Security Appellate Board.