Because of my injury caused by an accident at work, I could no longer perform my duties and responsibilities in the office. I am planning to file a claim for permanent total disability benefits with the SSS but I am hesitant as my injury did not result in loss of sight on both eyes, loss of two limbs and others enumerated in the SSS Law. Do I have a chance to be granted permanent total disability benefits?
Under Republic Act (RA) 8282 or the Social Security Act of 1997, a member who suffers permanent total disability is granted permanent disability benefits, which equate to a monthly pension if he has paid at least thirty six (36) monthly contributions prior to the semester of disability. If he has not paid the minimum monthly contribution, a lump sum monetary benefit is paid instead (Sec. 13-A, RA 8282). In order to remove doubt as to what constitutes permanent total disability, the Social Security System (SSS) Law listed down the disabilities considered as “permanent total.” These are complete loss of sight of both eyes, loss of two limbs at or above the ankles or wrists, permanent complete paralysis of two limbs, brain injury resulting in incurable imbecility or insanity and such cases as determined and approved by the SSS.
Given that the law has already designated what constitutes permanent total disability, it is indispensable on the part of the claimant to show that his injury falls under one of the enumerated disabilities in order to claim permanent total disability benefits. Otherwise, his claim will be denied. Thus, if your injury does not amount to any of the disabilities considered by the law as permanent total, as you have intimated in your narration, then we are sorry to say that your claim for SSS permanent total disability benefit will likely be denied.
Nevertheless, it is possible that you may still be entitled to permanent total disability benefits, albeit not under the SSS Law, but under the provisions of the Labor Code on Employees’ Compensation and State Assurance Fund. Under the Labor Code, employees’ compensation (EC) benefits are granted to employees or their dependents for work-connected disability or death, particularly those resulting from accident arising out of and in the course of the employment (Art. 166, Labor Code in relation to Sec. 1, Rule III, Amended Rules on Employees’ Compensation). Similar to the SSS Law, the Labor Code also provides compensation, a monthly income benefit to be precise, to employees who suffer permanent total disability.
Now under the Labor Code, a disability is already considered permanent total if the injury or sickness incapacitated the employee to perform any gainful occupation for a continuous period exceeding 120 days (Art. 192, Labor Code in relation to Sec. 2, Rule VII, Amended Rules on Employees’ Compensation). Further elaborating on the matter, the Supreme Court stated in the case of Austria vs. Court of Appeals (G.R. No. 146636, August 12, 2002) that the test of whether an employee suffers from “permanent total disability” is a showing of the capacity of the employee to continue performing his work notwithstanding the disability he incurred. xxx Thus, if by reason of the injury or sickness he sustained, the employee is unable to perform his customary job for more than 120 days, then the employee undoubtedly suffers from “permanent total disability” regardless of whether he loses the use of any part of his body.
You mentioned that you had an accident in your workplace and can no longer perform your office duties because of the resulting injury. If it can be proved that the injury you sustained is indeed work-connected and that it incapacitates you from performing your work for more than 120 days, then you are likely entitled to the permanent total disability benefits provided under the Labor Code. To claim, you may file an application with the SSS, which is the agency that receives application for EC benefits, and submit pertinent documents.
We hope that we were able to answer your queries. Please be reminded that this advice is based solely on the facts you have narrated and our appreciation of the same. Our opinion may vary when other facts are changed or elaborated.
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