QuestionsQuestions (ECC AMENDED RULES ON EMPLOYEES' COMPENSATION)
The injury must result from an accident arising out of and in the course of employment.
The sickness must be an occupational disease listed under Annex “A” with the conditions satisfied; otherwise, proof must show that the working conditions increased the risk of contracting the disease.
Any person (natural or juridical), domestic or foreign, carrying on a trade/business/industry/undertaking/activity in the Philippines who uses services of another person under his orders as regards employment.
Coverage is compulsory for every employee not over 60 years of age. Employees over 60 are covered if they had been paying contributions prior to 60 and have not been compulsorily retired.
The employee is compulsorily covered by both Systems.
Filipinos abroad in the service of a covered employer are covered and entitled to the same benefits as employees in the Philippines; medical services provided abroad follow the Rules’ limitations and accreditation rules do not apply, but strict notice requirements apply.
Employer coverage takes effect on the first day of operation but not earlier than January 1, 1975; employee coverage takes effect on the first day of employment.
Public sector employers must register by March 31, 1975 if operating before Jan 1, 1975, or within one month from first day of operation if operating on/after Jan 1, 1975; employees must be registered within one month from date of employment. Private sector employers are automatically registered if already registered; newly hired employees must be reported not later than 30 days from date of employment. Failure/refusal to register employees carries a fine and/or imprisonment; if a compensable contingency occurs after 30 days and before the System receives coverage report or contribution, employer is liable for a lump sum equivalent of benefits.
No compensation is allowed if the injury/sickness/disability/death was occasioned by the employee’s intoxication, willful intention to injure or kill himself/another, or notorious negligence.
Unless otherwise provided, the liability of the state insurance fund is exclusive and in place of all other liabilities of the employer to the employee/dependents or anyone entitled to damages.
If the illness or injury occurred before the employee is duly reported for coverage to the System, the employer is liable for the benefit.
Temporary total disability is inability to perform any gainful occupation for a continuous period not exceeding 120 days; permanent total disability is inability to perform any gainful occupation for a continuous period exceeding 120 days (with specific permanent categories also treated as permanent).
It is 90% of the employee’s average daily salary credit, subject to daily income benefit minimum and maximum (and duration rules).
Monthly income benefit is guaranteed for five (5) years, and it may be suspended for failure to present for annual examination upon notice, failure to submit quarterly medical report, full recovery, or upon being gainfully employed.
The period follows the schedule: one hand = 39 months, one arm = 50 months; wrist is treated as hand, elbow as arm, and similar rules apply.
The employee must be duly reported, must die as a result of an injury or sickness, and the System must be duly notified of the death and the injury/sickness causing it; employer liability applies if death occurred before the employee was duly reported.
A claim must be filed within three (3) years from the time the cause of action accrued.
Temporary total disability: submit monthly medical report certified by attending physician; otherwise benefits are suspended. Permanent disability resulting from disease: submit quarterly medical report; otherwise benefits are suspended.
Employees (or dependents/anyone on their behalf) must notify employer within five (5) days from occurrence unless employer already had knowledge or contingency occurred during working hours at workplace. Employers must record in a logbook within five (5) days; submit employer notice to the System within five (5) days from logbook entry. Failure/false information/withholding material information leads to liability for 50% of lump sum equivalent income benefit potentially due and/or fine and imprisonment; amount accrues to Employees’ Compensation Fund.