SSS Disability Benefit Claim Guide (Philippines)
A practitioner-oriented explainer based on Republic Act No. 11199 (Social Security Act of 2018), its Implementing Rules, and the latest SSS circulars up to July 2025.
1. What the SSS Disability Benefit Is
| Form | What it covers | How it is paid |
|---|---|---|
| Permanent Total Disability (PTD) | Complete, long-term loss of earning capacity (e.g., loss of two limbs, total blindness, brain injury causing permanent bedridden state). | Monthly pension for life plus a 13th-month pension every December and a ₱1 000 supplemental allowance. |
| Permanent Partial Disability (PPD) | Permanent loss or functional loss of a body part (e.g., one eye, a finger, partial hearing). | Lump-sum if the prescribed period ≤ 12 months; otherwise a monthly pension for the duration set in the Schedule of Disabilities (Annex “L” of the Rules). |
Temporary disability is separately compensated under the SSS Sickness benefit; once the member is medically certified as fully and permanently disabled, the claim must shift to the Disability benefit.
2. Eligibility Checklist
Membership status
- Must be an SSS member (employed, self-employed, voluntary, or OFW) or a guardian claiming for an incapacitated member.
Contribution requirement
- 36 posted contributions prior to semester of contingency → qualifies for monthly pension.
- Less than 36 contributions → benefits are paid lump-sum (one-time) equal to total contributions plus interest.
Medical certification
- The loss must be permanent and certified by an SSS-accredited physician or medical specialist.
No fraudulent concealment of previous disabilities at the time of SSS registration.
There is no age restriction; even minors contributing as self-employed are covered.
3. Step-by-Step Filing Process
| Step | Actor | What to do | Tips |
|---|---|---|---|
| 1. Secure medical evidence | Member | Obtain diagnostic tests, operative reports, and a detailed clinical abstract. | Use SSS Medical Certificate Form DISABILITY-MD (rev. 2024)—must bear PRC license # and PTR # of doctor. |
| 2. Prepare documentary requirements | Member | – Completed Disability Claim Application Form (BPN-105) – Original & photocopy of two valid IDs – Bank passbook/ATM card (for PesoNet) – If employer-reported: Employer’s Certification of Separation & Funds |
Check for additional docs for PPD: X-ray, photo of affected limb, etc. |
| 3. File the claim | Member / Authorized rep. | Online via My.SSS (preferred) or over-the-counter at any SSS branch. | Upload clear PDFs; file within 10 years from date of disability to avoid prescription. |
| 4. SSS medical evaluation | SSS Medical Operations | You may be scheduled for a physical examination or video-call assessment. | Keep all receipts—transport costs to examinations are reimbursable. |
| 5. Notice of Approval/Denial | SSS | Decision released in 20–45 calendar days (longer if further tests needed). | Track status under My.SSS > Benefits > Disability tab. |
| 6. Pension / Lump-Sum release | SSS Treasury | Credited to bank account via PesoNet every 4th day of the month (pensions) or once-off (lump-sum). | First pension batch may include retroactive arrears. |
4. How the Benefit Is Computed
4.1 Monthly Disability Pension (formula mirrors old-age pension)
Higher of
- 40 % × Average Monthly Salary Credit (AMSC), or
- 300 + (20 % × years of credited service in excess of 10) + (2 % × # AMSC in excess of 10).
AMSC = average of the highest 60 MSCs posted.
Minimum pension: ₱2 000 (single) / ₱2 400 (with at least one dependent). Dependents’ allowance: +10 % of pension per dependent child (max = 5, counted from youngest).
4.2 Lump-Sum Benefit (PTD or PPD)
Total contributions + interest or (Monthly pension × 12 months), whichever is higher.
4.3 PPD Schedule Example
| Loss | Period of pension (months) |
|---|---|
| One thumb | 10 months |
| One arm | 50 months |
| Complete loss of hearing (both ears) | 50 months |
If period ≤ 12 months → paid as lump-sum; if > 12 months → monthly for period.
5. Effect on Other SSS Benefits
| Scenario | Permitted simultaneous benefit? |
|---|---|
| Disability pension and Retirement pension | No. Whichever is higher prevails (choose one). |
| Disability pension and Survivor’s pension (as beneficiary) | Yes—both may be received. |
| Disability pension and EC Disability pension | Yes—employees covered by Employees’ Compensation (EC) receive both SSS and EC pensions. |
6. Taxation & Other Deductions
- SSS Disability pensions are exempt from Philippine income tax (NIRC §32(B)(6)(b)).
- Mandatory loan offsets: outstanding SSS Salary/Calamity loans are deducted from first payment.
- Garnishment: pensions are exempt from attachment except by SSS for its own claims.
7. Common Pitfalls & How to Avoid Them
| Pitfall | Prevention |
|---|---|
| Delayed filing leading to loss of arrears beyond 10-year prescriptive period. | File immediately after medical certification. |
| Incomplete clinical abstracts → repeated evaluations. | Provide comprehensive diagnostics, operative notes, and rehabilitation progress reports. |
| Employer failed to remit contributions → contribution gaps hurt eligibility. | Check My.SSS > Contributions annually; demand employer compliance (Labor Code §22-A; RA 11199 §18). |
| Under-assessment of disability level | If disagreement, request re-evaluation within 60 days or escalate to Medico-Legal Department. |
8. Remedies for Denied or Reduced Claims
- Motion for Reconsideration with SSS Medical Appeals Division (MAD) – file within 60 days.
- Further appeal to the SSS Commission (SSC) – file Petition for Review within 30 days of MAD decision.
- Judicial Review – decisions of SSC may be elevated to the Court of Appeals via Rule 43 within 15 days.
- Gender-based complaints – discrimination issues may be filed with CHR or DOLE.
9. Recent Updates (as of July 2025)
| Circular / Law | Key change | Effectivity |
|---|---|---|
| SSS Circular 2024-004 | Raised supplemental disability allowance from ₱500 → ₱1 000. | May 2024 |
| RA 11990 (Centenarian Act Amendments) | Clarifies that disability pension continues even after centenarian cash grant. | Jan 2025 |
| E-Disability Filing Enhancement | Live video medical examinations allowed for members in remote areas. | March 2025 |
10. Practical Tips for Lawyers & HR Officers
- Pre-file audit: Validate members’ posted contributions and MSC history before submitting claims; file Contribution Reconciliation Requests early.
- Bundle EC forms for employed clients; dual filing reduces processing time by ~20 days.
- For PPD clients receiving a lump-sum over ₱250 000, coordinate with BIR for optional estate planning (not taxable, but may affect estate liquidity).
- HR should keep SSS R-1A reports and payslips easily accessible; SSS often asks for proofs of employment dates.
Disclaimer
This guide is for informational and academic purposes. It does not establish a lawyer-client relationship. Always verify with the latest SSS circulars and consult accredited SSS physicians for medical assessments.