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BOOK FOUR In cases of hazardous workplaces, no employer shall engage the
HEALTH, SAFETY AND SOCIAL WELFARE BENEFITS
Title I
MEDICAL, DENTAL AND OCCUPATIONAL SAFETY
Chapter I
MEDICAL AND DENTAL SERVICES
ARTICLE 156. First-aid treatment. Every employer shall keep in
his establishment such first-aid medicines and equipment as the
nature and conditions of work may require, in accordance with such
regulations as the Department of Labor and Employment shall
prescribe.
The employer shall take steps for the training of a sufficient number
of employees in first-aid treatment.
First aid treatment means adequate, immediate and
necessary medical and dental attention or remedy given in
case of injury or sudden illness suffered by a worker during
employment, irrespective of whether or not such injury or
illness is work-connected, before more extensive medical
and/or dental can be secured.
It does not include continued treatment or follow-up
treatment for any injury or illness
Scope: applies to all employers regardless of the number of
employees they employ
ARTICLE 157. Emergency medical and dental services. It shall
be the duty of every employer to furnish his employees in any
locality with free medical and dental attendance and facilities
consisting of:
(a) The services of a full-time registered nurse when the number of
employees exceeds fifty (50) but not more than two hundred (200)
except when the employer does not maintain hazardous workplaces,
in which case, the services of a graduate first-aider shall be provided
for the protection of workers, where no registered nurse is available.
The Secretary of Labor and Employment shall provide by appropriate
regulations, the services that shall be required where the number of
employees does not exceed fifty (50) and shall determine by
appropriate order, hazardous workplaces for purposes of this Article;
(b) The services of a full-time registered nurse, a part-time physician
and dentist, and an emergency clinic, when the number of employees
exceeds two hundred (200) but not more than three hundred (300);
and
(c) The services of a full-time physician, dentist and a full-time
registered nurse as well as a dental clinic and an infirmary or
emergency hospital with one bed capacity for every one hundred
(100) employees when the number of employees exceeds three
hundred (300).
services of a physician or a dentist who cannot stay in the premises of
the establishment for at least two (2) hours, in the case of those
engaged on part-time basis, and not less than eight (8) hours, in the
case of those employed on full-time basis. Where the undertaking is
non-hazardous in nature, the physician and dentist may be engaged
on retainer basis, subject to such regulations as the Secretary of Labor
and Employment may prescribe to insure immediate availability of
medical and dental treatment and attendance in case of emergency.
(As amended by Presidential Decree NO. 570-A, Section 26).
The required medical and dental services:
a. 10-50 workers: graduate first aider
b. 51-200 workers: full-time RN; a full-time first aider
will suffice if the workplace is non-hazardous and a
nurse is not available
c. 201-300: full-time RN, part-time physician, part-time
dentist, emergency clinic regardless of the nature of
the undertaking
d. Over 300 workers:
1. Hazardous workplace: full-time RN, full-time
physician, full-time dentist, dental clinic,
infirmary or emergency hospital with 1 bed
capacity for every 100 workers
2. Non-hazardous: full-time RN, part-time
physician, part-time dentist
In all workplaces where there are more than 1 workshift in
a day, the employer shall, in addition to the aforesaid
requirements, provide the services of a full-time first-aider
for each workshift.
Part-time service contemplates at least 2 hours stay in the
premises in a day
Full-time contemplates at least 8 hours stay in the premises
a day
Hazardous workplace:
a. Where the nature of the work exposes the
workers to dangerous environmental
elements, contaminants or work conditions
including ionizing, radiation, chemicals, fire,
flammable substances, noxious components,
and the like.
b. Where the workers are engaged in
construction work, logging, firefighting,
mining, quarrying, blasting, stevedoring,
dock work, deep sea fishing and mechanical
farming
c. Where the workers are engaged in the
manufacture or handling of explosive and
other pyrotechnic products
d. Where the workers use or are exposed to
heavy or power-driven machinery or
equipment
e. Where he workers use or are exposed to
power-driven tools
ARTICLE 158. When emergency hospital not required. The
requirement for an emergency hospital or dental clinic shall not be
applicable in case there is a hospital or dental clinic which is
accessible from the employers establishment and he makes
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arrangement for the reservation therein of the necessary beds and Qualifications of first aider:
dental facilities for the use of his employees.
a. Must be able to read and write
Alternative to an emergency hospital or dental clinic: b. Must have completed a course in first aid
a. Hospital or clinic located not more than 5km away c. Must be duly certified by the Philippine National Red
from the workplace in an urban area, or which can be Cross or by any other organization accredited by the
reached by motor vehicle in 25 minutes of travel if the same
workplace is situated in a rural area
b. The employer has facilities readily available for
transporting a worker to the hospital or clinic in case Qualifications of nurses:
of emergency
c. The employer has a written contract with the hospital a. Must have passed the examinations given by the
or clinic for the use thereof in the treatment of workers Board of Examiners;
in case of emergency b. Duly licensed to practice nursing in the Philippines
c. Preferably, with at least 50 hours of training in
ARTICLE 159. Health program. The physician engaged by an occupational nursing
employer shall, in addition to his duties under this Chapter, develop
and implement a comprehensive occupational health program for the Qualifications of physician:
benefit of the employees of his employer.
a. Must have passed the examinations given by the
Duties of employer: Board of Examiners for physicians
b. Must be licensed to practice medicine on the
a. Establish in his workplace, occupational health Philippines
services to provide a healthful place of work c. Preferably, a graduate of a training course
b. Adopt a comprehensive occupational health program
for his employees Qualifications of a dentist:
c. Enter into a contract with hospitals or dental clinics, if
this is not available in his workplace; and
a. Must have passed the examinations given by the
d. Maintain a health record of his programs and activities
Board of Examiners for Dentists
and to submit annual reports of these to the Regional
b. Must be licensed to practice dentistry in the
Labor Office or authority concerned
Philippines
c. Preferably, has completed a training course in Dental
Physical examination: before entering employment for the Services of the DOH or organization duly accredited
first time; by the former

a. Periodically or at such intervals as may be necessary
on account of the condition or risks involved in the
work
b. When transferred or separated from employment
c. When injured or ill
Purpose: to determine the physical condition of the
prospective employee at the time of hiring and to prevent
the placement of a worker on a job where, through some
physical or mental defects, he may be dangerous to his
fellow workers or to property.
Purpose of periodic annual medical examination: to follow
up previous findings, to allow early detection of
occupational and non-occupational diseases, and to
determine the effect of exposure to health hazards
ARTICLE 160. Qualifications of health personnel. The
physicians, dentists and nurses employed by employers pursuant to
this Chapter shall have the necessary training in industrial medicine
and occupational safety and health. The Secretary of Labor and
Employment, in consultation with industrial, medical, and
occupational safety and health associations, shall establish the
qualifications, criteria and conditions of employment of such health
personnel.
2000+ workers, a higher degree of qualifications in
required
ARTICLE 161. Assistance of employer. It shall be the duty of any
employer to provide all the necessary assistance to ensure the
adequate and immediate medical and dental attendance and treatment
to an injured or sick employee in case of emergency.
Chapter II
OCCUPATIONAL HEALTH AND SAFETY
ARTICLE 162. Safety and health standards. The Secretary of
Labor and Employment shall, by appropriate orders, set and enforce
mandatory occupational safety and health standards to eliminate or
reduce occupational safety and health hazards in all workplaces and
institute new, and update existing programs to ensure safe and
healthful working conditions in all places of employment.
Purpose: protect every workingman against the dangers of
injury, sickness or death through safe and healthy working
conditions
Coverage:
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- All establishments, workplaces, and other
undertakings, including agricultural enterprises,
whether operating for profit or not.
Exceptions:
- Those engaged in land, sea and air transportation,
except their garages, dry-docks, hangars, maintenance
and repair shops and offices
- Residential places exclusively devoted to dwelling
purposes
- Activities of a lessee regarding the safety of mining
installations, surface or underground, within the
mining claim or lease
Duty of employers:
a. Keep and maintain his workplace free from work
hazards that are causing or likely to cause physical
harm to the workers or damage to property
b. Give complete job safety instructions to all his
workers, especially to those who are entering the job
for the first time
c. Provide only approved devices and equipment in his
workplace
Duty of employees:
a. Cooperate with their employer in carrying out the
occupational safety and health standards
b. Report to their supervisor any work hazard they may
discover in their workplace
c. Make proper use of all safeguards and safety devices
furnished to them by their employer
Duty of 3rd parties:
a. Observe occupational safety and health standards
Suspension of rules: (by the Sec of DOLE)
a. Unavailability of professional or technical personnel
or materials and equipment needed to comply with the
rule
b. Necessary construction or alteration of the prescribed
facilities cannot be completed on the effectivity date
of the rule
c. If the employer is participating in the experiments or
studies approved or conducted by the Bureau of
Working Conditions designed to demonstrate new
techniques to safeguard the safety and health of
workers
The suspension order shall not be in effect longer than the
period needed by the employer to come into compliance
with the rule, or 1 year, whichever is shorter, renewable for
another year subject to revocation or shortening by the
Secretary of DOLE
Variation order one issued by the Secretary of DOLE
allowing a variation in the compliance with the
requirements of any provision of the Occupational and
Health Standards, if there is practical difficulty or
unnecessary hardship in complying therewith, provided:
a. The purpose of the provision is substantially served
b. The safety and health of the workers remain ensured
The variation order shall stipulate the conditions under
which the variation is permitted and shall be applicable and
effective only to the particular employer and operations
covered by the order. It shall remain in effect until revoked
by the Minister.
All establishments are required to have a Safety Committee
which should be organized within 1 month from the date
the business starts operating and should reorganize every
January of the year.
Duties of the Safety Committee
a. Plan and develop accident prevention programs for the
establishment
b. Conduct safety meetings at least once a month
c. Submit reports to the manager on its meetings and
activities
d. Initiate and supervise safety training of employees
Types of Safety Committees:
a. Type A- total workforce: over 400
b. Type B: 201-400
c. Type C: 100-200
d. Type D: less than 100
e. Type E- an organization of the safety committees or
different establishments housed under one building
Other types of Safety Organizations:
a. Line type one wherein the general manager or head
of the establishment directs the safety programs and
assume overall responsibility for safety in the
establishment.
b. Staff type also known as the safety engineer type;
it is composed of a line organization with specialized
personnel employed to advise and assist management
in all matters of safety
The establishment of a line or staff type of organization by
the employer is subject to the approval of the Secretary of
DOLE or his duly authorized representative
The chairman, physician and the nurse shall be permanent
members of the Safety Committee.
The term of the department head in the Safety Committee
shall be for 1 year
In types A and B safety committees, the term of the
worker-members shall be 1 year
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In C,D, and E, 1 year
In type E, 1 year
The principal duty of the safety man is to act as the
employers principal assistant and consultant in the
application of programs to remove the hazards from the
workplace and to correct unsafe work practices
All work accidents or occupational illnesses in places of
employment, resulting in disabling condition:
a. Shall be reported by the employer to the Regional
Labor Office or duly authorized representative in
duplicate and a copy furnished the employee or his
duly authorized representative.
b. The investigation report shall be submitted to the
employer on or before the 20th day of the month
following the date of occurrence of the accident or
after illness is established
c. The formal report in the prescribed form should be
submitted to the Regional Labor Office (RLO) or duly
authorized representative on before the 30th day of the
same month
In case of temporary disability where the injured or ill
employee has not reported back to duty on the closing date
of reporting, an estimate of the probable days of disability
shall be made and entered in the report and corrected after
the return of the injured. In all computations, this estimate
shall be used. After the return of the injured, the corrected
days of absence shall be used.
Where the accident or illness results in death or permanent
total disability, the employer, in addition to the required
written report, shall initially notify the RLO or duly
authorized representative within 24 hours after the
occurrence using the fastest means of communication
All deaths and permanent total disabilities shall be
investigated by the RLO or duly authorized representative
within 48 hours after receipt of the initial report of the
employer, prepared in the duplicate.
Any dangerous occurrence which may or may not cause
serious bodily harm to workers or seriously damage the
premises of employment shall be investigated and reported
by the employer upon occurrence to the RLO or his duly
authorized representative having jurisdiction.
Dangerous occurrences:
a. Explosion of boilers
b. Explosion of a receiver or storage container
c. Bursting of a revolving wheel
d. Electrical short circuit
Purpose of reporting requirements:
- For information purposes so that the RLO can have
the necessary data to be used in connection with the
performance of its accident and illness prevention
duties
Records to be kept by employer:
a. Date of accident or illness
b. Name of injured or ill employee, sex and age
c. Occupation of employee at the time of accident or
illness
d. Assigned causes of accident or illness
e. Extent and nature of disability
f. Period of disability
g. Whether accident involved damage to materials,
equipment or machinery, kind and extent of damage,
including estimated or actual cost; and
h. Record of initial notice and/or report to the RLO or
authorized rep.
Employers are required to register their business with the
RLO or authorized rep having jurisdiction thereof to form
part of a data-bank of all covered establishments.
New establishments: register within 30 days before
operation
Registration: made in form MOL/BLS-IP-3 in 3 copies and
submitted to the RLO or authorized rep.
It shall be free of charge and valid for the lifetime of the
establishment except when any of the ff conditions exists,
in which case, a re-registration, as if it were a new
establishment, is required:
a. Change in the business name
b. Change in location
c. Change in ownership
d. Reopening after previous closing
ARTICLE 163. Research. It shall be the responsibility of the
Department of Labor and Employment to conduct continuing studies
and research to develop innovative methods, techniques and
approaches for dealing with occupational safety and health problems;
to discover latent diseases by establishing causal connections
between diseases and work in environmental conditions; and to
develop medical criteria which will assure insofar as practicable that
no employee will suffer impairment or diminution in health,
functional capacity, or life expectancy as a result of his work and
working conditions.
The task of conducting research is vested primarily on the
Bureau of Working Conditions and the Occupational Safety
and Health Center.
ARTICLE 164. Training programs. The Department of Labor and
Employment shall develop and implement training programs to
increase the number and competence of personnel in the field of
occupational safety and industrial health.
Every employer shall take steps to train a sufficient number
of his supervisors or technical personnel in occupational
safety and health. An employer may observe the ff:
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a. In non-hazardous establishment or workplace
1. 50 to 400 workers per shift at least 1 of the
supervisors or technical personnel shall be trained
in occupational health and safety and shall be
assigned as part-time safety man
2. Over 400 workers per shift at least 2 of its
supervisors shall be trained and a full-time safety
man shall be provided
b. In hazardous establishment or workplace
1. 20 to 200 workers per shift at least 1 of its
supervisors or technical men shall be trained who
shall work as part-time safety man
2. Over 200 workers per shift at least 2 of its
supervisors or technical personnel shall be trained
and one of them shall be appointed full-time
safety man and secretary of the safety committee
The employment of a full-time safety man may not be
required if the employer enters into a written contract with
a qualified consulting organization which shall develop and
carry out his safety and health activities; provided that all
the consultant shall conduct plant visits at least 4 hours a
week and is subject to call any time to conduct accident
investigations and is available during scheduled inspections
or surveys the by Secretary of DOLE or his authorized rep.
ARTICLE 165. Administration of safety and health laws. (a) The
Department of Labor and Employment shall be solely responsible for
the administration and enforcement of occupational safety and health
laws, regulations and standards in all establishments and workplaces
wherever they may be located; however, chartered cities may be
allowed to conduct industrial safety inspections of establishments
within their respective jurisdictions where they have adequate
facilities and competent personnel for the purpose as determined by
the Department of Labor and Employment and subject to national
standards established by the latter.
(b) The Secretary of Labor and Employment may, through
appropriate regulations, collect reasonable fees for the inspection of
steam boilers, pressure vessels and pipings and electrical
installations, the test and approval for safe use of materials,
equipment and other safety devices and the approval of plans for such
materials, equipment and devices. The fee so collected shall be
deposited in the national treasury to the credit of the occupational
safety and health fund and shall be expended
exclusively for the administration and enforcement of safety and
other labor laws administered by the Department of Labor and
Employment.
The Department of Labor and Employment shall be solely
responsible for the administration and enforcement of
occupational safety and health laws in all places
Exception: chartered cities may be authorized by the
Secretary of DOLE to enforce the same within their
respective jurisdictions if they have the facilities and
personnel for the purpose as determined by and subject to
the National Standards prescribed by the DOLE.
Types of inspection:
a. Technical safety inspection inspection the purpose
of which is safety determination of boilers, pressure
vessels, internal combustion engines, electrical
installations, elevators, hoisting equipment and other
mechanical equipment.
b. General safety inspection inspection of work
environment, including the location and operation of
machinery other than those covered by technical
safety inspection, adequacy of work storage or work
procedures, protection facilities and other safety and
health hazards in workplace.
Frequency of inspection: once a year
Special inspection may be authorized by the RLO:
a. To investigate accidents, occupational illness or
dangerous occurrences, especially those resulting in
permanent total disability or death
b. To conduct surveys of working conditions requested
by the Bureau for the purpose of evaluating and
assessing environmental contaminants and physical
conditions; or
c. To conduct investigations, inspections or follow-up
inspections upon request of an employer, worker or
labor union of the establishment
Title II
EMPLOYEES COMPENSATION AND STATE INSURANCE
FUND
Chapter I
POLICY AND DEFINITIONS
ARTICLE 166. Policy. The State shall promote and develop a tax-
exempt employees compensation program whereby employees and
their dependents, in the event of work-connected disability or death,
may promptly secure adequate income benefit and medical related
benefits.
Under the present law, an illness is compensable only when
it is classified as an occupational disease and the conditions
that would render them compensable are met.
Diseases not listed as occupational diseases are
compensable only if the claimant proves by substantial
evidence that the risk of contracting the disease is increased
by the conditions of employment
Compensation benefits are available only in case of work-
connected disability or death arising:
a. Injury; or
b. Illness
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It is not the injury or illness that is compensated but rather
the death or disability, i. e., the incapacity to work resulting
in the impairment of their employees earning capacity.
Compensability of disability or death arising from injury:
a. The employee must have been injured at the place
where his work requires him to be
b. The employee must have been performing his official
functions
c. If the injury is sustained elsewhere, the employee must
have been executing an order for the employer
As long as the employee acted within the purview of his
employment, the injury sustained by reason thereof falls
within the protection of the law, regardless of the place of
injury.
The Personal Comfort Doctrine
- Acts performed by an employee within the time and
space limits of his employment, to minister to his
personal comfort, shall be deemed incidental to his
employment, and injuries the employee suffered in the
performance of such acts shall be considered
compensable and arising out and in the course of
employment.
Injury or death resulting from an accident while an
employee is going to, or coming from, the workplace is
compensable if the following conditions are definitely
established:
a. The act of the employee of going to, or coming from,
the workplace must have been a continuing act, i. e.,
he had not been diverted therefrom by any other
activity, and he had not departed from his usual route
to, or from, his workplace; and
b. If the employee was sent on a special errand, the
special errands must have been official and connected
with his work.
The 24-hour Duty Doctrine
- A soldier on active duty status is really on a 24-hour
official duty status and is subject to military discipline
and military law 24 hours a day. He is subject to call
and to the orders of his superior officers at all times, 7
days a week, except when he is on vacation leave
status.
- For a military or policeman to be entitled to
compensation, the standard of work-connection must
still be established by substantial evidence.
Death or disability arising from injury sustained by an
employee while on vacation leave is not compensable
because an employee who is on leave does not perform his
usual duties.
Disability or death arising from injury by a member of the
military while on pass for a period not exceeding 72
hours is compensable. Beyond 72 hours, still compensable
if due to legitimate and valid reasons, such as fortuitous
events or force majeure, provided that there has been no
unjustified deviation from the conditions for the issuance of
the pass.
Death or disability arising from illness is compensable:
a. If the illness is classified as an occupational disease;
or
b. If not classified as occupational disease, the risk of
contracting the same is proven by substantial evidence
to have been increased by the working conditions
Compensability of Occupational Disease
a. The employees work must involve the described risk
b. The disease was contracted as a result of the
employees exposure to the described risks
c. The disease was contracted within a period of
exposure and under such factors necessary to contract
it
d. There was no notorious negligence on the part of the
employee
The Increased Risk Doctrine
- Diseases which are not classified as occupational
disease are compensable only if the claimant can
prove that the risk of contracting the disease was
increased by the working conditions
- There is increased risk if the illness is caused or
precipitated by factors inherent in the employees
nature of work and working conditions. It does not
include aggravation of a pre-existing illness.
- Direct causal connection between the disease and the
employment, not required. All that is required is
reasonable work-connection, which could be
established by mere substantial evidence.
- The test of evidence in compensation cases or the
relation of the disease with the employment is
probability and not certainty.
- Where the primary illness or injury is shown to have
arisen in the course of employment, every natural
consequence that flows from the illness or injury shall
be deemed employment-related, hence, compensable.
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ARTICLE 167. Definition of terms. As used in this Title, unless
the context indicates otherwise:
(a) Code means the Labor Code of the Philippines instituted under
Presidential Decree Numbered four
hundred forty-two, as amended.
(b) Commission means the Employees Compensation Commission
created under this Title.
(c) SSS means the Social Security System created under Republic
Act Numbered Eleven hundred sixty-one, as amended.
(d) GSIS means the Government Service Insurance System created
under Commonwealth Act Numbered One hundred eighty-six, as
amended.
(e) System means the SSS or GSIS, as the case may be.
(f) Employer means any person, natural or juridical, employing the
services of the employee.
(g) Employee means any person compulsorily covered by the GSIS
under Commonwealth Act Numbered One hundred eighty-six, as
amended, including the members of the Armed Forces of the
Philippines, and any person employed as casual, emergency,
temporary, substitute or contractual, or any person compulsorily
covered by the SSS under Republic Act Numbered Eleven hundred
sixty-one, as amended.
(h) Person means any individual, partnership, firm, association,
trust, corporation or legal representative thereof.
(i) Dependent means the legitimate, legitimated or legally adopted
or acknowledged natural child who is unmarried, not gainfully
employed, and not over twenty-one (21) years of age or over twenty-
one (21) years of age provided he is incapacitated and incapable of
self-support due to a physical or mental defect which is congenital or
acquired during minority; the legitimate spouse living with the
employee and the parents of said employee wholly dependent upon
him for regular support.
(j) Beneficiaries means the dependent spouse until he/she remarries
and dependent children, who are the primary beneficiaries. In their
absence, the dependent parents and subject to the restrictions imposed
on dependent children, the illegitimate children and legitimate
descendants, who are the secondary beneficiaries: Provided, That the
dependent acknowledged natural child shall be considered as a
primary beneficiary when there are no other dependent children who
are qualified and eligible for monthly income benefit.
(k) Injury means any harmful change in the human organism from
any accident arising out of and in the course of the employment.
(l) Sickness means any illness definitely accepted as an
occupational disease listed by the Commission, or any illness caused
by employment subject to proof that the risk of contracting the same
is increased by working conditions. For this purpose, the Commission
is empowered to determine and approve occupational diseases and
work-related illnesses that may be considered compensable based on
peculiar hazards of employment.
(m) Death means loss of life resulting from injury or sickness.
(n) Disability means loss or impairment of a physical or mental
function resulting from injury or sickness.
(o) Compensation means all payments made under this Title for
income benefits and medical or related benefits.
(p) Income benefit means all payments made under this Title to the
providers of medical care, rehabilitation services and hospital care.
(q) Medical benefit means all payments made under this Title to the
providers of medical care, rehabilitation services and hospital care.
(r) Related benefit means all payments made under this Title for
appliances and supplies.
(s) Appliances means crutches, artificial aids and other similar
devices.
(t) Supplies means medicine and other medical, dental or surgical
items.
(u) Hospital means any medical facility, government or private,
authorized by law, an active member in good standing of the
Philippine Hospital Association and accredited by the Commission.
(v) Physician means any doctor of medicine duly licensed to
practice in the Philippines, an active member in good standing of the
Philippine Medical Association and accredited by the Commission.
(w) Wages or Salary, insofar as they refer to the computation of
benefits defined in Republic Act No. 1161, as amended, for SSS and
Presidential Decree No. 1146, as amended, for GSIS, respectively,
except that part in excess of Three Thousand Pesos.
(x) Monthly salary credit means the wage or salary base for
contributions as provided in Republic Act Numbered Eleven hundred
sixty-one, as amended, or the wages or salary.
(y) Average monthly salary credit in the case of the SSS means the
result obtained by dividing the sum of the monthly salary credits in
the sixty-month period immediately following the semester of death
or permanent disability by sixty (60), except where the month of
death or permanent disability falls within eighteen (18) calendar
months from the month of coverage, in which case, it is the result
obtained by dividing the sum of all monthly salary credits paid prior
to the month of contingency by the total number of calendar months
of coverage in the same period.
(z) Average daily salary credit in the case of the SSS means the
result obtained by dividing the sum of the six (6) highest monthly
salary credits in the twelve-month period immediately preceding the
8|vmbt
semester of sickness or injury by one hundred eighty (180), except
where the month of injury falls within twelve (12) calendar months
from the first month of coverage, in which case it is the result
obtained by dividing the sum of all monthly salary credits by thirty
(30) times the number of calendar months of coverage in the period.
In the case of the GSIS, the average daily salary credit shall be the
actual daily salary or wage, or the monthly salary or wage divided by
the actual number of working days of the month of contingency.
(aa) Quarter means a period of three (3) consecutive months
ending on the last days of March, June, September and December.
(bb) Semester means a period of two consecutive quarters ending in
the quarter of death, permanent disability, injury or sickness.
(cc) Replacement ratio The sum of twenty percent and the
quotient obtained by dividing three hundred by the sum of three
hundred forty and the average monthly salary credit.
(dd) Credited years of service For a member covered prior to
January, 1975, nineteen hundred seventy-five minus the calendar year
of coverage, plus the number of calendar years in which six or more
contributions have been paid from January, 1975 up to the calendar
year containing the semester prior to the contingency. For a member
covered on or after January, 1975, the number of calendar years in
which six or more contributions have been paid from the year of
coverage up to the calendar year containing the semester prior to the
contingency.
(ee) Monthly income benefit means the amount equivalent to one
hundred fifteen percent of the sum of the average monthly salary
credit multiplied by the replacement ratio, and one and a half percent
of the average monthly salary credit for each credited year of service
in excess of ten years: Provided, That the monthly income benefit
shall in no case be less than two hundred fifty pesos.
Chapter II
COVERAGE AND LIABILITY
ART. 168. Compulsory coverage. - Coverage in the State Insurance
Fund shall be compulsory upon all employers and their employees
not over sixty (60) years of age: Provided, That an employee who is
over (60) years of age and paying contributions to qualify for the
retirement or life insurance benefit administered by the System shall
be subject to compulsory coverage.
Covered employers all employers, whether belonging to
the public or private sectors are covered.
- Public sectors those covered by the GSIS comprising
the national government, including GOCCs, the
Philippine Tuberculosis Society, the Philippine
National Red Cross and the Philippine Veterans Bank.
- Private sectors those covered by the SSS
Covered employees all not over 60 y/o, whether
belonging to the private or public sector.
Over 60 y/o may also be covered if they have been
paying contributions to the SSS and GSIS prior to the
age of 60 and has not been compulsorily retired.
Public sector employees those covered by the GSIS,
including the members of the AFP, elective officials
who are receiving regular salary and any person
employed as casual, emergency, temporary, substitute
or contractual.
Private sectors those who are covered by the SSS.
ARTICLE. 169. Foreign employment. The Commission shall
ensure adequate coverage of Filipino employees employed abroad,
subject to regulations as it may prescribe.
Filipinos working abroad Filipinos working abroad for an
employer who carries on in the Philippines any trade,
business, industry, undertaking or activity of any kind are
covered, and therefore, entitled to the same benefits given
to employees working in the Philippines.
ARTICLE. 170. Effective date of coverage. Compulsory coverage
of the employer during the effectivity of this Title shall take effect on
the first day of his operation, and that of the employee, on the date of
his employment.
Effective date of coverage: 1st day of operation but not
earlier than January 1, 1975.
ARTICLE. 171. Registration. Each employer and his employees
shall register with the System in accordance with its regulations.
Section 1 Requirement
1. Every employer shall register with the System by
accomplishing the prescribed forms
2. Every employee shall be registered with the System
through his employer by accomplishing the prescribed
forms
Section 2 GSIS (applicable to public sector)
1. employer operating before January 1, 1975 register
not later than March 31, 1975
2. employer operating on or after January 1, 1975
register within one month from the first day of
operation
Section 3 SSS (applicable to private sector)
a. employer already registered need not register again;
automatically registered
b. employer not yet registered register not later than the
first day of operation
c. employee already registered need not register again;
automatically registered
d. employee not yet registered register not later than
the date of employment
e. only one registration is needed for SSS, Medicare and
Employees Compensation
9|vmbt
Guidelines in reporting an unregistered employee by
employer
a. every employee already reported need not be reported
again; automatically reported
b. newly hired employee reported by his employer not
later than 30 days from date of employment
When An Employee is Deemed Reported
- When the SSS or GSIS has received a report or written
communication about him from his employer and
Employees Compensation contribution paid in his
name before a compensable contingency occurs
Effect of Failure to Report
- Employer fine (P1,000-P10,000) and/or
imprisonment for duration of the violation or non-
compliance or until such time that rectification of the
violation has been made, at the discretion of the Court
- Compensable contingency occurs after 30 days and
before the System receives any report for coverage
about the employee or EC contribution on his behalf
employer liable to System for the lump sum equivalent
to the benefits to which he or his dependents may be
entitled
ARTICLE. 172. Limitation of liability. The State Insurance Fund
shall be liable for compensation to the employee or his dependents,
except when the disability or death was occasioned by the employees
intoxication, willful intention to injure or kill himself or another,
notorious negligence, or otherwise provided under this Title.
Factors That Bar Compensability
a. Intoxication
b. Willful intention to injure or kill himself or another
c. Notorious negligence
1.1. Intoxication
Persons condition in being under the influence of liquor or
prohibited drugs to the extent that his acts, words or
conduct is impaired visibly, as to prevent him from
physically and mentally engaging in the duties of his
employment
Degree must be such that it rendered the employee
incapable of doing his work
Accident or injury must be shown by clear and convincing
proof that it arose out of his drunken condition and not
because of his work
Burden of proof party who raises drunkenness as a
defense
1.2. Willful Intention to Injure/Kill Himself or Another
Deliberate intent on the part of the employee to inflict
injuries to himself or another
Reason the resulting injury, disability or death was not
caused by the employment but by the employees own
voluntary act
Applies only work-connected injury, disability or death
1.3. Notorious Negligence
Something more than mere or simple negligence or
contributory negligence
Deliberate act of the employee to disregard his own
personal safety
Failure to observe any or slight care
Tantamount to gross negligence
Must be shown by clear and convincing proof that it was
the cause of the injury
Disobedience to rules, orders, and/or prohibition does not
per se constitute notorious negligence, if no intention can
be attributed to the injured to end his life
ARTICLE. 173. Extent of liability. Unless otherwise provided, the
liability of the State Insurance Fund under this Title shall be
exclusive and in place of all other liabilities of the employer to the
employee, his dependents or anyone otherwise entitled to receive
damages on behalf of the employee or his dependents. The payment
of compensation under this Title shall not bar the recovery of benefits
as provided for in Section 699 of the Revised Administrative Code,
Republic Act Numbered Eleven hundred sixty-one, as amended,
Republic Act Numbered Forty-eight hundred sixty-four as amended,
and other laws whose benefits are administered by the System or by
other agencies of the government. (As amended by Presidential
Decree No. 1921).
Exclusiveness of Liability
Liability of State Insurance Fund is exclusive and in
place of all other liabilities which the employer may
have to the employee, his dependents or anyone
entitled to receive damages in behalf of the employee
or his dependents
Relieves the employer from any further obligation to
directly pay compensation benefits to its employees
for work-connected sickness or injury
Recovery Under Other Laws
Art. 173 payment of compensation under this Title
shall nor bar recovery of benefits as provided for in:
o Sec. 699 of Revised Administrative Code
o RA 1161, as amended
o RA 610, as amended
o RA 4864, as amended
o Other laws whose benefits are administered
by the System or by other agencies of the
government
10 | v m b t
Q: Does it mean that the employee can recover from
both the Labor Code and other specified laws?
A: No (Rule IV of the Amended Rules on Employees
Compensation)
SEC 2. Exclusiveness (a) Whenever other laws
provide similar benefits for the same contingency
covered by these Rules, the employee who qualifies
for the benefits shall have the option to choose under
which law will be paid to him. However if benefits
chosen by law are less than the benefit provided under
these Rules Employees Compensation to pay only
the difference in benefits
(b) The employee shall not be qualified to avail
himself at the same time of similar benefits provided
by different laws, except the difference in benefits
The Labor Code vis--vis The Civil Code
Q: Can the injured employee avail of compensation
benefits under the Labor Code and sue the employer for
damages under the Civil Code?
A: 3 divergent opinions by several amici curae (Floresca
vs. Philex Mining Corporation)
a. Injured employee (or heirs in case of death) may
initiate an action for damages on the basis of
negligence of the employer pursuant to the Civil Code
b. The remedy of an employee for work-connected injury
or accident is exclusively restricted to seeking the
limited compensation provided under the Workmens
Compensation Act
The employee or his heirs can choose on whether
to avail of the limited compensation under the
Workmens Compensation Act or sue for higher
damages under the Civil Code by reason of the
employers negligence. (Choice is alternative, not
cumulative)
2. Distinction Between Compensation and Damages
Compensation Damages
Given to mitigate the harshness Given in order to vindicate a
and insecurity of industrial life for wrongful invasion of a right
the workman and his family
Entitlement exists so long as Recoverable by one who has
death, injury or illness is work- sustained injury either in
connected regardless of person, property or relative
negligence of employer rights, through the act or default
of another
ARTICLE. 174. Liability of third party/ies. (a) When the
disability or death is caused by circumstances creating a legal liability
against a third party, the disabled employee or the dependents, in case
of his death, shall be paid by the System under this Title. In case
benefit is paid under this Title, the System shall be subrogated to the
rights of the disabled employee or the dependents, in case of his
death, in accordance with the general law.
(b) Where the System recovers from such third party damages in
excess of those paid or allowed under this Title, such excess shall be
delivered to the disabled employee or other persons entitled thereto,
after deducting the cost of proceedings and expenses of the System.
Injury or Death Caused by a Third Party
Third Party
- Any person who is not the employer of the injured
employee
- Injury or death caused by a third party is compensable
if all the requisites for compensability are met, but
claimant cannot receive payment twice for the same
injury
ARTICLE. 175. Deprivation of the benefits. Except as otherwise
provided under this Title, no contract, regulation or device
whatsoever shall operate to deprive the employee or his dependents
of any part of the income benefits and medical or related services
granted under this Title. Existing medical services being provided by
the employer shall be maintained and continued to be enjoyed by
their employees.
Benefits Under The Employees Compensation Law
- Form:
a. Income
b. Services
- Consists of:
a. Medical services, appliances and supplies
b. Rehabilitation services
c. Permanent total disability
d. Permanent partial disability
e. Death
f. Funeral
The law guarantees the right to full enjoyment of
compensation benefits
To ensure that the employee or dependents get the full
amount that he is entitled to, the law exempts compensation
benefits from taxes, attachment, garnishment, levy or
seizure
Prohibited:
a. Retention or deduction of any amount from the
compensation
b. Transfer of compensation benefits to another
Null and void:
- Any contract, regulation or device which operate to
deprive the employee or his dependents of any part of
the income benefits and medical or related services
11 | v m b t
Chapter III
ADMINISTRATION
ARTICLE. 176. Employees Compensation Commission. (a) To
initiate, rationalize, and coordinate the policies of the employees
compensation program, the Employees Compensation Commission is
hereby created to be composed of five ex-officio members, namely:
the Secretary of Labor and Employment as Chairman, the GSIS
General Manager, the SSS Administrator, the Chairman of the
Philippine Medical Care Commission, and the Executive Director of
the ECC Secretariat, and two appointive members, one of whom shall
represent the employees and the other, the employers, to be appointed
by the President of the Philippines for a term of six years. The
appointive member shall have at least five years experience in
workmens compensation or social security programs. All vacancies
shall be filled for the unexpired term only. (As amended by Section
19 [c], Executive Order No. 126).
(b) The Vice Chairman of the Commission shall be alternated each
year between the GSIS General Manager and the SSS Administrator.
The presence of four members shall constitute a quorum. Each
member shall receive a per diem of two hundred pesos for every
meeting that is actually attended by him, exclusive of actual, ordinary
and necessary travel and representation expenses. In his absence, any
member may designate an official of the institution he serves on full-
time basis as his representative to act in his behalf. (As amended by
Section 2, Presidential Decree No. 1368).
(c) The general conduct of the operations and management functions
of the GSIS or SSS under this Title shall be vested in its respective
chief executive officers, who shall be immediately responsible for
carrying out the policies of the Commission.
(d) The Commission shall have the status and category of a
government corporation, and it is hereby deemed attached to the
Department of Labor and Employment for policy coordination and
guidance. (As amended by Section 2, Presidential Decree No. 1368).
Composition of Employees Compensation Commission
a. Chairman Secretary of Labor and
Employment
b. Ex-Officio Members Executive Director of ECC
GSIS General Manager
SSS Administrator
Chairman of Medicare
Commission
c. Appointive Members Employees Representative
Employers Representative
Qualification
- Appointive members at least five (5) years
experience in workmens compensation or social
security program
Term of Office
- Appointive members six (6) years
- Vacancies filled for unexpired term only
ARTICLE. 177. Powers and duties. The Commission shall have
the following powers and duties:
(a) To assess and fix a rate of contribution from all employers;
(b) To determine the rate of contribution payable by an employer
whose records show a high frequency of work accidents or
occupational diseases due to failure by the said employer to observe
adequate safety measures;
(c) To approve rules and regulations governing the processing of
claims and the settlement of disputes arising therefrom as prescribed
by the System;
(d) To initiate policies and programs toward adequate occupational
health and safety and accident prevention in the working
environment, rehabilitation other than those provided for
underArticle 190 hereof, and other related programs and activities,
and to appropriate funds therefor; (As amended by Section 3,
Presidential Decree No. 1368).
(e) To make the necessary actuarial studies and calculations
concerning the grant of constant help and income benefits for
permanent disability or death and the rationalization of the benefits
for permanent disability and death under the Title with benefits
payable by the System for similar contingencies: Provided, That the
Commission may upgrade benefits and add new ones subject to
approval of the President: and Provided, further, That the actuarial
stability of the State Insurance Fund shall be guaranteed: Provided,
finally, That such increases in benefits shall not require any increases
in contribution, except as provided for in paragraph (b) hereof; (As
amended by Section 3, Presidential Decree No. 1641).
(f) To appoint the personnel of its staff, subject to civil service law
and rules, but exempt from WAPCO law and regulations;
(g) To adopt annually a budget of expenditures of the Commission
and its staff chargeable against the State Insurance Fund: Provided,
That the SSS and GSIS shall advance on a quarterly basis, the
remittances of allotment of the loading fund for the Commissions
operational expenses based on its annual budget as duly approved by
the Department of Budget and Management; (As amended by Section
3, Presidential Decree No. 1921).
(h) To have the power to administer oath and affirmation, and to
issue subpoena and subpoena duces tecum in connection with any
question or issue arising from appealed cases under this Title;
(i) To sue and be sued in court;
(j) To acquire property, real or personal, which may be necessary or
expedient for the attainment of the purposes of this Title;
(k) To enter into agreements or contracts for such services and as
may be needed for the proper, efficient and stable administration of
the program;
12 | v m b t
(l) To perform such other acts as it may deem appropriate for the
attainment of the purposes of the Commission and proper
enforcement of the provisions of this Title. (As amended by Section
18, Presidential Decree No. 850).
Power to Approve Additional Occupational Diseases
- ECC has the power to determine and approve
additional occupational diseases and work-related
illnesses with specific criteria based on peculiar
hazards of employment
ARTICLE. 178. Management of funds. All revenues collected by
the System under this Title shall be deposited, invested, administered
and disbursed in the same manner and under the same conditions,
requirements and safeguards as provided by Republic Act Numbered
eleven hundred sixty-one, as amended, with regard to such other
funds as are thereunder being paid to or collected by the SSS and
GSIS, respectively: Provided, That the Commission, SSS and GSIS
may disburse each year not more than twelve percent of the
contribution and investment earnings collected for operational
expenses, including occupational health and safety programs,
incidental to the carrying out of this Title.
Disbursement Limitation for Operational Expenses
- Twelve percent (12%) of the contributions and
investment earning collected
ARTICLE. 179. Investment of funds. Provisions of existing laws
to the contrary notwithstanding, all revenues as are not needed to
meet current operational expenses under this Title shall be
accumulated in a fund to be known as the State Insurance Fund,
which shall be used exclusively for payment of the benefits under this
Title, and no amount thereof shall be used for any other purpose. All
amounts accruing to the State Insurance Fund, which is hereby
established in the SSS and GSIS, respectively, shall be deposited with
any authorized depository bank approved by the Commission, or
invested with due and prudent regard for the liquidity needs of the
System. (As amended by Section 4, Presidential Decree No. 1368).
The State Insurance Fund
- Comprised of all revenues that are not needed to meet
current operational expenses
- Cannot be used for any purpose than payment of the
employees compensation benefits
- Deposited with any authorized depositary bank
approved by the Employees Compensation
Commission or invested with due regard for the
liquidity needs of the System
ARTICLE. 180. Settlement of claims. The System shall have
original and exclusive jurisdiction to settle any dispute arising from
this Title with respect to coverage, entitlement to benefits, collection
and payment of contributions and penalties thereon, or any other
matter related thereto, subject to appeal to the Commission, which
shall decide appealed cases within twenty (20) working days from the
submission of the evidence.
Original and Exclusive Jurisdiction
- Disputes relating to coverage, entitlement to benefits,
collection and payment of contributions and penalties
thereon or any matter related thereto
- GSIS employees under the public sector
- SSS employees under the private sector
Appellate Jurisdiction
- Employees Compensation Commission
- Within thirty (30) calendar days from receipt of
decision
ARTICLE. 181. Review. Decisions, orders or resolutions of the
Commission may be reviewed on certiorari by the Supreme Court on
question of law upon petition of an aggrieved party within ten (10)
days from notice thereof.
Appeal to the Supreme Court
- Pure questions of law by way of appeal by certiorari
under Rule 45 of the rules of Court
- Within 15 days from notice of final order or resolution
appealed from
ARTICLE. 182. Enforcement of decisions. (a) Any decision,
order or resolution of the Commission shall become final and
executory if no appeal is taken therefrom within ten (10) days from
notice thereof. All awards granted by the Commissionin cases
appealed from decisions of the System shall be effected within fifteen
days from receipt of notice.
(b) In all other cases, decisions, orders and resolutions of the
Commission which have become final and executory shall be
enforced and executed in the same manner as decisions of the Court
of First Instance, and the Commission shall have the power to issue
to the city or provincial sheriff or to the sheriff whom it may appoint,
such writs of execution as may be necessary for the enforcement of
such decisions, orders or resolutions, and any person who shall fail or
refuse to comply therewith shall, upon application by the
Commission, be punished by the proper court for contempt.
Payment of Awards
- Decisions, orders or resolutions of the ECC en banc
shall be complied with by the SSS or GSIS within
fifteen (15) days from receipt
Enforcement of Other Decisions
- Same manner as decisions of the RTC
- Employees Compensation Commission (ECC)
o Power to issue to the City or Provincial Sheriff or
to the Sheriff it may appoint, such writs of
execution as may be necessary for the
enforcement of such decisions, orders or
resolutions
13 | v m b t
Chapter IV
CONTRIBUTIONS
ARTICLE. 183. Employers contributions. (a) Under such
regulations as the System may prescribe, beginning as of the last day
of the month when an employees compulsory coverage takes effect
and every month thereafter during his employment, his employer
shall prepare to remit to the System a contribution equivalent to one
percent of his monthly salary credit.
(b) The rate of contribution shall be reviewed periodically and subject
to the limitations herein provided, may be revised as the experience
in risk, cost of administration and actual or anticipated as well as
unexpected losses, may require.
(c) Contributions under this Title shall be paid in their entirety by the
employer and any contract or device for the deductions of any portion
thereof from the wages or salaries of the employees shall be null and
void.
(d) When a covered employee dies, becomes disabled or is separated
from employment, his employers obligation to pay the monthly
contribution arising from that employment shall cease at the end of
the month of contingency and during such months that he is not
receiving wages or salary.
Payment of Premium Contributions Sole Obligation
of Employer
- Payment of premium contributions for employees
compensation sole obligation of employer
- Any contract or device for the deduction of any
portion thereof from the wages of the employee null
and void
- Contributions non-refundable
Effect of Death or Separation from Employment
- Employers obligation to pay the monthly contribution
ceases in the last day of the month of contingency
Effect of Disability
- Employers obligation suspended during the months
that he is not receiving salary or wages
ARTICLE. 184. Government guarantee. The Republic of the
Philippines guarantees the benefits prescribed under this Title, and
accepts general responsibility for the solvency of the State Insurance
Fund. In case of any deficiency, the same shall be covered by
supplemental appropriations from the national government.
Purpose of the Law: Assure that the employee is paid the
benefits due him if the State Insurance Fund runs out of
money
Chapter V
MEDICAL BENEFITS
ARTICLE. 185. Medical services. Immediately after an employee
contracts sickness or sustains an injury, he shall be provided by the
System during the subsequent period of his disability with such
medical services and appliances as the nature of his sickness or injury
and progress of his recovery may require, subject to the expense
limitation prescribed by the Commission.
Scope of Medical Services
a. Ward services during confinement in an accredited
hospital
b. Subsequent domiciliary care by an accredited
physician
c. Medicines
d. Ambulatory services in an accredited hospital, in case
of injury
Condition for Entitlement
a. Employee should have duly reported to the SSS or
GSIS
b. He sustains an injury or contracts sickness
c. The System has been duly notified of the injury or
sickness
Period of Entitlement
- Beginning with the first day of injury or sickness,
during the subsequent period of his disability, and as
the progress of his recovery may require, subject to the
periodic submission of a medical report on his
disability certified by his physicians
Meaning of Ward Services
- Ward hospital room that can accommodate six (6) or
more patients
- Covers all of the services an in-patient would
ordinarily receive in a hospital, such as:
a. Bed in a ward (6 beds/room)
b. All meals, including special diets
c. Regular nursing services
d. Medicines furnished by the hospital
e. Laboratory services such as blood and urine
tests
f. Radiology services such as x-rays
g. Medical supplies such as splints and casts
h. Use of appliances and equipment furnished
by the hospital, such as wheelchairs,
crutches and braces
i. Anesthetic services
j. Operating room charges
k. Surgery
l. Doctors services
Not Included in Ward Services
a. Extra charge for more comfortable accommodation
e.g. private and semi-private rooms
14 | v m b t
b. Personal comfort or convenience e.g. charges for the
use of a telephone, radio or television
c. Private duty nurse
Medicines
- Provided by the hospital at a cost not exceeding the
retail prices prevailing in local drugstores
Payment
- Made directly to the providers of the medical services
in such amount as are prevailing in the community for
similar services or as provided for in the Rules,
whichever is less
ARTICLE. 186. Liability. - The System shall have the authority to
choose or order a change of physician, hospital or rehabilitation
facility for the employee, and shall not be liable for compensation for
any aggravation of the employees injury or sickness resulting from
unauthorized changes by the employee of medical services,
appliances, supplies, hospitals, rehabilitation facilities or physicians.
Change of Medical services
- Should be approved by the SSS or GSIS, otherwise,
System cannot be held liable for compensation for any
aggravation of the injury or sickness resulting from
any unauthorized changes
ARTICLE. 187. Attending physician. Any physician attending an
injured or sick employee shall comply with all the regulations of the
System and submit reports in prescribed forms at such time as may be
required concerning his condition or treatment. All medical
information relevant to the particular injury or sickness shall, on
demand, be made available to the employee or the System. No
information developed in connection with treatment or examination
for which compensation is sought shall be considered as privileged
communication.
Obligations of Attending Physician
a. Comply with all the regulations of the SSS or the
GSIS
b. Submit medical reports using the prescribed form
Medical Information Not Privileged Communication
- Employees compensation cases
- Art. 187 No information developed in connection
with treatment or examination for which compensation
is sought shall be considered as privileged
communication
ARTICLE. 188. Refusal of examination or treatment. If the
employee unreasonably refuses to submit to medical examination or
treatment, the System shall stop the payment of further compensation
during such time as such refusal continues. What constitutes an
unreasonable refusal shall be determined by the System which may,
on its own initiative, determine the necessity, character and
sufficiency of any medical services furnished or to be furnished.
Suspension of Compensation Payments
- Refusal of an employee to submit to medical
examination or treatment should be unreasonable
- unreasonable refusal matter to be determined by
SSS or GSIS
ARTICLE. 189. Fees and other charges. All fees and other
charges for hospital services, medical care and appliances, including
professional fees, shall not be higher than those prevailing in wards
of hospitals for similar services to injured or sick persons in general
and shall be subject to the regulations of the Commission.
Professional fees shall only be appreciably higher than those
prescribed under Republic Act Numbered sixty-one hundred eleven,
as amended, otherwise known as the Philippine Medical Care Act of
1969.
Fees and Charges
1. FOR HOSPITAL CONFINEMENT
- Injury benefit not to exceed actual cost of ward
services in an accredited hospital
- Sickness benefit not to exceed the actual cost of
ward in an accredited hospital equipped with facilities
necessary for the treatment of the disease
2. FOR DOMICILIARY CARE
- Benefit not to exceed P50.00 for the first visit and
P50.00 for each subsequent visit
3. FOR AMBULATORY SERVICES
- Benefit not to exceed P60.00/day exclusive of drugs
and medicines
4. FOR SURGICAL SERVICES
- Surgical expense benefit
1. Surgeons fee according to the ECC Relative
Value Study
2. Anesthesiologists fee ordinarily not exceeding
25% of the surgeons fee
3. Operating fee ordinarily not exceeding 25% of
the surgeons fee
- Surgeons fee paid to surgeon who performed the
operation; anesthesiologists fee anesthesiologist;
conditions:
1. Only one surgeon paid per operation
2. Only one anesthesiologist, if any, paid per
operation
3. Local anesthesia, other than regional nerve block
anesthesia shall not be compensable
- Operating room fee paid by SSS or GSIS only for
surgical procedure done in the operating-diagnostic-
therapeutic room complex of the accredited hospital
ARTICLE. 190. Rehabilitation services. (a) The System shall, as
soon as practicable, establish a continuing program, for the
rehabilitation of injured and handicapped employees who shall be
15 | v m b t
entitled to rehabilitation services, which shall consist of medical,
surgical or hospital treatment, including appliances if they have been
handicapped by the injury, to help them become physically
independent.
(b) As soon as practicable, the System shall establish centers
equipped and staffed to provide a balanced program of remedial
treatment, vocational assessment and preparation designed to meet
the individual needs of each handicapped employee to restore him to
suitable employment, including assistance as may be within its
resources, to help each rehabilitee to develop his mental, vocational
or social potential.
Meaning of Rehabilitation
- Process by which there is provided a balanced
program of remedial treatment, vocational assessment,
and preparation designed to meet the individual needs
of each handicapped employee to restore him to
suitable employment, including assistance as may be
within its resources to help each rehabilitee to develop
his mental, vocational, or social potential
Conditions for Rehabilitation
a. Employee has been reported to the SSS or GSIS
b. He sustains a permanent disability as a result of a
compensable injury or sickness
c. He has to been placed in suitable employment
Period of Entitlement
- Period of disability unless suspended or terminated
under any of the following grounds:
a. Upon suitable employment
b. Upon suspension or termination of such services
by the Rehabilitation Center by self-termination
c. By self-termination
Extent of Services
a. Medical-surgical management
b. Hospitalization
c. Necessary appliances and supplies
d. Vocational training
e. Assistance for placement
- Transportation allowance between place of residence
and the rehabilitation facility, lunch, and dormitory
allowance in appropriate cases may be included in the
extent of services
Limitations
- System not legally responsible when the injury,
sickness, disability, or death during the rehabilitation
is occasioned by any of the following:
a. Intoxication
b. Willful intention to injure or kill himself or
another
c. Notorious negligence
Chapter VI
DISABILITY BENEFITS
ARTICLE. 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 income 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 Section 2, Executive Order No.
179).
(b) The payment of such income benefit shall be in accordance with
the regulations of the Commission. (As amended by Section 19,
Presidential Decree No. 850).
Meaning of Temporary Total Disability
- Healing time, or that period of time in which the
claimant employee, by reason of the injury or
sickness, is unable to perform any kind of labor
- Situations:
a. 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
b. The injury or sickness still requires medical
attendance beyond 120 days but not to exceed
240 days from the onset of disability
- Disablement of a employee to earn wages in the same
kind of work of similar nature, that he was trained for
and accustomed to perform, or any kind of work
which a person of his mentality and attachment could
do
- Disability understood on the loss of earning capacity
o Reason: it is not the injury that is compensated
but the incapacity to work resulting in the
impairment of ones earning capacity
Conditions for Entitlement to Temporary Total
Disability
a. Employee duly has been reported to SSS or GSIS
b. He sustains temporary total disability as a result of the
injury or sickness
c. SSS or GSIS has been duly notified of the injury or
sickness which caused his disability
Purpose of the Law
- To compensate the employee for what he might have
earned during the period of treatment
Period for Entitlement
- Maximum of 120 days
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- Exception injury or sickness still requires medical
attendance beyond 120 days but not to exceed 240
days from onset of disability
Relapse of Illness
- Considered independent of and separate from the
period covered by the original disability in the
computation of his income benefit for temporary total
disability
Suspension of Income Benefit
- Failure of employee to submit to the SSS or GSIS a
monthly medical report on his disability certified by
his attending physician
ARTICLE. 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.
a. Temporary total disabilities lasting continuously
for more than 120 days (except when the
disability not exceeding 240 days is declared as
temporary total disability) regardless of whether
or not he loses the use of any part of his body
b. Complete loss of sight of both eyes
c. Loss of two limbs at or above the ankle or wrist
d. Permanent complete paralysis of two limbs
e. Brain injury resulting in incurable imbecility or
insanity
f. Such cases as determined by the SSS or GSIS
and approved by the ECC
- A persons disability might not emerge at one precise
moment in time but rather over a period of time
ARTICLE. 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 benefit for permanent total disability.
(b) The benefit shall be paid for not more than the period designated
in the following schedules:

(b) The monthly income benefit shall be guaranteed for five years, Complete and permanent No. of Months
and shall be suspended if the employee is gainfully employed, or loss of the use of
recovers from his permanent total disability, or fails to present One thumb 10
himself for examination at least once a year upon notice by the One index finger 8
System, except as otherwise provided for in other laws, decrees, One middle finger 6
orders or Letters of Instructions. (As amended by Section 5, One ring finger 5
Presidential Decree No. 1641). One little finger 3

(c) The following disabilities shall be deemed total and permanent: One big toe 6
One toe 3
(1) Temporary total disability lasting continuously for more than one One arm 50
hundred twenty days, except as otherwise provided for in the Rules; One hand 39
One foot 31
One leg 46
(2) Complete loss of sight of both eyes;
One ear 10
Both ears 20
(3) Loss of two limbs at or above the ankle or wrist; Hearing of one ear 10
Hearing of both ears 50
(4) Permanent complete paralysis of two limbs; Sight of one eye 25

(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.
(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 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 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 Section 7,
Presidential Decree No. 1368).

Meaning of Permanent Total Disability (d) In case of permanent partial disability less than the total loss of
- Disablement of an employee to earn wages because of: the member specified in the preceding paragraph, the same monthly
income benefit shall be paid for a portion of the period established for
17 | v m b t

the total loss of the member in accordance with the proportion that Sight of the 1 eye 25
the pARTICLEial 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

Chapter VII
thereof as specified in this Article, the same monthly income benefit
DEATH BENEFITS
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 ARTICLE. 194. Death. - (a) Under such regulations as the
integer. 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
(f) In cases of injuries or illnesses resulting in a permanent partial
thereof for each dependent child, but not exceeding five, beginning
disability not listed in the preceding
with the youngest and without substitution, except as provided for in
schedule, the benefit shall be an income benefit equivalent to the
paragraph (j) of Article 167 hereof: Provided, however, That the
percentage of the permanent loss of the capacity to work. (As added
monthly income benefit shall be guaranteed for five years: Provided,
by Section 7, Presidential Decree No. 1368).
further, That if he has no primary beneficiary, the System shall pay to
his secondary beneficiaries the monthly income benefit but not to
(g) Under such regulations as the Commission may approve, the exceed sixty months: Provided, finally, That the minimum death
income benefit payable in case of permanent partial disability may be benefit shall not be less than fifteen thousand pesos. (As amended by
paid in monthly pension or in lump sum if the period covered does Section 4, Presidential Decree No. 1921).
not exceed one year. (As added by Section 7, Presidential Decree No.
1368).
(b) Under such regulations as the Commission may approve, the
System shall pay to the primary beneficiaries upon the death of a
Permanent partial disability one where as a result of covered employee who is under permanent total disability under this
injury or sickness, the employee suffers a lasting partial Title, eighty percent of the monthly income benefit and his
loss of the use of any part of his body. dependents to the dependents pension: Provided, That the marriage
Conditions to entitlement of permanent partial disability must have been validly subsisting at the time of disability: Provided,
benefits: further, That if he has no primary beneficiary, the System shall pay to
his secondary beneficiaries the monthly pension excluding the
a. Te employee should have been reported to the SSS dependents pension, of the remaining balance of the five-year
or the GSIS guaranteed period: Provided, finally, That the minimum death benefit
b. He sustains permanent partial disability as a result shall not be less than fifteen thousand pesos. (As amended by Section
of injury or sickness 4, Presidential Decree No. 1921).
c. The SSS or GSIS has been duly notified of the
injury or sickness which caused his disability. (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 Section 8,
Entitlement exists even if the employee is gainfully
Presidential Decree No. 1368).
employed and receiving his wages or salary
Period of entitlement: beginning with the first month of
such disability but not longer than the designed number of (d) Funeral benefit. A funeral benefit of Three thousand pesos
months in the ff schedule: (P3,000.00) shall be paid upon the death of a covered employee or
permanently totally disabled pensioner. (As amended by Section 3,
Executive Order No. 179).
Complete AND permanent No. of months
loss of the use of
1 thumb 10 Only the primary beneficiaries are entitled to the death
1 index finger 8 benefits. In the absence of primary beneficiaries, the
1 middle finger 6 secondary beneficiaries are entitled thereto. If the deceased
1 ring finger 5 employee has no primary or secondary beneficiaries at the
1 little finger 3 time of death, the benefit shall accrue to the Employees
1 big toe 6 Compensation Fund.
Any toe 3 Primary beneficiaries:
1 arm 50
1 hand 39 a. The legitimate spouse living with the employee at the
1 foot 31 time of the employees death, until he or she
1 leg 46 remarries; and
1 ear 10 b. The legitimate, legitimated or legally adopted the
Both ears 20 children who are:
Hearing in 1 ear 10
Hearing in both ears 50 1. Unmarried
18 | v m b t
2. Not gainfully employed
3. Not over 21 y/o; or if over 21 y/o, he is incapable
of self-support due to physical or mental defect
which is congenital or acquired during minority
Secondary beneficiaries:
a. The legitimate parents wholly dependent upon the
employee for support;
b. The legitimate descendants and illegitimate children
who are:
1. Unmarried
2. Not gainfully employed
3. Not over 21 y/o; or if over 21 y/o, he is incapable
of self-support due to physical or mental defect
which is congenital or acquired during minority
General rule: the surviving spouse is entitled to the death
benefit only if he or she is living with the deceased
employee at the time of death
Exceptions:
a. Refusal of the covered employee to continue living
with the surviving spouse; or the employees
abandonment of the said spouse without justifiable or
valid cause
b. Attempt on the part of the covered employee against
the life of the surviving spouse or common child of the
spouse
c. Commission of an act of sexual abuse against the
surviving spouse, common child of the spouse by the
covered employee
d. The covered employees recurrent commission of
physical violence, or grossly abusive conduct against
thru surviving spouse or common child of the spouse
e. The covered employees infliction of physical
violence or imposition of moral duress to compel the
surviving spouse, common child of the spouse to
change their religious or political affiliation
f. Attempt of the covered employee to corrupt or induce
the surviving spouse or common child of the spouse to
engage in prostitution, or to make them connive with
the employee in such an act of corruption or
inducement
g. Drug addiction or habitual alcoholism of the covered
employee
h. Lesbianism or homosexuality of the covered employee
i. Contraction of bigamous marriage by the covered
employee, whether in the Philippines or abroad
j. Sexual infidelity or perversion of the covered
employee
k. The covered employees act of allowing the surviving
spouse or common child to be subjected to acts of
lasciviousness; and
l. The covered employees act of contraction of serious
STD extramaritally
Conditions for entitlement to death benefits:
a. The employee had been duly reported to the SSS or
GSIS
b. He died as a result of injury or sickness
c. The SSS or GSIS has been duly notified of his death,
as well as the injury or sickness which caused his
death
If the employee has been receiving monthly income benefit
for permanent total disability at the time of his death, the
surviving spouse must shoe that the marriage has been
validly subsisting at the time of his disability
Period of entitlement:
a. Primary beneficiaries:
- Income benefit shall start at the month of death
and shall continue to be paid for as long as the
beneficiaries are entitled thereto.
- Monthly income benefit not less than 15k
- Thereafter, the beneficiaries shall be paid the
monthly income benefit for as long as they are
entitled thereto.
b. Secondary beneficiaries:
- Payable in monthly pension
- Shall not exceed the period of 60 months
- Shall not be less than 60k
If one is declared presumptively dead after he had been
reported missing for some time, payment of death benefits
shall be reckoned form the date he was declared
presumptively dead by proper authority in accordance with
law, except when the declaration of death specifies another
date, in which case, payment of death benefits shall start
from the latter date.
Amount of death benefit:
a. Primary beneficiaries
- Equivalent to the monthly income benefit for
permanent total disability
- Guaranteed for 5 yrs
- Plus 10% for each dependent child not exceeding
beginning with the youngest and without
substitution
- Minimum, not less than 15k
- If the employee has been receiving income
benefits for permanent total disability at the time
of his death, equivalent to 80% plus the
dependents pension equivalent to 10% for every
dependent child but not exceeding 5 counted
from the youngest and without substitution
b. Secondary beneficiaries
- 60 times the monthly income benefit of a primary
beneficiary
- Not exceeding 15k
- Payable in monthly pension
- If the employee has been receiving income
benefits for permanent total disability at the time
of his death, shall be paid monthly pension,
19 | v m b t
excluding the dependents pension of the
remaining balance of the 5-yr guaranteed period
Funeral benefit (3k) shall be paid to 1 of the ff:
a. Surviving spouse
b. Legitimate child who spent for the funeral expenses
c. Any other person who can show incontrovertible proof
that he shouldered the funeral expenses
Beneficiaries are still entitled to the funeral benefits of a
missing person
Chapter VIII
PROVISIONS COMMON TO INCOME BENEFITS
ARTICLE. 195. Relationship and dependency. All questions of
relationship and dependency shall be determined as of the time of
death.
Meaning dependent:
a. The legitimate, legitimated or legally adopted (or
acknowledged natural child) the children who are:
1. Unmarried
2. Not gainfully employed
3. Not over 21 y/o; or if over 21 y/o, he is
incapable of self-support due to physical or
mental defect which is congenital or
acquired during minority
c. the legitimate spouse living with the employee
d. the parents of said employee wholly dependent upon
him for regular support
all questions of relationship and dependency shall be
determined as of the time of death
ARTICLE. 196. Delinquent contributions. (a) An employer who
is delinquent in his contributions shall be liable to the System for the
benefits which may have been paid by the System to his employees
or their dependents, and any benefit and expenses to which such
employer is liable shall constitute a lien on all his property, real or
personal, which is hereby declared to be preferred to any credit,
except taxes. The payment by the employer of the lump sum
equivalent of such liability shall absolve him from the payment of the
delinquent contribution and penalty thereon with respect to the
employee concerned.
(b) Failure or refusal of the employer to pay or remit the contribution
herein prescribed shall not prejudice the right of the employee or his
dependents to the benefits under this Title. If the sickness, injury,
disability or death occurs before the System receives any report of the
name of his employee, the employer shall be liable to the System for
the lump sum equivalent to the benefits to which such employee or
his dependents may be entitled.
An employer who is delinquent in his contributions shall be
liable to the SSS or GSIS for:
a. Benefits which may have been paid to his employee or
their dependents
b. 3% penalty per month from the date the contribution
falls due until paid
c. Fine not less than 1k nor more than 10k and/or
imprisonment for the duration of the violation or non-
compliance or until such time that a rectification of the
violation has been made, at the discretion of the Court.
Payment by the employer of the lump sum equivalent to his
liability shall absolve him; but he shall still be subject to
criminal liablility
ARTICLE. 197. Second injuries. If any employee under
permanent partial disability suffers another injury which results in a
compensable disability greater than the previous injury, the State
Insurance Fund shall be liable for the income benefit of the new
disability: Provided, That if the new disability is related to the
previous disability, the System shall be liable only for the difference
in income benefits.
2nd injury resulting in disability which may be suffered by
an employee under permanent partial disability, is
compensable
If the 2nd injury is greater than the previous injury, the State
Insurance Fund shall be liable for the income benefit of the
new disability
If the new injury is related to the previous one, the liability
is only for the difference in income benefits
ARTICLE. 198. Assignment of benefits. No claim for
compensation under this Title is transferable or liable to tax,
attachment, garnishment, levy or seizure by or under any legal
process whatsoever, either before or after receipt by the person or
persons entitled thereto, except to pay any debt of the employee to
the System.
Restrictions on compensation benefits:
a. Non-transferable
b. Not subject to tax
c. Not subject to execution, attachment, garnishment,
levy, or seizure, except of a payment to the System
ARTICLE. 199. Earned benefits. Income benefits shall, with
respect to any period of disability, be payable in accordance with this
Title to an employee who is entitled to receive wages, salaries or
allowances for holidays, vacation or sick leaves and any other award
of benefit under a collective bargaining or other agreement.
Accrued employees benefits are separate and distinct form
compensation benefits. Hence, they may be enjoyed
simultaneously with employees compensation benefits
Permanent total disability shall be suspended if the covered
employee obtains gainful employment
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With regard to permanent partial disability compensation,
the covered employee shall continue to receive benefits
even if he is gainfully employed
ARTICLE. 200. Safety devices. In case the employees injury or
death was due to the failure of the employer to comply with any law
or to install and maintain safety devices or to take other precautions
for the prevention of injury, said employer shall pay the State
Insurance Fund a penalty of twenty-five percent (25%) of the lump
sum equivalent of the income benefit payable by the
System to the employee. All employers, specially those who should
have been paying a rate of contribution higher than required of them
under this Title, are enjoined to undertake and strengthen measures
for the occupational health and safety of their employees.
Death or injury caused by failure to install and maintain
safety devices shall hold the employer liable to pay the
State Insurance Fund a penalty of 25% of the lump sum
equivalent of the income benefit due the employee
concerned.
ARTICLE. 201. Prescriptive period. No claim for compensation
shall be given due course unless said claim is filed with the System
within three (3) years from the time the cause of action accrued. (As
amended by Section 5, Presidential Decree No. 1921).
Claims for compensation should be filed within 3 yrs from
the time the cause of action accrued, otherwise, it will be
barred by prescription
3 yr prescriptive period shall be reckoned from the time the
employee lost his earning capacity
What is compensated is the incapacity to work resulting in
the impairment of ones earning capacity
ARTICLE. 202. Erroneous payment. (a) If the System in good
faith pays income benefit to a dependent who is inferior in right to
another dependent or with whom another dependent is entitled to
share, such payments shall discharge the System from liability, unless
and until such other dependent notifies the System of his claim prior
to the payments.
(b) In case of doubt as to the respective rights of rival claimants, the
System is hereby empowered to determine as to whom payments
should be made in accordance with such regulations as the
Commission may approve. If the money is payable to a minor or
incompetent, payment shall be made by the System to such person or
persons as it may consider to be best qualified to take care and
dispose of the minors or incompetents property for his benefit.
The SSS or GSIS is discharged from liability if it pays
income benefits in good faith:
a. To a dependent who is inferior in right to another
dependent
b. To a dependent with whom another dependent is
entitle to share such payment
The SSS or GSIS will be deemed in good faith if, prior to
payment, it does not receive any notice from the dependent
who is entitled to the compensation benefit
ARTICLE. 203. Prohibition. No agent, attorney or other person
pursuing or in charge of the preparation or filing of any claim for
benefit under this Title shall demand or charge for his services any
fee, and any stipulation to the contrary shall be null and void. The
retention or deduction of any amount from any benefit granted under
this Title for the payment of fees for such services is prohibited.
Violation of any provision of this ARTICLE shall be punished by a
fine of not less than five hundred pesos nor more than five thousand
pesos, or imprisonment for not less than six months nor more than
one year, or both, at the discretion of the court.
Prohibited activities:
a. Demanding or charging service fees
b. Deducting any amount from the compensation benefits
in payment of his services
Reason for the law: to free the award from any liability or
charge so that the claimant may enjoy it to the fullest. It is
the claimant who is exempt from liability for attorneys
fees
Attorneys fees may be awarded as an item separate and
distinct from the compensation benefits
ARTICLE. 204. Exemption from levy, tax, etc. All laws to the
contrary notwithstanding, the State Insurance Fund and all its assets
shall be exempt from any tax, fee, charge, levy, or customs or import
duty and no law hereafter enacted shall apply to the State Insurance
Fund unless it is provided therein that the same is applicable by
expressly stating its name.
Reason for the law: to preserve the integrity of the State
Insurance Fund thereby assuring every claimant payment of
whatever is due him
Chapter IX
RECORDS, REPORTS AND PENAL PROVISIONS
ARTICLE. 205. Record of death or disability. - (a) All employers
shall keep a logbook to record chronologically the sickness, injury or
death of their employees, setting forth therein their names, dates and
places of the contingency, nature of the contingency and absences.
Entries in the logbook shall be made within five days from notice or
knowledge of the occurrence of the contingency. Within five days
after entry in the logbook, the employer shall report to the System
only those contingencies he deems to be work-connected.
(b) All entries in the employers logbook shall be made by the
employer or any of his authorized official after verification of the
contingencies or the employees absences for a period of a day or
more. Upon request by the System, the employer shall furnish the
necessary certificate regarding information about any contingency
appearing in the logbook, citing the entry number, page number and
date. Such logbook shall be made available for inspection to the duly
authorized representative of the System.
21 | v m b t
(c) Should any employer fail to record in the logbook an actual
sickness, injury or death of any of his employees within the period
prescribed herein, give false information or withhold material
information already in his possession, he shall be held liable for fifty
percent of the lump sum equivalent of the income benefit to which
the employee may be found to be entitled, the payment of which shall
accrue to the State Insurance Fund.
(d) In case of payment of benefits for any claim which is later
determined to be fraudulent and the employer is found to be a party
to the fraud, such employer shall reimburse the System the full
amount of the compensation paid.
Every employer is required to keep a logbook to record
chronologically the sickness, injury or death of his
employees within 5 days from notice or knowledge. Upon
failure, the employee shall be liable for 50% of the lump
sum equivalent of the income benefit to which the
employee may be found to be entitled
ARTICLE. 206. Notice of sickness, injury or death. Notice of
sickness, injury or death shall be given to the employer by the
employee or by his dependents or anybody on his behalf within five
days from the occurrence of the contingency. No notice to the
employer shall be required if the contingency is known to the
employer or his agents or representatives.
Actual knowledge is equivalent to notice.
ARTICLE. 207. Penal provisions. (a) The penal provisions of
Republic Act Numbered Eleven Hundred Sixty-One, as amended,
and Commonwealth Act Numbered One Hundred Eighty-Six, as
amended, with regard to the funds as are thereunder being paid to,
collected or disbursed by the System, shall be applicable to the
collection, administration and disbursement of the Funds under this
Title. The penal provisions on coverage shall also be applicable.
(b) Any person who, for the purpose of securing entitlement to any
benefit or payment under this Title, or the issuance of any certificate
or document for any purpose connected with this Title, whether for
him or for some other person, commits fraud, collusion, falsification,
misrepresentation of facts or any other kind of anomaly, shall be
punished with a fine of not less than five hundred pesos nor more
than five thousand pesos and an imprisonment for not less than six
months nor more than one year, at the discretion of the court.
(c) If the act penalized by this Article is committed by any person
who has been or is employed by the Commission or System, or a
recidivist, the imprisonment shall not be less than one year; if
committed by a lawyer, physician or other professional, he shall, in
addition to the penalty prescribed herein, be disqualified from the
practice of his profession; and if committed by any official, employee
or personnel of the Commission, System or any government agency,
he shall, in addition to the penalty prescribed herein, be dismissed
with prejudice to re-employment in the government service.
Aggravating circumstances:
a. Any person has been or is employed by the ECC, SSS
or GSIS
b. A lawyer, physician, or any other professional
c. Any official, employee, or personnel; of the ECC,
SSS, or GSIS
ARTICLE. 208. Applicability. This Title shall apply only to injury,
sickness, disability or death occurring on or after January 1, 1975.
ARTICLE. 208-A. Repeal. All existing laws, Presidential Decrees
and Letters of Instructions which are inconsistent with or contrary to
this Decree, are hereby repealed: Provided, That in the case of the
GSIS, conditions for entitlement to benefits shall be governed by the
Labor Code, as amended: Provided, however, That the formulas for
computation of benefits, as well as the contribution base, shall be
those provided under Commonwealth Act Numbered One Hundred
Eighty-Six, as amended by Presidential Decree No. 1146, plus twenty
percent thereof. (As added by Section 9, Presidential Decree No.
1368 [May 1, 1978] and subsequently amended by Section 7,
Presidential Decree No. 1641).
Laws repealed:
a. Act no. 1874, otherwise known as the Employers
Liability Act
b. Act no. 3428, otherwise known as the Workmens
Compensation Act
Title III
MEDICARE
ARTICLE. 209. Medical care. The Philippine Medical Care Plan
shall be implemented as provided under Republic Act Numbered
Sixty-One Hundred Eleven, as amended.
Title IV
ADULT EDUCATION
ARTICLE. 210. Adult education. Every employer shall render
assistance in the establishment and operation of adult education
programs for their workers and employees as prescribed by
regulations jointly approved by the Department of Labor and
Employment and the Department of Education, Culture and Sports.