A practical legal guide

I. Legal framework & institutional scope

Primary statutes: Social Security Act of 1997 (R.A. 8282) as amended by the Social Security Act of 2018 (R.A. 11199); Employees’ Compensation (EC) Program under P.D. 626 (as amended); Maternity Leave Law (R.A. 11210); Portability Law (R.A. 7699); Domestic Workers Act (R.A. 10361).
Administering bodies:
- SSS (contributory social insurance for private-sector workers, self-employed, OFWs, non-working spouses).
- ECC/SSS for work-related contingencies under the EC Program (separate, employer-paid contributions; applies to covered employees).

Key idea: Eligibility hinges on coverage + minimum contributions + timing rules (“semester of contingency”), with special rules for each benefit.

II. Coverage: who must (or may) be an SSS member

Employees in the private sector (including casual, project-based, part-time, probationary; and kasambahay). Mandatory; employer registers and remits.
Self-employed (professionals, single proprietors, freelancers, farmers/fishers, drivers/operators, etc.). Mandatory self-coverage.
Overseas Filipino Workers (OFWs). Mandatory self-coverage; may remit from abroad.
Non-working spouse (of a working SSS member), optional, based on the working spouse’s income (with written consent).
Household employers and corporate officers are also separately covered in their respective capacities.

Active membership means: registered, with contributions posted corresponding to a Monthly Salary Credit (MSC). Contribution rates/schedules change from time to time; eligibility rules below refer to count of contributions and timing, not peso amounts.

III. The “semester of contingency” (timing rule you’ll see everywhere)

A semester is two consecutive quarters (6 months) ending with the quarter of contingency (the quarter when illness, childbirth, injury, disability, death, retirement, or separation occurs).

When a rule says “within the 12 months immediately before the semester of contingency,” you exclude the semester itself and count the 12 months before it.
Benefits generally ignore contributions paid within the semester of contingency.

Example: If confinement starts 15 August, the quarter of contingency is July–September; the semester is April–September; the 12-month look-back is April of the prior year through March.

IV. Benefit-by-benefit eligibility

A. Sickness Benefit (non-work-related)

What it is: Daily cash allowance (percentage of average daily salary credit) for confinement of at least 4 days (hospital or home), non-work-related.

Eligibility:

At least 3 monthly contributions within the 12-month period immediately before the semester of sickness.
Confinement of ≥ 4 days, medically certified.
No work and no pay for the days claimed.
Proper notification: employee notifies employer; self-employed/OFW/non-working spouse notify SSS directly within prescribed periods.

Common limits: Up to 120 days per calendar year; caps on total benefit days for same illness. Not payable for work-related cases (use EC).

B. Maternity Benefit (non-work-related, cash benefit)

Who: Female SSS members (employed, self-employed, OFW, voluntary). Covered events: Live childbirth, miscarriage, emergency termination, stillbirth, or qualified non-viable pregnancy.

Eligibility:

At least 3 monthly contributions within the 12 months before the semester of childbirth/miscarriage/ECT.
Timely notification (to employer or SSS, depending on member type).
No cap on number of pregnancies (limit removed by newer law).
Employed members receive benefit via employer advance, reimbursable by SSS; self-employed/OFW/voluntary get directly from SSS.

Duration (by law):

105 days for live childbirth; additional 15 days (total 120) for solo parents;
60 days for miscarriage/ECT.

Note: Maternity leave is a labor standard; the SSS cash benefit follows SSS rules but interacts with employer obligations.

C. Unemployment/Involuntary Separation Benefit (cash)

What it is: Cash equal to a percentage of Average Monthly Salary Credit (AMSC), up to 2 months, for members involuntarily separated (e.g., redundancy, retrenchment, closure, illness not due to employee fault).

Eligibility:

At least 36 monthly contributions total, with at least 12 contributions in the 18 months immediately before separation.
Age not over 60 at the time of separation (lower caps apply to certain occupations, e.g., underground/surface mine workers, racehorse jockeys, as provided by law).
Separation must be involuntary and not for just causes.
One claim every 3 years from date of separation.
Must apply within the prescribed filing period from separation (bring proof of involuntary separation).

D. Disability Benefit (non-work-related)

What it is: Monthly pension (for qualifying contributions) or lump sum for permanently partial or total disability (non-work-related).

Eligibility (typical):

Disability pension: generally requires at least 36 monthly contributions before the semester of disability (plus SSS medical evaluation of permanent disability).
Disability lump sum: granted when contribution requirement for pension isn’t met but there is compensable permanent disability.
Additional Dependent’s Pension for up to a capped number of qualified minor children may attach to total disability pensions.

For work-related disability, claim also (or instead) under EC if covered as an employee.

E. Retirement Benefit

What it is: Lifetime monthly pension (if contribution threshold met) or lump sum.

Eligibility:

Optional retirement at 60: Member must be separated from employment (and/or no longer self-employed) at the time of filing.
Mandatory at 65: Pension entitlement regardless of work status (filing typically required).
Contribution threshold for pension: At least 120 monthly contributions (10 years). If fewer than 120, lump sum is granted; pension may be converted once the 120 is completed before age 65 via continued self-payment.
Special early retirement ages for certain occupations (e.g., underground/surface mine workers; racehorse jockeys) subject to minimum contributions and years in occupation set by law.

Add-ons & rules:

13th-month pension paid annually.
Dependent’s Pension does not attach to retirement (it attaches to disability/death).
Portability/Totalization (R.A. 7699): If you worked under SSS and GSIS, or in a treaty country, creditable service periods may be totalized to meet minimums; benefits are pro-rated.

F. Death Benefit

What it is: Monthly pension to primary beneficiaries or lump sum if contribution condition is not met (or if only secondary beneficiaries exist).

Eligibility (at death):

If the deceased paid at least 36 monthly contributions before the semester of death or was already a pensioner → Death pension is payable.
If less than 36, lump sum to beneficiaries.

Beneficiary hierarchy:

Primary: legal spouse (marriage subsisting at time of death) and dependent minor/unmarried children (including legally adopted/illegitimate subject to ordering rules).
Secondary (only if no primary): dependent parents.
If no primary or secondary, the estate.

Dependent’s Pension: For each qualified dependent child (up to a statutory cap), an additional pension (percentage of the basic pension or a floor amount, whichever is higher).

G. Funeral Benefit

Who may claim: The person who paid the funeral expenses of a deceased member or pensioner. Eligibility: Typically requires that the deceased had at least one posted contribution (or was a pensioner). Amount is set by SSS schedules; documentary proof of death and payment is required.

H. Employees’ Compensation (EC) Benefits (work-related)

What it is: Separate package for work-connected sickness, injury, disability, or death (medical services, daily/temporary total disability income, permanent disability pension, death benefits, funeral, rehabilitation).

Eligibility (general):

Employee status under the EC program at the time of injury/sickness/death; employer must be EC-compliant (pays EC premium).
Causation: Illness/injury must be work-related (or within presumptively compensable lists, or proven work-aggravated).
No willful intent or intoxication; other statutory defenses may bar claims.

Note: EC is in addition to regular SSS benefits but applies only to employees (the employer pays EC contributions).

V. Loans (brief eligibility notes)

SSS also offers member loans (e.g., salary, calamity, educational, small business programs from time to time). Eligibility generally requires:

Good standing (no default on prior SSS obligations),
Minimum posted contributions (e.g., salary loan tiers often require 36 contributions for a 1-month loan, 72 for a 2-month loan), and
Active employment for employed borrowers (employer compliance), or active self-employed/OFW status. Specific terms and rates change; always verify the current circular before applying.

VI. Beneficiaries & dependency (who qualifies, how many)

Dependent child: usually unmarried, not gainfully employed, and below 21, or over 21 but permanently incapacitated and dependent for support.
Illegitimate children share in benefits subject to ordering caps and statutory rules.
Spouse must be the legal spouse at time of contingency (for death benefits).
Parents as secondary beneficiaries only if no primary beneficiaries exist.

VII. Practical eligibility checklists

For all claims

Confirm member type (employee vs self-employed/OFW/voluntary) and coverage status.
Count posted contributions in the look-back window (exclude the semester of contingency).
Verify age and employment status where relevant (retirement, unemployment).
Prepare IDs (UMID or accepted IDs) and supporting documents (medical certificates, birth/marriage certificates, employer certifications, separation papers, proof of contributions, etc.).
File within the prescribed periods (late filing can reduce or bar claims).

Common pitfalls (and how to avoid them)

Missing the timing window because the semester rule was misread → Re-count carefully using quarters.
Unposted contributions (e.g., employer remitted late) → Coordinate posting correction before filing.
Wrong benefit stream (filing SSS sickness for a work-injury that should be under EC) → Classify the contingency correctly.
Beneficiary issues (e.g., marital disputes or undocumented dependents) → Secure civil registry documents early.

VIII. Special situations

Multiple coverage (SSS + GSIS or foreign systems): Invoke Portability/Totalization so separate periods can be added up to meet minimum eligibility; each system then pro-rates its share.
Concurrent benefits: You generally cannot be paid twice for the same contingency under the same program, but SSS and EC can co-exist for the same work-related event (EC is supplemental).
Re-entry/continuity: Members who had gaps can resume as voluntary or self-employed/OFW, but remember: contributions within the semester of contingency won’t count toward the immediate claim.
Name/record discrepancies: Ensure your SSS number, civil status, and children’s records are updated before contingencies arise.

IX. How to self-assess eligibility (quick matrix)

Benefit	Core contribution test	Other key tests
Sickness	≥ 3 contributions in the 12 months before the semester of sickness	Confinement ≥ 4 days; non-work-related; no work/no pay; timely notice
Maternity	≥ 3 in the 12 months before the semester of delivery/miscarriage/ECT	Timely notice; benefit per event (no cap on number of pregnancies); duration per law
Unemployment	36 total, with 12 in last 18 before separation	Involuntary separation; age within statutory cap; file within period; once every 3 years
Disability (non-work)	36 before semester → pension; otherwise lump sum	Medical evaluation of permanent disability; dependent’s pension for total disability
Retirement	120 total → pension; fewer → lump sum	60 (optional, separated) / 65 (mandatory); special early ages for certain jobs
Death	36 before semester (or deceased was a pensioner) → pension	Primary vs secondary beneficiaries; dependent’s pension for qualified children
Funeral	Deceased was a member with ≥1 contribution (or pensioner)	Claimant is payer of funeral

X. Filing & documentation (high-level)

Register for an online My.SSS account; ensure employer compliance for employees (R-3/R-5 posting history).
Prepare IDs and event-specific papers (medical abstracts, PSA civil registry documents, employer separation/LOA, police/accident reports for EC, etc.).
Observe statutory filing windows (e.g., prompt notice for sickness; unemployment within the set period; maternity notice before childbirth where practicable).
Keep receipts and certifications; for funeral, keep proof of payment.

XI. Final pointers (compliance & updates)

Contribution schedules and benefit amounts are periodically adjusted by SSS regulations and actuarial updates. Eligibility tests (counts/timing/age) are more stable, but always check the latest circulars before filing.
For edge cases (overlapping contingencies, disputed dependency, totalization with GSIS/foreign systems, special occupations), it’s prudent to seek written guidance from SSS or consult counsel.

One-page takeaway

Make sure you’re covered (member type clear, contributions posted).
Apply the semester rule correctly.
Check the minimum contribution count for your benefit.
Verify other qualifiers (age, separation cause, confinement days, dependency, work-relatedness).
File on time with complete documents.