Definitions
- Clarifies terms such as "Code," "Commission," "SSS," "GSIS," "Employer," "Employee," "Dependents," "Beneficiaries," "Injury," "Sickness," "Death," "Disability," and types of benefits.
- Defines income benefit, medical benefit, related benefit, wages, monthly salary credit, and averages.
Coverage and Liability
- Compulsory coverage for all employers/employees under 60 years old; coverage also applies to employees over 60 under certain conditions.
- Coverage for Filipino employees abroad regulated by the Commission.
- Coverage begins from employer's operation and employee’s employment date.
- Employers and employees must register with the System.
- State Insurance Fund liable except in cases of intoxication, willful harm, negligence.
- Liability of the State Insurance Fund exclusive, barring other claims against employers.
Administration and Employees’ Compensation Commission
- Creation of the Employees’ Compensation Commission with ex-officio and appointed members.
- Commission powers include fixing contribution rates, approving rules, initiating health and safety programs, actuarial studies, staffing, budgeting, issuing subpoenas, suing, and other necessary acts.
- Revenues managed similarly to SSS and GSIS funds with 12% disbursement cap for operational expenses.
- Surplus funds form the State Insurance Fund, exclusively for benefit payments.
- The System has original and exclusive jurisdiction over disputes; the Commission hears appeals.
- Supreme Court reviews Commission decisions on questions of law.
- Enforcement of decisions akin to court orders with power to punish noncompliance.
Contributions
- Employers pay contributions equal to 1% of monthly salary credit; rate subject to review.
- Contributions paid solely by employers; deductions from employee wages are void.
- Contributions end upon employee’s death, disability, or separation.
- Government guarantees solvency of the State Insurance Fund with supplemental appropriations if needed.
Medical Benefits
- System to provide medical services/appliances immediately after sickness/injury during disability.
- System may choose/change medical providers; not liable for unauthorized employee changes.
- Attending physicians must comply with regulations, submit reports, and medical information is not privileged.
- Unreasonable refusal by employee to submit to medical examination/treatment stops benefit payments.
- Fees for hospital services and supplies regulated; professional fees regulated but can be higher than certain prescribed amounts.
- Rehabilitation services provided to restore physical independence and suitable employment.
Disability Benefits
- Temporary total disability: 90% average daily salary credit after first 3 days of sickness, capped payments.
- Permanent total disability: Income benefit computed based on salary credits and length of coverage, with caps and suspension conditions.
- Specific disabilities defined as total and permanent (e.g., loss of limbs, blindness).
- Permanent partial disability: Income benefits based on schedule of loss of specific body parts with time limits; proportionate payment for partial loss.
Death Benefits
- Primary beneficiaries receive monthly income benefit increased by 10% per dependent child (up to five), guaranteed for five years.
- If no primary beneficiary, lump sum benefit paid.
- Special provisions if death occurs under permanent total disability status.
Common Provisions to Income Benefits
- Relationship and dependency determined at time of death.
- Delinquent employers liable for benefits paid; lien on property for payment.
- State Insurance Fund liable for new disabilities after prior disabilities with specific conditions.
- Claims are non-transferable except debts owed to System.
- Income benefits payable despite other wages or benefits for leave or awards.
- Penalty imposed on employer for failure to observe safety measures leading to injury/death.
- Claims must be filed within one year; notice to employer required.
- Erroneous payments discharge System from liability unless notified by superior claimant.
- No fees chargeable by agents/attorneys preparing claims; violations penalized by fines/imprisonment.
- State Insurance Fund and assets exempt from taxes, levies, customs duties unless expressly stated by law.
Records, Reports, and Penal Provisions
- Employers keep logbooks recording sickness, injury, death within 5 days; false or withheld information leads to penalties.
- Notice of sickness, injury, or death must be given within 5 days; no notice required if employer already aware.
- Penal provisions for fraud, falsification related to claims include fines, imprisonment, disqualification from professions, dismissal from government.
Effectivity and Transitory Provisions
- Title applies to contingencies occurring on or after January 1, 1975.
- Medical care provisions implemented under relevant Republic Act.
- Money claims from employer-employee relations barred if not filed within three years of cause of action.
- Workmen’s compensation claims prior to Code’s effectivity have set filing deadlines.
- Abolition of existing compensation offices after December 31, 1975; transfer of personnel to Department of Labor.
- Pending cases transferred to appropriate labor relations bodies and processed under respective rules.
- Articles of Labor Code renumbered for consistency.
- Presidential Decree takes effect January 1, 1975.