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10th Malaysian Hospice Congress, Johor Bahru, Malaysia
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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