How to Apply for SSS Sickness Benefit Online (2024 Updated Guide) (2024)

Sickness is an unavoidable part of life, and it happens no matter how good we are at taking care of our bodies. That is why health insurance is so important – it helps defray the costs of medical treatment and hospitalization when sickness inevitably strikes.

In the Philippines, the state-run Philippine Health Insurance Corporation (PhilHealth) provides comprehensive health insurance coverage and benefits to millions of Filipinos. For a small monthly premium, PhilHealth members can avail of a wide range of medical and financial benefits during times of sickness and hospitalization.

However, there is another government agency that can also help you if and when you get sick. The Social Security System (SSS) offers sickness benefits to members who miss time from work due to illness or injury. You can apply for these benefits as long as you’re an active SSS member and can provide proof of your illness and/or hospitalization (e.g. a medical certificate).

When I got sick and had to spend a few days in the hospital, I became worried about my hospital bills. Good thing that I have PhilHealth and HMO insurance that significantly reduced my medical expenses. I also applied for sickness benefits as I’m a voluntary, self-paying member of the SSS.

You, too, can apply for SSS sickness benefits to reduce your medical expenses and to compensate for lost income due to your absence from work. You don’t need to visit the SSS office because you can apply online using your computer or smartphone.

SSS Sickness Benefit Eligibility and Qualifications

To be eligible to avail of SSS sickness benefits, you must meet the following qualifications:

• You’re unable to work due to sickness or injury,
• You were confined either at home or in the hospital for at least four (4) days,
• You have paid at least three (3) months worth of contributions within the 12-month period before the semester of sickness or injury,
• You have used up all company sick leaves with pay for the current year and you have notified your employer, and
• You have directly notified the SSS by filing a sickness benefit application if you are separated from employment, self-employed, OFW, or voluntary member.

SSS Sickness Benefit Documentary Requirements

These are the documentary requirements that you will need to submit when applying for SSS sickness benefits online:

• SS Medical Certificate (MED-01688) or attending physician’s personal medical certificate with the following information:
  • Name of attending physician,
  • PRC license number (not required if physician is practicing abroad),
  • Clinic address and/or contact information (such as landline or mobile number),
  • Diagnosis, and
  • Recommended number of days of convalescence including recuperation.
• Other medical documents, medical records and hospital records, such as:
  • Hospital abstract,
  • Discharge summary,
  • Laboratory results,
  • Record of operation,
  • Histopathology report,
  • Chest X-ray result,
  • X-ray result of affected part (for fracture),
  • MRI/CT scan result, or
  • ECG/2D echo result.

Take note that only the medical certificate is required to claim sickness benefits. However, other medical documents such as the hospital abstract and laboratory results can also be submitted to support your application.

SSS Sickness Benefit Online Application Process

This tutorial is intended for SSS self-employed, OFW and voluntary members who wish to avail of their SSS sickness benefits through the SSS online membership portal. Employed members may coordinate with their company’s HR department for the processing of their sickness benefit claims.

Step 1: Login to your SSS account

The first thing you need to do is to login to your SSS member account. If you don’t have an account yet, read this article to learn how to register and activate your account.

Open the SSS member portal website at https://member.sss.gov.ph and sign in using your user ID and password.

Step 2: Proceed to the SSS sickness benefit application page

Once logged in to your SSS account, click “BENEFITS” on the menu bar and then select “Apply for Sickness Benefit.”

Step 3: Review and confirm your membership details

On the sickness benefit application page, review your membership details including your home/mailing address, mobile number, landline number, email address, and disbursem*nt account number.

If your contact details are incorrect or outdated, select “Click here to update contact information” to change them. Read this article to learn how to update your SSS membership information.

If you don’t have an enrolled disbursem*nt account yet, select “Click here to update disbursem*nt account” and add your bank account. Make sure that your disbursem*nt account name is the same as your SSS-registered name.

Click “Proceed” to continue to the application form.

Step 4: Fill out the SSS sickness benefit application form

To be approved for sickness benefits, you’ll need to provide honest and accurate details of your sickness and/or hospitalization.

Enter the following details in the SSS sickness benefit online application form:

1. Start of Sickness – Indicate the date (in MM/DD/YYYY format) when you started feeling sick. You may click the calendar icon to use the date picker tool.
2. Confinement Location – Select “Home” if you’re confined at home or “Hospital” if you were admitted to the hospital. Check “Still Confined” if you’re currently confined in the hospital.
3. Date of Discharge (For Hospital Confinement) – Indicate the date (in MM/DD/YYYY format) when you were discharged from the hospital.
4. No. of Days Claimed – Enter the number of days that you were confined at home or in the hospital.
5. License No. of Attending Physician – Enter the license number of your attending physician. You can find your doctor’s license number in your medical certificate.
6. Physician is from abroad / Dentist – Choose “Physician is from abroad” if your doctor is based outside the Philippines, or “Dentist” if your physician is a dentist.
7. Work-Related – Select “Yes” if your sickness is related to (or caused by) your work. Otherwise, choose “No.”
8. Disbursem*nt Account Enrolled – Select your preferred disbursem*nt account where the cash benefit will be deposited. Read this article to learn how to enroll a disbursem*nt account.
9. Were you an employed member at the time of sickness? – Choose “Yes” if you were an employed member during your illness. Otherwise, select “No” (freelancers and self-employed members should select this option).

After filling out the form, click “Proceed” to continue with your application.

Step 5: Upload your medical documents

Now it’s time to upload your medical certificate and hospital/medical records (if available). Refer to this section for the complete documentary requirements.

Only colored images/photos or PDF files are accepted. You can use your phone’s camera to take a photo of your documents or have it scanned by a scanner or an all-in-one printer.

The maximum file size that you can upload is 3MB. If your photo is larger than 3MB, you can either resize it or use TinyPNG to compress it.

Make sure that your scanned or photographed documents are clear and readable with good image quality. Otherwise, your sickness benefit application might be rejected.

Click the “Choose Document” button and select the file to attach to your application. Take note that only the medical certificate is required, but you can also upload your hospital/medical records to support your claim.

After uploading your documents, review your application details to ensure that they are correct and accurate to the best of your knowledge. If there’s incorrect information, press the Back button of your browser or click “Cancel.”

Check the box indicating your agreement with the certification statement, and then click the “I Certify and Submit” button.

Step 6: Submit your application

An alert box will appear with the message: “This action will send the supplied information to SSS. Do you want to continue?”

Click “OK” to submit your SSS sickness benefit application.

Step 7: Your sickness benefit application has been submitted

Congratulations! You have submitted your sickness benefit application to SSS. It will be forwarded to the SSS Medical Evaluation Center for review and subsequent approval.

Take note of your transaction number as you might need it when inquiring about your application. A confirmation email will also be sent to your registered email address.

You will receive another email when your application is approved. Processing of the sickness benefit claim will begin once your application has been approved by the SSS Medical Evaluation Center.

In most cases, your cash benefit will be deposited in your disbursem*nt account within 7 working days from the approval of your application.

How to Compute Your SSS Sickness Benefit

So how do you compute the amount of SSS sickness benefit that you can claim? According to the SSS, the amount of a member’s daily sickness benefit is equivalent to 90% of the average daily salary credit (ADSC).

To compute your SSS sickness benefit amount, just follow these steps:

1. First, exclude the semester of contingency, which refers to two (2) consecutive quarters ending in the quarter of sickness (a quarter is equivalent to three (3) consecutive months ending in March, June, September, and December).
2. Count backwards for twelve (12) months starting from the month immediately before the semester of contingency.
3. Select the six (6) highest monthly salary credits (MSC) within the 12-month period, and add them all to get the total monthly salary credit. Read this article to know the SSS contribution table and monthly salary credits.
4. Divide the total monthly salary credit by 180 days to get the average daily salary credit (ADSC).
5. Multiply the ADSC by 0.90 (90%) to get the daily sickness allowance.
6. Finally, multiply the daily sickness allowance by the number of days claimed to get the total amount of sickness benefit.

For example, if you were sick in August 2023 for 14 days, the semester of contingency is April to September 2023 (since the quarter of sickness is July to September 2023). Counting backwards for 12 months, the 12-month period for the counting of monthly salary credits (MSC) is April 2022 to March 2023.

Now let’s say that your six (6) highest MSCs are ₱16,000, ₱16,000, ₱16,000, ₱15,000, ₱15,000, and ₱14,000. Adding them all up results in a total MSC of ₱92,000.

Divide the total MSC of ₱92,000 by 180 days to get the average daily salary credit (ADSC) of ₱511.

Then, multiply the ADSC of ₱511 by 0.90 (90%) to get the daily sickness allowance of ₱460.

To compute the amount of sickness benefit that you can claim, multiply the daily sickness allowance of ₱460 by 14 days (which is the number of days you were sick). The total amount of sickness benefit allowance that you will receive is ₱6,440.

Frequently Asked Questions

How many days can I claim my SSS sickness benefit?

For hospital confinement, you may submit your SSS sickness benefit application within one (1) year from the date of discharge. For home confinement, you may file your claim within five (5) days after the start date of confinement.

OFW members are given a 30-day grace period beyond the five-day prescriptive filing period. This grace period applies only to cases that don’t require hospital confinement.

Note: If the last day of filing coincides with a Saturday, Sunday, or holiday, you may still file your SSS sickness benefit claim on the next working day.

What happens if I was late in filing my sickness benefit claim?

In case you failed to submit your sickness claim application within the prescribed filing period, your benefits may be reduced or denied.

If you notify the SSS after the five-day filing period for home confinement, your confinement will be adjusted to start not more than five (5) days before the date of notification.

For example, a member was confined at home from February 1 to 15, and the application was submitted on February 9 (three days late). In this case, the prescribed filing period is February 2 to 6. Therefore, the confinement period is adjusted to February 4 to 15 for a total of 12 days.

What is the maximum number of days that I can claim sickness benefits for?

You may claim SSS sickness benefits for up to 120 days in a single calendar year. However, sickness benefits will only be paid for a maximum of 240 days for the same sickness, regardless of the number of years. Beyond 240 days, the claim will be deemed a disability claim.

How many days will my sickness benefit application be approved?

Typically, it may take anywhere from a few days to several weeks for your SSS sickness benefit application to be approved, depending on the completeness of your documents and the complexity of your case.

How long does it take for the cash benefit to be deposited to my disbursem*nt account?

In most cases, it will take 5-7 working days from the approval of your application for your cash benefit allowance to be deposited to your chosen disbursem*nt account.

How can I add a disbursem*nt account?

You can enroll a disbursem*nt account by logging in to your SSS account and selecting Services > Disbursem*nt Modules > Disbursem*nt Account Enrollment Module. Read this article to learn how to add a disbursem*nt account in SSS.

Wrapping Up

During sickness, most of us need all the help we can get to reduce our medical expenses. Good thing that the SSS provides its members with sickness benefits to somewhat compensate for the costs of treatment and hospitalization as well as the loss of income. Make sure that you’re also an active and paying member of PhilHealth so that your hospital bills are reduced even further.

That’s it! I hope that you’ve found this guide useful and don’t forget to share this article with your friends who might want to learn how to file for their SSS sickness benefits online. If you have any questions and concerns, you may reach out to the SSS by calling (02) 8841-8600 or emailing [emailprotected].