APPROVING THE PROCESS CYCLE TIME FOR THE PROCESSING OF CLAIMS FOR EMPLOYEES’ COMPENSATION (EC) AT THE SSS

 

WHEREAS, the ECC is mandated under P.D. No. 626, as amended, to initiate, rationalize and coordinate the policies of the Employees’ Compensation Program (ECP);

WHEREAS, the SSS serves as the implementing agency of the ECP in the private sector;

WHEREAS, the parties have agreed to strengthen its coordination on the evaluation and processing of EC claims for a more effective and efficient implementation of the ECP;

WHEREAS, the ECC, under its Performance Agreement with the Governance Commission for GOCCs for 2015, committed to establish a service level agreement with the SSS in order to mutually agree on a most viable process cycle time for the evaluation of EC claims;

WHEREAS, the ECC and the SSS agreed on the following process cycle time in the evaluation of EC claims, counting from the submission of all required documents up to the release of benefits, as appropriate:

EC Benefit Process Cycle Time
(Working Days)
a. Sickness
1. Notification 5
2. Reimbursement 12
b. Permanent Partial Disability (PPD)
c. Permanent Total Disability (PTD)
23
d. EC Medical Reimbursement 25
e. Rehabilitation Services* 12
f. Funeral Benefit 5
g. Death Pension 33
*Payment Only

WHEREAS, the prescribed process cycle time will benefit PWRDs through a quicker and definite timetable in the evaluation of their claims.

NOW THEREFORE, ON MOTION DULY MADE AND SECONDED,

This Commission RESOLVES AS IT HEREBY RESOLVED to approve the agreed process cycle time on the evaluation of SSS EC claim counting from the submission of all required documents up to the release of benefits, as follows:

EC Benefit Process Cycle Time
(Working Days)
a. Sickness
1. Notification 5
2. Reimbursement 12
b. Permanent Partial Disability (PPD)
c. Permanent Total Disability (PTD)
23
d. EC Medical Reimbursement 25
e. Rehabilitation Services* 12
f. Funeral Benefit 5
g. Death Pension 33
*Payment Only

RESOLVED FURTHER that the Secretariat shall, in close coordination with the SSS, develop a mechanism to monitor compliance to the agreed process cycle time;

RESOLVED FINALLY that a copy of this resolution be furnished to the SSS for information and implementation.

APPROVED in Quezon City, this 3rd day of November 2015.

(SGD.) CIRIACO A. LAGUNZAD
Chairperson-Alternate
Department of Labor and Employment

(SGD.) BRENDA P. VIOLA
Member-Designate
Social Security System                               

(SGD.)ROBERT G. VRGARA
Member
Government Service Insurance System

(SGD.) CARLITO P. ROBLE
Member
Employees’ Sector                                                   

(SGD.) MIGUEL B. VARELA
Member
Employers’ Sector

(SGD.) ALEXANDER A. PADILLA
Member-Designate
Philippine Health Insurance Corporation

(SGD.) STELLA ZIPAGAN-BANAWIS
Member
Employees’ Compensation Commission – Secretariat

 

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