STATUTORY BENEFITS – WE SHOULD BE

PROACTIVE Dato’ Seri Dr T Devaraj

Penang Hospice Society

SOCIAL SECURITY ORGANISATION (SOCSO)

Employees have to be protected by social insurance to

reduce their suffering and to provide financial guarantees

and protection to the family as a whole

SOCSO set up in 1971 to implement, administer, enforce

• Employees’ Social Security Act 1969

• Employees’ Security (General) Regulations 1971

EMPLOYER’S LIABILITY

EMPLOYEE

EMPLOYER

who employs one or more employees

register and contribute monthly from first month

EMPLOYEE

a person employed by an employer

Malaysian citizens or Permanent Residents

earning less than RM3000 monthly

earning more can be covered

“once in always in”

employee must register and contribute

employee identified by IC number

EMPLOYEES EXEMPTED FROM SOCSO’S

COVERAGE

Government employees

Domestic servants

Self-employed persons

Foreign workers

Business owner and spouses of sole-

proprietorship or partnership

TYPES AND CATEGORIES OF

CONTRIBUTIONS

First Category (Employment Injury Scheme and Invalidity

Pension Scheme)

all employees below 55 years of age

contributions by employer and employee

Second Category (Employment Injury Scheme Only)

for employees above 55 years

for employees above 50 years of age when first registered

for this category only employer makes contribution

CONTRIBUTIONS – employer / employee ratio @ 3:1

DEFINITION OF WAGES

All remuneration payable to an employee

salary

overtime payment

commission

payments for leave such as annual, sick, maternity

allowances such as incentive, good behavior, COLA

EMPLOYMENT INJURY INSURANCE SCHEME

“employment injury means personal injury caused by an accident or an occupational disease arising from work”

accidents in course of work accidents while travelling accidents during an emergency occupational disease eg hearing loss, industrial asthma BENEFITS Medical benefit, temporary disablement benefit, permanent

disablement benefit, constant attendance allowance, dependent’s benefit, funeral benefit, rehabilitation benefit, education benefit

INVALIDITY PENSION SCHEME

“a serious disablement or morbid condition of a

permanent nature that is either incurable or not likely to

be cured, as a result of which an employee is unable to

earn at least 1/3 of what a normal able person could earn”

BENEFITS

invalidity pension, invalidity grant, constant attendance

allowance, survivor’s pension, funeral benefit,

rehabilitation benefit, education benefit

INVALIDITY PENSION

Provides 24 hour coverage to an employee against

invalidity due to any cause not connected with his

employment

Chronic ailments or diseases e.g. heart attack, renal

failure, cancer, mental illness, chronic asthma

Paid as long as invalid or dies

If dies pension converted to survivor’s pension

(dependents of employee)

I P – CONDITIONS FOR ELIGIBILITY

Not completed age 55 when notice received by SOCSO

If completed age 55 has to provide proof that his invalidity

occurred before age 55 and he had ceased employment at that

time

Is certified as an invalid by Medical Board or Appellate Medical

Board

Has fulfilled the qualifying contribution conditions - minimum 2

years + covered for an additional 2 times the earlier period”

QUANTUM PENSION – from 50 – 65 % monthly wage with a

minimum of RM250 monthly

INVALIDITY GRANT – employee’s contributions plus interest as

a lump sum

MAKING CLAIM – submit notice of invalidity(PKS(F) 4,

medical report, copy IC

SOME EXAMPLES

1. Peter begins work on 1.1.90 and contributes to SOCSO. In mid 1991 he becomes invalid as a result of cancer. As less than 24 monthly contribution have been received by SOCSO he does not qualify.

2. Ahmad begins work on 1.1.90 and contributes to SOCSO. In mid 1992 he becomes invalid as a result of cancer. As more than 24 monthly contributions have been received by SOCSO he qualifies.

3. Ah Chai begins work on 1.1.90 and contributes to SOCSO till 31.12.92 (Total of 3 years). After that he goes into business and no longer contributes to SOCSO. In mid 1997 he becomes invalid as a result of cancer. He qualifies as contributed for 3 years + covered for a further 6 years i.e. till 31.12.98

SURVIVOR’S PENSION

pension payable to dependents

widow/widower/children or parents/brothers &

sisters or grandparents

rate is same or 50 - 65% of average monthly wage

minimum monthly pension of RM250

• permanent total

disablement

• when constant care

from another person

needed

• approved by Medical

Board or Appellate

Medical Board

• 40% of the Invalidity

Pension rate to a

maximum of RM500

monthly

REHABILITATION BENEFIT

Physical Rehabilitation

• Physiotherapy

• reconstructive surgery

supply, repair, replace

orthotic equipment

• dialysis

• occupational therapy

• artificial limb, dentures

• “return to work

program”

Vocational Rehabilitation

• training in courses e.g. electrical wiring, tailoring, typing

• all expenses incurred will be borne by SOCSO

FURTHER BENEFITS

Funeral

RM1500 to next of kin or person who incurred funeral

expenditure

Education Benefit

dependent children of employee on Invalidity Pension or

Survivor’s Pension may apply

SOME EXAMPLES IN HHP

Cik A, 39 yrs, worked in factory, had breast cancer, RM1000

Encik B, 53 yrs, worked statutory body, died cancer kidney. Wife getting pension RM1000. Daughter getting help for college fees.

Puan C, 53 yrs, factory worker, Guillain- Barre Syndrome, pension RM400, supplied with hospital bed, wheel chair, pampers

Cik D, worked in factory, Ca breast, RM 1000 , wheelchair, pampers

PROCESS FOR MAKING CLAIM

1. Employee must initiate claim with forms from SOCSO

2. He/she has to see a doctor who will prepare medical report

- at Hospital PP it will be ready within a month

- fee for report RM 40

3. SOCSO will then arrange for Medical Board / Appellate Board

4. If approved locally benefit 2 weeks / 4-6 weeks for invalidity

pension as approved in KL

5. To apply for prosthesis / orthotic aids same time or as need arises

6. Constant attendance allowance – further medical report/ M Board

FAILURE TO GET BENEFITS

Employee

unaware or not aware of all the benefits

did not apply or delays in application

failures in contribution by employer

Doctor

delays in advising SOCSO or giving report

not fully aware of all the benefits e.g. pampers, stoma bags, catheters,

nutritional aids

grey area – when patients needs change with time

SOCSO

is it only reactive or also proactive ?

Hospice staff /volunteers

unaware and do not ask patient

Questions to Ask

Is the patient less than 55 years old? Yes/No Was the patient ever employed in private sector

Yes / No If the answer to both questions is yes then the

patient should make a claim at the SOCSO office for invalidity pension

NB. If the patient was employed in the private sector and died before the age of 55 the family should make a claim at the SOCSO office for survivors pension

A QUESTION FOR SOCIETY

SOCSO benefits only apply before age of 55 years

For that one must fall ill or die before age 55 years An employee who gets say cancer when over the age of 55 and

becomes invalid will not be entitled to make any claims from SOCSO

This ruling applies even though an employee has contributed for years. Is this fair?

NB. Claim can be considered if cancer began before 55 yrs and employee stopped working at 55 and then cancer relapsed a few years later.

Does not apply say to DM if organ failure after age 55. Employees sick leave limited unlike Government servants (up to 2

yrs) so if procedures delayed have no sick leave and no benefits

EMPOYEES PROVIDENT FUND ACT 1991

CREDIT IN EPF

divided into sub accounts and can be withdrawn as per

regulations

ADDITIONAL BENEFITS

Incapacitation – physical or mental - RM5000

Death Benefit – dies before 60 yrs - RM2500 paid to

dependents

NB. Problems arise when a members fails to nominate a

beneficiary or change it say when he gets married.

DEATH BENEFITS FROM STATE

GOVERNMENTS

Not statutory

Some state governments only

Only Malaysian residents

Funeral benefits

• ranges from RM1000 to RM2500