Labor Law: Book IV; Title II; Chapter VII Death Benefits (Art. 200)

      Book IV

Health, Safety and Social Welfare

Title II

Employees’ Compensation and State Insurance Fund

Chapter VII

Death Benefits

Art. 200

Q: What are the death benefits under the Fund and to whom are  they payable? 

Art. 200  [194]. Death.

(a) Under such regulations as the Commission may approve, the System shall pay to the primary beneficiaries upon the death of the covered employee under this Title, an amount equivalent to his monthly income benefit, plus ten percent thereof for each dependent child, but not exceeding five, beginning with the youngest and without substitution, except as provided for in paragraph (j) of Article 167 hereof: Provided, however, That the monthly income benefit shall be guaranteed for five years: Provided, further, That if he has no primary beneficiary, the System shall pay to his secondary beneficiaries the monthly income benefit but not to exceed sixty months: Provided, finally, That the minimum death benefit shall not be less than fifteen thousand pesos. (As amended by Section 4, Presidential Decree No. 1921)

(b) Under such regulations as the Commission may approve, the System shall pay to the primary beneficiaries upon the death of a covered employee who is under permanent total disability under this Title, eighty percent of the monthly income benefit and his dependents to the dependents’ pension: Provided, That the marriage must have been validly subsisting at the time of disability: Provided, further, That if he has no primary beneficiary, the System shall pay to his secondary beneficiaries the monthly pension excluding the dependents’ pension, of the remaining balance of the five-year guaranteed period: Provided, finally, That the minimum death benefit shall not be less than fifteen thousand pesos. (As amended by Section 4, Presidential Decree No. 1921)

(c) The monthly income benefit provided herein shall be the new amount of the monthly income benefit for the surviving beneficiaries upon the approval of this decree. (As amended by Section 8, Presidential Decree No. 1368)
 
Funeral benefit. – A funeral benefit of Three thousand pesos (P3,000.00) shall be paid upon the death of a covered employee or permanently totally disabled pensioner. (As amended by Section 3, Executive Order No. 179)


Notes:
  • (a) Death Benefits for Covered Employees:
    • The System pays primary beneficiaries upon the death of a covered employee.
    • Amount equals monthly income benefit plus 10% for each dependent child (up to five), youngest to oldest, without substitution.
    • Monthly income benefit guaranteed for five years; if no primary beneficiary, paid to secondary beneficiaries up to 60 months.
    • Minimum death benefit guaranteed is not less than fifteen thousand pesos.
  • (b) Death Benefits for Permanently Totally Disabled Employees:
    • System pays primary beneficiaries when a permanently totally disabled covered employee dies.
    • Eighty percent of the monthly income benefit and dependents' pension paid.
    • Marriage must have been validly existing at the time of disability.
    • If no primary beneficiary, the System pays secondary beneficiaries monthly pension excluding dependents' pension for the remaining balance of the five-year guaranteed period.
    • Minimum death benefit is not less than fifteen thousand pesos.
  • (c) Monthly Income Benefit for Surviving Beneficiaries:
    • Monthly income benefit adjusted for surviving beneficiaries upon the approval of this decree.
    • The new amount of the monthly income benefit applies after the approval of this regulation.
  • (d) Funeral Benefit:
    • A funeral benefit of Three thousand pesos (P3,000.00) paid upon the death of a covered employee or permanently totally disabled pensioner.
Notes:
  • The death benefit under paragraph (a) of this Article is the same in amount as the benefits for permanent total disability or for permanent partial disability.
  • It is an "amount equivalent to his monthly income benefit plus ten percent thereof for each dependent child..."
  • ECC has increased the funeral benefit for the pnvate sector members to P10,000.

RULE VII – BENEFITS
SECTION 1. Types of benefits. 
The benefits under Employees Compensation are in the form of income or services, and consist of the following:
    (1) Medical services, appliances and supplies;
    (2) Rehabilitation services;
    (3) Temporary total disability benefit;
    (4) Permanent total disability benefit;
    (5) Permanent partial disability benefit;
    (6) Death benefit; and
    (7) Funeral benefit.

SECTION 2. Disability. 
(a) A total disability is temporary if as a result of the injury or sickness the employee is unable to perform any gainful occupation for a continuous period not exceeding 120 days, except as otherwise provided for in Rule X of these Rules.
(b) A disability is total and permanent if as a result of the injury or sickness the employee is unable to perform any gainful occupation for a continuous period exceeding 120 days, except as otherwise provided for in Rule X of these Rules.
(c) A disability is partial and permanent if as a result of the injury or sickness the employee suffers a permanent partial loss of the use of any part of his body.

SECTION 3. Income benefit. 
The disability or death resulting from the injury or sickness is compensable by cash payments, and not the injury or sickness itself, except in the case of permanent partial disability.

SECTION 3-A. Income benefit for permanent partial disability. -
In the case where the period covered for payment of income benefit for permanent partial disability does not exceed twelve months, the System may pay in lump sum or in monthly pension, otherwise income benefit shall be paid in monthly pension.

SECTION 4. Services.
The injury or sickness is compensable by medical services, appliances, supplies and rehabilitation services.

SECTION 5. Deprivation. 
No contract, regulation or device whatsoever shall operate to deprive the employee or his dependents of any part of the income benefits, and medical or related services, except as
provided under these Rules. Existing medical services being provided by the employer shall be maintained and continued to be enjoyed by his employees.

SECTION 6. Prescriptive period. - No claim for compensation shallbe given due course unless said claim is filed with the System within three years from the time the cause of action accrued. (ECC Resolution No. 2799, July 25, 1984).


RULE VIII - MEDICAL SERVICES, APPLIANCES AND SUPPLIES

SECTION 1. Condition to entitlement. 
Any employee shall be entitled to such medical services, appliances and supplies as the nature of his disability and the progress of his recovery may require, subject to the expense limitation as contained in Annex "C" hereof, if all of the following conditions are satisfied.
    (1) He has been duly reported to the System;
    (2) He sustains an injury or contracts sickness; and
    (3) The System has been duly notified of the injury or sickness.

SECTION 2. Period of Entitlement.
The medical services, appliances and supplies shall be provided to the afflicted employee beginning on the first day of the injury or sickness, during the subsequent period of his disability, and as the progress of his recovery may require, subject to Section 5 of Rule IV.

SECTION 3. Extent of Services.
(a) The employee is entitled to the benefits only for the ward services of an accredited hospital and accredited physician. However, if the employee chooses accommodations better than ward services the excess of the total amount of expenses incurred over the benefits provided under Annex "C" hereof, shall be borne by the employee. For this purpose, "ward" means a hospital room that can accommodate 6 or more patients.

(b) The hospital shall provide all the medicines, drugs or supplies necessary for the treatment of the employee. All reimbursements of medicines under P.D. 626, as amended, shall be in accordance with the amount that may be prescribed under Republic Act No. 9502 and its Implementing Rules and Regulations. (as provided under Board Resolution No. 09-09-134, September 25, 2009)

(c) Payments shall be made directly to the providers of such services in such amount as are prevailing in the community for similar services or provided under the schedule set forth in Annex "C" of these Rules, whichever is less.



RULE XIII - DEATH

SECTION 1. Condition to entitlement.
(a) The beneficiaries of a deceased employee shall be entitled to an income benefit if all of the
following conditions are satisfied:
  1. The employee has been duly reported to the System;
  2. He died as a result of an injury or sickness; and
  3. The System has been duly notified of his death, as well as the injury or sickness which caused his death. His employer shall be liable for the benefit if such death occurred before the employee is duly reported for coverage to the System.

(b) If the employee has been receiving monthly income benefit for permanent total disability at the time of his death, the surviving spouse must show that the marriage has been validly subsisting at the time of his disability.

SECTION 2. Period of entitlement.

A. For Primary Beneficiaries:
  1. The income benefit shall be paid beginning at the month of death and shall continue to be paid for as long as the beneficiaries are entitled thereto.
  2. The monthly income benefit shall be guaranteed for five years which in no case shall be less than fifteen thousand pesos (P15, 000.00). Thereafter, the beneficiaries shall be paid the monthly income benefit for as long as they are entitled thereto. (ECC Resolution No. 2799, July 25, 1984).
B. For Secondary Beneficiaries:
  1. The income benefit shall be sixty (60) times the monthly income benefit of a primary beneficiary which in no case be less than P 15,000.00, which shall likewise be paid in monthly pension. (ECC Resolution No. 2799, July 25, 1984).
SECTION 3. Amount of benefit.
(a) In the case of primary beneficiaries, the monthly income benefit shall be equivalent to the monthly income benefit for permanent total disability, which shall be guaranteed for five years, increased by ten percent for each dependent child but not exceeding 5, beginning with the youngest and without substitution:
Provided That, The aggregate monthly benefit payable in the case of the GSIS shall in no case exceed the monthly wage or salary actually received by the employee at the time of his death; and 
Provided Further, That the minimum income benefit shall not be less than Fifteen Thousand Pesos (P15,000.00). The death benefit shall be paid during the entire period for which they are entitled thereto.

If the employee has been receiving income benefits for permanent total disability at the time of his death, the primary beneficiaries shall be paid the monthly income benefit equivalent to eighty percent plus the dependent's pension equivalent to 10 percent thereof for every
dependent child but not exceeding five counted from the youngest and without substitution.

(b) In the case of secondary beneficiaries, the income benefit is payable in monthly pension which shall not exceed the period of 60 months and the aggregate income benefit shall not be less than P15, 000.00.

If the employee has been receiving monthly income benefit for permanent total disability at the time of his death, the secondary beneficiaries shall be paid the monthly pension, excluding the dependent's pension of the remaining balance of the five year guaranteed period. (ECC
Resolution No. 2799, July 25, 1984).

SECTION 4. Entitlement to the new income benefit under PD 1641. 
The new amount of the monthly income benefit computed under these amended Rules shall be applicable to all contingencies occurring on or after January 1, 1980. 

However, for contingencies which occurred before May 1, 1978, the limitation of P12, 000 or 5 years, whichever comes first, shall be enforced.

In the case of the SSS, the present monthly income benefit of current pensioners shall be increased by 20 percent effective January 1, 1980.

In the case of the GSIS, the monthly income benefit of the current pensioners shall be adjusted and recomputed to reflect the 20 percent increase over the benefit under PD 1146 effective January 1, 1980.

SECTION 5. 
The new amount of lump sum benefit computed under these Amended Rules shall be applicable to all contingencies occurring on or after May 1, 1980, otherwise entitlement thereto shall be governed by the immediately preceding Section.


RULE XIV - FUNERAL BENEFIT
SECTION 1. Entitlement to funeral benefit. 
A funeral benefit of Three Thousand (P3,000.00) Pesos shall be paid upon the death of a
covered employee or permanently totally disabled pensioner to one of the following:
  1. the surviving spouse; or
  2. the legitimate child who spent for the funeral services; or
  3. any other person who can show incontrovertible proof or proof of his having borne the funeral expenses. (ECC Resolution No.3682, July 21, 1987).

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