BENEFIT OF SOCSO
Benefits under the Employment Injury Insurance Scheme: i. Medical Benefit
Where an employee contracts any occupational disease or meets with an accident, they are entitled to free treatment at SOCSO panel clinics or government clinics or hospital. Treatment need to be continued until they are fully recovered. For serious injuries, medical care may be obtained from the Government hospital and the employee is eligible for second class ward treatment. Specialist treatment will be provided, if required.

How to claim:
To apply and receive medical benefits for the first time, the following documents must be completed and submitted to a SOCSO panel clinic:-

* Form 21 (Accident Report) or Form PKS 68 or PKS 69 (Occupational Disease Report) or * Identification Letter from employer * Form 10 (Claims Form)

For treatments received from a clinic which is not a SOCSO panel, the employer or employee can submit an application for Reimbursement Payment of the costs of receiving treatment to the relevant SOCSO office for approval subject to rates determined by SOCSO. To apply and receive the Reimbursement Payment, the following documents must be completed and submitted to a SOCSO office:-

* Form PKS (P) 24 (Reimbursement Travel Claim Form) * Form PKS (P) 26 (Reimbursement Payment (General) Claim Report) * Original receipt for treatment * A copy of the Appointment Card * A copy of the Medical Report (if any)

ii. Temporary Disablement
This benefit is paid on employees who have been certified by a doctor to be unfit for work for not less than (4) days including the day of the accident. This benefit will be paid for the period the employee is on medical leave. However, no benefit will be paid for the days for which the employee works and earns wages during this period. The benefit rate will be 80% of the daily wage of the employee from a minimum of RM30.00 to a maximum of RM78.67 per day.

How to claim:
Claims can be made by submitting the following documents to the employers registered SOCSO office not later than 12 months following incident date:- * 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, must also submit the following: * Police Report * Sketch map of place of accident

For Occupational Diseases, 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)

iii. Permanent Disablement Benefit
This is a benefit payment paid to employees who suffer from permanent disabilities due to workplace injuries, regardless of ability to continue working. The benefit rate will be 90% of the daily wage of the employee from a minimum of RM30.00 to a maximum of RM88.50 per day. An employee can claim the benefit to be paid as a lump sum if the permanent disablement is assessed to be 20% or less. However, where the assessment of the loss of earnings capacity exceeds 20%, the employee is given an option to exchange 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. While receiving this benefit, an employee may continue to work.

How to claim:
The Insured Employee must submit a written application to the relevant SOCSO office for reference to the Medical Board. Please include 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 employee’s savings account passbook for direct payment of benefits.

iv. Constant Attendant Allowance
This allowance is paid to an employee who is suffering from permanent total disablement or 100% loss of earnings capacity, and is so severely incapacitated that he constantly requires the personal attendance of another person. Subject to a maximum of RM500, the allowance is equivalent to 40% of the rate of permanent total disablement benefit. The Medical Board or the Appellate Medical Board will determine the eligibility for this allowance and the payment will be paid directly to the recipient of the benefit.

v. Rehabilitation Benefit
Facilities for vocational and physical rehabilitation are provided free of charge to an employee who suffers from invalidity as a result of a workplace accident. All expenses incurred for these purposes will be borne by SOCSO based on rates and conditions determined by SOCSO. 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 replacement) of other orthopaedic equipment such as wheelchairs, crutches, hearing aids, spectacles, callipers and orthopaedic shoes. * “Return to Work” Programme * Dialysis treatment for an employee receiving Invalidity Pension and is suffering from a chronic kidney ailment.

Vocational rehabilitation includes vocational training in course such as electrical wiring, tailoring, radio/TV repairs, metal trade, refrigerator and air-conditioner repairs, plumbing, typing and secretarial work.

vi. Return to Work Programme (RTW)
Benefits to employer: * To reduce the disability duration of Insured Person with injuries or diseases and enable a safe and fast return to work and increasing productivity thereafter * To be able to retain experienced and highly skilled workers at the work place * To reduce training and hiring costs of temporary workers * To optimize the employees’ rehabilitation period so they can return to work faster and increase their productivity * To provide work modification recommendations to accommodate employees with injuries or diseases

Benefits to employees: * To provide psychological support through counselling and consultation-To restore employee’s self-confidence by enhancing their physical and mental ability and to prevent low self-esteem caused by the illness or disability * To provide appropriate rehabilitative equipment’s including orthotic, prosthetic, implants and so forth, based on the prescription given by the treating doctors or specialists * Promotes speedy recovery and reduces the impact on the quality of life due to the disability or illness vii. Dependent’s Benefit
If an employee dies as a result of an employment injury, his dependents are entitled to this benefit. The benefit rate will be 90% of the daily wage of the employee from a minimum of RM30.00 to a maximum of RM88.50 per day. Where 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.

How to claim:
If there is a surviving widow, widower or children, the claimant must submit to SOCSO the following documents: * 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
*bring along the original documents for SOCSO’s verification.

Benefit allocation:
The 90% of daily wage benefit will be divided to the employee’s surviving spouse(s) and children in the following priority and proportions: * Spouse(s) – 3/5ths – receives benefit for life even after remarriage * Children (up to 21 years of age or upon marriage) – 2/5ths of total in total - includes biological, step-children, adopted children and children born out of wedlock * If the employee leaves behind no spouse(s) or children, the dependent’s benefit will be divided into the following priority and proportions: * Parents: 4/10ths – for life * Siblings: 3/10ths – till age of 21 or marriage * Grandparents: 4/10ths – for life

viii. Funeral Benefit
An amount of RM1, 500 will be paid if an employee who was receiving invalidity pension dies of any reason. Payments will be made to the eligible next of kin; the benefit will be paid to the person who incurs the funeral expenditure. The amount paid will be the actual amount incurred or RM1, 500 whichever is lower.

How to claim:
To apply and receive the cash benefit, the following documents and their certified copies must be completed and submitted: * Claim Form (Form 26) * Death Certificate* * Other relevant documents which certifies the next of kin*
*bring along the original documents for SOCSO’s verification

ix. Education Benefit
Dependents of an employee who is receiving monthly benefits from SOCSO may apply for certain education benefits in the form of loans of scholarships.

How to apply:
Education benefit applications should be made online at the official SOCSO website and by submitting the following documents: i. A copy of the latest passport sized picture of the applicant ii. A certified original copy of the applicant’s birth certificate iii. A certified original copy of the applicant’s identification card iv. A certified original copy of the applicant’s academic result for PMR, SPM, STPM, Certificate, Foundation/ A-Level / Matriculation / Diploma v. A certified original copy of the applicant’s high school testimony vi. Original Letter of Offer for placement into an Institute of Higher Education vii. Confirmation letter of registration from the Institute of Higher Education, registration fee receipt or a copy of the student identification card viii. A letter from the Institute of Higher Education following the SOCSO format highlighting the cost and tuition fees for the latest semester.

Benefits under the invalidity scheme: i. Invalidity Pension
The Invalidity Pension is paid to employees who suffer from a chronic illness (before they attain the age of 55) that renders them invalid and unable to work (e.g. heart attack, renal or kidney failure, cancer, mental illness etc.). This is paid for as long as the employee suffers from the invalidity or dies.

Conditions for eligibility: * Has not reached the age of 55 at the time of invalidity (this must be evidenced to SOCSO) * Certified invalid by SOCSO’s Medical Board or Medical Appeals Board * Fulfilled either the Full Qualifying Condition or Reduced Qualifying Condition

Full Qualifying Condition:
Monthly contributions paid for at least 24 out of the past 40 consecutive months immediately preceding the month in which notice of invalidity is received by SOCSO, or at least 2/3rds of contributing months from the point of start of coverage (usually start of employment) to date of notice of invalidity.
The full invalidity pension rate is between 50% – 65% of last monthly wage depending on the number of contributions made.

Reduced Qualifying Condition:
Monthly contributions paid for at least 1/3rds of complete months between the point of coverage starting to the date of notice of invalidity given to SOCSO, this must be at least 24 contributions.
The reduced invalidity pension rate is 50% of last monthly wage depending on number of contributions made, with a minimum amount of RM475 a month.

How to claim:
To apply, the Insured Person is required to fill in and complete the following forms and provide the following information: * Form PKS(F)41 (Notice of Invalidity) * Medical Report (Attachment 1 – Format provided by SOCSO) * A copy of Identity Card

ii. Invalidity Grant
An employee can receive the Invalidity Grant if they have been certified to be suffering from invalidity by the SOCSO Medical Board or the Medical Appeals Board, but are not eligible to receive Invalidity Pension as he does not fulfil any of the qualifying contribution conditions, but has made contributions for at least 12 months. The invalidity grant is equal to the total amount of contributions paid by the employee for the Invalidity Scheme including interest. This payment is made in form of a one-time lump sum payment.

iii. Constant Attendant Allowance
This allowance is paid to an employee who is suffering from invalidity, 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 the Invalidity Pension subject to a maximum of RM500 a month. Eligibility for this allowance is determined by the SOCSO Medical Board or the Medical Appeals Board and the payment is made directly to the recipient of the benefit.

iv. Survivor’s Pension
This pension is payable to the dependents of an employee who dies while receiving the Invalidity Pension, or who dies before the age of 55 but has met the Full or Reduced Qualifying Conditions.

Benefit allocation:
The same benefit (either Full or Reduced depending on same conditions) will be divided to the employee’s surviving spouse(s) and children in the following priority and proportions: * Spouse(s) – 3/5ths – receives benefit for life even after remarriage * Children (up to 21 years of age or upon marriage) – 2/5ths of total in total – includes biological, step-children, adopted children and children born out of wedlock * If the employee leaves behind no spouse(s) or children, the dependent’s benefit will be divided into the following priority and proportions: * Parents: 4/10ths – for life * Siblings: 3/10ths – till age of 21 or marriage * Grandparents: 4/10ths – for life

http://my.jobsdb.com/MY/EN/V6HTML/JobSeeker/handbook/regulation-of-employment/SOCSO_6.htm

http://www.perkeso.gov.my/en/social-security-protection/benefits-under-the-schemes/employment-injury-scheme.html

http://www.perkeso.gov.my/en/social-security-protection/benefits-under-the-schemes/invalidity-scheme.html