In the Philippines, the Social Security System (SSS) provides a safety net for workers who suffer from a partial loss of their physical or mental faculties due to injury or sickness. Unlike total disability, a Permanent Partial Disability (PPD) refers to the complete and permanent loss of use of any part of the body, or a condition that significantly impairs a member but does not result in total incapacity for work.
The following is a comprehensive guide on the requirements, qualifications, and processes for filing a Partial Disability claim.
I. Eligibility Criteria
To qualify for a partial disability benefit, a member must meet the following conditions:
- Membership: Must be an active or separated SSS member.
- Contribution Requirement: To qualify for a monthly pension, the member must have paid at least 36 monthly contributions prior to the semester of disability.
- Lump Sum Alternative: If the member has paid fewer than 36 monthly contributions, they are entitled to a lump sum amount instead of a monthly pension.
- Medical Evaluation: The disability must be evaluated and confirmed by an SSS medical officer as a permanent partial disability.
II. Documentary Requirements
The SSS requires specific documents to validate the claim. Ensure all photocopies are presented with the original copies for authentication.
1. Basic Forms
- SSS Form Med-1 (Medical Certificate): To be accomplished by the attending physician, detailing the nature of the disability and the physical examination findings.
- SSS Form Disability Claim Application: The primary form for the benefit request.
2. Identification and Support Documents
- Member’s ID: Unified Multi-Purpose ID (UMID) or SSS digitized ID. In their absence, two valid government-issued IDs with photos and signatures.
- Medical Records: Clinical abstracts, laboratory results, X-rays, ECGs, or other diagnostic tests relevant to the specific disability.
3. Employment-Related Documents (If applicable)
- If the cause of disability is work-related, an SSS Form B-301 (Report of Injury/Sickness) must be submitted to file for the Employees' Compensation (EC) benefit alongside the SSS disability claim.
III. List of Permanent Partial Disabilities
Under the Social Security Act and its implementing rules, specific injuries qualify for partial disability. The duration of the pension depends on the body part affected:
| Body Part Affected | Pension Duration (Example) |
|---|---|
| One thumb | 10 months |
| One index finger | 8 months |
| One big toe | 6 months |
| One hand | 39 months |
| One arm | 50 months |
| One foot | 31 months |
| One leg | 46 months |
| Hearing of one ear | 10 months |
| Sight of one eye | 25 months |
Note: If a member suffers multiple partial disabilities, the SSS will determine the total number of months for the pension, provided it does not exceed the limit set for permanent total disability.
IV. Types of Benefits
The amount of compensation is determined by the member’s Average Monthly Salary Credit (AMSC) and the number of credited years of service (CYS).
- Monthly Pension: A lifetime or fixed-period payment (depending on the degree of disability) for those with 36+ contributions.
- Lump Sum Amount: A one-time payment for those who do not meet the 36-contribution threshold.
- Supplemental Allowance: A monthly allowance (currently PHP 500) provided on top of the disability pension to assist with medical and personal needs.
V. Filing Procedure
- Submission: The application and supporting documents must be submitted to the nearest SSS branch or via the SSS online portal (My.SSS), if applicable for the specific claim type.
- Physical Examination: The member may be required to report to the SSS Medical Evaluation Center for a physical assessment by an SSS doctor.
- Review and Approval: The SSS Medical Research Department reviews the findings. If approved, the member will receive a notice of the benefit amount and the duration of the pension.
VI. Important Reminders
- Prescription Period: Claims should ideally be filed within ten years from the date of the occurrence of the disability.
- Re-evaluation: The SSS reserves the right to require the pensioner to report for periodic re-evaluation to confirm the continuing nature of the partial disability.
- Effect of Employment: A member receiving a partial disability pension can continue to work or return to work. The pension will not be suspended as long as the disability (the loss of the body part or its use) remains permanent.