Quick answer

To claim the SSS sickness benefit, follow the process for your membership status:

Currently employed: Notify your employer and submit your medical records. Your employer ordinarily files the sickness notification through its My.SSS account, advances the approved benefit after your paid company sick leave has been exhausted, and later seeks reimbursement from SSS.
Self-employed, voluntary, overseas Filipino worker, non-working spouse, or separated from employment without advance payment from the former employer: File a Sickness Benefit Application through your My.SSS member account and receive the approved benefit directly through an enrolled disbursement account.

As a general rule, you must be unable to work because of sickness or injury for at least four days, have at least three monthly contributions within the required 12-month period, and comply with the applicable notification deadline. The benefit is 90% of your average daily salary credit for each approved compensable day. (Social Security System)

The four-day requirement does not mean that the first three days are automatically unpaid. Once the confinement is approved and all qualifications are met, the compensable period generally begins on the first day of sickness.

Who qualifies

You may qualify when all applicable conditions are satisfied:

You were unable to work because of sickness or injury and were confined in a hospital, at home, or elsewhere recognized by SSS for at least four days.
At least three monthly contributions were paid within the 12-month period immediately before the semester of sickness or injury.
You or your employer gave the required notification on time.
If you are employed, you have exhausted your current company sick leave with full pay for the year. Sea-based OFWs are excepted from this condition. (Social Security System)

The three contributions do not have to be consecutive. What matters is whether they fall within the correct contribution period.

For self-employed, voluntary, and OFW members, contributions paid retroactively during or after the semester of sickness generally cannot be used to establish eligibility for that sickness.

Understanding the “semester of sickness”

A semester consists of two consecutive calendar quarters ending in the quarter when the sickness began. SSS excludes that semester, then looks at the 12 months immediately before it.

For example, if the sickness began in July 2026:

The quarter of sickness is July to September 2026.
The semester of sickness is April to September 2026.
The contribution period examined is April 2025 to March 2026.

Contributions made during the excluded semester do not increase the benefit for that sickness. (Social Security System)

How much is the sickness benefit?

The daily benefit is 90% of the average daily salary credit, or ADSC.

SSS calculates it by:

Excluding the semester of sickness.
Examining the 12 months immediately before that semester.
Adding the six highest monthly salary credits within those 12 months.
Dividing the total by 180 to obtain the ADSC.
Multiplying the ADSC by 90%.
Multiplying the daily amount by the number of days approved by SSS. (Social Security System)

Sample computation

Suppose your six highest monthly salary credits are all ₱15,000:

₱15,000 × 6 = ₱90,000
₱90,000 ÷ 180 = ₱500 ADSC
₱500 × 90% = ₱450 daily sickness benefit
For 10 approved days: ₱450 × 10 = ₱4,500

The Regular SSS Program currently uses monthly salary credits only up to ₱20,000 for benefit computation. Based on that ceiling, the maximum regular sickness allowance is approximately ₱600 per approved day. Contributions corresponding to salary credits above ₱20,000 are allocated to the mandatory provident fund and do not increase the regular sickness benefit. (Social Security System)

Maximum number of compensable days

SSS may pay sickness benefits for:

Up to 120 days in one calendar year; and
Up to 240 days for the same illness or confinement.

Unused days from the 120-day annual limit cannot be carried over to the next year. When the same condition continues beyond 240 days, SSS may evaluate it as a disability claim instead. (Social Security System)

The 120-day limit is a ceiling, not an automatic entitlement. SSS will approve only the period medically supported by the records and its evaluation.

Notification and filing deadlines

Employed member under home or non-hospital confinement

You must notify your employer within five calendar days after the start of confinement. Your employer must then notify SSS within five calendar days after receiving your notification. (Social Security System)

Send the notice in a form that can be proved later, such as an acknowledged HR form, company email, or message showing the date of receipt.

Employed member confined in a hospital

Formal employee-to-employer notification is not required by law. The employer must notify SSS within one year from the date of hospital discharge. As a practical precaution, inform HR as soon as possible so it can collect the documents and process the claim. (Social Security System)

Sickness or injury occurring at work or on company premises

The employee does not have to give the ordinary five-day notice to the employer. The employer must notify SSS within five calendar days from the onset of the sickness or injury.

Self-employed, voluntary, non-working spouse, unemployed, or separated member under home confinement

File the Sickness Benefit Application with SSS within five calendar days after the start of confinement. (Social Security System)

Do not treat the one-year prescriptive period as permission to wait. The notification deadline is much shorter.

OFWs under non-hospital confinement

The implementing rules grant OFWs 35 calendar days to file for non-hospital confinement. However, the current SSS public benefit page groups OFWs with members instructed to file within five calendar days. To avoid a reduction or dispute, file within five days whenever reasonably possible. When that was impossible because you were abroad, refer to the 35-day period in the IRR and ask SSS to confirm its treatment of your claim in writing.

Direct claimant confined in a hospital

A self-employed, voluntary, OFW, non-working spouse, unemployed, or separated member may file within one year from hospital discharge. (Social Security System)

Employer’s reimbursement application

The employer must file the reimbursement application:

For home confinement: within one year from the start of confinement.
For hospital confinement: within one year from hospital discharge. (Social Security System)

What happens when notice is late?

Late notification can reduce or defeat the claim.

When the member gives a required notification late, SSS may treat the confinement as having begun no earlier than the fifth day immediately before the notification date. Earlier days may therefore be excluded. (Social Security System)

When an employer notifies SSS more than five days after receiving the employee’s timely notice, the employer may be reimbursed only for the days beginning on the tenth calendar day immediately before its notification to SSS.

If the employee gave timely notice but the employer’s failure to notify SSS or file the reimbursement claim caused a reduction or denial, the employer has no right to recover from the employee the sickness allowance it was required to advance.

How an employed member claims the benefit

1. Notify your employer promptly

For home or non-hospital confinement, send notice within five calendar days from the first day you were unable to work.

Include:

Your full name and SSS number;
The first day of sickness or injury;
Whether you are at home or in a hospital;
Your physician’s recommended period of rest or recuperation; and
A request for acknowledgment of receipt.

2. Obtain a complete medical certificate

Submit the SSS Medical Certificate or an attending physician’s certificate. It should contain, at minimum:

Physician’s full name;
PRC license number, when applicable;
Clinic address and contact information;
History of the present illness;
Complete diagnosis; and
Recommended number of days of convalescence, including recuperation. (Social Security System)

A vague certificate stating only “rest for several days” may be insufficient.

3. Submit the supporting medical records

Depending on the condition, provide clear copies of:

Laboratory or diagnostic results;
X-ray, ECG, scan, or similar reports;
Clinical or operating-room records;
Hospital or medical abstract; and
Discharge summary. (Social Security System)

SSS may request additional records if the diagnosis, confinement period, or recommended recuperation requires further medical evaluation.

4. Ask the employer for the sickness-notification reference

The employer files the Sickness Notification online through its My.SSS account. Over-the-counter submission of the ordinary employed-member notification is generally no longer necessary. (Social Security System)

Keep the claim reference number, transaction number, submission date, and any SSS email relating to the notification.

5. Wait for the employer’s advance payment

For qualified employees, the employer advances the approved sickness allowance after all current company sick leave with full pay has been exhausted. Payment should be made on the regular payday or on the fifteenth and last day of the month while the allowance is due.

The sickness benefit is separate from ordinary wages and should not be treated as a loan to the employee.

6. Confirm that you received the advance

After the employer submits its Sickness Benefit Reimbursement Application, SSS sends the employee an email or My.SSS notification. Confirm receipt of the employer’s advance within seven working days through:

The link in the SSS email; or
The employee’s My.SSS account.

Failure to confirm within the period can cause the employer’s reimbursement application to be rejected. A rejected application may have to be filed again as a new transaction. Confirmation is generally not required for claims tagged as separated, AWOL, or involving a deceased member. (Social Security System)

How an individual member files directly with SSS

This process generally applies to self-employed members, voluntary members, OFWs, non-working spouses, and members separated from employment who did not receive an advance from the former employer.

1. Register for My.SSS

Create or activate a My.SSS member account. Make sure your email address and mobile number are current because SSS uses them for transaction and claim notices.

2. Enroll a disbursement account

Before filing, enroll and obtain approval for a disbursement account through the Disbursement Account Enrollment Module, or DAEM.

Depending on the options available to you, payment may be made through:

A UMID card enrolled as an ATM card;
A participating PESONet bank;
An approved electronic wallet;
An accredited remittance transfer company; or
A cash payout outlet. (Social Security System)

The account details and account holder’s name must match the claimant’s records.

3. Prepare clear electronic copies

Scan or photograph the original colored documents or certified true copies with good image quality. Make sure:

Every page is complete;
Text and license numbers are readable;
Dates are consistent;
No part of the document is cropped; and
The file format and size meet the portal’s requirements. (Social Security System)

4. File through My.SSS

Open the Benefits tab.
Select Sickness Benefit or Sickness Application.
Enter the confinement and medical information.
Upload the required documents.
Review the entries carefully.
Certify that the information and documents are true and correct.
Submit the application. (Social Security System)

5. Save the transaction number

Take a screenshot or download proof of submission. The transaction number establishes when the online application was successfully filed.

SSS sends the result through email and My.SSS notifications after medical evaluation and claims processing. (Social Security System)

Documents to prepare

Basic medical documents

Prepare:

SSS Medical Certificate or a sufficiently detailed attending physician’s medical certificate;
Relevant laboratory and diagnostic results;
Hospital or medical abstract, when hospitalized;
Discharge summary; and
Other clinical records supporting the diagnosis and length of confinement. (Social Security System)

When an electronic laboratory or diagnostic document is issued without the issuing official’s signature, the 2026 SSS Citizen’s Charter directs claimants to submit the official receipt for the procedure. (Social Security System)

Additional documents for self-employed members

SSS may require:

A barangay-issued certificate of livelihood; and
A police report when the sickness claim involves an accident or circumstances requiring one. (Social Security System)

Additional documents for separated members

You may need either:

A certificate of separation stating the effective date of separation and that no sickness-benefit advance was granted, signed by the employer’s HR manager; or
A notarized affidavit of undertaking stating the separation date and that no advance payment was received. (Social Security System)

The current SSS benefit page also lists alternative proof for members whose former employer is on strike, dissolved, no longer operating, involved in a pending separation case, or has strained relations with an AWOL or separated employee. These may include a DOLE certification, notice of strike, or notarized affidavit. (Social Security System)

Documents issued abroad

Medical documents issued abroad should be in English or accompanied by an English translation. The SSS benefit page also instructs claimants to have foreign documents authenticated by the Philippine embassy or consulate or notarized in the host country. Check the current online checklist because the 2026 Citizen’s Charter separately states that certified true copies of foreign medical documents are not required. (Social Security System)

Do not allow an authentication issue to make you miss the notification deadline. File or notify promptly and ask SSS what supplementary document must follow.

How long processing may take

The 2026 SSS Citizen’s Charter lists a standard processing time of approximately:

20 working days for an ordinary individual Sickness Benefit Application, including medical evaluation and claims processing; and
Seven working days for an ordinary employer reimbursement application after the employee-confirmation stage. (Social Security System)

These are service standards for complete and regular claims. Processing may take longer when SSS requests additional medical records, encounters inconsistent member data, or must resolve a special case.

After settlement, SSS states that crediting to the approved payment channel is generally made within five banking days. (Social Security System)

For employer reimbursement, the Social Security Act separately provides that SSS must adjudicate the claim within two months from receipt. If the employer receives no payment within one month after that adjudication period, the reimbursement earns simple interest of 1% per month until paid.

If the employer refuses or fails to process the claim

Act promptly rather than waiting until the one-year period is nearly over.

Give the employer a dated written notice and complete medical records.
Obtain proof that HR or the employer received them.
Request the sickness-notification claim reference number in writing.
Preserve payslips, leave records, attendance records, and communications about the benefit.
Contact SSS through Hotline 1455, the nearest branch, or usssaptayo@sss.gov.ph and ask for written guidance.
If SSS issues an adverse written action and the dispute concerns entitlement to an SSS benefit, seek legal advice on bringing the matter before the Social Security Commission.

Under the Commission’s procedural rules, disputes involving benefit entitlement are cognizable by the Social Security Commission after the appropriate SSS department or regional manager has first acted on the issue in writing. (Supreme Court E-Library)

If the application is rejected, reduced, or denied

Read the SSS notice carefully. Common reasons include:

Insufficient qualifying contributions;
Late notification;
Incomplete or unreadable medical documents;
Inconsistent confinement dates;
A diagnosis not adequately supported by records;
Failure to prove inability to work;
Missing separation or no-advance-payment proof;
An unapproved or mismatched disbursement account; or
Failure to confirm the employer’s advance payment.

For a correctable rejection, submit the missing or corrected records and refile when instructed. SSS Circular No. 2021-019 allows a previously unacceptable online claim to be refiled as a new transaction after compliance with SSS requirements.

Obtain the written reason before pursuing a formal dispute. The Social Security Commission generally requires the prior written action of the responsible SSS office before a petition is docketed. (Supreme Court E-Library)

Special situations and exceptions

Work-related sickness or injury

Tell your employer immediately if the condition arose from work or was aggravated by working conditions. Ask whether the claim should also be processed under the Employees’ Compensation Program.

Preserve:

Accident or sickness reports;
Workplace logbook entries;
Police or incident reports;
Job description;
Employment history;
Pre-employment medical examination; and
Evidence of the conditions or hazards involved.

The SSS Citizen’s Charter lists these among the possible additional records for an EC claim. (Social Security System)

Maternity-benefit period

A member cannot recover an SSS sickness benefit for the same period already covered by daily maternity benefits. (Lawphil)

Existing disability benefit

Sickness and disability benefits may be received at the same time only when the sickness or injury is unrelated to the disability and the member independently satisfies the conditions for both benefits.

More than 240 days of the same condition

Ask SSS about filing a disability-benefit claim when the illness or injury persists or leaves a permanent impairment after the sickness-benefit limit has been reached. (Social Security System)

Claims that cannot use the ordinary online process

The following special cases must generally be submitted over the counter at an SSS branch or foreign representative office:

A denied claim already reconsidered for payment;
An unclaimed benefit belonging to a deceased member; and
An unclaimed reimbursement of an inactive, closed, terminated, or retired employer. (Social Security System)

Evidence worth preserving

Keep copies of:

The original medical certificate;
Laboratory, imaging, and diagnostic reports;
Hospital abstract and discharge summary;
Prescriptions and official receipts;
Written notice to the employer and proof of receipt;
HR acknowledgments and company leave records;
My.SSS screenshots, transaction numbers, and claim-reference numbers;
SSS emails, text messages, and decision notices;
Proof of the employer’s advance payment;
Your online confirmation of receipt;
DAEM approval and proof of account;
Contribution and employment records; and
Accident, workplace, police, or barangay records when applicable.

Keep the records even after payment. They may be needed for an adjustment, reimbursement issue, later disability claim, or formal dispute.

Common mistakes to avoid

Waiting until recovery before giving the five-day notice.
Counting contributions paid during the semester of sickness.
Assuming retroactive payments will cure a contribution deficiency.
Submitting a medical certificate without a complete diagnosis or recommended recuperation period.
Uploading blurred, cropped, or incomplete records.
Using confinement dates that conflict with the medical certificate or discharge summary.
Filing directly as an individual despite still being employed and covered by the employer-advance process.
Failing to obtain proof that the employer received the notice.
Forgetting to confirm the employer’s advance payment within seven working days.
Waiting for the one-year outer limit even though the claim is subject to a five-day notification rule.
Assuming that four days of absence automatically guarantees four approved days.
Using a bank or e-wallet account that is not approved in DAEM or is not in the claimant’s correct name.

When help is urgent

Contact SSS or obtain legal assistance promptly when:

The five-day notification period is about to expire or has already passed.
Hospital discharge occurred nearly one year ago.
Your employer refuses to receive the notice, file the notification, or disclose the claim reference.
The employer has closed, dissolved, or stopped operating.
You were separated, placed on AWOL status, or have a disputed termination date.
SSS denied the claim despite timely notice and complete medical evidence.
The condition is work-related or arose from an accident.
The member has died before receiving an approved benefit.
The illness has lasted close to or beyond 240 days.
SSS and the employer give conflicting explanations about who must pay.
A formal SSS or Social Security Commission decision contains a deadline for reconsideration or appeal.

Frequently asked questions

Can I claim for only three days of sickness?

No. The sickness or injury must result in at least four days of qualifying confinement or inability to work. (Social Security System)

Are the first three days excluded from payment?

Not automatically. When a four-day-or-longer confinement is approved, the compensable period generally begins on the first day, subject to paid-sick-leave and notification rules.

Can home confinement qualify?

Yes. Hospital admission is not mandatory. You must show that the sickness or injury made you unable to work and that the home-confinement period is medically supported and approved by SSS. (Social Security System)

Can a currently employed member file directly through My.SSS?

Ordinarily, no. The employer handles the employed member’s notification, advance payment, and reimbursement. Direct online filing is generally for self-employed, voluntary, OFW, non-working-spouse, and qualified separated members. Contact SSS immediately when the employer is closed, refuses to act, or the employment status is disputed.

What if I notified my employer late?

SSS may recognize the confinement only from the fifth day immediately before the notice, reducing the number of compensable days. File immediately and retain proof of the actual circumstances. (Social Security System)

Can I claim even if I have company sick leave?

For an employed member, the SSS sickness allowance begins only after the employee’s current sick leave with full pay has been exhausted. Sea-based OFWs are excepted under the implementing rules.

Who pays an employed member?

The employer advances the approved benefit. SSS later reimburses the employer upon proof of payment and compliance with the notification and filing rules.

Is there a filing fee?

The ordinary online sickness-benefit and reimbursement services have no standard processing fee under the 2026 SSS Citizen’s Charter. (Social Security System)

Official sources

General-information disclaimer

This article provides general legal and procedural information, not individualized legal advice. Eligibility and payment depend on the member’s contribution records, employment status, dates, medical evidence, approved confinement period, and compliance with current SSS requirements. Obtain written guidance from SSS or advice from a Philippine lawyer for disputed, denied, late, work-related, or fact-sensitive claims.

Sources checked as of 23 July 2026.