Workers Compensation and Rehabilitation
Content
What is SOCSO?
SOCSO or the Social Security Organization is an organization that has been established to administer, enforce and implement the Employees¶ Social Security Act, 1969 and the Employees¶ Social Security (General) Regulations 1971. It provides protection social security by social insurance including medical and cash benefits, provision of artificial aids and rehabilitation to employees to reduce the sufferings and to provide financial guarantees and protection to the family. SOCSO administer two types of social protection schemes which are the Employment Injury Insurance Scheme and Invalidity Pension Scheme. The Employment Injury Insurance Scheme provides protection to employees who are involved in accidents arising out of and in the course of his employment occupational diseases and also commuting or dies irrespective of the cause of death. The other aim is to ensure payments are made to workers and dependants when unexpected incident occurs. The functions include registration of employer and employees, collecting contribution, processing benefits claims and make payment to the injured worker and their dependents. It also provides vocational and physical rehabilitation benefits and enhances occupational safety and health awareness of workers.
What category of people covers under this act?
In the Employees¶ Social Security Act, Section 5 stated that employee who is any person who is employed for wages under a contract of service or apprenticeship with an employer whether the contract is expressed or implied or is oral or in writing, on or in connection with the work of an industry to which this act applies which are firstly, a person who is employed by the principal employer on any work in any workplace. Secondly, a person who is employed by or through an immediate employer on the premises of the industry or under the supervision of the principal employer which is preliminary to the work carried on in or incidental to the purpose of the industry or thirdly, whose services are temporarily lent or let on hire to principal employer by the person or agent. In other word, an employee who employed under a contract of service or apprenticeship and earning a monthly wages of RM3,000 and below must compulsorily register and contribute to SOCSO regardless of the employment status whether it is permanent, temporary or casual in nature. The employee must be registered with the SOCSO irrespective of the age, it also covers Malaysian workers and permanent residents. In the nutshell, foreign workers are protected under the Workmen¶s Compensation Act 1952. However, these category of people are not covered by the SOCSO which are a person whose wages exceed RM3,000 a month and has never been covered before. Second, government employees. Next, domestic servants employed to work in a private dwelling house which includes a cook, gardeners, house servants, watchman, washer
woman and driver. Fourth, employees who have attained the age of 55 only for purposes of invalidity but if they continue to work they should be covered under the Employment Injuries Scheme. Next, self±employed persons and lastly, the foreign workers.
What are the conditions to entitle person to claim the compensation under this scheme?
Employment Injury Insurance Scheme Employment Injury Insurance Scheme provides protection to employees who suffer from accidents arising from work. It means personal injury to an employee caused by accident or an occupational disease arising out of and in the course of employment in an industry to which this act applies. The condition to entitle the claim are the accidents that occurred the employee must be at the workplace that caused by the employee¶s job. Second, while traveling the employee is involved in an accident where the route must be between his place of residence and his workplace. The route between his workplace and his place where his takes his meal during any authorized recess. Lastly, on the journey to any place for any reason which is directly connected to his employment, however, on the condition the accident does not occur during any interruption or deviation of the journey. Thirdly, an accident that occurred during an emergency in the employer¶s premises while in the course of assisting, rescuing, or protecting other people from the disasters such as fire breakout. The last condition is the occupational disease which results from his occupation and the list of the diseases and cause agent can be found in the 5th Schedule of the Employee¶s Social Security Act, 1969. For example, poison by lead or compound of lead or being poison by the arsenic chemical.
The benefits provided under this scheme are medical benefit, temporary disablement benefit, permanent disablement benefit, constant attendance allowance, rehabilitation benefit, dependent¶s benefit, funeral benefit and education benefit. MEDICAL BENEFIT Medical benefit protects employees who meet with an accident or suffers from an occupational disease. They are entitled to free treatment at SOCSO panel clinic or government hospital. When they do receive treatment from the panel clinic, they must continue the treatment there until fully recovers. Transferring of treatment place to a government hospital can only be made if referred by the panel clinic. If seriously injured, the treatment should be obtained at a government hospital and the employee is eligible for second class ward treatment and specialist will be provided if required. To claim the benefit, firstly we must apply and receive the medical benefits for the first time; the following documents must be completed and submitted to a SOCSO panel clinic. The form that required to fill are form 21 (accident report), form PKS 68 or 69 (Occupational Disease Report) or (Identification Letter from employer).
TEMPORARY DISABLEMENT BENEFIT This benefit is paid on employee who has been certified by a doctor to be unfit for work for not less than four days including the day of the accident. It is paid for the period the employee is on medical leave. The rate of daily benefit to be paid is 80% of the average assumed daily wage. A minimum of RM10.00 per day for the employees who earn less than RM10.00 per day and a maximum of RM78.67 per day for employee that earns more than RM2, 900.00 per month. To claim the benefit, it can be made by submitting the following documents: Form 21 (Accident Report) Form 10 (Claim Form) Doctor's Certification (Form 13) or the original copy of the Medical Certificate A copy of Identity Card Attendance Record/Punch Card/Employer Certification Form PKS (F) 1 (Statement of Wages/Contribution details) For accidents which occur while commuting, please also submit the following: Police Report Sketch map of place of accident
For Occupatioal Disease claims may be made by submitting the following documents: Form 68 (if the employee is still working) Form 69 (if the employee has stopped working)
Original copy of the Medical Certificate (if any) Form 10 (if there is any medical leave) Completed forms and documents must be submitted to the SOCSO office where the employer was registered. The employer must report an accident within 48 hours and any report received later than 12 months will not be entertained. PERMANENT DISABLEMENT BENEFIT The employee is unable to work for a long time due to an employment injury. He or she may continue to work while receiving the benefit. The duration to claim must be made within 12 months from the date of final Medical Certificate issued. The rate of daily benefit is 90% of the average assumed daily wage of the insured and subject to a minimum of RM10.00 per day and a maximum of RM88.50 per day. To claim the benefit, the insured must submit a written application to the relevant SOCSO office for reference to the Medical Board including the following documents: Application Form A copy of Identity Card Medical Report (from hospital/clinic which treated him) Form 10 (Claim Form) Form PKS (F) 1 (Statement of Wages/Contribution details) A copy of the savings account book for direct payment of benefits.
CONSTANT ATTENDANCE ALLOWANCE This allowance is paid to an employee who is suffering from permanent total disablement (i.e. 100% loss of earning capacity), and is so severely incapacitated that he constantly requires the personal attendance of another person. The allowance is equal to 40% of the rate of permanent total disablement benefit subject to a maximum of RM500/-. Eligibility for this allowance is determined by the Medical Board or the Appellate Medical Board and the payment is made directly to the recipient of the benefit. REHABILITATION BENEFIT Services for occupational and bodily rehabilitation are provided at no cost by SOCSO to an employee who suffers from permanent disablement.
1. Physical rehabilitation includes: Physiotherapy Occupational therapy Reconstructive surgery Supply of artificial limbs such as artificial leg, hand, eye and dentures Supply (as well as repair and replace) of other orthotic equipments such as wheelchairs, crutches, hearing aids, spectacles, calipers and orthopedic shoes Return to Work
2. Occupational Programme rehabilitation includes: Occupational training in courses such as electrical wiring, tailoring, radio/TV repairs, metal trade, refrigerator and air-conditioner repairs, plumbing, typing and secretarial work. DEPENDENTS BENEFIT This benefit is applied when the employee dies cause by employment injury. The rate of benefit to be paid is 90% of the average assumed daily wage. A minimum rate is RM10.00 for employees who earn less than RM 10.00 per day and a maximum of RM88.50 per day. To claim, the claimant must submit: Claim Form (Form 24) Death Certificate of the employee Birth Certificates of all the children Marriage Certificate Widow/widower's Identity Card (whichever relevant) A copy of the savings account book of the claimant
Allocation of the benefit The following is the allocation of share based on priority: Divide on full Dependant daily rate Receives benefit for life even though widow or widower Widow or widower 3/5 remarries on or after 1st May 2005 Children - All eligible children are entitled to receive benefit which includes natural, dependant stepchild, adopted child or a child out of wedlock 2/5 Receives benefit up to age 21 or marriage whichever occurs studying in a institute of higher learning, he/she will receive benefit up to completion of the first Degree or marriage (whichever occurs earlier). If a child is mentally retarded or physically handicapped and is unable to support himself, the benefit will be paid as long as the child is unable to support himself. Condition
If the Insured dies and doesn't leave any widow or widower or children, the dependent's benefit will be paid to: Divide on Dependant full daily rate Parents 4/10 Receive benefit for life Receive benefit up to age 21 or Brothers and sisters 3/10 marriage (whichever occurs earlier) Grandparents (If parents have 4/10 pass) Receive benefit for life Condition
If there is no widow, widower or eligible children, the claimant must submit: Claim Form (Form 24) Death Certificate of the employee Birth Certificates of the deceased employee Birth Certificates of all brothers and sisters (if relevant) Identity Card of parents or guardian or grandparents (if relevant) A copy of the savings account book of the claimant
FUNERAL BENEFIT The benefit is to be paid if an employee dies cause by the employment injury or while receiving disablement benefit and the payments will be made to the eligible next of kin. If there is no next of kin, the benefit will be paid to the person who incurred or RM1, 500 whichever is lower. The amount to be paid to the employee is RM1, 500. To claim, apply and receive the benefit, these documents must be fill and submitted: Claim Form (Form 26) Death Certificate Other relevant documents which certifies the next of kin EDUCATION BENEFIT The dependent children of an employee who is in receipt of SOCSO's monthly benefit for Permanent Disability, Invalidity Pension or Survivor's Pension may apply for this education benefit.
The second scheme is the Invalidity Pension Scheme which is defined as a serious disablement or morbid condition of a permanent nature that is either incurable or not likely to be cured; as a result the employee is unable to earn at least 1/3 of what a normal able person could earn.
REFERENCES
1. Employees Social Security Act 1969. Retrieved June 30 2011, from the World Wide Web:
http://www.agc.gov.my/Akta/Vol.%201/Act%204.pdf
2. SOCSO. Retrieved June 30 2011, from the World Wide Web: http://www.perkeso.gov.my/ 3. Malaysian Labour Law: Regulation of Employment. Retrieved from June 30 2011, from the
World Web:http://www.jobsdb.com.ph/MY/EN/V6HTML/JobSeeker/handbook/regulation-ofemployment/SOCSO_4.htm Wide
4. Social Security Organization. The Lawyerment. Retrieved from June 30 2011, from the World
Wide Web: http://www.lawyerment.com.my/library/doc/empl/socso/1000000-1.shtml
SOCSO or the Social Security Organization is an organization that has been established to administer, enforce and implement the Employees¶ Social Security Act, 1969 and the Employees¶ Social Security (General) Regulations 1971. It provides protection social security by social insurance including medical and cash benefits, provision of artificial aids and rehabilitation to employees to reduce the sufferings and to provide financial guarantees and protection to the family. SOCSO administer two types of social protection schemes which are the Employment Injury Insurance Scheme and Invalidity Pension Scheme. The Employment Injury Insurance Scheme provides protection to employees who are involved in accidents arising out of and in the course of his employment occupational diseases and also commuting or dies irrespective of the cause of death. The other aim is to ensure payments are made to workers and dependants when unexpected incident occurs. The functions include registration of employer and employees, collecting contribution, processing benefits claims and make payment to the injured worker and their dependents. It also provides vocational and physical rehabilitation benefits and enhances occupational safety and health awareness of workers.
What category of people covers under this act?
In the Employees¶ Social Security Act, Section 5 stated that employee who is any person who is employed for wages under a contract of service or apprenticeship with an employer whether the contract is expressed or implied or is oral or in writing, on or in connection with the work of an industry to which this act applies which are firstly, a person who is employed by the principal employer on any work in any workplace. Secondly, a person who is employed by or through an immediate employer on the premises of the industry or under the supervision of the principal employer which is preliminary to the work carried on in or incidental to the purpose of the industry or thirdly, whose services are temporarily lent or let on hire to principal employer by the person or agent. In other word, an employee who employed under a contract of service or apprenticeship and earning a monthly wages of RM3,000 and below must compulsorily register and contribute to SOCSO regardless of the employment status whether it is permanent, temporary or casual in nature. The employee must be registered with the SOCSO irrespective of the age, it also covers Malaysian workers and permanent residents. In the nutshell, foreign workers are protected under the Workmen¶s Compensation Act 1952. However, these category of people are not covered by the SOCSO which are a person whose wages exceed RM3,000 a month and has never been covered before. Second, government employees. Next, domestic servants employed to work in a private dwelling house which includes a cook, gardeners, house servants, watchman, washer
woman and driver. Fourth, employees who have attained the age of 55 only for purposes of invalidity but if they continue to work they should be covered under the Employment Injuries Scheme. Next, self±employed persons and lastly, the foreign workers.
What are the conditions to entitle person to claim the compensation under this scheme?
Employment Injury Insurance Scheme Employment Injury Insurance Scheme provides protection to employees who suffer from accidents arising from work. It means personal injury to an employee caused by accident or an occupational disease arising out of and in the course of employment in an industry to which this act applies. The condition to entitle the claim are the accidents that occurred the employee must be at the workplace that caused by the employee¶s job. Second, while traveling the employee is involved in an accident where the route must be between his place of residence and his workplace. The route between his workplace and his place where his takes his meal during any authorized recess. Lastly, on the journey to any place for any reason which is directly connected to his employment, however, on the condition the accident does not occur during any interruption or deviation of the journey. Thirdly, an accident that occurred during an emergency in the employer¶s premises while in the course of assisting, rescuing, or protecting other people from the disasters such as fire breakout. The last condition is the occupational disease which results from his occupation and the list of the diseases and cause agent can be found in the 5th Schedule of the Employee¶s Social Security Act, 1969. For example, poison by lead or compound of lead or being poison by the arsenic chemical.
The benefits provided under this scheme are medical benefit, temporary disablement benefit, permanent disablement benefit, constant attendance allowance, rehabilitation benefit, dependent¶s benefit, funeral benefit and education benefit. MEDICAL BENEFIT Medical benefit protects employees who meet with an accident or suffers from an occupational disease. They are entitled to free treatment at SOCSO panel clinic or government hospital. When they do receive treatment from the panel clinic, they must continue the treatment there until fully recovers. Transferring of treatment place to a government hospital can only be made if referred by the panel clinic. If seriously injured, the treatment should be obtained at a government hospital and the employee is eligible for second class ward treatment and specialist will be provided if required. To claim the benefit, firstly we must apply and receive the medical benefits for the first time; the following documents must be completed and submitted to a SOCSO panel clinic. The form that required to fill are form 21 (accident report), form PKS 68 or 69 (Occupational Disease Report) or (Identification Letter from employer).
TEMPORARY DISABLEMENT BENEFIT This benefit is paid on employee who has been certified by a doctor to be unfit for work for not less than four days including the day of the accident. It is paid for the period the employee is on medical leave. The rate of daily benefit to be paid is 80% of the average assumed daily wage. A minimum of RM10.00 per day for the employees who earn less than RM10.00 per day and a maximum of RM78.67 per day for employee that earns more than RM2, 900.00 per month. To claim the benefit, it can be made by submitting the following documents: Form 21 (Accident Report) Form 10 (Claim Form) Doctor's Certification (Form 13) or the original copy of the Medical Certificate A copy of Identity Card Attendance Record/Punch Card/Employer Certification Form PKS (F) 1 (Statement of Wages/Contribution details) For accidents which occur while commuting, please also submit the following: Police Report Sketch map of place of accident
For Occupatioal Disease claims may be made by submitting the following documents: Form 68 (if the employee is still working) Form 69 (if the employee has stopped working)
Original copy of the Medical Certificate (if any) Form 10 (if there is any medical leave) Completed forms and documents must be submitted to the SOCSO office where the employer was registered. The employer must report an accident within 48 hours and any report received later than 12 months will not be entertained. PERMANENT DISABLEMENT BENEFIT The employee is unable to work for a long time due to an employment injury. He or she may continue to work while receiving the benefit. The duration to claim must be made within 12 months from the date of final Medical Certificate issued. The rate of daily benefit is 90% of the average assumed daily wage of the insured and subject to a minimum of RM10.00 per day and a maximum of RM88.50 per day. To claim the benefit, the insured must submit a written application to the relevant SOCSO office for reference to the Medical Board including the following documents: Application Form A copy of Identity Card Medical Report (from hospital/clinic which treated him) Form 10 (Claim Form) Form PKS (F) 1 (Statement of Wages/Contribution details) A copy of the savings account book for direct payment of benefits.
CONSTANT ATTENDANCE ALLOWANCE This allowance is paid to an employee who is suffering from permanent total disablement (i.e. 100% loss of earning capacity), and is so severely incapacitated that he constantly requires the personal attendance of another person. The allowance is equal to 40% of the rate of permanent total disablement benefit subject to a maximum of RM500/-. Eligibility for this allowance is determined by the Medical Board or the Appellate Medical Board and the payment is made directly to the recipient of the benefit. REHABILITATION BENEFIT Services for occupational and bodily rehabilitation are provided at no cost by SOCSO to an employee who suffers from permanent disablement.
1. Physical rehabilitation includes: Physiotherapy Occupational therapy Reconstructive surgery Supply of artificial limbs such as artificial leg, hand, eye and dentures Supply (as well as repair and replace) of other orthotic equipments such as wheelchairs, crutches, hearing aids, spectacles, calipers and orthopedic shoes Return to Work
2. Occupational Programme rehabilitation includes: Occupational training in courses such as electrical wiring, tailoring, radio/TV repairs, metal trade, refrigerator and air-conditioner repairs, plumbing, typing and secretarial work. DEPENDENTS BENEFIT This benefit is applied when the employee dies cause by employment injury. The rate of benefit to be paid is 90% of the average assumed daily wage. A minimum rate is RM10.00 for employees who earn less than RM 10.00 per day and a maximum of RM88.50 per day. To claim, the claimant must submit: Claim Form (Form 24) Death Certificate of the employee Birth Certificates of all the children Marriage Certificate Widow/widower's Identity Card (whichever relevant) A copy of the savings account book of the claimant
Allocation of the benefit The following is the allocation of share based on priority: Divide on full Dependant daily rate Receives benefit for life even though widow or widower Widow or widower 3/5 remarries on or after 1st May 2005 Children - All eligible children are entitled to receive benefit which includes natural, dependant stepchild, adopted child or a child out of wedlock 2/5 Receives benefit up to age 21 or marriage whichever occurs studying in a institute of higher learning, he/she will receive benefit up to completion of the first Degree or marriage (whichever occurs earlier). If a child is mentally retarded or physically handicapped and is unable to support himself, the benefit will be paid as long as the child is unable to support himself. Condition
If the Insured dies and doesn't leave any widow or widower or children, the dependent's benefit will be paid to: Divide on Dependant full daily rate Parents 4/10 Receive benefit for life Receive benefit up to age 21 or Brothers and sisters 3/10 marriage (whichever occurs earlier) Grandparents (If parents have 4/10 pass) Receive benefit for life Condition
If there is no widow, widower or eligible children, the claimant must submit: Claim Form (Form 24) Death Certificate of the employee Birth Certificates of the deceased employee Birth Certificates of all brothers and sisters (if relevant) Identity Card of parents or guardian or grandparents (if relevant) A copy of the savings account book of the claimant
FUNERAL BENEFIT The benefit is to be paid if an employee dies cause by the employment injury or while receiving disablement benefit and the payments will be made to the eligible next of kin. If there is no next of kin, the benefit will be paid to the person who incurred or RM1, 500 whichever is lower. The amount to be paid to the employee is RM1, 500. To claim, apply and receive the benefit, these documents must be fill and submitted: Claim Form (Form 26) Death Certificate Other relevant documents which certifies the next of kin EDUCATION BENEFIT The dependent children of an employee who is in receipt of SOCSO's monthly benefit for Permanent Disability, Invalidity Pension or Survivor's Pension may apply for this education benefit.
The second scheme is the Invalidity Pension Scheme which is defined as a serious disablement or morbid condition of a permanent nature that is either incurable or not likely to be cured; as a result the employee is unable to earn at least 1/3 of what a normal able person could earn.
REFERENCES
1. Employees Social Security Act 1969. Retrieved June 30 2011, from the World Wide Web:
http://www.agc.gov.my/Akta/Vol.%201/Act%204.pdf
2. SOCSO. Retrieved June 30 2011, from the World Wide Web: http://www.perkeso.gov.my/ 3. Malaysian Labour Law: Regulation of Employment. Retrieved from June 30 2011, from the
World Web:http://www.jobsdb.com.ph/MY/EN/V6HTML/JobSeeker/handbook/regulation-ofemployment/SOCSO_4.htm Wide
4. Social Security Organization. The Lawyerment. Retrieved from June 30 2011, from the World
Wide Web: http://www.lawyerment.com.my/library/doc/empl/socso/1000000-1.shtml
