SOCIAL WELFARE BENEFITS

 SSS Law (R.A. No. 8282, as amended by R.A. No. 11199)

1. Benefits; Coverage and Exclusions
2. Dependents and Beneficiaries
 GSIS Law (R.A. No. 8291)
1. Benefits; Coverage and Exclusions
2. Dependents and Beneficiaries
 Limited Portability Law (R.A. No. 7699)
 Disability and Death Benefits; Labor Code and Civil Code
 Claims of Seafarers; 2010 Standard Terms and Conditions Governing the Overseas Employment
of Filipino Seafarers On-board Ocean-going Ships (Secs. 20, 32, 32-A)

Social Security System Law (R.A. No. 8282)

1. COVERAGE AND EXCLUSIONS
Compulsory Coverage
 All employees not over sixty (60) years of age and their employers, including domestic
helpers with at least P1,000.00 monthly pay [Sec. 9, RA 8282].
 Self-Employed Persons [Sec. 9-A, RA 8282]
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
 A domestic worker who has rendered at least one (1) month of service shall be covered
by the Social Security System (SSS), the Philippine Health Insurance Corporation
(PhilHealth), and the Home Development Mutual Fund or Pag-IBIG, and shall be entitled
to all the benefits in accordance with the pertinent provisions provided by law.
o Premium payments or contributions shall be shouldered by the employer.
However, if the domestic worker is receiving a wage of Five thousand pesos
(P5,000.00) and above per month, the domestic worker shall pay the
proportionate share in the premium payments or contributions, as provided by
law.
o The domestic worker shall be entitled to all other benefits under existing laws
[Sec. 30, RA 10361].
Voluntary Coverage
 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 Filipinos recruited by foreign-based employers for employment abroad (OFWs)
[Sec. 9 (b)].
 An OFW upon the termination of his/her employment overseas; [Sec 9-B, (f)]
 A covered employee who was separated from employment who continues to pay his/her
contributions; [Sec 11]
 A self-employed member who realizes no income in any given month who continues to
pay his/her contributions. [Sec 11-A]
  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 [Sec. 9-B(g)]

Exclusion
 Excluded employers: The government and any of its political subdivisions, branches or
instrumentalities, including corporations owned or controlled by the Government [Sec.
8(c), R.A. No. 11199]
 Excluded employees:
a. Services where there is no employer-employee relationship in accordance with
existing labor laws, rules, regulations and jurisprudence;
b. Service performed in the employ of the Philippine Government or instrumentality or
agency thereof;
c. Service performed in the employ of a foreign government or international
organization, or their wholly-owned instrumentality: they may however enter into an
agreement with the Philippine Government for the inclusion of such employees in the
SSS except those already covered by their respective civil service retirement systems.
d. Such other services performed by temporary and other employees which may be
excluded by regulation of the Commission. Employees of bona fide independent
contractors shall not be deemed employees of the employer engaging the service of
said contractors. (8(j), R.A. No. 11199)
Effect of separation from employment When an employee under compulsory coverage is
separated from employment, his employer's contribution on his account and his obligation to pay
contributions arising from that employment shall cease at the end of the month of separation but
said employee shall be credited with all contributions paid on his behalf and entitled to benefits
according to the provisions of R.A. No. 11199. He may, however, continue to pay the total
contributions to maintain his right to full benefit.
Effect of interruption of business or professional income. If the self-employed realizes NO
income in any given month, he shall not be required to pay contributions for that month. He may,
however, be allowed to continue paying contributions under the same rules and regulations
applicable to a separated employee member

Effective Date of Coverage

For Compulsory Coverage:
 Employer - Compulsory coverage of the employer shall take effect on the first day of his
operation or on the first day he hires employee/s. The employer is given only 30 days
from the date of employment of the employee to report the person for coverage to the
SSS. (Sec. 10)
 Employee - Compulsory coverage of the employee shall take effect on the first day of
his/her employment. (Sec. 10)
 Self-employed - Compulsory coverage of the self-employed person shall take effect upon
his/her registration with the SSS. Registration shall mean payment of first contribution
(Sec. 3, Rule 15, R.A. No. 11199 IRR).
 OFWs
o A sea-based OFW shall take effect on the first day of his/her employment;
o A land-based OFW covered under BLAs shall take effect based on the provisions
of the Agreement and its implementing arrangement;
o Compulsory coverage of a land-based OFW not covered under BLAs shall take
effect on the applicable month and year of the first contribution payment.
 For Voluntary Coverage:
 Land-based OFWS -Voluntary coverage of land-based overseas Filipinos shall take
effect on the applicable month and year of the first contribution payment. (Sec. 4, Rule
15, R.A. No. 11199, IRR)
 Non-working spouse – upon first payment of contribution.
 Separated member – on the month he/she resumed payment of contribution

2. DEPENDENTS AND BENEFICIARIES

Dependents
1. The legal spouse entitled by law to receive support from the member; [Sec 8, (e), (1)];
2. The legitimate, legitimated or legally adopted and illegitimate child who is:
a. Unmarried,
b. Not gainfully employed, and
c. Has not reached twenty-one (21) years of age, or if over 21 years of age, he/she is
congenitally or while still a minor has been permanently incapacitated and incapable
of self-support, physically or mentally. [Sec 8, (e), (2)]

A child who has entered in a common-law relationship and has not reached the age of
eighteen (18) is still a dependent. However, upon reaching the age of 18, the child is
no longer qualified as a dependent.
3. The parent who is receiving regular support from the member. [Sec 8, (e), (3)

Beneficiaries
Primary: The following are considered as primary beneficiaries:
1. The dependent spouse who has not remarried [Sec 8, (k)], cohabited or entered in a “live-in”
relationship before or after the death of the member, and
2. The dependent legitimate, legitimated or legally adopted and illegitimate children. Where
there are legitimate or illegitimate children, the former shall be preferred. The dependent
illegitimate children shall be entitled to fifty percent (50%) of the share of the legitimate,
legitimated or legally adopted children.

In the absence of the dependent legitimate, legitimated or legally adopted children of the
member, his/her dependent illegitimate children shall be entitled to one hundred percent
(100%) of the benefits. (Sec 8, [k], Rule 12 Sec 12 IRR)

Secondary: In the absence of primary beneficiaries, the secondary beneficiaries are as follows:
1. The dependent parents of the deceased member; and
2. Any other person designated by the member as his/her secondary beneficiary, in the absence
of all the foregoing primary beneficiaries and dependent parents. (Sec. 13, Rule 12, IRR)
Benefits
a. Monthly Pension (Sec. 12) f. Funeral (Sec. 13-B)
b. Dependent’s Pension (Sec.12-A) g. Sickness (Sec. 14)
c. Retirement (Sec.12-B) h. Maternity Leave (Sec. 14-A)
d. Death (Sec.13) i. Unemployment Insurance or Involuntary
e. Permanent Disability (Sec. 13-A) Separation Benefits (Sec.14-B)
Non-Transferability of Benefits: The SSS shall promptly pay the benefits provided in this Act to such
persons as may be entitled thereto in accordance with the provisions of this Act.
Such benefits are not transferable, and no power of attorney or other document executed by those entitled
thereto in favor of any agent, attorney or any other person for the collection thereof on their behalf shall
be recognized, except when they are physically unable to collect personally such benefits:
In case of death benefits, if no beneficiary qualifies under this Act, said benefits shall be paid to the legal
heirs in accordance with the law of succession (Sec 15)

a. MONTHLY PENSION The Monthly Pension is a monthly specified cash amount that a qualified
member or a qualified beneficiary will receive on account of permanent total disability, retirement or
death. (Sec 1, Rule 18, IRR of RA 11199)
The monthly pension shall be the highest of the following amounts:
a. P300.00 + (20% x AMSC) + (2% x AMSC) x (CYS – 10); or
b. 40% x AMSC; or
c. Minimum monthly pension For Retirement: -
 P1,200.00, if with at least 10 CYS
 P2,400.00 if with at least 20 CYS
For Death/Disability benefit: -
 P1,000.00 if with less than 10 CYS,
 P1,200.00, if with at least 10 CYS, or
 P2,400.00 if with at least 20 CYS.

b. DEPENDENT’S PENSION Where monthly pension is payable on account of death, permanent total
disability or retirement, dependents’ pension equivalent to ten percent (10%) of the monthly pension
or Two hundred fifty pesos (P250.00), whichever is higher, shall also be paid for each dependent child
conceived or legally adopted on or before the date of the contingency. [Sec 12-A in relation to Sec 8,
(e), (2)]
 The dependent’s pension shall be paid to dependent children, not exceeding five (5),
beginning from the youngest and without substitution. [Sec 12-A]
 Where there are legitimate and illegitimate children, the former shall be preferred. [Sec 12-A,
proviso] (Sec 1, Rule 20, IRR of RA 11199)

c. RETIREMENT BENEFIT The Retirement Benefit is a monthly pension or lump sum granted to a
member who can no longer work due to old age.
 Monthly pension - a lifetime cash benefit paid to a retiree who has paid at least 120 monthly
contributions to the SSS prior to the semester of retirement.
 Lump sum amount - is granted to a retiree who has not paid the required 120 monthly
contributions. It is equal to the total contributions paid by the member and by the employer
including interest.
 WHO ARE QUALIFIED A member must have at least one hundred twenty (120) monthly
contributions prior to semester of retirement; and
o Has reached sixty (60) years old and is separated from employment or has ceased to
be self-employed (Optional Retirement)
o Is at least sixty-five (65) years old (Technical Retirement)
 o A separated member who has paid less than one hundred twenty (120) monthly
contributions who continues as a voluntary-paying member to complete the required
monthly contributions to qualify for full pension benefit (Sec. 11 and 11-A).
 Exceptions as to age:
o Underground Mineworker whose date of actual retirement is not earlier than March
13, 1998:
 Optional Retirement - 55 y/o
 Technical Retirement - 60 y/o
o Underground Mineworker whose date of actual retirement is not earlier than April 27,
2016:
 Optional Retirement - 50 y/o
 Technical Retirement -60 y/o (Rule 21, Sec. 2 IRR)
 13TH MONTH PENSION A retired member is entitled to a thirteenth (13th) month pension
equivalent to the amount of the monthly pension due and additional benefit allowance,
payable every month of December of the applicable year.
 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.

d. DEATH BENEFITS The Death Benefit is a cash benefit either in monthly pension or lump sum paid
to the beneficiaries of a deceased member (Sec. 1, Rule 22, IRR R.A. No. 11199)
 What are the types of death benefits? They are:
o the monthly pension; and
o the lump sum amount.
 The monthly pension is granted only to the primary beneficiaries of a deceased member who
had paid 36 monthly contributions before the semester of death.
 The lump sum is the amount granted to the primary beneficiaries of a deceased member who
had paid less than 36 monthly contributions before the semester of death.
o The secondary beneficiaries shall be entitled to a lump sum benefit.
 Upon death of the member:
o If a member has paid at least 36 monthly contributions prior to the semester of death:
 Primary Beneficiaries - entitled to monthly pension;
 Secondary Beneficiaries - entitled to a lump sum benefit equivalent to thirty-
six (36) times the monthly pension; and
 If a member has not paid the required 36 monthly contributions the primary
or secondary beneficiaries shall be entitled to whichever is higher between.
o A lump sum benefit equivalent to the monthly pension times the number of monthly
contributions paid to the SSS; and
o Twelve (12) times the monthly pension (Sec. 13, R.A No. 11199)
 The deceased member’s beneficiaries are entitled to a 13th month pension payable every
December and the funeral benefit, which is paid to whoever, shouldered the funeral expenses
of the deceased member.
 The primary or secondary beneficiaries of a deceased employee-member, who had no
contribution payment at all and who was reported for coverage shall be entitled to funeral
benefit only
 The dependent legitimate, legitimated, legally adopted or illegitimate children, conceived on
or before the date of death of a deceased will each receive a dependents’ pension equivalent
to 10 percent of the members’ monthly pension or P250, whichever is higher.
 o Only five (5) minor children, beginning from the youngest, are entitled to the
dependents’ pension. No substitution is allowed.
o Where there are more than five (5) legitimate and illegitimate minor children, the
legitimate shall be preferred.
 The dependents’ pension stops when the child reaches 21 years old, gets married, gets
employed or dies. However, the dependents’ pension is granted for life to children who are
over 21 years old, provided they are incapacitated and incapable of self-support due to
physical or mental defect which is congenital and acquired during minority.

e. PERMANENT DISABILITY BENEFIT The Permanent Disability Benefit is a cash benefit granted
to a member who becomes permanently disabled either partially or totally. (Sec. 1 Rule 23, IRR R.A.
No. 11199)
 PERMANENT TOTAL DISABILITY. – The following disabilities shall be deemed
permanent total:
o Complete loss of sight of both eyes;
o Loss of two limbs at or above the ankle or wrists;
o Permanent complete paralysis of two limbs;
o Brain injury resulting to incurable imbecility or insanity; and
o Such cases as determined and approved by the SSS and/or the Commission.
 PERMANENT PARTIAL DISABILITY. – If disability is permanent partial and such
disability occurs after thirty-six (36) monthly contributions have been paid prior to the
semester of disability, the benefit shall be the monthly pension for permanent total disability
payable not longer than the period designated in the following schedule:
Complete and Permanent Loss Number of
of/Use of Months
One thumb 10
One index finger 8
One middle finger 6
One ring finger 5
One little finger 3
One big toe 6
One hand 39
One arm 50
One foot 31
One leg 46
One ear 10
Both ears 20
Hearing of one ear 10
Hearing of both ears 50
Sight of one eye 25
 ENTITLEMENT TO MONTHLY PENSION. - The disabled member is entitled to a
monthly pension if he/she has paid at least thirty-six (36) monthly contributions prior to the
semester of disability. [Sec 13-A, (a)]
o In case of permanent partial disability, the monthly pension benefit shall be given in
lump sum if it is payable for less than twelve (12) months. [Sec 13-A, (h)
 LUMP SUM For members who have not met the required thirty-six (36) monthly
contributions prior to the semester of disability, a lump sum disability benefit is granted. [Sec
13-A, (a)]
  13TH MONTH PENSION. – A permanent disability pensioner is entitled to a thirteenth
(13th) month pension equivalent to the amount of the monthly pension due and additional
benefit allowance, which is payable every month of December of the applicable year.
 SUSPENSION OF MONTHLY BENEFITS. - The monthly benefits shall be suspended
upon
o Reemployment or resumption of self-employment;
o Recovery from permanent total disability; or
o Failure to report or present oneself for examination at least once a year upon notice
by the SSS.
 RETIREMENT OR DEATH OF A PERMANENT PARTIAL DISABILITY
PENSIONER. – The disability pension shall cease upon retirement or death of a member
who is on partial disability pension.
 PRESCRIPTIVE PERIOD FOR FILING DISABILITY CLAIMS. – Applications for
disability benefit claim shall be filed within ten (10) years from the date of occurrence of
disability.
f. FUNERAL BENEFIT. – The Funeral Benefit is intended to help defray the cost of funeral expenses
upon the death of a member, including permanently totally disabled or retired member.
 AMOUNT OF FUNERAL BENEFIT. – The funeral benefit is equivalent to the following
amounts paid either in cash or in kind, depending on the date of contingency and may be
adjusted as may be determined by the Commission
o A variable amount ranging from a minimum of twenty thousand pesos (P20,000.00)
to a maximum of forty thousand pesos (P40,000.00), depending on the member's
number of contributions and average monthly salary credit, effective August 1, 2015.
g. SICKNESS BENEFIT. – The Sickness Benefit is a daily cash allowance paid by the employer to the
member who is unable to work due to sickness or injury for each day of compensable confinement or
a fraction thereof, or by the SSS, if such person is unemployed or is SE, OFW, VM who have been
previously covered either as employed/SE/OFW and NW spouse.
 ELIGIBILITY. – To qualify for the grant of the sickness benefit, the member must meet the
following requirements:
o Has paid at least three (3) monthly contributions within the twelve-month (12) period
immediately before the semester of sickness or injury; [Sec 14, (a)]
No contributions paid retroactively by SE/VM/OFWs shall be used in determining
his/her eligibility to sickness benefit wherein the date of payment is within or after
the semester of contingency;
o Was confined for at least four (4) days either in a hospital or elsewhere as defined by
the SSS; [Sec 14, (a)]
o Has notified the employer, if employed, or the SSS, if unemployed or SE/VM of the
sickness or injury; [Sec. 14, (a), 3] and
o Has used up all current company sick leave with pay for the current year, if
employed, except sea-based OFWs. [Sec. 14, (b)]
 SICKNESS NOTIFICATION REQUIREMENT. – The rules on notification in the grant of
sickness benefit are as follows:
o For hospital confinement, notification to employer is not necessary, however, the
employer shall inform the SSS of such confinement in the prescribed manner within
one (1) year from date of discharge; [Sec. 14, (c)]
o For confinement elsewhere, as may be defined by the SSS, the employee shall notify
the employer of the sickness or injury in the prescribed manner within five (5)
calendar days after the start of confinement. The employer shall in turn notify the
SSS within five (5) calendar days after receipt from employee; [Sec. 14, (a) (3)]
 o For sickness/injury that occurred while working or within premises of the employer,
notification by employee to employer is not necessary. However, the employer shall
notify the SSS of such sickness/injury in the prescribed manner within five (5)
calendar days after onset of sickness/injury; [Sec. 14, (a) (3)]
o The unemployed or SE member, land-based OFWs, or VM including NW spouse,
shall directly notify the SSS of the confinement in the prescribed manner within five
(5) calendar days after the start of confinement, except when such confinement is in a
hospital, notification to the SSS in the prescribed manner shall be within one (1) year
from date of discharge; and [Sec. 14, (a) (3)]
o OFWs are given thirty-five (35) calendar days in filing sickness benefits. This applies
only for confinement elsewhere as defined by the SSS.
 SICKNESS NOTIFICATION BY THE EMPLOYER. – The rules on notification in the
grant of sickness benefit are as follows:
o For hospital confinement, the employer shall notify the SSS in the prescribed manner
within one (1) year from date of discharge; [Sec. 14, (c)]
o For confinement elsewhere as defined by the SSS, the employer shall notify the SSS
in the prescribed manner within five (5) calendar days after receipt of notification
from the employee; [Sec. 14, (c)] and
o For sickness/injury that occurred while working or within company’s premises, the
employer shall notify the SSS of such sickness/injury/confinement in the prescribed
manner within five (5) calendar days after onset of sickness/injury. [Sec. 14, (a) (3)]
 AMOUNT OF BENEFIT. – The daily sickness allowance shall be equivalent to ninety-
percent (90%) of the member's average daily salary credit. [Sec 14, (a)]
 GUIDELINES FOR THE GRANT OF SICKNESS BENEFIT. – The grant of sickness
benefit is subject to the following guidelines:
o A member may be granted a maximum sickness benefit of one hundred twenty (120
days) in one (1) calendar year; [Sec 14, (a) (1)]
o The sickness benefit shall be paid for not more than two hundred forty (240) days on
account of the same illness or confinement; [Sec 14; (a) (2)]
o Any unused portion of the allowable one hundred twenty (120) days sickness benefit
cannot be carried forward nor added to the total number of compensable days
allowable in the following year; [Sec 14, (a) (1)]
o In cases where notification is necessary, the confinement shall be deemed to have
started not earlier than the fifth (5th) day immediately preceding the date of
notification; [Sec 14, (a) (3)]
o The compensable confinement shall begin on the first (1st) day of sickness and the
payment of such allowances shall be made by the employer every regular payday or
on the fifteenth (15th) and last day of each month, and similarly in the case of direct
payment by the SSS, for as long as such allowances are due and payable, provided
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, as applicable; [Sec 14,
(b)]
o One hundred percent (100%) of the daily benefits provided in the preceding
paragraph shall be reimbursed by the SSS to said employer upon receipt of
satisfactory proof of such payment and legality thereof, subject to the following: [Sec
14, (c)]
 The employer has notified the SSS of such confinement in the prescribed
manner within five (5) calendar days after receipt of notification from the
employeemember; and
  The SSS shall reimburse the employer or pay the unemployed member only
for confinement within the one-year period immediately preceding the date
the claim for benefit or reimbursement is received by the SSS, except
confinement in a hospital in which case the claim for benefit or
reimbursement must be filed within one (1) year from the last day of
confinement.
o For notification to the SSS made by the employer beyond five (5) calendar days after
receipt of the notification from the employee-member, said employer shall be
reimbursed only for each day of confinement starting from the tenth (10th) calendar
day immediately preceding the date of notification to the SSS; [Sec 14, (c)]
o Where the employee has given the required notification to the employer, but the latter
fails to notify the SSS of the confinement within the prescribed period resulting in the
reduction of the benefit or denial of the claim, such employer shall have no right to
recover the daily sickness allowance advanced to the employee-member; [Sec 14,
(d)]
o The claim of reimbursement shall be adjudicated by the SSS within a period of two
(2) months from receipt thereof, provided, that should no payment be received by the
employer within one (1) month after the period prescribed herein for adjudication, the
reimbursement shall thereafter earn simple interest of one percent (1%) per month
until paid; [Sec 14, (e)]
o The provisions regarding the notification required of the member and the employer as
well as the period within which the claim for benefit or reimbursement may be filed
shall apply to all claims filed with the SSS; [Sec 14, (f)]
o When the start of the sickness confinement period falls on the semester wherein the
member will not qualify for sickness benefit, the confinement period shall be
shortened in such a way that the first (1st) day of confinement shall be adjusted
forward to the next semester wherein he/she would qualify for the remaining period
of confinement; and
o Sickness and disability benefits may be availed of simultaneously, provided, that the
following conditions are satisfied:
 Sickness/injury and disability are not related; and
 Member meets all the qualifying conditions for the grant of sickness and
disability benefits.
h. MATERNITY LEAVE (R.A No. 11210) Maternity Leave Benefit is a daily cash allowance
granted to female members who gave birth via normal delivery or caesarean section or suffered
miscarriage, regardless of civil status or legitimacy of the child.
 Amount of Benefit Covered female workers must receive their full pay. Full payment of
the maternity leave benefit shall be advanced by the employer within thirty (30) days
from the filing of the maternity leave application.
o In the case of self-employed female members, including those in the informal
economy, OFWs and voluntary SSS members, the SSS shall directly pay the
maternity benefit. (Sec. 3, Rule 3, IRR R.A 11210)
i. UNEMPLOYMENT INSURANCE OR INVOLUNTARY SEPARATION BENEFIT. – The
unemployment insurance or involuntary separation benefit is a monthly cash payment equivalent
to fifty percent (50%) of the AMSC for a maximum of two (2) months, subject to the rules and
regulations that the Commission may prescribe. [Sec 14-B]
 ELIGIBILITY. – The grant of unemployment insurance or involuntary separation benefit
may be availed by members subject to the following conditions: [Sec 14-B]
o Not over sixty (60) years old at the time of involuntary separation, except;
  In the case of underground mineworker or surface mineworker [R.A. No.
10757], not over fifty (50) years old; or
 In the case of racehorse jockey [R.A. No. 10789], not over 55 years old.
o Has paid at least thirty-six (36) monthly contributions, twelve (12) months of
which should be in the eighteen (18) month period immediately preceding the
unemployment or involuntary separation;
o Involuntarily separated from employment provided that such separation did not
arise from fault or negligence of the employee and which may be attributed to
any of, but not limited to, the following:
 Installation of labor-saving devices;
 Redundancy;
 Retrenchment to prevent loss;
 Closure or cessation of operation; or
 Disease/illness.
 LIMITATION. – A covered employee who is involuntarily unemployed can only claim
unemployment benefits once every three (3) years starting from the date of involuntary
separation or unemployment. [Sec 14-B, 1st proviso]
 OVERLAPPING BENEFITS. – In case of concurrence of two (2) or more
contingencies within the same compensable period, only the highest benefit shall be paid.
[Sec 14-B, 2nd proviso]
 PRESCRIPTIVE PERIOD FOR FILING OF UNEMPLOYMENT INSURANCE
OR INVOLUNTARY SEPARATION BENEFIT CLAIMS. – A claim for
unemployment insurance or involuntary separation benefits shall be filed within one (1)
year from the date of separation or unemployment
Government Service Insurance System Law (R.A. No. 8291)
1. COVERAGE AND EXCLUSIONS
Compulsory Coverage
 All employees receiving compensation who have not reached the compulsory retirement age,
irrespective of employment status;
 Contractual and other employees with an employee relationship to an Employer are included
under compulsory coverage, provided that the following conditions that determine an employee
employer relationship exist:
o the person was selected and engaged by an employer as an individual, rather than as a
representative, assignee or agent of another entity;
o the employer pays the salary to the employee as an individual;
o the employer has power of dismissal; and
o the employer has the power to control the means and the result of the work to be done.
 Exclusions:
o Armed Forces of the Philippines and Philippine National Police. However, they must
settle first their financial obligation with the GSIS.
o Contractuals who have no employer and employee relationship with the agencies they
serve.
 Effectivity of Membership. — Membership in the GSIS shall take effect upon the employee’s
actual assumption of duty pursuant to a valid appointment or election and oath of office.
 General Rule: All members of the GSIS shall have life insurance, retirement, and all other social
security protection such as disability, survivorship, separation, and unemployment benefits.
o Exception: Members of the judiciary and constitutional commissions who shall have life
insurance only.
2. DEPENDENTS AND BENEFICIARIES
Dependents
a. the legitimate spouse dependent for support an & member or pensioner;
b. any legitimate, legitimated and/or legally adopted child, including any illegitimate child,
who is unmarried, not gainfully employed, who has not attained the age of majority, or
being at the age of majority but incapacitated and incapable of selfsupport due to a
mental or physical defect acquired prior to age of majority; and
c. the parents dependent upon the member for support;
Primary Beneficiaries
a. Legal dependent spouse until he/she remarries
b. Dependent children
Secondary Beneficiaries
a. Dependent parents
b. Other legitimate descendants
3. BENEFITS
 For purposes of benefit entitlement, the members of the GSIS shall be classified as
follows:
o Active members. These members are still in the service and are paying the
integrated premiums prescribed under R.A. 8291. These members are covered for
the entire package of benefits and privileges being extended by the GSIS.
 o Policyholders. These members are covered for life insurance only and are entitled
to the specific benefits accruing from the life insurance coverage; they can avail
of policy loan privilege only.
o Separated members. These members are former active members who have been
separated from the service and are still covered by the GSIS under the principle
of “once a member, always a member”; as such, unless the terms of their
separation provide otherwise, they shall be entitled to receive future benefits
under PD. 1146 in the event of compensable contingency such as old-age
(attainment of age 60 years), disability, survivorship and death. They are not,
however, entitled to any loan privilege.
o Retired members. These members are former active members who have retired
from the service and are already enjoying the corresponding retirement benefits
applied for. These members are not entitled to any loan privilege.
 Separation Benefit – A member who has rendered a minimum of Three (3) years
creditable service shall be entitled to separation benefit upon resignation or separation
under the following terms:
o For a Member with at least Three (3) years but less than Fifteen (15): A cash
payment equivalent to one hundred percent (100%) of the average monthly
compensation for every year of service the member has paid contributions, but
not less than Twelve Thousand Pesos (P12,000), payable upon reaching sixty
(60) years of age or upon separation, whichever comes later;
o For a Member with at least Fifteen (15) years of service and less than Sixty years
(60) of age upon separation:
 A cash payment equivalent to eighteen (18) times the basic monthly
pension, payable at the time of resignation or separation;
 An old-age pension benefit equal to the basic monthly pension, payable
monthly for life upon reaching age 60.
 Unemployment Benefit. — Unemployment benefit is in the form of monthly cash
payments equivalent to fifty percent (50%) of the average monthly compensation.
o A member shall be entitled to the unemployment benefits in the form of monthly
cash payments if all the conditions below are met:
 he/she was a permanent employee at time of separation;
 his/her separation was involuntary due to the abolition of his/her office or
position resulting from reorganization; and
 he/she has been paying the contributions specified under Rule 3.1 (a) for
at least One (1) Year prior to separation.
o A member who has rendered at least Fifteen (15) years service will be entitled to
the Separation Benefits described in Rule VI, instead of the Unemployment
Benefit.
 Retirement Benefit. — Retirement benefit is either one of the following:
o The lump sum equivalent to Sixty (60) months of the BMP payable at the time of
retirement plus an old-age pension benefit equal to the basic monthly pension
payable for life, starting upon the expiration of the five-years covered by the
lump sum; or
o A cash payment equivalent to Eighteen (18) times his/her basic monthly pension
plus monthly pension for life payable immediately.
 o A Member shall be entitled to the Retirement Benefit on condition that:
 he/she has rendered at least Fifteen (15) years of service;
 he/she is at least Sixty (60) years of age at the time of retirement; and
 he/she is not receiving a monthly pension benefit from permanent total
disability.
o Compulsory Retirement Age. — Unless the service is extended by appropriate
authorities, retirement shall be compulsory for an employee at Sixty-five (65)
Years of age with at least Fifteen (15) Years service: Provided, that if he/she has
less than Fifteen (15) years of service, he/she may be allowed to continue in the
service in accordance with existing Civil Service rules and regulations.
 When a retiree is reemployed, his/her previous services credited at the
time of his/her retirement shall be excluded in the computation of future
benefits. In effect, he/she shall be considered a new entrant.
 Disability and Sickness-Income Benefits — The benefits which are granted to a
member due to the loss or reduction in earning capacity caused by a loss or impairment of
the normal functions of his/her physical and/or mental faculties as a result of an injury or
disease;
o Injury resulting in any of the following shall be deemed Permanent Total
Disability:
 Complete loss of sight of both eyes;
 Loss of two (2) limbs at or above the ankle or wrist;
 Permanent complete paralysis of two (2) limbs;
 Brain injury resulting in incurable imbecility, insanity, or other
irreversible conditions;
 Such other cases as may be determined by the GSIS.
o Injury resulting in complete and permanent loss of the use of any of the following
shall be deemed Permanent Partial Disability:
 any finger;
 any toe;
 one arm;
 one hand;
 one foot;
 one leg;
 one or both ears;
 hearing of one or both ears; or
 sight of one eye;
o Temporary Total Disability accrues or arises when there is complete but
temporary incapacity to continue with a member’s present employment or engage
in any gainful occupation due to the loss or impairment of the normal function of
the physical and/or mental faculties of the member. In effect, this loss or
impairment can be- reversed to the point where the member can continue with his
previous employment or engage in another gainful occupation
o A Member who becomes permanently and totally disabled shall entitled to the
monthly income benefit for life equivalent to the basic month pension effective
from the date of disability when:
 he/she is in the service at the time of disability; or
  if separated from the service; (1) he/she has paid at least Thirty-Six (36)
monthly contributions within the Five (5) year period immediately
preceding his/her disability; or (2) he/she has paid a total of at least One
Hundred Eighty (180) monthly contributions, prior to his/her disability;
and
 he/she is not receiving the old-age retirement pension benefit.
o A member whose disability is partial shall be entitled to a cash payment
equivalent to the basic monthly pension to be paid in accordance with the
schedule of disabilities or Table of Loss Percentages if he/she satisfies the
conditions cited in (a) and (b) under Section 9.4.1.
o A member who suffers temporary total disability shall be entitled to seventy-five
percent (75%) of his/her current daily compensation for each day or fraction
thereof of temporary total disability benefit to start not earlier than the Fourth
(4th) Day, but not exceeding one hundred twenty (120) days in one calendar year
when:
 he/she has exhausted all sick leave credits and collective bargaining
agreement sick leave benefits, if any; and
 he/she was in the service at the time of his/her disability; or
 if separated, he/she has rendered at least Three (3) years of service and
has paid at least Six (6) monthly contributions in the twelve-month
period immediately preceding his/her disability.
 Survivorship and Death Benefits — Survivorship and death benefits are those granted
to surviving and qualified beneficiaries of the deceased member or pensioner to cushion
them against the adverse economic, psychological and emotional loss resulting from the
death of a wage earner or pensioner.
o Survivorship pension, as follows:
 A Basic Survivorship Pension of Fifty Percent (50%) of the basic
monthly pension; and in case the member is survived by dependent
children;
 Dependent children’s pension not exceeding fifty percent (50%) of the
basic monthly pension.
o Cash payment equivalent to One Hundred Percent (100%) of the member’s
average monthly compensation for each year of service he paid contributions, but
not less than Twelve Thousand Pesos (P12,000.00)
o Conditions for Entitlement and Corresponding Benefits
 Funeral Benefit. — The amount of the funeral benefit shall be determined and specified
by the GSIS from time to time as deemed necessary, through an information circular
distributed to all employers for posting at their premises; but shall not be less than Twelve
Thousand Pesos (P12,000.00): Provided, That it shall be increased to at least Eighteen
Thousand Pesos (P18,000.00) after Five (5) years and shall be paid upon the death of:
o an active member; or
o a member who has been separated from the service, but who is entitled to future
separation or retirement benefit; or
o a member who is a pensioner (excluding survivorship pensioners); or
o a retiree who at the time of his/her retirement is at least Sixty (60) Years old but
opts to retire under Republic Act No. 1616; or
o a member who retired under Republic Act No. 1616 prior to the effectivity of this
Act with at least Twenty (20) Years service regardless of age.
o The following are not entitled to funeral benefits:
 all survivorship pensioners; and
 those who have optional life insurance coverage only.
Limited Portability Law (R.A. No. 7699)

R.A. 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 SSS or GSIS, as the case may be, to satisfy the required
number of years of service for entitlement to the benefits under the applicable laws.

 The term “totalization” refers to the process of adding up the periods of creditable services or
contributions under each of the Systems, SSS or GSIS, for the purpose of eligibility and
computation of benefits.
 The term “portability” refers to the transfer of funds for the account and benefit of a worker
who transfers from one system to the other
 The benefits provided under R.A. No. 7699 apply to active or inactive members of either System
(GSIS/SSS) as of the date of its effectivity on May 20, 1994.
 Coverage – R.A. No. 7699 and its implementing rules apply to all worker-members of the GSIS
and/or SSS who transfer from the public sector to the private sector or vice-versa, or who wish
to retain their membership in both Systems
Disability and Death Benefits; Labor Code and Civil Code
ART. 197 [191]. TEMPORARY TOTAL DISABILITY
(a) Under such regulations as the Commission may approve, any employee under this Title who sustains
an injury or contracts sickness resulting in temporary total disability shall for each day of such a disability
or fraction thereof be paid by the System an income benefit equivalent to ninety percent of his average
daily salary credit, subject to the following conditions: the daily benefit shall not be less than Ten Pesos
nor more than Ninety Pesos, nor paid for a continuous period longer than one hundred twenty days,
except as otherwise provided for in the Rules, and the System shall be notified of the injury or sickness.
(As amended by Sec. 2, E.O. 179.)
(b) The payment of such income benefit shall be in accordance with the regulations of the Commission.
(As amended by Sec. 19, P.D. No. 850.)
ART. 198 [192]. PERMANENT TOTAL DISABILITY
(a) Under such regulations as the Commission may approve, any employee under this Title who contracts
sickness or sustains an injury resulting in his permanent total disability shall, for each month until his
death, be paid by the System during such a disability, an amount equivalent to the monthly income
benefit, plus ten percent thereof for each dependent child, but not exceeding five, beginning with the
youngest and without substitution: Provided, That the monthly income benefit shall be the new amount of
the monthly benefit for all covered pensioners, effective upon approval of this Decree.
(b) The monthly income benefit shall be guaranteed for five years, and shall be suspended if the employee
is gainfully employed, or recovers from his permanent total disability, or fails to present for examination
at least once a year upon notice by the System, except as otherwise provided for in other laws, decrees,
orders or Letters of Instructions. (As amended by Sec. 5, P.D. No. 1641.)
(c) The following disabilities shall be deemed total and permanent:
(1) Temporary total disability lasting continuously for more than one hundred twenty days, except
as otherwise provided for in the Rules;
(2) Complete loss of sight of both eyes;
(3) Loss of two limbs at or above the ankle or wrist;
(4) Permanent complete paralysis of two limbs;
(5) Brain injury resulting in incurable imbecility or insanity; and
(6) Such cases as determined by the Medical Director of the System and approved by the
Commission.
(d) The number of months of paid coverage shall be defined and approximated by a formula to be
approved by the Commission.
ART. 199 [193]. PERMANENT PARTIAL DISABILITY
(a) Under such regulations as the Commission may approve, any employee under this Title who contracts
sickness or sustains an injury resulting in permanent partial disability shall for each month not exceeding
the period designated herein be paid by the System during such a disability an income benefits equivalent
to the income benefit for permanent total disability.
(b) The benefit shall be paid for not more than the period designated in the following schedules:

Complete and permanent loss of No. of months

One thumb 10
One index finger 8
One middle finger 6
One ring finger 5
One little finger 3
One big toe 6
Any toe 3
One arm 50
One hand 39
One foot 31
One leg 46
One ear 10
Both ears 20
Hearing on one ear 10
Hearing on both ears 50
Sight of one eye 25

(c) A loss of a wrist shall be considered as a loss of the hand, and a loss of an elbow shall be considered as
a loss of the arm. A loss of an ankle shall be considered as a loss of a foot, and a loss of a knee shall be
considered as a loss of the leg. A loss of more than one joint shall be considered as a loss of the whole
finger or toe, and a loss of only the first joint shall be considered as a loss of one-half of the whole finger
or toe: Provided, That such a loss shall be either the functional loss of the use or physical loss of the
member. (As amended by Sec. 7, P.D. No. 1368.)
(d) In case of permanent partial disability less than the total loss of the member specified in the preceding
paragraph, the same monthly income benefit shall be paid for a portion of the period established for the
total loss of the member in accordance with the proportion that the partial loss bears to the total loss. If
the result is a decimal fraction, the same shall be rounded off to the next higher integer.
(e) In cases of simultaneous loss of more than one member or a part thereof as specified in this Article,
the same monthly income benefit shall be paid for a period equivalent to the sum of the periods
established for the loss of the member or the part thereof. If the result is a decimal fraction, the same shall
be rounded off to the next higher integer.
(f) In cases of injuries or illnesses resulting in a permanent partial disability not listed in the preceding
schedule, the benefit shall be an income benefit equivalent to the percentage of the permanent loss of the
capacity for work. (As added by Sec. 7, P.D. No. 1368.)
(g) Under such regulations as the Commission may approve, the income benefit payable in case of
permanent partial disability may be paid in monthly pension or in lump sum if the period covered does
not exceed one year. (As added by Sec. 7, P.D. No. 1368.)
ART. 200 [194]. DEATH
(a) Under such regulations as the Commission may approve, the System shall pay to the primary
beneficiaries upon the death of the covered employee under this Title an amount equivalent to his
monthly income benefit, plus ten percent thereof for each dependent child, but not exceeding five,
beginning with the youngest and without substitution, except as provided for in paragraph (j) of Article
167 hereof: Provided, however, That the monthly income benefit shall be guaranteed for five years:
Provided, further, That if he has no primary beneficiary, the System shall pay to his secondary
beneficiaries the monthly income benefit but not to exceed sixty months: Provided, finally, That the
minimum death benefit shall not be less than fifteen thousand pesos. (As amended by Sec. 4, P.D. No.
1921.)
(b) Under such regulations as the Commission may approve, the System shall pay to the primary
beneficiaries upon the death of a covered employee who is under permanent total disability under this
Title, eighty percent of the monthly income benefit and his dependents to the dependents pension;
Provided, That the marriage must have been validly subsisting at the time of disability: Provided, further,
That if he has no primary beneficiary, the System shall pay to his secondary beneficiaries the monthly
pension excluding the dependents pension, of the remaining balance of the five-year guaranteed period:
Provided, finally, That the minimum death benefit shall not be less than fifteen thousand pesos. (As
amended by Sec. 4, P.D. No. 1921.)
(c) The monthly income benefit provided herein shall be the new amount of the monthly income benefit
for the surviving beneficiaries upon the approval of this decree. (As amended by Sec. 9, P.D. No. 1368.)
(d) Funeral Benefit. — A funeral benefit of Three Thousand Pesos (P3,000.00) shall be paid upon the
death of a covered employee or permanently totally disabled pensioner. (As amended by Sec. 3, E.O.
179.)

 Disability does not refer to the injury nor to the pain and suffering it has occasioned, but to the
loss or impairment of earning capacity. There is disability when there is a loss or diminution of
earning power because of actual absence from work due to the injury or illness arising out of and
in the course of employment. The basis of compensation is reduction of earning power.
 Article 167(n) defines “disability” as loss or impairment of a physical or mental function
resulting from injury or sickness
 Employee’s disability under the Labor Code is classified into three distinct categories: (a)
temporary total disability; (b) permanent total disability; and (c) permanent partial disability
 The object of the law in allowing compensation during temporary disability is to compensate the
laborer or employee for what he might have earned during the period of the treatment of his
injury. On the other hand, the object of the law in granting compensation for a permanent
disability is to compensate the injured laborer or employee for the actual and permanent loss of a
member of the body, or the use thereof.
 A total disability is temporary if as a result of the injury or sickness, the employee is unable to
perform any gainful occupation for a continuous period not exceeding 120 days, except as
otherwise provided in Rule X of the Rules.
 Permanent total disability means an incapacity to perform gainful work which is expected to be
permanent. This status does not require a condition of complete helplessness. Nor is it affected by
the performance of occasional odd jobs.
 A disability is partial and permanent if as a result of the injury or sickness the employee suffers a
permanent partial loss of the use of any part of his body.