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Compensation

- a payment is usually made in exchange for the provision of goods, services or both,
or to fulfll a legal obligation.
Workers compensation
- is a form of insurance providing wage replacement and medical benefts to
employees injured in the course of employment in exchange for mandatory
relinuishment of the employee!s right to sue his or her employer for the tort of
negligence. "he tradeo# between assured, limited coverage and lack of recourse
outside the worker compensation system is known as $the compensation bargain$.
Laws on Employees Compensation
RULE I - COVERAGE
SECTION 1. Natue
SECTION !. S"ope
%a& 'very employer shall be covered.
%b& 'very employee not over () years of age shall be covered.
%c& *n employee over () years of age shall be covered if he had been paying contributions
to the +ystem prior to age () and has not been compulsorily retired.
%d& *n employee who is coverable by both the ,+-+ and +++ shall be compulsorily covered
by both +ystems.
SECTION #. Employe
SECTION $. Employee
%a& "he term shall mean any person who performs services for an employer as defned in
+ection . hereof.
%b& employee shall belong to either the public sectors comprising the employed workers
who are covered by the ,+-+ and the private sector comprising the employed workers who
are covered by the +++.
SECTION %. &oei'n employment
SECTION (. E)e"ti*ity
%a& /overage of employers shall take e#ect on the frst day of operation but not earlier
than 0anuary 1, 1234.
%b& /overage of employees shall take e#ect on the frst day of employment.
RULE II + REGISTRATION
SECTION 1. Re,uiement
%a& 'very employer shall register with the +ystem by accomplishing the prescribed forms.
%b& 'very employee shall be registered with the +ystem through his employer by
accomplishing the prescribed forms.
SECTION !. GSIS
"he following guidelines shall apply to the public sector.
%1& 'very employer operating before 0anuary 1, shall register not later than 5arch .16
%7& 'very employer operating on or after 0anuary 1, 1234 shall register within one month
from the frst day of operation, and
%.& 'very employee shall be registered through his employer within one month from the
date of employment.
SECTION #. SSS
%a& "he following guidelines shall apply to the private sector8
'very employer already registered need not register again, for he is automatically
registered6 'very employer not yet registered shall register not later than the frst day of
operation6 'very employee already registered need not register again, for he is
automatically registered. 'very employee not yet registered shall register not later than
the date of employment6 and 9nly one registration is needed for +++, 5edicare and
'mployees /ompensation.
%b& -n case the employee has not yet been registered, he shall be reported by his employer
according to the following guidelines8
'very employer already registered need not register again, for he is automatically
registered. 'very newly hired employee shall be reported by his employer not later than
.) days from the date of employment6 and 'very employee shall be deemed as having
been duly reported for coverage if the +ystem has received a written communication
about him from his employer or an '/ contribution paid in his name by his employer,
before a compensable contingency occurs.
SECTION $. -enalty
- *ny violation under this :ule shall be penali;ed as follows8
%1& -n case of failure or refusal to register employees, the employer or responsible o<cial
who committed the violation shall be punished with a fne of not less than =1,))) nor more
than
=1),))) and>or imprisonment for the duration of the violation or non-compliance or until
such time that rectifcation of the violation has been made, at the discretion of the /ourt.
%7& -n case a compensable contingency occurs after .) days from employment and before
the +ystem receives any report for coverage about the employee or '/ contribution on his
behalf, his employer shall be liable to the +ystem for the lump sum euivalent
.ISA/ILIT0 /ENE&ITS
ART. 111. Tempoay total 2isa3ility
%a& ?nder such regulations as the /ommission may approve, any employee under this "itle
who sustains an injury or contracts sickness resulting in temporary total disability shall for
each day of such a disability or fraction thereof be paid by the +ystem an income beneft
euivalent to ninety percent of his average daily salary credit, subject to the following
conditions8 "he daily income beneft shall not be less than "en =esos nor more than @inety
=esos, nor paid for a continuous period longer than one hundred twenty days, except as
otherwise provided for in the :ules, and the +ystem shall be notifed of the injury or
sickness. %*s amended by +ec. 7, '.9. 132&.
%b& "he monthly income beneft shall be in accordance with the regulations of the
/ommission. %*s amended by +ec. 12, =.A. B4)&.
ART. 11!. -emanent total 2isa3ility
%a& ?nder such regulations as the /ommission may approve, any employee under this "itle
who contracts sickness or sustains an injury resulting in his permanent total
disability shall, for each month until his death, be paid by the +ystem
during such a disability, an amount euivalent to the monthly income
beneft, plus ten percent thereof for each dependent child, but not exceeding fve,
beginning with youngest and without substitution8 =rovided,
"hat the monthly income beneft shall be the new amount of the monthly beneft for all
covered pensioners, e#ective upon approval of this Aecree.
%b& "he monthly income beneft shall be guaranteed for fve years,
and shall be suspended if the employee is gainfully employed, or recovers from his
permanent total disability, or fails to present himself for examination at least once a year
upon notice by the +ystem, except as otherwise provided for in other laws, decrees, orders
or Cetters of -nstructions. %*s amended by +ec. 4, =.A. 1(D1&.
%c& "he following disabilities shall be deemed total and permanent8
%1& "emporary total disability lasting continuously for more than one hundred twenty
days, except as otherwise provided for in the :ules6
%7& /omplete loss of sight of both eyes6
%.& Coss of two limbs at or above the ankle or wrist6
%D& =ermanent complete paralysis of two limbs6
%4& Erain injury resulting in incurable imbecility or insanity6 and
%(& +uch cases as determined by the 5edical Airector of the +ystem and approved
by the /ommission.
%d& "he number of months of paid coverage shall be defned and approximated by a
formula to be approved by the /ommission.
ART. 11#. -emanent patial 2isa3ility
%a& ?nder such regulation as the /ommission may approve, any employee under this "itle
who contracts sickness or sustains an injury resulting in permanent partial
disability shall for each month not exceeding the period designated
herein be paid by the +ystem during such a disability an income beneft euivalent to the
income beneft for permanent total disability.
%b& "he beneft shall be paid for not more than the period designated
in the following schedule8
.EAT4
SECTION 1. Con2ition to entitlement
%a& "he benefciaries of a deceased employee shall be entitled to an income beneft if all of
the following conditions are satisfed8
%1& "he employee has been duly reported to the +ystem6
%7& Fe died as a result of an injury or sickness6 and
%.& "he +ystem has been duly notifed of his death, as well as the injury or sickness which
caused his death. Fis employer shall be liable for the beneft if such death occurred before
the employee is duly reported for coverage to the +ystem.
%b& -f the employee has been receiving monthly income beneft for permanent total
disability at the time of his death, the surviving spouse must show that the marriage has
been validly subsisting at the time of his disability.
SECTION !. -eio2 o5 entitlement.
*. For Primary Benefciaries:
%a& "he income beneft shall be paid beginning at the month of death and shall continue to
be paid for as long as the benefciaries are entitled thereto.
%b& "he monthly income beneft shall be guaranteed for fve years which in no case shall
be less than ffteen thousand pesos %=14, ))).))&. "hereafter, the benefciaries shall be
paid the monthly income beneft for as long as they are entitled thereto. %'// :esolution
@o. 7322, 0uly 74, 12BD&.
E. For Secondary Benefciaries:
%a& "he income beneft shall be sixty %()& times the monthly income beneft of a primary
benefciary which in no case be less than = 14,))).)), which shall likewise be paid in
monthly pension. %'// :esolution @o. 7322, 0uly 74, 12BD&.
SECTION #. Amount o5 3ene6t
%a& -n the case of primary benefciaries, the monthly income beneft shall be euivalent to
the monthly income beneft for permanent total disability, which shall be guaranteed for
fve years, increased by ten percent for each dependent child but not exceeding 4,
beginning with the youngest and without substitution8
-o*i2e2 T7at8 "he aggregate monthly beneft payable in the case of the ,+-+ shall in no
case exceed the monthly wage or salary actually received by the employee at the time of
his death6 and -o*i2e2 &ut7e8 "hat the minimum income beneft shall not be less than
Gifteen
"housand =esos %=14,))).))&. "he death beneft shall be paid during the entire period for
which they are entitled there to.-f the employee has been receiving income benefts for
permanent
total disability at the time of his death, the primary benefciaries shall be paid the
monthly income beneft euivalent to eighty percent plus the dependent!s pension
euivalent to 1) percent thereof for every dependent child but not exceeding fve counted
from the youngest and without substitution.
%b& -n the case of secondary benefciaries, the income beneft is payable in monthly
pension which shall not exceed the period of () months and the aggregate income beneft
shall not be less than =14,
))).)). -f the employee has been receiving monthly income beneft for permanent total
disability at the time of his death, the secondary benefciaries shall be paid the monthly
pension, excluding the dependent!s pension of the remaining balance of the fve year
guaranteed period. %'//
:esolution @o. 7322, 0uly 74, 12BD&.
RULE 9IV - &UNERAL /ENE&IT
SECTION 1. Entitlement to 5uneal 3ene6t. - * funeral beneft of "hree "housand
%=.,))).))& =esos shall be paid upon the death of a covered employee or permanently
totally disabled pensioner to one of
the following8
%a& the surviving spouse6 or
%b& the legitimate child who spent for the funeral services6 or
%c& any other person who can show incontrovertible proof or proof of his having borne the
funeral expenses. %'// :esolution @o. .(B7, 0uly 71, 12B3&.
Note: ECC Res. No. 92-07-0032, dated !"y #, $992 increased t%e
&!nera" 'eneft to (ri)ate sector to ei*%t t%o!sand (esos +P#,000, e-ecti)e
.ay $, $992.
RULE 9V - /ENE&ICIARIES
SECTION 1. .e6nition
%a& Eenefciaries shall be either primary or secondary, and determined at the time of
employees death.
%b& "he following benefciaries shall be considered primary8
%1& "he legitimate spouse living with the employee at the time of the employees death
until he remarries6 and
%7& Cegitimate, legitimated, legally adopted or acknowledged natural children, who are
unmarried not gainfully employed, not over 71 years of age, or over 71 years of age
provided that he is incapacitated and incapable of self - support due to physical or mental
defect which is congenital or acuired during minority6 =rovided, further, that a dependent
acknowledged natural child shall be considered as a primary benefciary only when there
are no other dependent children who are ualifed and eligible for monthly income beneft6
provided fnally, that if there are two or 47 more acknowledged natural children, they shall
be counted from the youngest and without substitution,
but not exceeding fve. %'// :esolution @o. 7322, 0uly 74, 12BD&.
%c& "he following benefciaries shall be considered secondary8
%1& "he legitimate parents wholly dependent upon the employee for regular support6
%7& "he legitimate descendants and illegitimate children who are unmarried, not gainfully
employed, and not over 71 years of age, or over 71 years of age provided that he is
incapacitated and incapable of self - support due to physical or mental defect which is
congenital or acuired during minority.
SECTION !. -ioity.
%a& =rimary benefciaries shall have priority claim to death beneft over secondary
benefciaries. Whenever there are primary benefciaries, no death beneft shall be paid to
his secondary benefciaries.
%b& -f the deceased employee has no primary benefciaries at the time of his death, the
death beneft shall be paid to his secondary benefciaries.
%c& -f the deceased employee has no benefciaries at the time of his death, the death
beneft shall accrue to the 'mployees /ompensation fund.
SECTION #. - =rimary benefciaries shall be entitled to a monthly income beneft. -n their
absence, the secondary benefciaries shall be entitled to a monthly income beneft not to
exceed () months and the death beneft shall not be less than =14,))).)). %'//
:esolution @o. 7322 dated 0uly 74, 12BD&.

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