The SSS Sickness Reimbursement Application (SBRA) is a significant process managed by the Social Security System (SSS) in the Philippines. It facilitates the reimbursement of sickness benefits advanced by employers to their employees. Implemented to facilitate efficiency and ease, the SBRA process is significant for maintaining financial support for employees during periods of illness, thereby contributing to a healthier and more productive workforce.
Overview of SBRA
The Sickness Benefit Reimbursement Application (SBRA) is a process managed by the Social Security System (SSS) in the Philippines. It is designed to reimburse employers for the sickness benefits they advance to their employees. This guide provides a detailed overview of the SBRA process, eligibility requirements, application steps, and important policies for a smooth and efficient experience for both employers and employees.
Benefits and Coverage
Daily Cash Allowance
The SSS sickness benefit provides a daily cash allowance equivalent to 90% of the employee’s average daily salary credit.
Maximum Duration
The benefit can be availed for a maximum of 120 days in one calendar year. Any unused portion cannot be carried over to the next year.
Important Policies
Online Filing Only
As of December 27, 2021, all initial or new claims and adjustments must be filed online through the My.SSS portal.
Medical Evaluation
All sickness claims are subject to medical evaluation and approval by SSS before payment is made.
Employer Obligations
Employers must register their employees with SSS, pay the employer’s share of contributions, deduct the employee’s share from their salary, and remit these contributions to SSS.
Eligibility and Requirements
To qualify for the SSS sickness benefit, an employee must meet the following criteria:
- Contributions
The employee must have paid at least three months of contributions within the 12-month period immediately before the semester of sickness or injury.
- Incapacity
The employee must be unable to work due to sickness or injury and must be confined either in a hospital or at home for at least three days.
- Company Sick Leave
The employee must have used up all company-provided sick leave with pay for the current year.
- Notification
The employee must have duly notified their employer about their sickness or injury.
Application Process
For Employers:
- Advance Payment
The employer advances the payment of the SSS sickness benefit to the employee.
- Online Filing
Employers must file the SBRA through the My.SSS Portal. The mandatory online filing policy was implemented to streamline the process and achieve efficiency.
- Documentation
Employers need to upload required supporting documents corresponding to the type of claim or adjustment being filed. These documents are reviewed by SSS.
- Employee Confirmation
The receipt of the advance payment must be confirmed by the employee within seven working days from the date of sending the email by SSS. If the employee does not confirm receipt, the SBRA will be rejected and must be re-submitted by the employer.
For Employees:
- Notification
Employees must inform their employer about their sickness or injury promptly.
- Confirmation
Employees need to confirm the receipt of the advance payment through their My.SSS account within the prescribed period.
How to Access the My.SSS Portal to File for SBRA
Steps to Access the My.SSS Portal
For Employers:
- Visit the SSS Website
Go to the official SSS website: www.sss.gov.ph.
- Select the Employer Portal
On the homepage, click on the “EMPLOYER” option under the “Portals” section.
- Register or Log In
If you do not have an account, you will need to register. Click on “Register in My.SSS” and follow the registration instructions. You will need to provide necessary information such as your Employer ID, email address, and other relevant details.
If you already have an account, enter your User ID and Password to log in.
- Navigate to SBRA Filing
Once logged in, navigate to the section for filing Sickness Benefit Reimbursement Applications. This is typically found under the “E-Services” or “Benefits” menu.
For Employees:
- Visit the SSS Website
Go to the official SSS website: www.sss.gov.ph.
- Select the Member Portal
On the homepage, click on the “MEMBER” option under the “Portals” section.
- Register or Log In
If you do not have an account, click on “Register in My.SSS” and follow the registration instructions. You will need to provide your CRN/SS number, email address, and other personal information.
If you already have an account, enter your User ID and Password to log in.
- Confirm Receipt of Sickness Benefit
After logging in, confirm the receipt of the advance payment for the sickness benefit within the prescribed period. This confirmation is necessary for the employer’s SBRA to be processed.
Required Documents for SBRA Application
To file for the Sickness Benefit Reimbursement Application (SBRA) with the Social Security System (SSS), you need to prepare and submit several documents. Here is a detailed list of the required documents:
- Sickness Benefit Application (SBA) Form
This is the primary form that needs to be filled out to apply for the sickness benefit. It can be downloaded from the SSS website or obtained from an SSS branch.
- Approved Sickness Notification Form
This form must be submitted to notify the SSS of the employee’s sickness. The original copy of the approved Sickness Notification should be attached to the SBRA.
- Medical Certificate
A medical certificate from the attending physician or hospital is required to confirm the employee’s illness or injury.
- Valid Identification Cards/Documents
The employee must present valid ID cards or documents. Acceptable IDs include the SS ID, UMID card, or any other valid primary ID such as a driver’s license or passport.
- Bank Documents
Documents to verify the employee’s bank account for the benefit payment. This is necessary to make sure that the sickness benefit is credited to the correct account.
- Employer’s Certification
A certification from the employer confirming that the employee has used up all company sick leaves and that the sickness benefit has been advanced to the employee.
Processing Time for SBRA
The processing time for the SBRA by the Social Security System (SSS) varies depending on the method of submission and the completeness of the required documents. Here is a detailed breakdown:
Online Applications via My.SSS Portal
Processing Time: Typically within 7 to 10 working days from the date of successful submission.
Employee Confirmation: The employee must confirm receipt of the advance payment within seven working days from the date of the SSS email notification. This confirmation is necessary for the processing to proceed.
Applications Filed Through SSS Branches
Processing Time: Generally within 21 working days from the date filed.
Factors Affecting Processing Time
Evaluation and Verification
The processing time may be extended depending on the evaluation and verification of the submitted documents. All claims are subject to medical evaluation and approval before payment is made.
Complete Documentation
Making sure that all required documents are submitted correctly can help avoid delays. Missing or incorrect documentation can result in the application being rejected and needing to be re-submitted.
Total Timeframe
From submission to the receipt of funds, the total time can range from approximately 1 to 4 weeks, depending on the method of filing and the promptness of the employee’s confirmation.
No Fees for Filing SBRA
There are no fees associated with filing a Sickness Benefit Reimbursement Application (SBRA) with the Social Security System (SSS). The process is designed to be free for employers and employees, so that they can access their benefits without incurring additional costs.
Appeal Process for Denied SBRA
If your SBRA is denied, you can appeal the decision by following these steps:
- Reconsideration Request
Submit a written request to the SSS, providing additional documentation or clarification that might support your claim.
- Filing an Appeal with the Social Security Commission (SSC)
File a formal appeal with the SSC, including a clear statement of the grounds for the appeal and copies of all relevant documents.
- Review and Resolution
The SSC will review the petition and may require additional hearings or submission of further evidence. The decision will be based on the merits of the case.
- Motion for Reconsideration
If the SSC’s decision is unfavorable, you can file a motion for reconsideration within 15 days of receiving the decision. No second motion for reconsideration is allowed.
- Finality of Decision
If no further appeal is filed within the prescribed period, the SSC’s decision becomes final and executory.
By following these steps, you can appeal against a denied SBRA and seek a fair review of your claim. See to it that all documentation is thorough and accurate to support your case effectively.
Video: #eSSSkwela Webinar S02E08 | Online Filing of Sickness Benefit Reimbursement Application (SBRA)
In Part 2 of the #eSSSkwela Webinar Episode 8, learn about the streamlined SSS Sickness Benefit claims filing via My.SSS Portal. Discover the online submission process for Sickness Notification and Benefit Reimbursement Application for employed-members, as well as the Sickness Benefit Application for newly-separated and individually-paying members. Don’t miss out on this opportunity to enhance your knowledge of the SSS benefit application process!
Conclusion
The SSS Sickness Reimbursement Application (SBRA) provides an essential service for both employers and employees, so that sickness benefits are efficiently processed and reimbursed. By understanding the eligibility requirements, following the application process carefully, and submitting the necessary documentation, you can navigate the SBRA system with ease. The transition to online filing through the My.SSS Portal has streamlined the process, making it more accessible and less time-consuming. Remember, there are no fees associated with filing an SBRA, and if your application is denied, there are clear steps you can take to appeal the decision. By staying informed and proactive, you can make sure that you and your employees receive the financial support needed during periods of illness or injury, ultimately contributing to a healthier, more productive workforce.