What is the Security Organization?
The Social Security Organization is basically an organization that is set up to administer as well as implement the Employees’ Social Security Act, 1969 and the Employees’ Social Security (General) Regulations 1971. As the name suggests this particular organization will provide social security protection by social insurance that includes medical and cash benefits, provision of artificial aids as well as rehabilitation to the employees so that they will be able to reduce the sufferings that they are experiencing, and also to provide protection along with financial guarantee to their family. The abbreviation for the Social Security Organization is SOCSO while in Malay it is known as Pertubuhan Keselamatann Sosial or PERKESO.
Who is obligated to contribute to SOCSO?
Contribution to SOCSO is compulsory for employees who are on a contract of service or apprenticeship and their monthly wages should be RM3, 000 and below. It does not take into the person’s particular employment status, so this basically means that employees are required to register as well as contribute whether their job is permanent, temporary or casual in nature. Also irrespective of their age, an employee is also required to register with SOCSO. Currently, SOCSO only covers Malaysian workers as well as permanent residents while the foreign workers are protected under the Workmen’s Compensation Act 1952. However you should take note that SOCSO will not cover the following categories and they include those that consist of the Government employees, the employees who have already attained the age of 55 years old only for the purposes of the invalidity however if they do continue to work then they should be covered under the Employment Injuries Scheme, foreign workers, any person that earns more than RM3, 000 per month and has never been covered by SOCSO before, domestic workers that have been employed in a private dwelling house that includes being a gardener, house servants, a washer, a cook, a driver and self-employed persons.
What do the wages mean for the purpose of the SOCSO contribution?
In the case of SOCSO contribution, the wages in such circumstances are basically all the remuneration that is payable in money to any of the employees. The following list will show the payments that can be considered as wages; overtime payment, payment for leave, annual, public holidays, sick, rest day, maternity, as well as others, the monthly salary, commission and service charge as well as allowances, incentives, food, shifts, housing, cost of living and others. This will also include the payment that has been made to an employee that is paid on an hourly rate, daily rate, weekly rate, by task or piece rate, which will also be considered as wages. Those that do not fall under the category of wages include the mileage claims, annual bonuses, payments that has been made by the employer to any of the statutory fund for the employees and the gratuity payments or the payments for the retrenchment or the dismissal of the employees.
What is the coverage that will be provided to an insured person by SOCSO under the Employees Social Security Act 1969?
Any person that has been insured or either their dependants will be entitled to the following benefits and they include; periodical payments in the case of disablement that sustained as a result of an employment injury, payments for the funeral benefits or the expense on the death of the insured person as result of the employment injury, medical treatments for the attendance on the insured persons that has suffered from the disablement, periodical payments in the case of invalidity, periodical payments to the dependants of the person that has been insured who has passed away as a result of an employment injury, periodical payments to an insured person who is in receipt of invalidity pension or a disablement benefits and is so severely incapacitated or disabled that the particular person who require the personal attendance of another person and the periodical payments to the dependants of an insured person who has passed away while they were in receipt of the invalidity pension.
Eligible employees will be covered through 2 schemes by SOCSO and they include the Invalidity Pension Scheme and the Employment Injury Insurance Scheme. The schemes are then further classified into 2 categories and they include; the first category is the Employment Injury Insurance Scheme and Invalidity Pension Scheme where the contribution of the payment is made by both the employee and the employer. While the second category is known as the Employment Insurance Scheme Only, here the contribution is paid by the employer only and the particular scheme are for the employees who are not eligible for the coverage under the Invalidity Pension Scheme will be protected under this particular category. The schemes provide the benefits of invalidity grant, rehabilitation, constant attendance allowance, invalidity pension, supervisor’s pension funeral benefit and educational allowance.
What does the Invalidity Pension Scheme cover along with the benefits that is provides?
The Invalidity Pension Scheme will provide 24-hour coverage to employees against invalidity as well as death to any of the cause that was not connected with employment before the age of 55 years old. Benefits that are provided under this particular scheme include the Invalidity Grant, Survivors Pension, Rehabilitation, Invalidity Pension, Constant Attendance and Educational Loan.
- Invalidity Pension – In this circumstance of the Invalidity Pension, the invalidity in this context means a serious disease or disablement that is of a permanent nature that is either incurable or not likely to be cured. This would eventually result in that particular employee being unable to earn at least 1/3 of what someone would be able to earn in normal situations. Examples of chronic ailments or diseases that would be considered as invalidity would be that of kidney failure, mental illness, heart attack, cancer and so on. To be eligible for the Invalidity Pension, the employee must then fulfil certain conditions and they include if the employee has completed the age of 55 year when the notice of the invalidity has been received, then that particular employee has to provide that the invalidity occurred before the 55 years and they had ceased employment as that time, has fulfilled the contribution to qualify for such conditions, at the time of the notice of invalidity was received, the employee has not yet completed the age of 55 years, and that they have been certified as an invalid by a Medical Board or the Appellate Medical Board. As mentioned before there are 2 types of contribution qualifying conditions and they include the reduced qualifying condition and the full qualifying condition. An employee will be deemed to fulfil the conditions of full contribution qualification if that particular employee has made a monthly contribution for at least 2/3 of the number of full months in the period between the date of the first coverage under the Invalidity Pension Scheme and the date that the notice of invalidity was received by SOCSO. This of course is subject to the condition that the total number of the monthly contributions is made during the stated period which is usually at least 24. Or it could be the month in which the notice of the invalidity was received; also the employee’s monthly contributions within a period of 40 consecutive months must be at least 24 months.
- Invalidity Grant – The Invalidity Grant is an outright payment that is paid to the workers or the employees who are not qualified for the Invalidity Pension. This is due to the fact that they do not meet any of the contribution qualifying conditions as stated previously, but they still have made at least a 12 month contribution. The Invalidity Grant is the same as the total amount of the contributions that is paid by the employee and the employer for the Invalidity Pension Scheme that includes the interest. The recipient of the Invalidity Pension will also be entitled to the Constant Attendance Allowance if the employee or the worker has been severely incapacitated and requires constant personal attendance. After an Appellate Medical Board or a Medical Board has decided that one is eligible to receive the allowance, they will then pay the benefits to the recipient directly. The benefits provided to the recipient are 40% of the rate of the Invalidity Pension, but it is also subject to a maximum of RM500 per month.
- Survivors Pension – The dependants will be paid the Survivors Pension where an employee dies in any of the following situations, irrespective of the cause of the death and this includes an employee or a worker who is not a recipient of the invalidity pension and has also not reached the age of 55 years, but has either met the full contribution condition or the reduced contribution of the qualifying condition or if the employee has received the invalidity pension irrespective of their age. If the deceased is also the recipient of the Invalidity Pension, then the Survivors Pension will be equivalent to the rate of the Invalidity Pension that they received. However if the deceased is not a recipient of the Invalidity Pension but they have met the full contribution of the qualifying conditions, then the full rate of the Survivor’s Pension will between that of 50% to 65% of the average monthly wage depending on the number of contributions that is made on the member’s behalf. For the employees that meet the reduced contribution qualifying condition, then the rate of the Survivors Pension will be 50% of the average monthly wage.
- Funeral Benefit – This type of benefit is paid to the eligible next-of-kin if the employee or the worker passed away before they reach the age of 55 years old but they meet the full or reduced qualifying contribution conditions or while they are receiving the Invalidity Pension. The amount as well as the persons that are qualified to receive these particular benefits is the same as the ones that are covered by the Employment Injury Scheme.
- Rehabilitation Benefit – Not only do the workers get the benefits but the employer who suffers from invalidity will also be entitled to receive the Rehabilitation Benefit as provided under the Employment Insurance Injury Scheme.
The total of contribution for the Invalidity Scheme is about 1% of the wages of the employee and this is shared equally by both the employee as well as the employer.
What does the Employment Injury Scheme cover?
The Employment Injury Scheme provides coverage for the accidents that occur while the employee or worker is;
- Travelling (commuting accident) and this includes while they are travelling on a journey that is directly connected to work, while they are travelling on a route between the place of their residence or stay and that of the work place, or while travelling between the work place and the place where the employees take their meals during any of the authorized recess. Besides an accident that had occurred during a stoppage or deviation that was done for personal reasons, all of the commuting accidents will be considered as employment related.
- Arises out of and in the course of the employment – this is the type of accidents that occurs while performing official duties at the work place which had arisen out of the employment.
- Occupational diseases – An employee who had contracted a particular disease to which they are exposed to the various hazards due to the nature of their duty. For a list of the occupational disease one can find them in the Fifth Schedule of the Employees’ Social Security Act 1969.
Under the Employment Injury Insurance Scheme there are several benefits that are provided and they include;
- Medical Benefit – Employees will be entitled to the treatments provided at any of the government hospital or clinic or at a SOCSO Panel Clinic, if an employee has met with an accident or contracts an occupational disease. In order to be eligible for the free treatment at the designated places, the employee or their representative are required to bring along documentation for verification purposes and they consist of; a letter from the Report of Occupational Diseases Form 68 & Form 69 or a letter from the employer (whichever is relevant) and the Accident Report (Form 21) or an Identification. SOCSO will then settle the medical bill on behalf of the employee by paying the medical treatment provider directly. You should also take note that an employee who initially receives treatment at a SOCSO Panel Clinic, then the treatment must be continued at the same clinic until they have recovered or unless they have been referred to a Government Hospital. If the employee has sustained serious injuries then the treatment should be at the nearest government hospital and if the employee requires in-patient treatment, then they will be eligible for second class ward treatment at the hospital. If the employee requires certain specialist treatment, then such treatment can also be provided at a government hospital. If you have received treatment at a non-SOCSO Panel Clinic, you may submit an application to be considered for reimbursement for the medical expenditure that was incurred.
- Temporary Disablement Benefit – Employees will be entitled to this particular benefit are those that have been certified by a doctor to be unfit for work for not less than 4 days and this includes the day that the accident had occurred. The benefit will then be paid to the employee for the period that they are on medical leave. The daily rate of the benefit that will be paid to the employee will be equivalent to 80% of the average assumed daily wages of that particular person. However if the employee’s daily rate is below RM10 then they will be paid a minimum rate of RM10, for the employee who earn more than RM1, 900 per month, they will be paid a maximum rate of RM52 per day.
- Permanent Disablement Benefit – Those that will be eligible for this particular benefit are those that have been certified by a Medical Board or an Appellate Medical Board to be suffering from a permanent disablement that is due to an employment injury.
- Permanent Disablement Benefit – Those that will be eligible for this type of benefit is an employee who has been certified by an Appellate Medical Board or Medical Board to be suffering from a permanent disablement that was due to an employment injury. If the disablement is assessed to be 100% then that particular employee will be paid a daily rate that is equivalent to 90% of the average daily wage that they used to receive, it is also subjected to a minimum daily rate of RM10. If the disablement is assessed to be 20% or less then the employee will be able to claim the benefit to be paid as a lump sum. However is the assessment by the medical board shows that the disablement exceeds the 20%, and then the employee will be given an option to exchange 1/5 of the daily rate of the permanent disablement benefit into a lump sum payment while the remainder will be paid as a form of monthly pension for life. You should also take note that while receiving such benefits an employee may also continue to work.
- Constant Attendance Allowance – This type of allowance is only eligible for an employee or worker that has suffered from permanent total disablement or 100% loss or earning capacity, and they are so severely incapacitated that they require the personal attendance of another person. Subject to a maximum of RM500, the allowance is equivalent to 40% of the rate of the permanent total disablement benefit. As mentioned before it will be up to the Appellate Medical Board or the Medical Board to decide the eligibility of the allowance and the payment will then be paid directly to the recipient of this particular benefit.
- Funeral Benefits – An amount of RM1, 500 will be paid to an employee if they had passed away due to any employment related injury or while they are receiving the disablement benefit. The payment will then be made to the eligible next-of-kin and if there is no next-of-kin, then the benefit will be paid to the person who has incurred the funeral expenditure. The maximum amount that is paid is the actual amount incurred or RM1, 500, whichever one is lower.
- Rehabilitation Benefit – Employees that suffer from permanent disablement will be able to utilize the facilities for physical as well as vocational rehabilitation that is provided by SOCSO. Physical rehabilitation in these cases involves occupational therapy, physiotherapy, reconstructive surgery, and will also include the supply of artificial limps such as artificial hands, dentures, legs and eye. Other prosthetic appliances such as hearing aids, spectacles, orthopaedic shoes, wheelchairs, crutches, callipers will also be provided that will also include repair and replacement. Any of the employee that is unable to find a suitable job due to their permanent disablement, will be able to apply to undergo vocational training in course such as metal trade, repairs of air-conditioner and refrigerator, plumbing, radio or television repairs, electrical wiring, tailoring, typing and secretarial work. In such cases SOCSO will bear all the expenses that have been incurred for the purpose of physical and vocational rehabilitation that has been based on the conditions as well as the rates by SOCSO.
- Dependant’s Benefit – The dependants will be entitled to this particular benefit if the employee or the worker has died as a result of an employment injury. The full daily rate of the dependant’s benefit is 90% of the average assumed daily wage, subject to a minimum rate of RM10 per day.
||Share of full daily rate
||Receives benefit for life or until the person remarries, or whichever one occurs earlier
|Children that includes, natural, dependant stepchild, adopted child, or a child out of wedlock will also receive the benefits
||Receive the benefits up to the age of 21 or until they marry, whichever occurs first.
If they are receiving higher education, then SOCSO may continue to pay for the benefits until the complete their first degree or until marriage, whichever one occurs first.
As for the mentally retarded or physically handicapped children who are unable to support themselves, then the benefit will be paid as long as the child is unable to support themselves.
||On the condition that he is wholly or mainly dependant on the earning of his wife at the time of her death
Will be able to receive the benefits until he remarries or as long as he is not earning enough to support himself.
In the event that the widower is not eligible for the benefit, then it will be the children who will be entitled to receive the benefits (the rate of the benefits is 3/5).
If there is no eligible child, widow or widower, then the following persons will be able to receive the benefits if these persons depend partially or wholly on the employee’s income at the time of the particular employee or worker’s death.
||Share of the full daily rate
||Payment of the benefits will be made for life
|Grandparents (if the parents have passed away)
||Payment of the benefits will be made for life
||Payment of the benefits will be made until they reach the age of 21 or until marriage, whichever one occurs first.
What is the rate of the SOCSO contribution?
According to the Act a principal employer will need to make a monthly contribution for each of the employees who are eligible. So the employer will pay 1.5% for the Invalidity Pension and the Employment Injury Insurance Scheme while the employee’s share of 0.5% of their wages will be paid for the coverage under the Invalidity Pension Scheme.
According to the 24 categories, the rate of the contribution is based on the monthly wages of the employee.
|(First Category) Employment Injury and & Invalidity
||(Second Category) Employment Injury
||Employer Contribution Only
|Up to RM30
|Exceeds that of RM30 but does not exceed RM50
|Exceeds the amount of RM50 but does not exceed RM70
|Exceeds the amount of RM70 but does not exceed RM100
|Exceeds the amount of RM100 but does not exceed RM140
|Exceeds the amount of RM140 but does not exceed RM200
|Exceeds the amount of RM200 but does not exceed RM300
|Exceeds the amount of RM300 but does not exceed RM400
|Exceeds the amount of RM400 but does not exceed RM500
|Exceeds the amount of RM500 but does not exceed RM600
|Exceeds the amount of RM600 but does not exceed RM700
|Exceeds the amount of RM700 but does not exceed RM800
|Exceeds the amount of RM800 but does not exceed RM900
|Exceeds the amount of RM900 but does not exceed RM1000
|Exceeds the amount of RM1000 but does not exceed RM1, 100
|Exceeds the amount of RM1, 100 but does not exceed RM1, 200
|Exceeds the amount of RM1, 200 but does not exceed RM1, 300
|Exceeds the amount of RM1, 300 but does not exceed RM1, 400
|Exceeds the amount of RM1, 400 but does not exceed that of RM1, 500
|Exceeds the amount of RM1, 500 but does not exceed RM1, 600
|Exceeds the amount of RM1, 600 but does not exceeds RM1, 700
|Exceeds the amount of RM1, 700 but does not exceed RM1, 800
|Exceeds the amount of RM1, 800 but does not exceed RM1, 900
|Exceeds the amount of RM1, 900
What are the responsibilities of an employer?
Even if their worker or employee has other private insurance coverage the employer must also cover their employees. For the companies or firms that have one or more employees who individual earnings do not exceed that of RM1000 per month, then they will have to register with SOCSO. These contributions for the employees will be borne solely by the employers. If the employer has reached the age of 55 years old and has continued to be employed after the retirement age, then it will be only the employer who will contribute to SOCSO for these employees.
It is the duty of the employer to make the contribution to SOCSO on behalf of each of the employees under the Employees’ Social Security Act 1969; this is of course to insure them against employment injury and the contingencies of invalidity. It is the liability of the principal employer to ensure that all the employees that are employed by the immediate employer have been registered and their contributions have been paid for. In the event that the employees have not been registered and the immediate employer cannot be located then the one that will be liable is the principal employer, this is of course according to the Employees’ Social Security Act 1969.
How does an employer register an employee under SOCSO?
In order for the employers to register their employees with SOCSO, they will be required to fill in the Employer Registration Form 1 and the Employee Registration Form 2. Both the forms must be filled by the employer and they must provide complete information on each of the applicants. Employers are also required to enclose a copy of the company, trading, or business license along with the applications. The name of the employee that is submitted in the application has to be the same as in the Identity Card and both the new and old Identity Card numbers of the employee must also be included. After that is done, the duly filled form along with the other relevant documents should be sent to the SOCSO local office. Once SOCSO have received the application they will then issue the employer with an employer’s Code Number in about a month’s time and this particular number will be used in all the future correspondence with SOCSO. The contributions to SOCSO should then be made within the first month the employee has been employed. The employers can make the contribution to the appointed banks and in Sabah and Sarawak; they can make the contributions to SOCSO through the post offices. The detail records of the contributions to SOCSO can be sent using pre-printed Form 8A, computer tapes and diskettes or through electronic data transfers.
Will there be any interest incurred on the contributions that are due and not paid on time by the employer?
Employers will be held liable to pay interest that has been specified under regulation 33 of the Employees Social Security (General) Regulations 1971, if the employer fails to pay the contributions within the specified time. The interest that is payable will then be calculated at the rate of 6% per annum is respect of each day of the default or the delay that is beyond the end of such a period, subject to a minimum payment of RM5.
What about the employees who earn the monthly wages that exceed RM2, 000?
If an employee has a monthly salary that exceeds that of RM2, 000, the employees will fall into either of the situation;
- If the employee has not registered previously and has been receiving a monthly salary that exceeds the amount of RM2, 000 then that such employee may opt to be covered by the act. If the employee does chooses to be covered, then both the employee as well as the employer will have to consent to the coverage by filling up the necessary forms; or
- If the employee has previously registered and has already contributed to SOCSO, then that employee must compulsorily contribute despite the fact that their present wage exceeds the amount of RM2, 000 per month. This goes in line with the principle of “once covered always covered” in order to preserve the employee’s rights that has been accumulated under the Invalidity Pension Scheme.
How do I report an accident and make my claim?
According to the Employment Injury Insurance Scheme;
- All of the commuting and work related accidents will have to be reported by completing as well as submitting the Accident Report Form 21. You will then have to make sure that the accidents as well as the injuries are clearly described in the report inclusive of the full details. Other relevant information that should include with the completed Form 21 includes the employee’s sick leave certificates, the employer’s statement as well as the Claim Form 10.
An employer’s statement, Claim Form 10 and sick leave certificates should be attached to the completed Form 21. A police report, attendance records and a sketch map of the route indicating the place of the accident are additional requirements to report commuting accidents.
- Form 68 should be used if the employee is still in employment and has contracted an occupational disease while carrying tasks for the company, however if the employee has ceased employment then they should use Form 69 instead.
- In order to make claims for the Temporary Disablement Benefit, the victim or the representative should submit the relevant documents that is required for processing and they include; in the event that a commuting accident has occurred and it involves the payment of the Temporary Disablement or the Permanent Disablement Benefit, then the following actions should be taken; a police report should be obtained either by the insured or anyone else on their behalf, the employer of the insured person should submit the police report, sketch a map of the place where the accident had occurred, attendance record and other documents together with the Accident Report in form 21 to the SOCSO local office, the employer must also be notified of the accident either verbally or in writing as soon as possible either by the insured or another person acting on the victim’s behalf and a copy of the police report must be obtained and submitted to the employer either by the insured or another person, Doctor’s Certificate (Form 13) or the original copy of the Medical Certificate, and also the Claim Form 10.
- In order to make a claim for the Permanent Disablement Benefit, the employee or the worker must submit the Claim Form 10 as well as a written application to the SOCSO local office for reference to the Medical Board. The employee must also submit a medical report from the clinic or the hospital where they had received their treatment.
- For the claimant to claim the Dependants Benefit, they will be required to submit Claim Form 24 as well as other certified true copies of documents that include; post-mortem reports (if any), marriage certificates, death certificate, birth certificate of all the children and the widow’s identity card (if relevant). If the situation arises where there is no eligible child, widow or widower, then the claimant that intends to receive the benefits should submit Claim Form 24 along with the certified true copies of the following documents; the birth certificates of all the younger brothers and sisters where applicable, the death certificate, birth certificate of the deceased, the identity cards of the parents, guardian or grandparents (if relevant) and the statement of dependency.
- If the claimant is trying to make claims for the Funeral Benefit, then they should submit Claim Form 26 and return it along with a certified true copy of the death certificate to the SOCSO local office.
According to the Invalidity Pension Scheme:
- In order to make claims for the Survivor Pension of the Invalidity Pension Scheme, the claimant should submit the Claim Form 24 as well as the certified true copies of all the birth certificate of the children, the widow or widower’s identity card where applicable, the death certificate and the marriage certificate.
- To make claims for the Invalidity Grant, the claimant should then submit the PKS. (F) 41 (Notice of Invalidity) Form along with the medical report as well as the true certified copies of the birth certificate or identity card.
If there are no children, widow, or widower, then in this situation the claimant must submit Claim Form 24 as well as certified true copies of the birth certificates of the younger brothers and sisters, if relevant, the birth and death certificates of the deceased employee, and the identity cards of the parents, guardian or the grandparents, if relevant.
All of the completed forms or applications should then be sent to the nearest SOCSO local office so that it can be processed.
How long will it take to process a claim?
You should be aware that incomplete applications will result in late withdrawals payment, so before you submit your application make sure that it is complete and the information provided is accurate. If you have fulfilled the necessary requirements and the application forms and the supporting documents are complete, then SOCSO will undertake to; pay the permanent disablement benefit (first payment) and the constant attendance allowance to the injured employees within 3 months, pay the invalidity pension (first payment) or the invalidity grant or constant attendance allowance to the employees who will qualify within a period of 3 months, pay for the funeral benefits to the eligible dependants of the deceased person within 15 days, pay the temporary disablement benefit (first payment) to the injured employees within a month’s time, pay the dependant’s benefits (first payment) to the dependant’s within 3 months or pay the survivor’s pension (first payment) to the dependants within a period of 3 months.
Currently the state offices of SOCSO have the power to process and settle compensation claims that do not exceed the amount of RM20, 000. For the general compensation claims, they can usually be settled within 3 days time, however for the specific ones, it will take a longer time to have the application finalized.
Is it possible for me to make an appeal if I am not satisfied with the compensation claim from SOCSO?
If you are not satisfied with the compensation, currently there are two types of appeal boards, which are the Appellate Medical Board and the Social Security Appellate Board. These boards have been set up to basically review on the cases or to decide on the appeals that relate to the approvals as well as the claims for benefits.
- Social Security Appellate Board – The Social Security Appellate Board is basically the board that has been set up to review the decisions that have been made by SOCSO. So if the employees or the dependants are not satisfied with the decision that was made by SOCSO, they can make their appeal to this board. To initiate the appeal, one would need to complete and submit Form A and send it over to the relevant board at any of the Social Security Appellate Board. The appellant can be represented by a lawyer, a trade union representative or anyone else that has been by the Board to represent you in this particular case.
- Appellate Medical Board – If anyone is not satisfied with the decision that is made by the Medical Board then it is up to the Appellate Medical Board to review the decision that was made. Employees can make the appeals regarding the assessment of the permanent loss of the earnings capacity or the determination of the invalidity; however appellants should take note that the decision made by the board is final. To initiate the appeal, you will be required to complete and submit the PKS (P) 12 Form to the SOCSO local office. You will then be informed about the decision of the Medical Board within 90 days of the date on the letter.