The Social Security System (SSS) grants sickness benefit to qualified members. For this year, most branches requires applications and claim filing via dropbox, instead of walking-in on a branch.
This is a sharing of my experience in filing a sickness benefit claim under voluntary status, the list of documents I submitted plus how many days it took for the medical evaluation approval, and how long was it to finally get the money from SSS.
Last January I was hospitalized for 3 days, after my discharged my doctor recommended another 9 days of home confinement. So the total number of confinement and recuperation is 12 days (January 24 to February 4). 12 days is also the number of days I filed for sickness benefit.
For those who were hospitalized, deadline of sickness benefit application is 1 year from start date of confinement. For those who were sick but were not hospitalized, please contact SSS directly for proper guidance.
What To Submit To SSS for Sickness Benefit Application?
Here are the documents I submitted to SSS to support my sickness claim as a voluntary member:
- Sickness Benefit Application form for Self-Employed, Voluntary Member, and Member Separated from Employment
I am using the sickness benefit form appropriate for voluntary members and self-employed. I picked up one copy of this form from a branch but this can also be downloaded online and printed. To see what the form looks like, visit this SSS website link.
Take note that the attending doctor needs to fill-out and sign under section PART II-A. Medical Certificate.
For those who are employed, there are three forms to submit Sickness Notification (SN), Sickness Benefit Reimbursement Application form, SSS Medical Certificate form. Consult your HR for proper and timely filing.
2. SSS Medical Certificate form duly filled up by attending doctor.
I got this med cert form from SSS. Then I gave the form to my doctor to fill-up and sign.
Interested members may also download and print the Medical Certificate form from the SSS website. https://www.sss.gov.ph/sss/DownloadContent?fileName=SSSForms_Medical_Certificate.pdf
3. Supporting documents
I submitted photocopy of of my hospital Discharge Summary / Clinical Abstract, lab test and imaging results during my confinement like CBC, Ultrasound, and Urinalysis.
4. Valid Government ID
Photocopy of 1 valid government ID if the ID is considered primary ID. If the ID is considered secondary, submit two valid IDs.
Primary IDs accepted by SSS are passport, PRC card, SSS UMID card, SSS card, Seaman’s Book.
Secondary IDs examples are company ID card, driver’s license, bank account passbook, Pag-ibig ID, NBI clearance, OWWA card, Postal ID card, TIN card, Voter’s ID, etc.
*I submitted photocopy of 2 IDs just to be sure – passport and driver’s license.
5. Proof of bank account
I am already approved for DAEM before I filed for sickness benefit. So at first I submitted my application to SSS Lapu Lapu branch without proof of bank account. Instead, I indicated on the claim form that I was already approved for DAEM. My contention was that in the application form under Section B it says therein “Member’s Enrollment in the Payment Thru Bank (if not yet enrolled)”, so I assumed I won’t need to fill-up that section nor submit bank document since heyyy I am already enrolled in the Disbursement Account Enrollment Module.
But unfortunately, SSS Lapu Lapu branch returned my sickness claim application with advised to ‘submit bank document’. Oh well, no choice but to submit. But this delayed the processing of my application.
So what I am suggesting now is even if you are already enrolled in DAEM, still submit proof of bank document so your documents will not be returned like mine.
I resubmitted my application together with proof of bank document, an original copy of a validated deposit slip made in January to my DAEM-registered bank ATM account.
See here for 11 reasons why DAEM enrollment was not approved by SSS.
5. Put all accomplished forms and supporting documents in a brown envelop labeled with name and mobile number.
Important: Put your name and SSS ID on all the pages of all the documents that you will submit.
I then put all these documents in a brown envelop and submitted this to SSS Lapu Lapu City branch via the dropbox.
How Many Days to Claim SSS Sickness Benefit
This is per my experience, your sickness claim processing may be faster than mine or delayed. Hope it’s the former and definitely hope your sickness benefit application will not be rejected!
February 19 – Submitted my sickness benefit application form to SSS Lapu Lapu branch via dropbox.
February 22 – Got an sms from SSS LLC personnel with message “ This is to acknowledge receipt of your Sickness Benefit Application submitted thru Dropbox. You will receive another message after evaluation of your documents.”
March 10 – Got an sms from the SSS official txt line saying that “Your sickness claim was evaluated. For the result, visit your nearest SSS Branch or check online by going to the e-services tab of My.SSS.”
After a few minutes I also got an sms from an SSS Lapu Lapu personnel with the message “Please pick up your sickness application at sss lapu lapu medical section for further advisory”.
March 12 – My returned application was picked-up. SSS medical section officer says my docs were returned because I failed to provide proof of bank document. On the same day I resubmitted my sickness benefit application, this time the bank document portion is filled-up and a validated deposit slip was stapled to the form.
After this I did not receive any other sms from SSS, however I regularly check My.SSS for status updates.
March 29 – I found out by checking My.SSS website that the medical evaluation for my 12 days sickness application was approved.
There is further processing before I will get the money for the sickness benefit claim.
The SSS staff said that after medical evaluation is approved, my papers will be forwarded to SSS regional office in Cebu City for further processing. According to her, it will take more or less a month more before the whole process is completed. I hope that it’s true. If the money will be given earlier, that’ll be a treat!
I was stalking the SSS FB page earlier and saw some comments about very delayed sickness benefit claim. 🙁
Date deposited in the bank – as of today, April 7, I am still waiting for the sickness benefit reimbursement to be credited to my bank account. I will update this post once I have it.
Update April 22, 2021: The money is now in my BPI bank account! Yeyyy!
The SSS sickness benefit check was issued April 20, 2021. Then the amount reflected in my BPI ATM bank account April 22 through eLink Transfer. This is now considered as “Settled Claim“.
SSS Lapu Lapu Branch Hotlines
I appreciate that SSS Lapu Lapu branch made it possible to submit claims via dropbox. I much prefer this method versus walking-in, though many says that walk-in processing may be faster.
In case you need the telephone number of SSS Lapu Lapu Branch, here they are:
Hotline operation is Monday to Friday at 8 AM to 12 NN and then again at 1 PM to 5 PM. Email address: firstname.lastname@example.org
How to Check SSS Sickness Benefit Status
The easiest and fastest way on how to check SSS sickness benefit status is to go online and access My.SSS member’s area. Follow the steps below to find the info:
First, login to My.SSS account
Second, click “Inquiry”
Third, click “Sickness / Maternity”
Fourth, click “Medical Evaluation”
Fifth, open the blue link under “CLMNO” for the status and update of the SSS sickness benefit claim
You can also monitor if the sickness claim is already deposited by SSS to bank account or eWallet by regularly checking online or via mobile app.
I hope this info helps you in processing your own SSS sickness benefit application.
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