Employee Compensation and State Insurance Fund Print this Page

While one could only hope for the best, it is a fact that life has full of uncertainties. This is why we always try to secure our future and our family’s as well. We try to be ready to what may happen, in case we get sick or be in an accident while we are at work.

We, however, do not have to carry the entire burden. The Employees Compensation and State Insurance Fund, as provided under Presidential Decree No. 626, is another security blanket for the working class. The EC Fund for government employees is administered by the GSIS.

The employees' compensation benefits or disability benefits is a compensation package for public and private sector employees and their dependents in the event of work-related injury, sickness, disability or death.

The EC is a purely employer-based contribution benefit. Thus, the employee does not contribute any amount to the program.

Benefits under the EC are in the form of income or services, and consist of the following:

1. Medical services, appliances and supplies; 2. Rehabilitation services; 3. Temporary total disability benefit; 4. Permanent total disability benefit; 5. Permanent partial disability benefit; 6. Death benefit; and 7. Funeral Benefit

In case of death and funeral benefits, the beneficiaries may either be one of the following:

1. Primary 1. Your legitimate spouse until he or she remarries 2. Your dependent children (legitimate, legitimated or adopted, and illegitimate):

1. Below 18 years old, unmarried, not gainfully employed; or 2. More than 18 years old but incapacitated and incapable of self-support due to

mental or physical defect acquired prior to age of majority. 2. Secondary

1. Your dependent parents 2. Your legitimate descendants

To be more specific, the benefits given to the employee or his beneficiaries are in the form of:

1. Daily cash income benefit for temporary total disability (TTD); 2. Monthly cash income benefit for permanent total disability (PTD) on a lifetime basis; 3. Monthly cash income benefit for permanent partial disability (PPD);

4. Monthly cash income benefit for death, also on a lifetime basis, except for benefit paid to secondary beneficiaries, which is a monthly pension not to exceed 60 months but not less than fifteen thousand pesos;

5. Medical services, appliances and supplies for injury or sickness; 6. Rehabilitation services for permanent disability; and 7. Carer's allowance for permanent disability. 8. Funeral benefit of P3,000 to be paid upon the death of a covered employee or permanently

totally disabled pensioner to one of the following: 1. A surviving spouse; 2. The legitimate child who spent for the funeral services; or 3. Any other person who can show unquestionable proof or proof of his having borne the

funeral expenses (ECC Resolution No. 3682, July 21, 1987.

The Compensability Conditions are as follows:

1. Injury must be the result of accident arising out of and in the course of employment 2. Sickness must be listed /considered an "occupational disease"; or even if not listed as one, it

must be shown that the risk of contracting the sickness is increased by the working conditions 3. Disability/Death is caused by work-connected injury or sickness

Exceptions to Compensability or injury, sickness, disability or death

When any of these is due to the employee's:

1. Intoxication or drunkenness 2. Willful intention to injure or kill himself or another 3. Notorious negligence 4. Not work-related

List of Occupational Diseases (under PD626)

1. Papilloma of the bladder 2. Cancer, epithellomatous or ulceration of the skin or of the

corneal surface of the eye 3. Cataract 4. Deafness 5. Decompression sickness

Caisson disease Aeroembolism

6. Dermatitis due to irritants and sensitizers 7. Infections: Anthrax, Brucellosis, Glanders, Rabies, Tuberculosis, Tularemia, Weill's disease, Q

Fever or equine encephalomyelitis, Mite dermatitis 8. Ionizing radiation disease, inflammation, ulceration or malignant disease of the skin or

subcutaneous tissues of the bones or leukemia or anemia of the aplastic type due to X-rays, ionizing particles, radium or other radioactive substances Acute radiation syndrome: Chronic radiation syndrome and Glass blower's cataract.

9. Poisoning 10. Pneumoconiosis 11. Diseases caused by abnormalities in temperature and humidity 12. Vascular disturbance in the upper extremities due to continuous vibration from pneumatic tools

or power drills, riveting machines or hammers 13. Viral hepatitis 14. Poisoning by cadmium 15. Leukemia and lymphoma 16. Cancer of the stomach and other lymphatic and blood forming vessels, nasal cavities and sinuses 17. Cancer of the lungs, liver and brain 18. Cardio-vascular diseases 19. Cerebro-vascular accidents 20. Malaria and schistosomiasis 21. Pneumonia 22. Hernia 23. Bronchial asthma 24. Osteoarthritis 25. Viral encephalitis 26. Peptic ulcer 27. Pulmonary tuberculosis 28. Viral hepatitis 29. Essential hypertension 30. Asbestosis

No claim for compensation shall be given due course unless said claim is filed with the GSIS within 3 years from the time the cause of action accrued. (ECC Resolution No. 2799, July 25, 1984)