Quick answer: the SSS sickness benefit pays 90% of your Average Daily Salary Credit for each day you cannot work because of illness or injury, for up to 120 days a year. You need 3 contributions in the 12 months before the semester of sickness, a confinement of more than 3 days, and (if you are employed) your sick leave with pay must already be used up. Check your MSC and what it unlocks →
The sickness benefit is one of the SSS benefits you earn through your monthly contribution. It uses the same ADSC idea as the maternity benefit.
Who can claim the SSS sickness benefit?
You are eligible if you are an employed, voluntary, self-employed or OFW member and you meet all of these:
- You have paid at least 3 monthly contributions in the 12-month period immediately before the semester of sickness (the semester is the two consecutive quarters ending in the quarter you fell sick, the same rule as in the maternity qualifying period).
- You were confined for more than 3 days, in a hospital or at home with SSS approval, and were unable to work.
- You have used up all your sick leave with full pay for the current year (employed members).
- You notified your employer (or SSS, if you are unemployed, voluntary or self-employed) on time.
How the sickness benefit is computed
Daily allowance = 90% × ADSC ADSC = (sum of 6 highest MSCs in the 12-month window) ÷ 180 Benefit = daily allowance × number of compensable days
The ADSC is defined in Section 8(n) of the Social Security Act of 2018 (RA 11199), and the 90% rate comes from Section 14.
Worked example
Ana is an employee whose six highest MSCs in the window are all ₱15,000. She is confined for 10 days after her company sick leave is used up.
- ADSC = (₱15,000 × 6) ÷ 180 = ₱500
- Daily allowance = 90% × ₱500 = ₱450
- Benefit = ₱450 × 10 days = ₱4,500
The maximum
SSS guidance caps the MSC used for the sickness benefit at the Regular SS ceiling of ₱20,000. That gives a maximum ADSC of ₱666.67, a daily allowance of ₱600 and ₱72,000 for the full 120 days. The ceiling is taken from SSS guidance as indexed, so confirm the current figure with SSS before you rely on it.
| MSC (six equal MSCs) | ADSC | Daily allowance (90%) | 30 days | 120 days |
|---|---|---|---|---|
| ₱8,000 | ₱266.67 | ₱240.00 | ₱7,200 | ₱28,800 |
| ₱12,000 | ₱400.00 | ₱360.00 | ₱10,800 | ₱43,200 |
| ₱15,000 | ₱500.00 | ₱450.00 | ₱13,500 | ₱54,000 |
| ₱20,000 or higher | ₱666.67 | ₱600.00 | ₱18,000 | ₱72,000 |
Maximum days
- 120 days in one calendar year.
- 240 days for the same confinement (for a long illness that continues across years).
- Unused days do not carry over.
How to file: employed members
- Notify your employer within 5 calendar days after your confinement begins. Hospital confinement and sickness that starts at work are exempt from the 5-day notice.
- Submit the medical certificate and other documents your employer asks for.
- Your employer pays the daily allowance on your regular paydays, after your company sick leave is used up, and then files with SSS for reimbursement. The employer must notify SSS within 5 days of receiving your notice, or it may lose the right to be reimbursed.
- SSS reimburses the employer. You do not need to chase SSS yourself.
How to file: voluntary, self-employed and unemployed members
- Notify SSS directly through My.SSS (or at a branch).
- File the sickness benefit application online with the medical documents.
- SSS pays the benefit to your registered disbursement account.
Claims for hospital confinement must be filed within one year from the last day of confinement.
Common reasons a claim is denied or delayed
- Fewer than 3 contributions in the right 12-month window. Remember that contributions paid inside the semester of sickness do not count.
- Late notice to the employer, or an employer that did not report to SSS.
- Sick leave with pay that was not yet used up.
- Missing medical documents or a disbursement account that is not enrolled.
Related reading
- SSS maternity benefit calculator
- SSS unemployment benefit
- SSS salary loan calculator
- SSS contribution table to find your MSC
Sources: Social Security Act of 2018 (RA 11199 on lawphil.net), Sections 8(n) and 14; SSS sickness benefit page. The ₱20,000 ceiling and ₱600 daily maximum come from SSS guidance as indexed. For estimation only. Confirm with SSS.