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Malaysian Financial Planning Council (MFPC) 12-1 RFP Programme - Module 2 Chapter 12: SOCSO (Social Security) Chapter 12 SOCSO (Social Security) Chapter Objectives Students must be able to: What is SOCSO? The Mission, Goal, Objective and Strategies of SOCSO Who May Qualify? Definition of Employer, Employers’ Liabilities and Wages What is Covered under Employment Injury Insurance Scheme What is Coveredunder Invalidity Pension Scheme The Full and Reduced Qualifying Conditions How to Incorporate The Coverage into the Overall Risk Management Programme.

SOCSO (Social Security) · 2018. 9. 4. · Malaysian Financial Planning Council (MFPC) 12- RFP Programme - Module 2 Chapter 12: SOCSO (Social Security) UNDERSTANDING KEY TERMS UNDER

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  • Malaysian Financial Planning Council (MFPC) 12-1

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Chapter 12

    SOCSO (Social Security)

    Chapter Objectives

    Students must be able to:

    What is SOCSO?

    The Mission, Goal, Objective and Strategies of SOCSO

    Who May Qualify?

    Definition of Employer, Employers’ Liabilities and Wages

    What is Covered under Employment Injury Insurance Scheme

    What is Coveredunder Invalidity Pension Scheme

    The Full and Reduced Qualifying Conditions

    How to Incorporate The Coverage into the Overall Risk Management Programme.

  • 12-2 Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Chapter 12

    SOCSO (Social Security)

    Introduction

    Employees are exposed to various contingencies which can cause hardship in their lives. Accidents which result in disablement or death, occupational diseases and others not only results in problems to the employee but also affects the lives of the dependants. The Malaysian government recognizes the predicament that employees and their families can undergo if a contingent event befalls the employee. Thus, the government created SOCSO to look at creating some social security for employees and their dependents.

    SOCSO was established in 1971 to administer the social security schemes established under the Employees’ Social Security Act (1969) (Act 4), that is the Employment Injury Insurance Scheme and the Invalidity Pension Scheme. Under the scheme, workers are protected against industrial accident including accidents that occur during working, occupational diseases, and invalidity or death due to any cause.

    The main objective of SOCSO is to formulate and provide a comprehensive social security protection for Malaysians and to promote occupational health and safety. In meeting these objectives, SOCSO undertakes:

    • To provide for human resource development.

    • To review the benefit structure of the social security scheme periodically

    • To review the benefit disbursement system under the scheme.

    • To secure and strengthen SOCSO’s funds through prudent financial and investment management.

    • To promote and encourage work safety and health of workers and employers alike.

    In ensuring that SOCSO is able to meet its obligations to its members, it has a quality policy which provides for excellent and fair services to all clients through the development of its process and staff.

  • Malaysian Financial Planning Council (MFPC) 12-�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    UNDERSTANDING KEY TERMS UNDER THE SOCSO SCHEME

    1. EMPLOYER

    The employers under the SOCSO scheme can be categorized into two groups, namely the principal employer and immediate employer. Each of these terms is explained below:

    Principal Employer

    The term refers to the employer who has employed the employee directly to work for him. The employer undertakes the payment of wages and all the service matters of the employee.

    Immediate Employer Refers to an employer who works for a principal employer or undertakes a part of the work of the principal employer by sub-contract. The immediate employer has direct control of the employees employed by him.

    The principal and immediate employer who employs one or more employees is required to register and contribute monthly for all employees. The principal employer is also liable to ensure all employees employed by the immediate employer have been registered and their contributions have been paid.

    In the event the employees have not been registered and the immediate employer cannot be located the principal employer is liable under the Social Security Act 1969, for all contributions.

    2. EMPLOYEE

    An employee under the Social Security Act (1969) is defined as a person employed under a contract of service or apprenticeship.

    An employee earning a monthly wage of RM3,000 or less must compulsorily contribute to SOCSO (September 10, 2003, the Malaysian Cabinet approved proposed amendments to the Socso Act of 1969.). Where an employee earns a monthly wage more than RM3,000, there are two situations that can arise :

    Employees who have been previously registered and have contributed to SOCSO must compulsorily continue to contribute even if the present wage exceeds RM3,000 per month. These employees will be protected in line with the principle of “once covered always covered” to preserve their rights accumulated under the Invalidity Pension Scheme.

    Employees who receive a monthly wage exceeding RM3,000 and who have not previously registered or paid contributions to SOCSO are given an option to be covered under the Act. Both the employer and employee have to consent to the coverage, by filling the necessary forms.

  • 12-� Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    All employees eligible for coverage under the Act must register and contribute to SOCSO irrespective of the employment status whether it is permanent, temporary or casual in nature. However, certain categories of workers are exempted from coverage namely:

    Government Employees

    Domestic Servants

    Self Employed Persons

    Foreign Workers (exempted from coverage from 1.4.93)

    All employees as stated above must be registered with SOCSO irrespective of their age. However employees who exceed age 55 will continue to be protected under the employment injury scheme if they continue to be employed after that age. Only the employer shall contribute to SOCSO for such employees.

    It must be noted that his is a compulsory scheme. Employers must cover their employees even if they have other private insurance coverage for them. Employees are eligible for all benefits from SOCSO and compensation under any private insurance policy in the event of an accident.

    �. WAGES

    For purposes of SOCSO contributions all remuneration payable in money to an employee is defined as wages. Thus the term wages will include the following payments: -

    Salary

    Overtime payments

    Commissions and service charge

    Payments for leave; annual, sick, maternity, rest day, public holidays and others

    Allowances; incentive, shift, food, cost of living, housing and others

    All payments made to an employee and paid at an hourly rate, daily rate, weekly rate, piece or task rate is considered as wages. However, the following payments are not considered as wages: -

    Payments by an employer to any statutory fund for employees ( for example EPF)

    Mileage claims

    Gratuity payments or payments for dismissal or retrenchments

    Annual bonus

  • Malaysian Financial Planning Council (MFPC) 12-�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    REGISTRATION

    Once an employee has been contracted by the employer, the employer is required to fill Form 1 (Employer Registration Form) and Form 2 (Employee Registration Form) for registration with SOCSO. Employers must fill both forms neatly providing complete details in a legible manner. The name of an employee has to be written as found on the identity card. Both the identity card numbers of the employee i.e. old and new (where applicable) have to be entered, otherwise only the new identity card (Mykad) number is added. Both the duly filled forms should be sent to the relevant Local Office of SOCSO which will then issue the employer with an employer’s Code Number to be used in all correspondence with SOCSO.

    CONTRIBUTION

    The principal employer must make a monthly contribution for each eligible employee according to the rates specified under the Act. The employee’s share of 0.5% of wages should be paid for coverage under the Invalidity Pension Scheme while the employer pays 1.75% for the Employment Injury Insurance Scheme and the Invalidity Pension Scheme. The rate of contribution is based on the monthly wage of the employee in accordance to 24 categories. Contributions should be made from the first month the employee is employed.

    Types and categories of contribution

    The first category (Employment Injury Insurance Scheme and Invalidity Pension Scheme). The payment of the contribution is by both the employer and employee.

    The second category (Employment Injury Insurance Scheme Only). The payment of contributions is made only by the employer, i.e. for an employee who is not eligible for coverage under the Invalidity Pension Scheme.

    The contributions can be made through appointed banks or through the Post Offices in Sabah and Sarawak only and the detailed records of contributions to SOCSO can be sent using: -

    computer tapes and diskettes

    electronic data transfers

    preprinted Form 8A

    An employer who fails to pay contributions within the period specified shall be liable to pay interest as specified under regulation 33 of the Employees Social Security (General) Regulations, 1971.

    Interest payable will be calculated at the rate of six percent per annum in respect of each day of default or delay beyond the end of such period, being minimum payable at RM5.00.

  • 12-� Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    COVERAGE UNDER THE SOCSO SCHEME

    SOCSO provides protection to eligible employees through two schemes namely the Employment Injury Insurance Scheme and the Invalidity Pension Scheme. Let’s look at each of these schemes. A financial planner must have a sound understanding of the schemes as the benefits from these schemes must be factored into the needs based solution in risk management.

    A. Employment Injury Insurance Scheme

    The scheme provides an employee with protection for accidents that occur while: -

    Traveling (Commuting accident)

    o while traveling on a route between his place of residence/stay and his work place

    o while traveling between his work place and the place where he takes his meals during any authorized recess

    o while traveling on a journey directly connected to his work

    All commuting accidents are considered as employment related as long as the accident does not occur during a stoppage or deviation done for personal reasons. All reports of commuting accidents must be accompanied by a police report and a sketch map of the route indicating the place of the accident.

    Arising out of and in the course of employment

    Accidents occurring while working at the work place which arise out of the employment.

    Occupational diseases

    Diseases contracted due to exposure to work environment. Examples are:

    • Loss of hearing due to excessive noise at the work place;

    • Respiratory diseases or industrial asthma due to exposure to dust in sawmills, powder factories, flour plants and others.

    The listed diseases can be found in the fifth schedule of Employee’s Social Security Act, 1969.

  • Malaysian Financial Planning Council (MFPC) 12-�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    What are the benefits provided under the scheme?

    The benefits provided under the scheme are: -

    a. Medical Benefit

    b. Temporary Disablement Benefit

    c. Permanent Disablement Benefit

    d. Constant Attendance Allowance

    e. Dependant’s Benefit

    f. Funeral Benefit

    g. Rehabilitation Benefit

    h. Education Benefit

    Let’s take a look at each benefit to appreciate how these affect the risk management solution for the employee.

    a. Medical Benefit

    When an employee meets with an accident or suffers from any occupational disease, he is entitled to treatment at a SOCSO Panel Clinic or at any government hospital or clinic. The employee or his representative is required to bring along an Accident Report (Form 21) or an Identification Letter from his employer or Report of Occupational Diseases Form 68 & Form 69 (whichever is relevant) to enable him to get free treatment. SOCSO will settle his medical bill by directly paying the medical treatment provider.

    If the treatment is received in a SOCSO Panel Clinic, the employee must continue the treatment at the same clinic until he recovers unless he is referred to a Government Hospital.

    In case of a serious injury, the treatment should be at the nearest government hospital. The employee is eligible for second class ward treatment at the hospital if he requires in-patient treatment. Specialist treatment, if required will also be provided at a government hospital. An employer may submit a claim for reimbursement for medical expenditure incurred at a non SOCSO Panel Clinic for consideration.

    b. Temporary Disablement Benefit

    This benefit is payable to an employee who has been certified by a doctor to be unfit for work for not less than 4 days including the day of the accident. This benefit is paid for the period

  • 12-� Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    the employee is on medical leave. However, no benefit will be paid for the days of which the employee works and earns wages during the period.

    The daily rate of temporary disablement benefit is equivalent to 80% of the average assumed daily wage. However, if the daily rate is below MR10.00 the employee will be paid a minimum rate of MR10.00. The maximum rate payable for an employee whose wage exceeds MR2,900 a month is MR78.67 per day.

    c. Permanent Disablement Benefit

    This benefit is payable to an employee who has been certified, by a Medical Board or an Appellate Medical Board, to be suffering from Permanent Disablement as a result of an employment injury. If the permanent disablement is assessed to be 100%, the daily rate is equivalent to 90% of the average assumed daily wage, subject to a minimum daily rate of RM10.00.

    If the permanent disablement is assessed to be 20% or less the employee can claim the benefit be paid as a lump sum.

    However, if the assessment of the loss of earnings capacity exceeds 20%, the employee is given an option to commute 1/5 of the daily rate of permanent disablement benefit into a lump sum payment while the balance will be paid as a monthly pension for life.

    The employee may continue to work while receiving this benefit.

    d. Constant Attendance Allowance

    This allowance is paid to an employee who is suffering from permanent total disablement (i.e. 100% loss of earnings 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.

    e. Dependant’s Benefit

    If an employee dies as a result of an employment injury, his dependants are entitled to this benefit. The full daily rate of dependants’ benefit is 90% of the average assumed daily wage, subject to a minimum rate of RM10.00 per day.

  • Malaysian Financial Planning Council (MFPC) 12-�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Dependants Share of full daily rate

    Conditions

    Widow 3/5 • receives benefit for life or until re-marriage, whichever occurs earlier.

    Children including natural, dependant step-child, adopted child or a child out of wedlock will receive the benefit

    2/5 • receive benefit up to age 21 or marriage, whichever occurs earlier.

    • if receiving higher education, SOCSO may continue paying the benefit up to completion of the first Degree or marriage, whichever occurs earlier.

    • for a mentally retarded or physically handicapped child who is unable to support himself the benefit is paid as long as the child is unable to support himself

    Widower 3/5 • on condition that he is wholly or mainly dependant on the earning of his wife at the time of her death.

    • receives benefits until remarriage or as long as he is not earning enough to support himself.

    • in the event the widower is not eligible for the benefit, the children are entitled to receive the benefit (rate of the benefit is 3/5)

    If there is no widow, widower or an eligible child, the following persons can receive the benefits if they depend wholly or partially on the employee’s income at the time of his death.

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    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Dependants Share of full

    daily rate Conditions

    Parents 4/10 • payment of benefit will be made for life.

    Grandparents (if parents have passed away)

    4/10 • payment of benefit will be made for life.

    Brothers and sisters 4/10 • payment of benefit will be made up to age 21 or marriage whichever occurs earlier.

    f. Funeral Benefit

    An amount of RM1,500 will be paid if an employee dies as a result of an employment injury or while receiving disablement benefit. Payments will be made to the eligible next of kin. If there are no next of kin, the benefit will be paid to the person who incurred the funeral expenditure. The maximum amount for the benefit is the actual amount incurred or MR1,500 whichever is lower.

    g. Rehabilitation Benefit

    Facilities for vocational and physical rehabilitation are provided free by SOCSO to an employee who suffers from permanent disablement.

    Physical rehabilitation includes physiotherapy, occupational therapy, reconstructive surgery, as well as the supply of artificial limps such as artificial leg, hand, eye and dentures and other prosthetic appliances such as wheelchairs, crutches, hearing aids, spectacles, calipers and orthopedics shoes, including their repair and replacement.

    An employee who is suffering from permanent disablement and who is unable to find a suitable job due to his disablement, can apply to undergo vocational training in courses such as radio/TV repairs, electrical wiring, metal trade, repairs of refrigerator and air-conditioner, plumbing, tailoring, typing and secretarial work.

    All expenses incurred for the purpose of vocational and physical rehabilitation will be borne by SOCSO based on rates and conditions determined by SOCSO.

    h. Education Benefit (see later under Section B on Invalidity Pension Scheme)

  • Malaysian Financial Planning Council (MFPC) 12-11

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    B. Invalidity Pension Scheme

    This scheme provides 24 hours coverage to an employee against invalidity or death due to any cause not connected with his employment.

    The benefits provided are :-

    a. Invalidity Pension

    b. Invalidity Grant

    c. Constant Attendance Allowance

    d. Survivors Pension

    e. Funeral Benefit

    f. Rehabilitation

    g. Educational Loan

    a. Invalidity pension

    Invalidity is defined as a serious disablement or disease 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 normally able person could earn.

    Chronic ailments or diseases that could be considered for invalidity are heart attack, renal or kidney failure, cancer, mental illness, chronic asthma and other similar conditions.

    Qualifying Conditions

    An employee must fulfill the following conditions to be eligible for Invalidity Pension :-

    has not completed years of age 55 at the time the notice of invalidity is received by SOCSO.

    In the event he has completed 55 years at the time the notice of invalidity is received the employee has to provide proof that the invalidity occurred before 55years and he had ceased employment at that time.

    is certified as an invalid by a Medical Board or Appellate Medical Board

    has fulfilled the contribution qualifying conditions

    There are two contribution qualifying conditions :-

    (i).Full qualifying condition

    (ii). Reduced qualifying condition

  • 12-12 Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    (i). Full qualifying condition

    A worker is considered to have fulfilled the conditions of full contribution qualification if:-

    a. Monthly contributions in his respect has been made for at least 24 months within a period of 40 consecutive months, preceding the month in which the notice of invalidity is received by SOCSO.

    Example: 1

    Claim for invalidity received on; 1st January 2006 Period for consideration is 40 preceding consecutive months i.e. September 2003 to December 2006

    Employee contribution records

    Year No. of Paid Contributions

    2003 4

    The employee qualifies for Invalidity Pension although no contributions were being made at the time of application

    2004 12

    2005 8

    2006 0

    Total 24

    b. Monthly contributions in his respect has been made for at least 2/3 of the number of full months included in the period between the date he was first covered under the Invalidity Pension Scheme and the date his notice of invalidity is received by SOCSO, subject to the condition that the total number of such monthly contributions made during the stated period, is at least 24.

    Example 2:

    Date of 1st liability of employee under the Act 1 July 1990

    Date of claim 1 Jan 2007

    Period from 1 Jul 1990 to 31 December 2006 198 months

    2/3 number of contributions 198 x 2/3 = 132

  • Malaysian Financial Planning Council (MFPC) 12-1�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Employee contribution records

    YearNo. of Paid

    ContributionsYear

    No. of Paid Contributions

    1990 5 1999 12

    1991 12 2000 12

    1992 12 2001 8

    1993 12 2002 0

    1994 12 2003 0

    1995 12 2004 0

    1996 12 2005 0

    1997 12 2006 0

    1998 12

    Total months of contributions 133

    The employee is eligible to receive a full pension with a rate calculated as follows :

    133 - 24 50% + ------------ % = �0 + � = �� % 12

    (ii). Reduced qualifying conditions

    An employee is considered to have met the reduced qualifying contribution conditions if the monthly contribution conditions in respect of him has been made for not less than 1/3 of the ‘time period’ between the date he was first covered by the Invalidity Pension Scheme and the date his notice of invalidity is received, subject to the condition that the number of monthly contributions made during the state period is at least 24. The employee is eligible to reduced pension at the rate of 50%.

    Date of first entry into insurance under the Act: 1 July 1990

    Date of claim: 1 January 2007

    Period from 1 July 1990 to 31 December 2006: 198 months

    1/3 total contributions: 66 months

  • 12-1� Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    YearNo. of Paid

    ContributionsYear

    No. of Paid Contributions

    1990 5 1999 0

    1991 12 2000 0

    1992 12 2001 8

    1993 12 2002 0

    1994 12 2003 0

    1995 12 2004 0

    1996 2 2005 0

    1997 0 2006 0

    1998 0

    Total months of contributions is 67

    The employee is eligible to reduced pension at the rate of 50%.

    Rates of the Invalidity Pension

    The rate of pension paid to an employee who meets the full qualifying contribution condition ranges from 50% to 65% of his average monthly wage, depending on the total number of contributions that have been paid.

    For an employee who meets the reduced contribution qualifying condition, the rate of pension is 50% of the average monthly wage. However the minimum pension payable in both cases is RM 250.00 per month.

    This pension is paid as long as the employee remains invalid and will be replaced by Survivor’s Pension if he dies at whatever age while receiving this pension.

    b. Invalidity Grant

    The Grant is paid to the worker who does not qualify for the Invalidity Pension, as he does not meet any of the contribution qualifying conditions stated above, but has made at least 12 monthly contributions. The Invalidity grant is equal to the total amount of contributions paid by the employee and the employer for the Invalidity Pension Scheme including the interest thereof. This is an outright payment.

    c. Constant Attendance Allowance

    The recipient of Invalidity Pension is also entitled to this allowance if he is severely incapacitated and constantly requires the personal attendance of another person. The eligibility to receive

  • Malaysian Financial Planning Council (MFPC) 12-1�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    this allowance is decided by a Medical Board or an Appellate Medical Board and will be paid directly to the recipient of the benefit. The benefit is 40% of the rate of Invalidity Pension, subject to a maximum of RM500.00 per month.

    d. Survivors Pension

    This pension is paid to dependants of an employee who dies irrespective of the cause of death, in any of the following situations

    while an employee is receiving invalidity pension irrespective of his age

    when an employee (not a recipient of the invalidity pension) and who has not reached 55 years of age but has met either the full contribution qualifying condition or the reduced contribution qualifying condition.

    The rate of the Survivor’s Pension

    If the deceased is a recipient of Invalidity Pension, the rate of the Survivor’s Pension is equal to the rate of the Invalidity Pension received by him. If the deceased is not a recipient of the Invalidity Pension, the full rate of the Survivor’s Pension (if he has met the full contribution qualifying conditions) is between 50% to 65% of the average monthly wage depending on the number of contributions made in his behalf.

    For an employee who meets the reduced contribution qualifying condition, the rate of Survivor’s Pension is 50% of the average monthly wage.

    Dependants who are eligible for the pension are the same as those under the Dependent

    e. Funeral Benefit

    Funeral Benefit will be paid to an employee who dies :-

    While receiving Invalidity Pension ,or

    Before reaching the age of 55 but meets the full or reduced qualifying contribution conditions.

    The amount and the persons qualified to receive this benefit are the same as those under the Employment Injury Scheme.

    f. Rehabilitation Benefit

    An employee who suffers invalidity is also entitled to receive the Rehabilitation Benefit such as physical and vocational rehabilitation as provided under the Employment Insurance Injury Scheme.

  • 12-1� Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    g. Education Benefit

    This benefit is in the form of a loan given to dependant children who are in receipt of a monthly benefit for :-

    Dependants Benefit

    Survivor’s Pension

    or children of an employee who is in receipt of a monthly benefit for :-

    Permanent Disablement

    Invalidity Pension

    The benefit is in the form of loan. However, it can be converted into a scholarship if the child obtains excellent results.

    Conditions for eligibility for the Education Benefits

    Children who are eligible for the education loan are :-

    Dependant children of an employee receiving Invalidity Pension or periodic permanent disablement who are below 21 years of age and unmarried at the time of the application, or

    Dependant children of an insured person, who has died as a result of an employment injury or while receiving invalidity pension or before reaching age 55 and who fulfills the contribution qualifying conditions, should be below 21 years of age and unmarried. If the child exceeds age 21 and is receiving a monthly benefit and is continuing his education in an institution of higher learning and is unmarried at the time of the application;

    Has been offered a place and has registered in any university or college or Local Institution of Higher Learning including institution that has a twinning program on condition the degree is completed locally, which is registered with the Ministry of Education, to acquire a degree, diploma or a certificate which is awarded by the National Vocational Training Council, Ministry of Human Resources;

    Has not been given any other scholarship or loan by any other authority;

    The family finances are insufficient to support the cost of the education

    Amount of Loan Available

    The amount of the loan is depends on the course taken and includes cost of living and other expenditure as determined for loans by SOCSO.

  • Malaysian Financial Planning Council (MFPC) 12-1�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    The actual amount of the loan includes :

    Registration fees

    Course fees including laboratory and lecture fees

    Examination fees

    Subscription for student associations made compulsory by the university, college or institution of higher learning

    Other expenses will determine from time to time and include:

    Subsistence

    Flight cost

    Books

    Instruments

    Expenditure for preparation of a thesis

    Practical/training costs

    APPEALS UNDER THE SOCSO SCHEME

    Just like under any other benefit schemes where claims are made based on medical conditions and there are established guidelines for payment, there are bound to be employees whose may not be satisfied with the claims payments. There are 2 types of Appeal Boards that review cases and decide on appeals relating to approvals and claims for benefits. They are:-

    a. Appellate Medical Board

    Employees who are not satisfied with a decision of a Medical Board regarding assessment of permanent loss of earnings capacity or the determination of invalidity can appeal to the Appellate Medical Board to review the decision of the Medical Board. The decision of the board is final.

    An appeal can be made to the SOCSO Local Office within 90 days of the date on the letter informing the decision of the Medical Board.

    b. Social Security Appellate Board

    If an employer or an employee or his dependants are not satisfied with the decision made by SOCSO an appeal can be made to the Social Security Appellate Board. They can be represented by a lawyer, a trade union representative or any person authorised by the Board.

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    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    SOCSO AND THE RISK MANAGEMENT PROGRAMME.

    It is pertinent for the financial planner to understand the detailed benefits available to the employee under the SOCSO schemes.

    APPENDIX : SOME OF SOCSO’S STRATEGIES AND CORPORATE POLICIES

    A. SOCSO’s Strategies

    • Giving top priority to the interest of the nation and the organisation.

    • Providing quality, fair, precise, speedy and economical services to the clients

    • Improving the skills and expertise of the personnel besides utilising advanced technology to upgrade services.

    • Maintaining and ensuring the viability of the SOCSO’S Fund in order to further strengthen it.

    • Fostering goodwill and noble values amongst SOCSO’S personnel.

    • Cooperation with all the parties involved in Social Security.

    B. SOCSO’S Safety and Health Policy

    • SOCSO commits to ensure it will be a healthy and highly secured organisation based on the principle that safety and health is a common responsibility.

    • The management and staff commits to create and maintain a safer and healthier work place which will prevent work injuries and damages to property and life.

    The organisation guarantees the success of the policy based on: -

    • Developing staff training programmes on health and accident prevention measures.

    • Instil the relevant social values necessary to control the action of an individual, which may jeopardise his personal health and safety including other people.

    • Constantly keep abreast to changes in safety standards, health care trends and techniques.

    • Regular inspection on office equipments to identity and correct irregularities from the health and safety perspective.

  • Malaysian Financial Planning Council (MFPC) 12-1�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    • Review plans for new location including the facilities for the office to guarantee the designing, contraction, installation and operation are within the stipulated government guidelines.

    • Management commits to ensure every person in the organisation understands and accepts that he has role and responsibility towards his safety and health as well as that of his surroundings.

    C. SOCSO’s Client Charter

    To provide social security protection and a just, accurate, timely and quality service economically to all employees and their dependants as well as the employers. SOCSO hereby pledges that upon receiving all the relevant information together with completed claims, SOCSO will undertake to: -

    • Pay temporary disablement benefit (first payment) to injured employees within a month.

    • Pay permanent disablement benefit (first payment) and constant attendance allowance to all injured employees within 3 months.

    • Pay dependant’s benefit (first payment) to dependants within 3 months.

    • Pay invalidity pension (first payment)/invalidity grant/constant attendance allowance to employees who qualify within a period of 3 months.

    • Pay survivor’s pension (first payment) to dependants within a period of 3 months.

    • Pay funeral benefits to eligible dependants of deceased persons within 15 days.

    • Register new employers and employees and inform employer of their code number and employees social security registration number within 1 month

    • Reinvestigate and provide information on every complaint regarding benefit claims within 2 weeks.

    D. SOCSO’S Quality Policy

    SOCSO strives to provide an excellent and fair service to all clients through the development and advancement of SOCSO’s staff.

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    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    Self Assessment

    1. The statements below represent the mission of SOCSO.

    I. To promote and encourage work safety and health of workers.

    II. To promote and encourage work safety and health of employers.

    III. To strengthen SOCSO’s fund through review of contribution rate.

    A. I and II

    B. II and III

    C. I and III

    D. All the above

    2. Categories of workers who are exempted from SOCSO:

    I. Self-employed Persons

    II. Government servants

    III. Contract workers

    A. I and II

    B. II and III

    C. I and III

    D. All the above

    3. Contribution rates by employees and employers are:

    A. Employees 0.5% and employers 1.75%

    B. Employees 0.75% and employers 1.50%

    C. Employees 0.5% and employers 1.50%

    D. Employees 0.75% and employers1.75%

  • Malaysian Financial Planning Council (MFPC) 12-21

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    4. The following statements are TRUE for SOCSO:

    I. The scheme is compulsory to all workers except for workers who are exempted.

    II. In the event of a claim, one who has SOCSO coverage and other insurance schemes can only elect to claim form one of the schemes.

    III. After age 55, an employee can still be covered under the scheme provided the employer contributes to scheme.

    A. I and II

    B. II and III

    C. I and III

    D. None of the above

    5. The following payments are NOT considered as part of wages for the purpose of SOCSO contribution:

    I. Annual bonus

    II. Employers’ contribution to statutory fund for employees

    III. Payments for leave.

    A. I and II

    B. II and III

    C. I and III

    D. None of the above

    6. Employment Injury Insurance Scheme covers:

    I. Diseases contracted due to exposure of work environment.

    II. Accidents occur at work place but employees are not on duty

    III. Accidents occur while an employee is out for lunch during break time.

    A. I and II

    B. II and III

    C. I and III

    D. None of the above

  • 12-22 Malaysian Financial Planning Council (MFPC)

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    7. Under Invalidity pension scheme, an employee and/or his dependants will receive the following benefits:

    I. Invalidity pension

    II. Constant attendance allowance

    III. Education loan for dependant children

    A. I and II

    B. II and III

    C. I and III

    D. All the above

    8. If an employer or an employee or his dependants are not satisfied with the decision made by SOCSO an appeal can be made to the

    A. SOCSO Board.

    B. Social Security Appellate Board.

    C. Medical and Hospital Appeal Board.

    D. Social Security Appellate Board.

    9. Employers under the SOCSO scheme can be categorized into two

    I. principal employer

    II. immediate employer.

    A. I only

    B. II only.

    C. I and II only.

    D. Neither I nor II is true.

  • Malaysian Financial Planning Council (MFPC) 12-2�

    RFP Programme - Module 2 Chapter 12: SOCSO (Social Security)

    10. The term ‘Principal Employer’ refers to :

    I. Refers to the employer who has employed the employee directly to work for him.

    II. The employer who undertakes the payment of wages and all the service matters of the employee.

    A. I only

    B. II only.

    C. I and II only.

    D. Neither I nor II is true.

    Answers: 1-A, 2-A, 3-A, 4-D, 5-A, 6-C, 7-D, 8-B, 9-C, 10-C