Question & AnswerQ&A (PRESIDENTIAL DECREE No. 1921)
Dependents are defined as the legitimate, legitimated, legally adopted or acknowledged natural child who is unmarried, not gainfully employed, and not over twenty-one years of age or over twenty-one years if incapable of self-support due to physical or mental defect; the legitimate spouse living with the employee; and the parents wholly dependent on the employee for support.
Beneficiaries include the dependent spouse until remarriage and dependent children as primary beneficiaries. In their absence, dependent parents and dependent acknowledged natural children (when no other dependent children exist) are considered secondary beneficiaries.
Injury means any harmful change in the human organism resulting from any accident arising out of and in the course of employment.
The monthly income benefit is equivalent to 115% of the sum of the average monthly salary credit multiplied by the replacement ratio plus 1.5% of the average monthly salary credit for each credited year of service beyond ten years. It shall not be less than Two Hundred Fifty pesos.
The liability of the State Insurance Fund is exclusive and in place of all other liabilities of the employer to the employee or dependents. Payment of compensation does not bar recovery of benefits under other specified laws and administrative codes.
Among its powers is the adoption of an annual budget for its expenditures chargeable against the State Insurance Fund, with advances from the SSS and GSIS for operational expenses based on approved budgets.
The system pays the primary beneficiaries an amount equivalent to the monthly income benefit plus 10% for each dependent child (up to five), guaranteed for five years. If no primary beneficiaries exist, secondary beneficiaries receive benefits not exceeding 60 months. The minimum death benefit is Fifteen Thousand Pesos.
Primary beneficiaries receive 80% of the monthly income benefit and dependents receive dependents' pension, provided the marriage was valid at the time of disability. If no primary beneficiaries exist, secondary beneficiaries receive a monthly pension based on the remaining guaranteed period.
A funeral benefit of One Thousand Five Hundred Pesos is payable upon the death of a covered employee or permanently totally disabled pensioner.
No claim for compensation shall be given due course unless filed within three years from the time the cause of action accrued.