10-18

My sister, a private school teacher, gave birth in January 21, 2016 to a healthy baby boy.  I am not sure if her case can be considered a premature delivery since she gave birth three weeks earlier than her scheduled due date.  Nonetheless, her delivery was uneventful and the baby came out healthy and strong.

Less than two months after she gave birth, my sister suffered from a severe case of skin asthma.  It got so bad that she was even prohibited by her doctor to carry or cuddle her baby.  She also had difficulty breathing at night and whenever she is exposed to smoke and dust.  She was confined in the hospital for five days until her rashes cleared out.

A few days after she was discharged from confinement, she filed her sickness benefit claims from the Social Security System (SSS).  Unfortunately, her claim was denied.  This was puzzling to us as she just recently received her maternity benefits from the SSS; she had no difficulty filing and claiming the proceeds.

We tried calling the SSS but no one seems to be able to give us a plausible answer.  I did my own research and these are my findings:

  1. A female SSS member who has successfully claimed her maternity benefits is no longer eligible to claim other types of benefits within a specified period:
    • A female who gave birth through normal delivery, or had a miscarriage, cannot file for sickness benefits claim within 60 days after childbirth or miscarriage.
    • A female who gave birth through caesarean section cannot file for sickness benefits claim within 78 days after childbirth.
  2. By law, an SSS member may only receive / claim one benefit at a given time.

My sister was able to claim her maternity benefits shortly after her baby turned one month old.  This was the reason why her claim for sickness benefits was denied by the SSS.

When we got hold of this information, my sister was able to clarify her concern better with the SSS.  She was then able to confirm that due to her maternity claim, she is not eligible for sickness benefits claims until after the 60-day prescription period.

Most SSS members may not be aware of this policy and it is best that claimants clarify minor details in their claims in order to avoid confusion later on.

Now you know.

Source:

http://www.facebook.com/SSSPh

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=sicknessapplication

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