UST Golden Notes 2011 - Social Legislation.pdf

SOCIAL LEGISLATION

F. SOCIAL LEGISLATION

A:

Q: What is Social Legislation? A: It consists of statutes, regulations and jurisprudence that afford protection to labor, especially to working women and minors, and is in full accord with the constitutional provisions on the promotion of social justice to insure the well being and economic security of all of all the people.

Social Security Commission (SSC)

1.SOCIAL SECURITY LAW (RA 8282)

The enactment of SSS of SSS law is a legitimate exercise of the police power. It affords protection to labor and is in full accord with the constitutional mandate on the promotion of social justice. (Roman Catholic Archbishop of Manila of Manila v. SSS, G.R. No. 15045 15045 Jan. Jan. 20, 1961) Q: Are the premiums considered as taxes? A: No. The funds contributed to the System belong to the members who will receive benefits, as a matter of right, whenever the hazards provided by the law occur. (CMS Estate, Inc., v. SSS, G.R. No. 26298 Sep.28, 1984) Q: Are benefits received under SSS Law part of the of the estate of a of a member? A: No. Benefits receivable under the SSS Law are in the nature of a special privilege or an arrangement secured by the law pursuant to the policy of the State to provide social security to the workingman. The benefits are specifically declared not transferable and exempt from tax, legal processes and liens. (SSS v. Davac, et. al., G.R. No.21642, July 30, 1966) Q: How are disputes settled?

Note: Disputes within the mandatory period of 20 days after the submission of evidence. (Sec. 5a) Decision, in the absence of appeal, shall be final and executory 15 days after date of notification. of notification. (Sec. 5b)

Q: What is the policy objective in the enactment of (SSS) Law? A: It is the policy of the State to establish, develop, promote and perfect a sound and viable tax‐exempt SSS suitable to the needs of the people throughout the Phils., which shall promote social justice and provide meaningful protection to members and their beneficiaries against the hazards of disability, sickness, maternity, old age, death, and other contingencies resulting in loss of income of income or financial burden. (Sec. 2)

DISPUTE SETTLEMENT Disputes involving: 1. Coverage 2. Benefits 3. Contributions 4. Penalties 5. Any other matter related thereto.

CA / SC

Execution of decision of decision

Decisions of SSC of SSC shall be appealable to: 1. CA – CA – questions of law of law and fact (Sec. 5c) 2. SC – SC – questions of law of law. (Sec. 5c) motu proprio or on motion of SSC may, motu proprio any interested party, issue a writ of execution to enforce any of its decisions or awards, after it has become final and executory. (Sec. 5d)

Q: Can the SSC validly re‐evaluate the findings of the RTC, and on its own, declare the latter’s decision to be bereft of any of any basis? A: No. It cannot review, much less reverse, decisions rendered by courts of law as it did in the case at bar when it declared that the CFI Order was obtained through fraud and subsequently disregarded the same, making its own findings with respect to the validity of Bailon of Bailon and Alice’s marriage on the one hand and the invalidity of Bailon and Teresita’s marriage on the other. In interfering with and passing upon the CFI Order, the SSC virtually acted as an appellate court. The law does not give the SSC unfettered discretion to trifle with orders of regular courts in the exercise of its authority to determine the beneficiaries of the SSS. (SSS vs. Teresita Jarque Vda. De Bailon, G.R. No. 165545, Mar. 24, 2006, 2006, J. J. Carpio‐Morales) Q: Who is an employer (Er)? A: Any person, natural or juridical, domestic or foreign, who carries into the Phils. any trade, business, industry, undertaking or activity of any kind and uses the services of another of another person who is under his orders as regards the employment, except the Government and any of its political subdivisions, branches or instrumentalities, including corporations owned or controlled by the Government: Provided , That a self ‐employed person shall be both Ee and Er at the same time. (Sec 8[c])

ACADEMICS CHAIR: LESTER JAY ALAN E. FLORES II UNIVERSITY OF VICE CHAIRS FOR ACADEMICS: KAREN JOY G. SABUGO & JOHN HENRY C. MENDOZA VICE CHAIR FOR ADMINISTRATION AND FINANCE: JEANELLE C. LEE VICE CHAIRS FOR LAY‐OUT AND DESIGN: EARL LOUIE M. MASACAYAN & THEENA C. MARTINEZ

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UST GOLDEN NOTES 2011

Q: Who is an employee (Ee)? A: Any person who performs services for an Er in which either or both mental and physical efforts are used and who receives compensation for such services, where there is an Er‐Ee relationship: Provided , That a self ‐employed person shall be both Ee and Er at the same time. (Sec. 8[d]) Q: What is employment? A: GR: Any service performed by an Ee for his Er. XPNs: 1. Employment purely casual and not for the purpose of occupation or business of the Er; 2. Service performed on or in connection with an alien vessel by an Ee if he is employed when such vessel is outside the Phils; 3. Service performed in the employ of the Phil. Government or instrumentality or agency thereof; 4. Service performed in the employ of a foreign government or international organization, or their wholly‐owned instrumentality: 5. Such other services performed by temporary and other Ees which may be excluded by regulation of the SSC. Ees of bona fide independent contractors shall not be deemed Ees of the of the Er engaging the services of said of said contractors. (Sec. 8[j])

c. d. e. f.

g. h.

Q: What is a contingency? A: The retirement, death, disability, injury or sickness and maternity of the of the member.

2.

Voluntary a. Spouses who devote full time to managing the household and family affairs, unless they are also engaged in other vocation or employment which is subject to mandatory coverage ; (Sec. 9[b]) b. Filipinos recruited by foreign‐based Ers for employment abroad may be covered by the SSS on a voluntary basis; (Sec. 9[c]) c. Ee separated from employment to maintain his right to full benefits d. Self ‐employed who realizes no income for a certain month

3.

By Agreement Agreement Any foreign government, international organization, or their wholly‐owned

a.Coverage Q: Who are covered by SSS? A:

1.

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Compulsory Coverage Compulsory Coverage a. All Ees not over 60 years of age and their Ers; b. Domestic helpers whose income is not less than P 1000/month and not over 60 years of age of age and their Ers; Limitations: a. Any benefit earned by the Ees under private benefit plans existing at the time of the approval of the Act shall not be

discontinued, reduced or otherwise impaired; b. Existing private plans shall be integrated with the SSS but if the Er under such plan is contributing more than what is required by this Act, he shall pay to the SSS the amount required to him, and he shall continue with his contributions less the amount paid to SSS; c. Any changes, adjustments, modifications, eliminations or improvements in the benefits of the remaining private plan after the integration shall be subject to agreements between the Ers and the Ees concerned; and d. The private benefit plan which the Er shall continue for his Ees shall remain under the Ers management and control unless there is an existing agreement to the contrary All self ‐employed – considered both an Er and Ee Professionals; Partners and single proprietors of business; Actors and actresses, directors, scriptwriters and news correspondents who do not fall within the definition of the term “Ee”; Professional athletes, coaches, trainers and jockeys; and jockeys; AND Individual farmers and fisherman. (Sec. 9)

LABOR LAW TEAM: ADVISER: ATTY. JOEVEN D. DELLOSA; SUBJECT HEAD: ANGELO S. DIOKNO; ASST. SUBJECT HEADS: KAREN SABUGO, GENESIS R. FULGENCIO MEMBERS: PALMA CLARISSA V. CARILLO, RANDOLPH IAN CLET, MICHAEL AARON P. GACUTAN, LORRAINE TAGUIAM

SOCIAL LEGISLATION

instrumentality employing workers in the Phils., may enter into an agreement with the Phil. government for the inclusion of such Ees in the SSS except those already covered by their respective civil service retirement systems. Q: When is the compulsory coverage deemed effective?

A: No. It is not necessary, for the enjoyment of benefits under the SSS Law that the injury is work‐ connected. What is important is membership in the SSS and not the causal connection of the work of the Ee to his injury or sickness. Claims based on work‐connected injuries or occupational diseases are covered by the State Insurance Fund.

A:

b.Exclusions from coverage 1. 2. 3.

Employer – on the first day of operation Employee – on the day of his employment Compulsory coverage of self ‐employed – upon his registration with the SSS

Q: What is the effect of separation of an employee from his employment under compulsory coverage?

Q: Enumerate the kinds of employment which are excepted from compulsory coverage under the SSS Law. A: Under Section 8(j) of R.A. 1161, as amended, the following services or employments are excepted from coverage:

A: 1.

2.

3.

His Ers obligation to contribute arising from that employment shall cease at the end of the month of separation, But said Ee shall be credited with all contributions paid on his behalf and entitled to benefits according to the provisions of R.A. 9282. He may, however, continue to pay the total contributions to maintain his right to full benefit. (Sec. 11)

1.

Employment purely casual and not for the purpose of occupation or business of the employer;

2.

Service performed on or in connection with an alien vessel by an employee if he is employed when such vessel is outside the Philippines;

3.

Service performed in the employ of the Philippine Government or instrumentality or agency thereof;

4.

Service performed in the employ of a foreign government or international organization, or their wholly‐owned instrumentality:

Note: The above provision recognizes the “once a member, always a member” rule.

Q: What is the effect of interruption of business or professional income? A: If the self ‐employed member realizes no income in any given month: 1. 2.

3.

He shall not be required to pay contributions for that month. He may, however, be allowed to continue paying contributions under the same rules and regulations applicable to a separated Ee member: Provided , that no retroactive payment of contributions shall be allowed other than as prescribed under Sec.22‐A. (Sec. 11‐ A)

Q: On her way home from work, Asteria Benedicta, a machine operator in a sash factory, enters a movie house to relax. But she is stabbed by an unknown assailant. Her claim for benefits under the SSS Law is denied on the ground that her injury is not work‐connected. Is the denial legal? Why?

Provided, however, That this exemption notwithstanding, any foreign government, international organization or their wholly‐ owned instrumentality employing workers in the Philippines or employing Filipinos outside of the Philippines, may enter into an agreement with the Philippine Government for the inclusion of such employees in the SSS except those already covered by their respective civil service retirement systems:Provided, further, That the terms of such agreement shall conform with the provisions of this Act on coverage and amount of payment of contributions and benefits: Provided, finally, That the provisions of this Act shall be supplementary to any such agreement; and


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5.

iv.

Such other services performed by temporary and other employees which may be excluded by regulation of the Commission. Employees of bona fide independent contractors shall not be deemed employees of the employer engaging the service of said contractors. c.Benefits 2.

Q: What are the benefits under the SSS Act? A:

1. 2. 3. 4. 5. 6. 7.

Monthly Pension Retirement Benefits Death Benefits Disability Benefits Funeral Benefits Sickness Benefits Maternity Benefits

Q: What will happen to the monthly pension of a retiree in case of death? A:

1. Q: Are the benefits provided for in the SSS Law transferable? A: Benefits provided for in the SSS Law are not transferable and no power of attorney or other document executed by those entitled thereto in favor of any agent, attorney or any other person for the collection thereof on their behalf shall be recognized, except when they are physically unable to collect personally such benefits. (Sec.15, R.A. 1161, as amended) Q: What are the reportorial requirements of the Er and self ‐employed? A:

1. Er ‐ Report immediately to SSS the names, ages, civil status, occupations, salaries and dependents of all his covered Ees 2. Self ‐employed ‐ Report to SSS within 30 days from the first day of his operation, his name, age, civil status, occupation, average monthly net income and his dependents Monthly Pension Q: How much is the monthly pension? A:

1.

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The monthly pension shall be the highest of the following amounts: a. The sum of the following: ii. P300.00; plus iii. 20% of the average monthly salary credit; plus

2% of the average monthly salary credit for each credited year of service in excess of 10 years; or b. 40% of the average monthly salary credit; or c. P1,000.00, provided that the monthly pension shall in no case be paid for an aggregate amount of less than sixty (60) months (Sec. 12 [a]) Minimum Pension a. P1,200.00 ‐ members with at least 10 credited years of service b. P2,400.00 for those with 20 credited years of service. (Sec. [b])

Upon the death of the retired member, his primary beneficiaries as of the date of his retirement will get 100% of his monthly pension plus the dependent's pension for each child. Note: The above phrase “primary beneficiaries (as of the date of his retirement) was declared unconstitutional by the SC in Dycaico v. SSS and SSC (G.R. No. 16137, June 6, 2006) because it is in violation of the equal protection, due process and social justice.

2.

If he dies within 60 months from the start of his pension and he has no primary beneficiaries, his secondary beneficiaries will receive a lump sum benefit equivalent to the difference of 60 multiplied by the monthly pension and the total monthly pensions paid by the SSS excluding the dependent's pension. (Sec. 12‐B [d])

Q: Bonifacio and Elena are living together as husband and wife without the benefit of marriage. Bonifacio declared Elena and their children as his primary beneficiaries in his self ‐ employed data record in SSS. A few months prior to his death, Bonifacio married Elena.Is Elena entitled to the survivor’s pension? A: Yes, she is considered primary beneficiary of Bonifacio. The phrase “Upon the death of the retired member, his primary beneficiaries as of the date of his retirement will get 100 per cent of his monthly pension xxx” of Sec. 12‐B d of RA 8282 is unconstitutional because it violates the: (1) equal protection clause because it impermissibly discriminates against dependent spouses whose


SOCIAL LEGISLATION

respective marriages to the SSS members were contracted after the latter’s retirement; (2) due process clause because it outrightly deprives spouses who married the SSS members after their retirement of the survivor’s pension, a property interest, without giving them opportunity to be heard; and (3) social justice. Further, the survivorship pension applied for was classified as death benefits. Hence, the contingency that gives rise to the entitlement of Elena is the death of Bonifacio and not his retirement. (Dycaico v. SSS, G. R. No. 16137, June 6, 2006)

A member a. At least 60 years old at retirement; and b. Does not qualify for pension benefits under paragraph (a) above ‐ entitled to a lump sum benefit equal to the total contributions paid by him and on his behalf; c. Must be separated from employment and is not continuing payment of contributions to the SSS on his own. (Sec. 12‐B [b])

Q: When is the monthly pension and dependent’s pension suspended?

Q: What happens when the retirement pensioner is re‐employed or resumes self ‐employment?

A:

A: The monthly pension of a retirement pensioner who resumes employment and is less than 65 years old will be suspended. He and his Er will again be subject to compulsory coverage. (Sec. 12‐B [c])

1. 2. 3.

Upon the reemployment or resumption of self ‐employment Recovery of the disabled member from his permanent total disability Failure to present himself for examination at least once a year upon notice by the SSS. (Sec. 13‐ A [b]) Retirement Benefit

Q: What is a retirement benefit? A: It is a cash benefit paid to a member who can no longer work due to old age. Q: What are the types of retirement benefits? A: 1.

2.

Monthly Pension ‐ Lifetime cash benefit paid to a retiree who has paid at least 120 monthly contributions to the SSS prior to the semester of retirement . Lump Sum Amount ‐ Granted to a retiree who has not paid the required 120 monthly contributions.

3.

Q: Are the children of a retiree member entitled to the dependent's pension? A: Yes (Sec. 12[A]). However, only 5 minor children, beginning from the youngest, are entitled to the dependents' pension. No substitution is allowed. Where there are more than 5 legitimate and illegitimate children, the legitimate ones will be preferred. Q: For how long will the dependent child receive the pension? A: Until the child reaches 21 years of age, gets married, gets employed and earns P300 a month or more, or dies. However, the dependent's pension is granted for life to children who are over 21 years old, provided they are incapacitated and incapable of self ‐support due to physical or mental defect which is congenital or acquired during minority.

Q: Who are entitled for retirement benefits? Death Benefit A: 1.

2.

A member who a. has paid at least 120 monthly contributions prior to the semester of retirement; b. at least 60 years old; and c. already separated from employment or has ceased to be self ‐employed, OR At least 65 years old, shall be entitled for as long as he lives to the monthly pension; (Sec 12‐B [a])

Q: When is a beneficiary entitled to death benefits? A: 1.

Upon death of a member, if he has paid at least 36 monthly contributions prior to the semester of death: a. primary beneficiaries shall be entitled to the monthly pension; or b. If there are no primary beneficiaries, secondary beneficiaries shall be


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2.

entitled to a lump sum benefit equivalent to 36 times the monthly pension. Upon death of a member If he has not paid the required 36 monthly contributions prior to the semester of death: a. Primary or secondary beneficiaries shall be entitled to a lump sum benefit equivalent to the monthly pension multiplied by the number of monthly contributions paid to the SSS: or b. 12 times the monthly pension, whichever is higher. (Sec. 13)

A: Disability pension shall cease retirement or death. (Sec 13‐ A [j])

upon

his

Funeral Benefit Q: What is the funeral benefit? A: A funeral grant equivalent to P12, 000.00 shall be paid, in cash or in kind , to help defray the cost of expenses upon the death of a member or retiree. (Sec. 13‐B)

Sickness Benefit Q: What is sickness benefit?

Disability Benefit A: It is a daily cash allowance paid for the number of days a member is unable to work due to sickness or injury.

Q: What is a disability benefit? A: It is a cash benefit paid to a member who becomes permanently disabled, either partially or totally. Q: What is the difference between death benefits and Permanent Total Disability benefits?

Q: What are the requirements to be entitled for sickness benefit? A:

1.

A: Death Benefits

PTD Benefits

2.

Requisite

at least 36 monthly contributions Benefits payable to whom

Primary Beneficiaries

Failure to make 36 monthly payments

Benefits shall be in lump sum equivalent to the monthly pension times the number of monthly contributions paid to SSS or 12 times the monthly pension, whichever is higher.

Q: What is the effect of the death of the PTD pensioner? A:

1.

2.

Primary beneficiaries are entitled to receive monthly pension as of the date of disability. No primary beneficiaries and he dies within 60 months from the start of his monthly pension ‐ secondary beneficiaries shall be entitled to a lump sum benefit equivalent to the total monthly pensions corresponding to the balance of the 5‐ year guaranteed period excluding the dependents’ pension. (Sec. 13‐ A [c])

Q: What is the effect of retirement or death to partial disability pension?

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3.

Member

4.

The member paid at least 3 monthly contributions in the 12‐month period immediately preceding the semester of sickness or injury Confined for more than 3 days in a hospital or elsewhere with the approval of the SSS He has used all current company sick leaves with pay for the current year Notified his Er or the SSS, if he is a separated, voluntary or self ‐employed member

Q: Who will pay sickness benefits? and how much is the benefit? A: The Er shall pay the: 1. Ee for each compensable confinement or fraction thereof or

2.

SSS if member is self ‐employed daily sickness benefit equivalent to 90% of his average daily salary credit, subject to the following conditions: a. In no case shall the daily sickness benefit be paid longer than 120 days in 1 calendar year, nor shall any unused portion of the 120 days of sickness benefit granted be carried forward and added to the total number of compensable days allowable in the subsequent year;


SOCIAL LEGISLATION

b.

c.

3.

4.

Not paid for more than 240 days on account of the same confinement; and Ee member shall notify his Er of the fact of his sickness or injury within 5 calendar days after the start of his confinement unless such confinement: i. is in a hospital ii. the Ee became sick or was injured while working or within the premises of the Er (notification to the Er not necessary);

If the member is unemployed or self ‐ employed, he shall directly notify the SSS of his confinement within 5 calendar days after the start thereof unless such confinement is in a hospital in which case notification is also not necessary; Where notification is necessary, confinement shall be deemed to have started not earlier than the 5th day immediately preceding the date of notification. (Sec.14 [b])

Note: The law does not require that sickness must be related to the duties of the beneficiaries.

Q: When commence?

will

compensable

confinement

2.

Er shall be reimbursed only for each day th of confinement starting from the 10 calendar day immediately preceding the date of notification to the SSS if the notification to the SSS is made beyond 5 calendar days after receipt of the notification from the Ee member. (Sec. 14 [c])

Q: When will reimbursement be made by SSS? A:GR: SSS shall reimburse the Er or pay the unemployed member only for confinement within 1 year immediately preceding the date the claim for benefit or reimbursement is received by the SSS XPN: Confinement in a hospital in which case the claim for benefit or reimbursement must be filed within 1 year from the last day of confinement. (Sec. 14[c]) Maternity Benefit Q: What is the maternity benefit? A: The maternity benefit is a daily cash allowance granted to a female member who was unable to work due to childbirth or miscarriage. Q: What are the qualifications for entitlement to the maternity benefit? A:

A:

1. 1. 2.

Begins on the 1st day of sickness Payment of such allowances shall be promptly made by the Er: th a. every regular payday or on the 15 and last day of each month, b. in case of direct payment by the SSS ‐ as long as such allowances are due and payable. (Sec. 14[b])

Q: What are the requirements in order that Er may claim reimbursement of the sickness benefit? A: 1.

100% of daily benefits shall be reimbursed by SSS if the following requirements are satisfied: a. Receipt of SSS of satisfactory proof of such payment and legality thereof: b. The Er has notified the SSS of the confinement within 5 calendar days after receipt of the notification from the Ee member:

2.

She has paid at least three monthly contributions within the 12‐month period immediately preceding the semester of her childbirth or miscarriage. She has given the required notification of her pregnancy through her employer if employed, or to the SSS if separated, voluntary or self ‐employed member.

Q: Is the voluntary or self ‐employed member also entitled to the maternity benefit? A: Yes, A voluntary or a self ‐employed member is entitled to the maternity benefit provided that she meets the qualifying conditions. Q: How much is the maternity benefit? A: The maternity benefit is equivalent to 100 per cent of the member’s average daily salary credit multiplied by 60 days for normal delivery or miscarriage, 78 days for caesarean section delivery. Q: How is the maternity benefit computed?


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A:

1.

Exclude the semester of contingency (delivery or miscarriage). Note: Semester refers to two consecutive quarters ending in the quarter of contingency. Quarter refers to three consecutive months ending March, June, September or December.

2.

3.

Count 12 months backwards starting from the month immediately before the semester of contingency.

any gainful occupation for a continuous period exceeding 120 days regardless of whether he loses the use of any of his body parts.

d.Beneficiaries Q: Who are primary beneficiaries? A:

Identify the six highest monthly salary credits within the 12‐month period. Note: Monthly salary credit means the compensation base for contributions benefits related to the total earnings for the month.

4.

5.

6.

Add the six highest monthly salary credits to get the total monthly salary credit. Divide the total monthly salary credit by 180 days to get the average daily salary credit. This is equivalent to the daily maternity allowance. Multiply the daily maternity allowance by 60 (for normal delivery or miscarriage) or 78 days (for caesarean section delivery) to get the total amount of maternity benefit.

Q: What is the difference of compensability under the Labor Law and the Social Security Law? A: The claims are different as to their nature and purpose. (Ortega vs. Social Security Commission, G.R. No. 176150, June 25, 2008) LABOR LAW

SOCIAL SECURITY LAW Purpose Governs compensability Benefits are intended to of : provide insurance or 1. work‐related protection against the disabilities hazards or risks of 2. when there is loss disability, sickness, old of income due to age or death, inter alia, work‐connected irrespective of whether or work‐ they arose from or in the aggravated injury course of the employment. or illness. Nature A disability is total and Disability may be permanent if as a result of permanent total or the injury or sickness the permanent partial. Ee is unable to perform

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1.

The dependent spouse until he or she remarries

2.

The dependent legitimate, legitimated or legally adopted, and illegitimate children,: Provided , That the dependent illegitimate children shall be entitled to 50% of the share of the legitimate, legitimated or legally adopted children.

Q: Who are secondary beneficiaries? A: In the absence of primary beneficiaries, the dependent parents.

In the absence of all the foregoing, any other person designated by the member as his or her secondary beneficiary. (Sec. 8[k]) Q: Who are considered dependents? A:

1. The legal spouse entitled by law to receive support from the member; 2. The legitimate, legitimated, or legally adopted, and illegitimate child who: a. Is unmarried, b. Not gainfully employed, and c. Has not reached 21 years of age, or if over 21 years of age, he is congenitally or while still a minor has been permanently incapacitated and incapable of self ‐support, physically or mentally. 3. The parent who is receiving regular support from the member. Q: What is meant by “dependent for support”? A: The entitlement to benefits as a primary beneficiary requires not only legitimacy but also dependence upon the member Ee. (Gil v. SSC CA‐ GR SP. 37150, May 8, 1996)

If a wife who is already separated de facto from her husband cannot be said to be "dependent for support" upon the husband, absent any showing to


SOCIAL LEGISLATION

the contrary. Conversely, if it is proved that the husband and wife were still living together at the time of his death, it would be safe to presume that she was dependent on the husband for support, unless it is shown that she is capable of providing for herself. (SSS v. Aguas, G.R. No. 165546, Feb. 27, 2006) Q: Who is entitled to the benefits of an SSS member who was survived not only by his legal wife, who is not dependent upon the member, but also by two common‐law wives with whom he had illegitimate minor children? A: The illegitimate minor children shall be entitled to the death benefits as primary beneficiaries because the legal wife is not dependent upon the member. The SSS Law is clear that for a minor child to qualify as a “dependent” the only requirements are that he/she must be below 21 yrs. of age, not married nor gainfully employed. (Signey v. SSS, G.R. No. 173582, Jan.28, 2008) Q: What is compensation? A: All actual remuneration for employment, including the mandated cost of living allowance, as well as the cash value of any remuneration paid in any medium other than cash except that part of the remuneration received during the month in excess of the maximum salary. Q: The owners of FALCON Factory, a company engaged in the assembling of automotive components, decided to have their building renovated. (50) persons, composed of engineers, architects and other construction workers, were hired by the company for this purpose. The work was estimated to be completed in 3 years. The Ees contended that since the work would be completed after more than 1 year, they should be subject to compulsory coverage under the Social Security Law. Do you agree with their contention? Explain your answer fully. A: No. Under Sec. 8 (j) of R.A. 1161, as amended, employment of purely casual and not for the purpose of the occupation or business of the employer are excepted from compulsory coverage. An employment is purely casual if it is not for the purpose of occupation or business of the Er. In the problem given, Falcon Factory is a company engaged in the assembly of automotive components. The 50 persons (engineers, architects and construction workers) were hired by Falcon Factory to renovate its building. The work to be

performed by these 50 people is not in connection with the purpose of the business of the factory. Hence, the employment of these 50 persons is purely casual. They are, therefore, excepted from the compulsory coverage of the SSS law. (2000 Bar Question) 2.GSIS (R.A. 8291) Q: What are the purposes behind the enactment of the GSIS Act? A: To provide and administer the following social security benefits for government employees (Ee): 1. 2. 3. 4. 5.

Compulsory life insurance Optional life insurance Retirement benefits Disability benefits to contingencies; and Death benefits

work‐related

Q: Who are considered employers (Er) under the GSIS Act? A: 1. 2. 3. 4.

National Government Its political subdivisions, branches, agencies, instrumentalities GOCCs, and financial institutions with original charters Constitutional Commissions and the Judiciary (Sec. 2[c])

Q: Can SSS Ees be covered by GSIS? A: Yes. Q: Who is an Employee or member? A: Any person, receiving compensation while in the service of an Er, whether by election or appointment, irrespective of status of appointment, including barangay and sanggunian officials. (Sec. 2[d]) Q: What is compensation? A: The basic pay or salary received by an Ee, pursuant to his or her election or appointment, excluding per diems, bonuses, OT pay, honoraria, allowances and any other emoluments received in addition to the basic pay which are not integrated into the basic pay under existing laws. (Sec. 2[i]) Q: Baradero is a member of the Sangguniang Bayan of the Municipality of La Castellana, Negros


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Occ. and is paid on a per diem basis. On the other hand, Belo a Vice‐Governor of Capiz is in a hold over capacity and is paid on a per diem basis. Are the services rendered by Baradero and Belo on a per diem basis creditable in computing the length of service for retirement purposes?

a.Coverage Q: What government Ees are subject to coverage under the GSIS? A: GR: All Ees receiving compensation who have not reached the compulsory retirement age, irrespective of employment status.

A: Yes. The traditional meaning of per diem is a reimbursement for extra expenses incurred by the public official in the performance of his duties. Under this definition the per diem is intended to cover the cost of lodging and subsistence of officers and employees when the latter are on a duty outside of their permanent station. On the other hand, a per diem could rightfully be considered a compensation or remuneration attached to an office.

The per diems paid to Baradero and Belo were in the nature of compensation or remuneration for their services as Sangguniang Bayan and Vice‐ Governor, respectively, rather than a reimbursement for incidental expenses incurred while away from their home base.

XPNs: 1. Uniformed members of the: a. AFP; and b. PNP. 2. Contractuals who have no Er and Ee relationship with the agencies they serve. Q: Who are covered by life insurance, retirement and other social security protection? A: GR: All members of the GSIS shall have life insurance, retirement, and all other social security protections such as disability, survivorship, separation, and unemployment benefits. (Sec. 3)

If the remuneration received by a public official in the performance of his duties does not constitute a mere “allowance for expenses” but appears to be his actual base pay, then no amount of categorizing the salary as a “per diem” would take the allowances received from the term service with compensation for the purpose of computing the number of years of service in government. (GSIS v. CSC, G. R. Nos. 98395 and 102449, June 19, 1995) Q: What are the sources of funds of the GSIS? A: It comes from the monthly contributions of the covered Ees and Ers. (Sec. 5)

XPNs: Members of: 1. The judiciary; and 2. Constitutional commissions who shall have life insurance only.

b.Exclusions from coverage Q: Who, under the GSIS, are excluded from the coverage? A:

1.

The contributions of the Ees are deducted and withheld by the Er each month from the monthly salary of the former and are remitted by the latter, together with its own share, to the System within the first 10 days of each calendar month following the month to which the contributions apply. (Sec. 6)

2. 3.

4.

Q: What is the penalty in case of delayed remittance or non‐remittance of contributions? A: The unremitted contributions shall be charged interests as prescribed by the GSIS Board of Trustees but shall not be less than 2% simple interest per month from due date to the date of payment by the employers concerned.

Q: For the purpose of benefit entitlement, how are the members classified? A:

1.

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Ees who have separate retirement schemes (members of the Judiciary, Constitutional Commissions and others similarly situated) Contractual Ees who have no Er‐Ee with the agencies they serve Uniformed members of the AFP, BJMP, whose coverage by the GSIS has ceased effective June 24, 1997 Uniformed members of the PNP whose coverage by the GSIS has ceased effective February 1, 1996. (Sec. 2.4, Rule II, IRR)

Active members a. Still in the service and are paying integrated premiums.


SOCIAL LEGISLATION

b.

2.

3.

Covered for the entire package benefits and privileges being extended by GSIS.

Policyholders a. Covered for life insurance only b. Can avail of policy loan privilege only c. May also apply for housing loans d. Judiciary and Constitutional Commissions

Separation Benefits Q: When will a member be entitled to separation benefits and what comprises these separation benefits? A: A member who has rendered a minimum of 3 years creditable service shall be entitled to separation benefit upon resignation or separation under the following terms:

Retired Members a. Former active members who have retired from the service and are already enjoying the corresponding retirement benefits applied for b. Not entitled to any loan privilege, except stock purchase loan (Sec. 2.2, Rules II, IRR)

1.

A member with at least 3 years but less than 15 years: Cash payment equivalent to 100% of the AMC for every year of service the member has paid contributions: a. not less than P12,000.00 b. Payable upon reaching 60 years of age or upon separation, whichever comes later.

2.

A member with less than 15 years of service and less than 60 years of age at the time of resignation or separation: a. Cash payment equivalent to 18 times the basic monthly pension (BMP), payable at the time of resignation or separation b. An old‐age pension benefit equal to the basic monthly pension, payable monthly for life upon reaching the age of 60.

c.Benefits Q: What are the benefits provided by the GSIS Act? A: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Separation Unemployment or involuntary separation Retirement Permanent disability Temporary disability Survivorship Funeral Life Insurance Such other benefits and protection as may be extended to them by the GSIS such as loans.

Q: What are the benefits under P.D. 1146 (Revised GSIS Act of 1977) that may be granted to the separated members of the PNP, BJMP and BFP? A: GR: 1. 2. 3. 4. 5.

Old‐age benefit Permanent disability benefit Survivorship benefit Funeral benefit Retirement benefit

XPN: Judiciary (Life insurance only – tax exempt) Q: What are the reportorial requirements of the Er? A: Er must report to GSIS the names, employment status, positions, salaries of the employee and such other matter as determined by the GSIS.

Q: What are the effects of separation from service with regard to membership? A: A member separated from the service shall continue to be a member and shall be entitled to whatever benefits he has qualified to. Note: A member separated for a valid cause shall automatically forfeit his benefits, unless the terms of resignation or separation provide otherwise. In the case of forfeiture, the separated employee shall be entitled to receive only ½ of the cash surrender value of his insurance.

Unemployment Benefits Q: What are the conditions for entitlement to unemployment benefits? A: 1. 2.

The recipient must be a permanent employee at the time of separation; His separation was involuntary due to the abolition of his office or position resulting from reorganization; and


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3.

He has been paying the contribution for at least 1 year prior to separation.

Q: What will consist of an unemployment benefit?

Q: What are the options of the retiree with regard to his or her retirement benefits? A: The retiree may get either of the following:

A: It will consists of cash payment equivalent to 50% of the average monthly compensation

1.

Note: A member who has rendered at least 15 years of service will be entitled to separation benefits instead of unemployment benefits.

2. Retirement Benefits Q: What are the conditions in order to be entitled to retirement benefits? A:

Lump sum equivalent to 6 months of the basic monthly pension (BMP) payable at the time of retirement and an old‐age pension benefit equal to BMP payable for life, starting upon the expiration of the 5 years covered by the lump sum; or Cash payment equivalent to 18 times his BMP and monthly pension for life payable immediately. (Sec. 13[a]) Permanent Disability Benefits

Q: What is disability?

1. 2. 3.

A member has rendered at least 15 years of service; He is at least 60 years of age at the time of retirement; and He is not receiving a monthly pension benefit from permanent total disability. (Sec. 13‐ A)

A: Any loss or impairment of the normal functions of the physical and/or mental faculty of a member, which reduces or eliminates his/her capacity to continue with his/her current gainful occupation or engage in any other gainful occupation. Q: What is total disability?

Q: What is the rule in case of extension of service in order to be entitled for retirement benefit? A: The doctrine in Cena vs. CSC (G.R. No. 97419, July 3, 1992), was modified in Rabor vs. CSC, (G.R. No. 111812, May 31, 1995), where the SC held that: The head of the government agency concerned is vested with discretionary authority to allow or disallow extension of the service of an official or Ee who has reached 65 years old without completing the 15 years of government service. However, this discretion is to be exercise conformably with the provisions of Civil Service Memorandum Circular No. 27, series of 1990 which provides that the extension shall not exceed 1 year. Q: What is the reason for compulsory retirement? A: The compulsory retirement of government officials and Ees upon their reaching the age of 65 years is founded on public policy which aims by it to maintain efficiency in the government service and at the same time give to the retiring public servants the opportunity to enjoy during the remainder of their lives the recompense, for their long service and devotion to the government , in the form of a comparatively easier life, freed from the rigors of civil service discipline and the exacting demands that the nature of their work and their relations with their superiors as well as the public would impose upon them. (Beronilla v. GSIS, G.R. No. 21723, Nov. 26, 1970)

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A: Complete incapacity to continue with present employment or engage in any gainful occupation due to the loss or impairment of the normal functions of the physical and/or mental faculties of the member. Q: What is permanent total disability (PTD)? A: Accrues or arises when recovery from impairment mentioned in Sec.2(q) (defining disability) is medically remote. Q: What is permanent partial disability (PPD)? A: Accrues or arises upon the irrevocable loss or impairment of certain portions of the physical faculties, despite which the member is able to pursue a gainful occupation. Q: What are the conditions in order to be entitled for permanent disability benefits? A: The permanent disability was not due to any of the ff:

1. 2. 3. 4.

Grave misconduct Notorious negligence Habitual intoxication Willful intention to kill himself or another


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Q: What are the two types of permanent disability?

contribution prior his disability He is not receiving old‐age retirement pension benefits

e.

A: 1.

2.

Permanent total disability (PTD) ‐ accrues or arises when recovery from any loss or impairment of the normal functions of the physical and/or mental faculty of a member which reduces or eliminates his capacity to continue with his current gainful occupation or engage in any other gainful occupation is medically remote. [Section 2 (q) and (s)] Permanent partial disability (PPD) ‐ accrues or arises upon the irrevocable loss or impairment of certain portion/s of the physical faculties, despite which the member is able to pursue a gainful occupation. (Sec. 2[u]) PTD

1. 2.

3. 4.

5.

PPD

Causes Complete loss of sight Complete and of both eyes permanent loss of the Loss of 2 limbs at or use of: above the ankle or wrist 1. Any finger Permanent complete 2. Any toe paralysis of 2 limbs 3. One arm 4. One hand Brain injury resulting in incurable imbecility 5. One foot or insanity 6. One leg 7. One or both ears Such other cases as may be determined 8. Hearing of one or both ears by the GSIS 9. Sight of one eye

Such other causes as determined by GSIS Benefits 1. A member is entitled to A member is entitled to the monthly income cash payment in benefit for life equivalent accordance with the to the BMP when: schedule of disabilities to a. He is in the service be prescribed by GSIS, if at the time of the he satisfies the given conditions of either (1) disability or b. If separated from or (2) of Sec. 16(a). service c. He has paid at least 36 monthly contributions within 5 years immediately preceding his disability d. He has paid a total of at least 180 monthly

2. If the member does not satisfy the conditions above but has rendered at least 3 years service, he shall be advanced the cash payment equivalent to 100% of his average monthly compensation for each year of service he has pad contributions but not less than P12,000.00 which should have been his separation benefit (he shall no longer receive separation benefits)

Q: When will the payment of these benefits be suspended? A: 1. 2. 3.

In case a member is re‐employed; or Member recovers from disability as determined by the GSIS; or Fails to present himself for medical examination when required by the GSIS. (Sec. 16 [c])

Q: Manioso was suffering from several diseases from 1959 to 1994 when he worked as Accounting Clerk I at the Budget Commission up to the time he was transferred and promoted to the DENR as Senior Bookkeeper. On ‘95, he was hospitalized. The results of his examinations showed that he was suffering from Acute Myocardial Infarction and Hypertensive Vascular Disease. From Jan‐ May ‘95 when he compulsory retired from government service and after serving for 36 yrs, he no longer reported for work. His sick leave covering said period was duly approved. In the meantime, Manioso filed a claim for income benefits with the GSIS which found his ailments work‐related. He was granted Temporary Total Disability benefits for 2 months. He was later granted Permanent Partial Disability benefits for 8 months. It appears that he appealed for more disability benefits with the GSIS which subjected him to a series of medical tests. In ‘97, he was brought to the PGH several times due to Chronic Renal Infection 2 to Obstructive Uropathy 2 to Staghorn Calculi (L) and Benign Prostatic Hypertrophy; Diabetes Mellitus Neprophaty, Stage IV, and Hypertensive Nephrosclerosis. He then filed a request with the GSIS for additional disability benefits, claiming that the ailments for


˚

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which he was hospitalized several times in ‘97 developed from his work‐related illnesses. The GSIS disapproved Manioso’s request. Do Manioso’s ailments which later developed fall under the category of permanent total disability? A: Yes. Under Art. 192 (c) of P.D. No. 442, as amended (the LC), the following disabilities are deemed total and permanent: (1) Temporary total disability lasting continuously for more than 120 days. Under Section 2(b), Rule VII of the Amended Rules on Ee’s Compensation, “[a] disability is total and permanent if as a result of the injury or sickness the Ee is unable to perform any gainful occupation for a continuous period exceeding 120 days, except as otherwise provided under Rule X of these Rules.” In the case at bar, Manioso was on sick leave from Jan 11, ‘95 up to his date of retirement on May 15, ‘95 or for a period of more than 120 days. Surely, the DENR, in approving his more than 120 days leave must have passed upon his Medical Certificate relative to his ailments. Manioso’s disability having lasted for more than 120 days, he is entitled to PTD benefits. (Manioso, v. GSIS, G.R. No. 148323, Apr. 29, 2005) Q: Does Manioso’s retirement from service prevent him from entitlement to PTD benefits? A: No. Benefits due an Ee due to work‐related sickness shall be provided until he becomes gainfully employed, or until his recovery or death. None of these are present in Manioso’s case. It would be an affront to justice if Manioso, a government Ee who had served for 36 years, is deprived of the benefits due him for work‐related ailments that resulted in his Permanent Total Disability. (Manioso v. GSIS, G.R. No. 148323, Apr. 29, 2005)

Temporary Disability Benefits

2.

Note: A member cannot enjoy the temporary total disability benefit and sick leave pay simultaneously.

An application for disability must be filed with the GSIS within 4 years from the date of the occurrence of the contingency.

Survivorship Benefits Q: Who are entitled to survivorship benefits? A: Upon the death of a member or pensioner, his beneficiaries shall be entitled to survivorship benefits. Such benefit shall consist of:

1. 2.

A: Upon the death of a member, the primary beneficiaries shall be entitled to:

1.

Survivorship pension: Provided , That the deceased: a. was in the service at the time of his death; or b. if separated from the service, has rendered at least 3 years of service at the time of his death and has paid 36 monthly contributions within the five‐year period immediately preceding his death; or has paid a total of at least 180 monthly contributions prior to his death; or

2.

The survivorship pension plus a cash payment equivalent to 100% of his average monthly compensation for every year of service: Provided, That the deceased was in the service at the time of

A: It accrues or arises when the impaired physical and/or mental faculties can be rehabilitated and/or restored to their normal functions. (Sec 2[t]) are

given

for

temporary

A:

1.

120

Member is entitled to 75% of his current daily compensation for each day or fraction thereof of total disability benefit, th to start at the 4 day but not exceeding 120 days in one calendar year when:

The basic survivorship pension which is 50% of the basic monthly pension; and The dependent children’s pension not exceeding 50% of the basic monthly pension

Q: Under what conditions are the primary beneficiaries entitled to the basic monthly pension?

Q: When does temporary total disability arises?

Q: What benefits disability?

a. He has exhausted all sick leaves b. CBA sick leave benefits Provided, that: i. He was in the service at time of disability; or ii. If separated, he has rendered at least 3 years of service and has paid at least 6 monthly contributions in the year preceding his disability The temporary total disability benefits shall in no case be less than P70 a day.


SOCIAL LEGISLATION

his death with at least 3 years of service; OR 3.

A cash payment equivalent to 100% of his average monthly compensation for each year of service he paid contributions, but not less than P12,000.00: Provided , That the deceased has rendered at least 3 years of service prior to his death but does not qualify for the benefits under item (1) or (2) of this paragraph. [Sec. 21 (a)]

2.

Q: What are the benefits that the beneficiaries are entitled to upon the death of the pensioner? A: 1.

Q: After the end of the guaranteed 30 months, are the beneficiaries still entitled to any survivorship benefits? A: Yes. The survivorship pension shall be paid as follows: 1.

When the dependent spouse is the only survivor, he/she shall receive the basic survivorship pension for life or until he or she remarries;

2.

When only dependent children are the survivors, they shall be entitled to the basic survivorship pension for as long as they are qualified, plus the dependent children’s pension equivalent to 10% of the basic monthly pension for every dependent child not exceeding 5, counted from the youngest and without substitution;

3.

When the survivors are the dependent spouse and the dependent children, the dependent spouse shall receive the basic survivorship pension for life or until he/she remarries, and the dependent children shall receive the dependent children’s pension. (Sec. 21[b])

Note: The dependent children shall be entitled to the survivorship pension as long as there are dependent children and, thereafter, the surviving spouse shall receive the basic survivorship pension for life or until he or she remarries.

Q: When are secondary beneficiaries entitled to survivorship benefits? A: In the absence of primary beneficiaries, the secondary beneficiaries shall be entitled to: 1.

The cash payment equivalent to 100% of his average monthly compensation for each year of service he paid contributions, but not less than

P12,000.00: Provided, That the member is in the service at the time of his death and has at least 3 years of service; or In the absence of secondary beneficiaries, the benefits under this par. shall be paid to his legal heirs. (Sec. 21[c])

2.

Upon the death of an old‐age pensioner or a member receiving the monthly income benefit for permanent disability, the qualified beneficiaries shall be entitled to the survivorship pension defined in Sec. 20 of this Act, subject to the provisions of par. (b) of Sec.21. When the pensioner dies within the period covered by the lump sum, the survivorship pension shall be paid only after the expiration of the said period.

Q: Gary Leseng was employed as a public school teacher at the Marinduque High. On April 27, 1997, a memorandum was issued by the school principal designating Gary to prepare the model dam project, which will be the official entry of the school in the search for Outstanding Improvised Secondary Science Equipment for Teachers. Gary complied with his superior's instruction and took home the project to enable him to finish before the deadline. While working on the model dam project, he came to contact with a live wire and was electrocuted. The death certificate showed that he died of cardiac arrest due to accidental electrocution. Bella (Gary’s common‐law wife) and Jobo (his only son) filed a claim for death benefits with the GSIS which was denied on the ground that Gary’s death did not arise out of and in the course of employment and therefore not compensable because the accident occurred in his house and not in the school premises. Is Bella entitled to file a claim for death benefits with the GSIS? Why? A: The beneficiaries of a member of the GSIS are entitled to the benefits arising from the death of said member. Death benefits are called survivorship benefits under the GSIS Law. Not being a beneficiary, Bella is not entitled to receive survivorship benefits. She is not a beneficiary because she is a common‐law wife and not a legal dependent spouse. (1991 Bar Question) Q: Is the cause of death of Gary (cardiac arrest


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due to accidental electrocution in his house) compensable? Why? A: Yes. To be compensable under the GSIS Law, the death need not be work connected. Q: Abraham, a policeman, was on leave for a month. While resting in their house, he heard two of his neighbors fighting with each other. Abraham rushed to the scene intending to pacify the protagonists. However, he was shot to death by one of the protagonists. Eva Joy, a housemaid, was Abraham's surviving spouse whom he had abandoned for another woman years back. When she learned of Abraham's death, Eva Joy filed a claim with the GSIS for death benefits. However, her claim was denied because: (a) when Abraham was killed, he was on leave; and (b) she was not the dependent spouse of Abraham when he died. Resolve with reasons whether GSIS is correct in denying the claim.

Funeral Benefits Q: What comprises the funeral benefit? A: Cash not less than P12,000 to be increased to at least P18,000 after 5 years (specifically year 2002). The amount shall be determined and specified by the GSIS through an information circular distributed to all Ers for posting at their premises. (Sec. 23, par.1) Q: When will it be paid? A: Upon the death of :

1. 2.

3. 4.

A: Yes, because under the law, a dependent is one who is a legitimate spouse living with the Ee. ( Art. 167 [i], LC) In the problem given, Eva Joy had been abandoned by Abraham who was then living already with another woman at the time of his death.

Moreover, Abraham was on leave when he was killed. The 24‐hour duty rule does not apply when the policeman is on vacation leave. (ECC v. CA, G.R. No. 121545, Nov. 14, 1996) Taking together jurisprudence and the pertinent guidelines of the ECC with respect to claims for death benefits, namely: 1. 2. 3.

That the Ee must be at the place where his work requires him to be; That the Ee must have been performing his official functions; and That if the injury is sustained elsewhere, the Ee must have been executing an order for the Er, it is not difficult to understand then why Eva Joy's claim was denied by the GSIS. (Tancinco v. GSIS, G.R. No. 132916, Nov. 16, 2001)

In the present case, Abraham was resting at his house when the incident happened; thus, he was not at the place where his work required him to be. Although at the time of his death Abraham was performing a police function, it cannot be said that his death occurred elsewhere other than the place where he was supposed to be because he was executing an order for his Er. (2005 Bar Question)

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An active member A member who has been separated from the service but is entitled to future separation or retirement benefits A member who is a pensioner (excluding survivorship pensioners) A retiree who is at the time of his retirement was of pensionable age, at least 60 years old, who opted to retire under RA 1616 ( An act further amending Sec.12, C.A. 186, as amended, by prescribing two other modes of retirement and for other purposes). Life Insurance

Q: What are the classes of life insurance coverage? A:

1. 2.

Compulsory life insurance Optional life insurance

Note: The plans may be endowment or ordinary life.

Q: When does compulsory life insurance coverage take effect? A: All Ees including the members of the Judiciary and the Constitutional Commissioners except for Members of the AFP, the PNP, BFP and BJMP, shall, under such terms and conditions as may be promulgated by the GSIS, be compulsorily covered with life insurance, which shall automatically take effect as follows:

1.

2.

Those employed after the effectivity of this Act, their insurance shall take effect on the date of their employment; For those whose insurance will mature after the effectivity of this Act, their insurance shall be deemed renewed on the day following the maturity or expiry date of their insurance;


SOCIAL LEGISLATION

3.

For those without any life insurance as of the effectivity of this Act, their insurance shall take effect following said effectivity.

2.

Q: When may a member obtain optional life insurance coverage? A:

3. 1.

A member may at any time apply for himself and/or his dependents an insurance and/or pre‐need coverage embracing: a. Life b. Memorial plans c. Health d. Education e. Hospitalization f. Other plans as maybe designed by GSIS

2.

Any employer may apply for group insurance coverage for its employees.

Q: Where can GSIS loans be invested in?

Within 15 days from receipt of the notice of decision or award, the aggrieved party may appeal the decision of the GSIS Board of Trustees to the CA. Appeal shall be taken by filling a verified petition for review with the CA. (Sec 1 to 5, Rule 43, Rules of Court) When no appeal is perfected and there is no order to stay by the Board, by the CA or by the SC, any decision or award of the Board shall be enforced and executed in the same manner as decisions of the RTC. Note: The social security benefits shall be exempt from attachment, garnishment, execution, levy or other processes issued by the courts, quasi‐ judicial bodies or administrative agencies including the Commission on Audit, disallowances, and from all financial obligations of the members.

Q: May a member enjoy the benefits provided for in the Revised GSIS Act simultaneous with similar benefits provided under other laws for the same contingency?

A: 1.

2.

In direct housing loans to members and group housing projects secured by first mortgage giving priority to the low income groups In short and medium term loans to members such as salary, policy, educational, emergency stock purchase plan, and other similar loans

A: Whenever other laws provide similar benefits for the same contingencies covered by this Act, the member who qualifies to the benefits shall have the option to choose which benefits will be paid to him. However, if the benefits provided by the law chosen are less than the benefits provided under this Act, the GSIS shall pay only the difference. (Sec. 55) d.Beneficiaries

Q: What is the prescriptive period to claim the benefits?

Q: Who are the considered beneficiaries?

A:

A: GR: 4 Years from the date of contingency

1.

Primary beneficiaries a. The legal dependent spouse until he/she remarries and b. The dependent children. (Sec. 2[g])

2.

Secondary beneficiaries a. The dependent parents and b. Subject to the restrictions on dependent children, the legitimate descendants. (Sec. 2[h])

XPN: Life insurance and retirement (Sec. 28)

Q: What is the process for the adjudication of claims and disputes regarding the GSIS benefits? A: The quasi‐ judicial functions of the GSIS shall be vested in its Board of Trustees. 1.

The GSIS, in appropriate cases, or any person whose rights are or may be prejudiced by the operations or enforcement of R.A. 8291 and other laws administered by the GSIS, may file a petition before the GSIS either personally or through counsel.

Q: Who are considered dependents? A: 1. 2.

Legitimate spouse dependent for support upon the member or pensioner; Legitimate, legitimated, legally adopted child, including the illegitimate child, a. who is unmarried,


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b. c.

3.

not gainfully employed, not over the age of majority, or if over the age of majority, incapacitated and incapable of self ‐ support due to a mental or physical defect acquired prior to age of majority; and Parents dependent upon the member for support. (Sec. 2[f]) 3.LIMITED PORTABILITY LAW (RA 7699)

4.EMPLOYEES’S COMPENSATION Q: Discuss briefly the Employee’s Compensation Program (ECP). A: It is the program provided for in Article 166 to 208 of the Labor Code whereby a fund known as the State Insurance Fund (SIF) is established through premium payments exacted from Ers and from which the Ees and their dependents in the event of work‐connected disability or death, may promptly secure adequate income benefit, and medical or related benefits.

Q: What is the Limited Portability Rule?

Coverage A: A covered worker who transfers employment from one sector to another or is employed on both sectors, shall have creditable services or contributions on both Systems credited to his service or contribution record in each of the Systems and shall be totalized for purposes of old ‐ age, disability, survivorship, and other benefits in either or both Systems. (Sec. 3)

All contributions paid by such member personally, and those that were paid by his employers to both Systems shall be considered in the processing of benefits which he can claim from either or both Systems. (Sec. 4)

Q: Who are subject to coverage under the ECP? A: Ers and their Ees not over sixty (60) years of age are subject to compulsory coverage under this program.

The Er may belong to either the: 1.

2. Q: How are the "portability" provisions of R.A. No. 7699 beneficial or advantageous to SSS and GSIS members in terms of their creditable employment services in the private sector or the government, as the case may be, for purposes of death, disability or retirement? A: Portability provisions of R.A. No. 7699 shall benefit a covered worker whose creditable services or contributions in both systems credited to his service or contribution record in each of the system and shall be totalized for purposes of old‐ age, disability, survivorship and other benefits. (Sec. 3)

Public sector covered by the GSIS, comprising the National Government, including GOCCs, Philippine Tuberculoses Society, the Philippine National Red Cros, and the Philippine Veterans Bank; and Private sector covered by the SSS, comprising all Ers other than those defined in the immediately preceding paragraph.

The Ee may belong to either the: 1.

2.

Public sector comprising the employed workers who are covered by the GSIS, including the members of the AFP, elective officials who are receiving regular salary and any person employed as casual emergency, temporary, substitute or contractual; Private sector comprising the employed workers who are covered by the SSS.

Q: When does compulsory coverage take effect?

The "portability" provisions of R.A. 7699 allow the transfer of funds for the account and benefit of the worker who transfers from one system to another. This is advantageous to the SSS and GSIS members for purposes of death, disability or retirement benefits. In the event the employees transfer from the private sector to the public sector, or vice‐versa, their creditable employment services and contributions are carried over and transferred as well. (2005 Bar Question)

124

A:

1.

Employer – on the first day of operation

2.

Employee – on the day of his employment

Q: What is an Occupational Disease? A: One which results from the nature of the employment, and by nature is meant conditions which all Ees of a class are subject and which produce the disease as a natural incident of a particular occupation, and attach to that


SOCIAL LEGISLATION

occupation a hazard which distinguishes it from the usual run of occupations and is in excess of the hazard attending the employment in general To be occupational, the disease must be one wholly due to causes and conditions which are normal and constantly present and characteristic of the particular occupation.

4.

Claim was filed beyond three (3) years from the time the cause of action accrued (Art. 201, LC, as amended by P.D. 1921)

Note: Notorious negligence is equivalent to gross negligence; it is something more than mere carelessness or lack of foresight.

A: It means any illness definitely accepted as an occupational disease listed by the Commission or any illness caused by employment, subject to proof that the risk of contracting the same is increased by working conditions (Art. 167(l), LC).

Q: Abraham Dino works as a delivery man in a construction supply establishment owned by Abraham Julius. One day, while Dino was making reports on his delivery, he had an altercation with Julius; irked by the disrespectful attitude of Dino, Julius pulled out his gun and shot Dino, hitting him in the spinal column and paralyzing him completely. Julius was prosecuted for the act.

Q: Discuss briefly the theory of Increased Risk.

1.

A: The term “sickness” as defined in Article 167(l) of the Labor Code is a recognition of the theory of increased risk. To establish compensability under the same, the claimant must show substantial proof of work‐connection, but what is required is merely a reasonable work‐connection and not a direct causal relation. Proof of actual cause of the ailment is not necessary. The test of evidence of relation of the disease with the employment is probability and not certainty. (Jimenez v. Employees’ Compensation Commission, G.R. No. L‐58176, March 23, 1984; Panotes vs. ECC, G.R. No. L‐64802, March 29, 1984)

2.

Q: What is Sickness?

Q: May an illness not listed by the Employees Compensation Commission as an occupational disease be compensable? A: Where the illness is not listed by the Employees Compensation Commission as an occupational disease, it must be established that the risk of contracting the same is increased by working conditions. Q: What defenses may be interposed by the State Insurance Fund (SIF) against a claim for compensation made by a covered Ee or his dependents? A: The following defenses may be set up: 1. 2.

3.

Injury is not work‐connected or the sickness is not occupational Disability or death was occasioned by the Ee’s intoxication, wilful intention to injure or kill himself or another, or his notorious negligence (Art. 172, LC) No notice of sickness, injury or death was given to the Er (Art. 206, LC)

A: 1.

2.

Is the disability suffered by Abraham Dino compensable? If Abraham Dino recovers compensation from the SIF, can he still recover from Abraham Julius damages in the criminal case? Why?

Yes. The injury was sustained by Abraham Dino in his place of work and while in the performance of his official functions. No. Under Article 173 of the Labor Code, as amended by P.D. 1921, the liability of the State Insurance Fund under the Employee’s Compensation Program shall be exclusive and in place of all other liabilities of the Er to the Ee or his dependents or anyone otherwise entitled to recover damages on behalf of the Ee or his dependents.

Q: Socrates Benjie, a truck driver employed by a local construction company, was injured in an accident while on assignment in one of his employer’s project in Iraq. Considering that his injury was sustained in a foreign country, is Socrates Benjie entitled to benefits under the ECP? A: Yes. Filipinos working abroad in the service of an Er, domestic or foreign, who carries on in the Philippines any trade, business, industry, undertaking or activity of any kind, are covered by the ECP. (Rule 1, Section 5, ECC Rules; Art.169, LC) Q: What is the “Going and Coming Rule”? Is this rule absolute? A: GR: In the absence of special circumstances, an Ee injured while going to or coming from his place of work is excluded from the benefits of Workmen’s Compensation Act. XPNS:


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1. 2.

3.

4.

Where the Ee is proceeding to or from his work on the premises of the Er; Proximity Rule—where the Ee is about to enter or about to leave the premises of his Er by way of exclusive or customary means of ingress and egress; Ee is charged, while on his way to or from his place of employment or at his home, or during this employment with some duty or special errand connected with his employment; and Where the Er as an incident of the employment provides the means of transportation to and from the place of employment.

Q: Who are entitled to benefits under the ECP? A: The covered Ee, his dependents, and in case of his death, his beneficiaries.

2. 3. 4.

Disability Benefits Death Benefits Funeral Benefits Medical Benefit

Q: What are the conditions of entitlement to Medical Services? A: For an Ee to be entitled to medical services, the following conditions must be satisfied: 1. He has been duly reported to the System (SSS or GSIS); 2. He sustains a permanent disability as a result of an injury or sickness; and 3. The System has been notified of the injury or sickness which caused his disability.

Disability Benefit Q: What are disability benefits?

Q: Who are the dependents of the Ee? A:

1.

2. 3.

Legitimate, legitimated, legally adopted or acknowledged natural child who is unmarried, not gainfully employed, and not over twenty‐one (21) years of age or over twenty‐one (21) years of age provided he is incapacitated and incapable of self ‐support due to a physical or mental defect which is congenital or acquired during minority; Legitimate spouse living with the Ee; and Parents of said Ee wholly dependent upon him for regular support. (Art.167(i), LC, as amended by P.D. 1921)

Q: Who are included in the term beneficiaries? A: "Beneficiaries" means the dependent spouse until he remarries and dependent children, who are the primary beneficiaries. In their absence, the dependent parents and subject to the restrictions imposed on dependent children, the illegitimate children and legitimate descendants who are the secondary beneficiaries; Provided , that the dependent acknowledged natural child shall be considered as a primary beneficiary when there are no other dependent children who are qualified and eligible for monthly income benefit. (Art. 167, LC, as amended by Sec. I, P.D. 1921) Q: What are the benefits which may be enjoyed under the SIF? A: 1.

A: They are income benefits in case of temporary total disability, permanent total disability and permanent partial disability Q: What are the disabilities that are considered total and permanent? A: The following disabilities shall be deemed total and permanent: 1. Temporary total disability lasting continuously for more than one hundred twenty days, except as otherwise provided for in the Rules; 3. Complete loss of sight of both eyes; 4. Loss of two limbs at or above the ankle or wrist; 5. Permanent complete paralysis of two limbs; 6. Brain injury resulting in incurable imbecility or insanity; and 7. Such cases as determined by the Medical Director of the System and approved by the Commission. (Art.192(c), LC) Q: May a permanent partial disability be converted to permanent total disability after the Ee’s retirement? Why? A: Yes. This is in line with the social justice provision in the Constitution. A person’s disability may not manifest itself fully at one precise moment in time but rather over a period of time. And disability should not be understood more on its medical significance but on the loss of earning capacity.

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Q: May permanent total disability arise although the Ees does not lose the use of any part of his body? A: Yes. Where the Ee is unable, by reason of the injury or sickness, to perform his customary job for more than 120 days, permanent total disability arises. (Ijares vs. CA, G.R. No. 105854, August 26, 1999) Death Benefit Q: What are the conditions for entitlement to death benefits? A: The beneficiaries of a deceased Ee shall be entitled to an income benefit if all of the following conditions are satisfied: 1. 2. 3.

The Ee has been duly reported to the System; He died as a result of an injury or sickness; and The System has been duly notified of his death, as well as the injury or sickness which caused his death.

Q: For how long are the primary beneficiaries entitled to the death benefits? A: 1. 2.

3.

Dependent Spouse—until he or she remarries. Dependent Children—until they get married, or find gainful employment, or reach twenty‐one (21) years of age. Dependent Child suffering from physical or mental defect—until such defect disappears.

Q: If an Ee suffers disability or dies before he is duly reported for coverage to the System (SSS or GSIS), who will be liable for the benefits? A: The Er (Sec.1, Rule X; Sec.1, Rule XI; Sec. 1, Rule XII; Sec. 1, Rule XIII; ECC Rules ) Funeral Benefit Q: What is the funeral benefit? A: A funeral benefit of P10, 000.00 shall be paid upon the death of a covered Ee or permanently totally disabled pensioner. Q: When is an Er liable to pay a penalty to the State Insurance Fund (SIF)?

A: In case the employee's injury or death was due to the failure of the employer to comply with any law, or to install and maintain safety devices, or take other precautions for the prevention of injury, said employer shall pay to the State Insurance Fund a penalty of twenty‐five percent of the lump sum equivalent of the income benefit payable by the System to the employee. All employers, especially those who should have been paying a rate of contribution higher than required of them under this Title, are enjoined to undertake and strengthen measures for the occupational health and safety of their employee. (Art.200, LC) Q: Who are required to make contributions to the SIF? A: Contributions under this Title shall be paid in their entirety by the employer and any contract or device for the deduction of any portion thereof from the wages or salaries of the employees shall be null and void. (Art.183(c), LC) The Republic of the Philippines guarantees the benefits prescribed under this Title, and accepts general responsibility for the solvency of the State Insurance Fund. In case of any deficiency, the same shall be covered by supplemental appropriation from the national government. (Art.184, LC) Q: When does the right to compensation or benefit for loss or impairment of an Ee’s earning capacity due to work‐related illness or injury arise? A: It arises or accrues upon, and not before, the happening of the contingency. Hence, an Ee acquires no vested right to a program of compensation benefits simply because it was operative at the time he became employed. (San Miguel Corporation vs. NLRC, G.R. No. 57473, August 15, 1988) Q: Does recovery from the SIF bar a claim for benefits under the SSS Law? Why? A: No, as expressly provided for in Article 173 of the Labor Code, payment of compensation under the SIF shall not bar the recovery of benefits under the SSS Law, Republic Act No. 1161, as amended. Benefits under the SIF accrue to the Ees concerned due to hazards involved and are made a burden on the employment itself. On the other hand, social security benefits are paid to SSS members by reason of their membership therein for which they contribute their money to a general fund. (Maao Sugar Central Co., Inc. vs. CA, G.R. No. 83491, August 27, 1990)


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UST Golden Notes 2011 - Social Legislation.pdf

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