BOOK FOUR
HEALTH, SAFETY AND SOCIAL WELFARE BENEFITS
Title I
MEDICAL, DENTAL AND OCCUPATIONAL SAFETY
Chapter I
MEDICAL AND DENTAL SERVICES
Article 156. First-aid
treatment. Every employer shall keep in his establishment such
first-aid medicines and equipment as the nature and conditions of work may
require, in accordance with such regulations as the Department of Labor and
Employment shall prescribe.
The employer shall take steps for the
training of a sufficient number of employees in first-aid treatment.
Article 157. Emergency
medical and dental services. It shall be the duty of every employer to
furnish his employees in any locality with free medical and dental attendance and
facilities consisting of:
The services of a full-time registered
nurse when the number of employees exceeds fifty (50) but not more than two
hundred (200) except when the employer does not maintain hazardous workplaces,
in which case, the services of a graduate first-aider shall be provided for the
protection of workers, where no registered nurse is available. The Secretary of
Labor and Employment shall provide by appropriate regulations, the services
that shall be required where the number of employees does not exceed fifty (50)
and shall determine by appropriate order, hazardous workplaces for purposes of
this Article;
The services of a full-time registered
nurse, a part-time physician and dentist, and an emergency clinic, when the
number of employees exceeds two hundred (200) but not more than three hundred
(300); and
The services of a full-time physician,
dentist and a full-time registered nurse as well as a dental clinic and an
infirmary or emergency hospital with one bed capacity for every one hundred
(100) employees when the number of employees exceeds three hundred (300).
In cases of hazardous workplaces, no
employer shall engage the services of a physician or a dentist who cannot stay
in the premises of the establishment for at least two (2) hours, in the case of
those engaged on part-time basis, and not less than eight (8) hours, in the
case of those employed on full-time basis. Where the undertaking is
non-hazardous in nature, the physician and dentist may be engaged on retainer
basis, subject to such regulations as the Secretary of Labor and Employment may
prescribe to insure immediate availability of medical and dental treatment and
attendance in case of emergency. (As amended by Presidential Decree NO. 570-A,
Section 26)
Article 158. When emergency
hospital not required. The requirement for an emergency hospital or
dental clinic shall not be applicable in case there is a hospital or dental
clinic which is accessible from the employer’s establishment and he makes
arrangement for the reservation therein of the necessary beds and dental
facilities for the use of his employees.
Article 159. Health
program. The physician engaged by an employer shall, in addition to
his duties under this Chapter, develop and implement a comprehensive
occupational health program for the benefit of the employees of his employer.
Article 160. Qualifications
of health personnel. The physicians, dentists and nurses employed by
employers pursuant to this Chapter shall have the necessary training in
industrial medicine and occupational safety and health. The Secretary of Labor
and Employment, in consultation with industrial, medical, and occupational
safety and health associations, shall establish the qualifications, criteria
and conditions of employment of such health personnel.
Article 161. Assistance of
employer. It shall be the duty of any employer to provide all the
necessary assistance to ensure the adequate and immediate medical and dental
attendance and treatment to an injured or sick employee in case of emergency.
Chapter II
OCCUPATIONAL HEALTH AND SAFETY
Article 162. Safety and
health standards. The Secretary of Labor and Employment shall, by
appropriate orders, set and enforce mandatory occupational safety and health
standards to eliminate or reduce occupational safety and health hazards in all
workplaces and institute new, and update existing, programs to ensure safe and
healthful working conditions in all places of employment.
Article 163. Research. It
shall be the responsibility of the Department of Labor and Employment to
conduct continuing studies and research to develop innovative methods,
techniques and approaches for dealing with occupational safety and health
problems; to discover latent diseases by establishing causal connections
between diseases and work in environmental conditions; and to develop medical
criteria which will assure insofar as practicable that no employee will suffer
impairment or diminution in health, functional capacity, or life expectancy as
a result of his work and working conditions.
Article 164. Training
programs. The Department of Labor and Employment shall develop and
implement training programs to increase the number and competence of personnel
in the field of occupational safety and industrial health.
Article 165. Administration
of safety and health laws.
The Department of Labor and Employment
shall be solely responsible for the administration and enforcement of
occupational safety and health laws, regulations and standards in all
establishments and workplaces wherever they may be located; however, chartered
cities may be allowed to conduct industrial safety inspections of
establishments within their respective jurisdictions where they have adequate
facilities and competent personnel for the purpose as determined by the
Department of Labor and Employment and subject to national standards
established by the latter.
The Secretary of Labor and Employment
may, through appropriate regulations, collect reasonable fees for the
inspection of steam boilers, pressure vessels and pipings and electrical
installations, the test and approval for safe use of materials, equipment and
other safety devices and the approval of plans for such materials, equipment
and devices. The fee so collected shall be deposited in the national treasury
to the credit of the occupational safety and health fund and shall be expended
exclusively for the administration and enforcement of safety and other labor
laws administered by the Department of Labor and Employment.
Title II
EMPLOYEES’ COMPENSATION AND STATE INSURANCE FUND
Chapter I
POLICY AND DEFINITIONS
Article 166. Policy. The
State shall promote and develop a tax-exempt employees’ compensation program
whereby employees and their dependents, in the event of work-connected
disability or death, may promptly secure adequate income benefit and medical
related benefits.
Article 167. Definition of
terms. As used in this Title, unless the context indicates otherwise:
"Code" means the Labor Code of
the Philippines instituted under Presidential Decree Numbered four hundred
forty-two, as amended.
"Commission" means the
Employees’ Compensation Commission created under this Title.
"SSS" means the Social Security
System created under Republic Act Numbered Eleven hundred sixty-one, as
amended.
"GSIS" means the Government Service
Insurance System created under Commonwealth Act Numbered One hundred
eighty-six, as amended.
"System" means the SSS or GSIS,
as the case may be.
"Employer" means any person,
natural or juridical, employing the services of the employee.
"Employee" means any person
compulsorily covered by the GSIS under Commonwealth Act Numbered One hundred
eighty-six, as amended, including the members of the Armed Forces of the
Philippines, and any person employed as casual, emergency, temporary,
substitute or contractual, or any person compulsorily covered by the SSS under
Republic Act Numbered Eleven hundred sixty-one, as amended.
"Person" means any individual,
partnership, firm, association, trust, corporation or legal representative
thereof.
"Dependent" means the legitimate,
legitimated or legally adopted or acknowledged natural child who is unmarried,
not gainfully employed, and not over twenty-one (21) years of age or over
twenty-one (21) years of age provided he is incapacitated and incapable of
self-support due to a physical or mental defect which is congenital or acquired
during minority; the legitimate spouse living with the employee and the parents
of said employee wholly dependent upon him for regular support.
"Beneficiaries" means the
dependent spouse until he/she remarries and dependent children, who are the
primary beneficiaries. In their absence, the dependent parents and subject to
the restrictions imposed on dependent children, the illegitimate children and
legitimate descendants, who are the secondary beneficiaries: Provided, That the
dependent acknowledged natural child shall be considered as a primary
beneficiary when there are no other dependent children who are qualified and
eligible for monthly income benefit.
"Injury" means any harmful
change in the human organism from any accident arising out of and in the course
of the employment.
"Sickness" means any illness
definitely accepted as an occupational disease listed by the Commission, or any
illness caused by employment subject to proof that the risk of contracting the
same is increased by working conditions. For this purpose, the Commission is
empowered to determine and approve occupational diseases and work-related
illnesses that may be considered compensable based on peculiar hazards of
employment.
"Death" means loss of life
resulting from injury or sickness.
"Disability" means loss or
impairment of a physical or mental function resulting from injury or sickness.
"Compensation" means all
payments made under this Title for income benefits and medical or related
benefits.
"Income benefit" means all
payments made under this Title to the providers of medical care, rehabilitation
services and hospital care.
"Medical benefit" means all
payments made under this Title to the providers of medical care, rehabilitation
services and hospital care.
"Related benefit" means all
payments made under this Title for appliances and supplies.
"Appliances" means crutches,
artificial aids and other similar devices.
"Supplies" means medicine and
other medical, dental or surgical items.
"Hospital" means any medical
facility, government or private, authorized by law, an active member in good
standing of the Philippine Hospital Association and accredited by the Commission.
"Physician" means any doctor of
medicine duly licensed to practice in the Philippines, an active member in good
standing of the Philippine Medical Association and accredited by the
Commission.
"Wages" or "Salary",
insofar as they refer to the computation of benefits defined in Republic Act
No. 1161, as amended, for SSS and Presidential Decree No. 1146, as amended, for
GSIS, respectively, except that part in excess of Three Thousand Pesos.
"Monthly salary credit" means
the wage or salary base for contributions as provided in Republic Act Numbered
Eleven hundred sixty-one, as amended, or the wages or salary.
"Average monthly salary credit"
in the case of the SSS means the result obtained by dividing the sum of the
monthly salary credits in the sixty-month period immediately following the
semester of death or permanent disability by sixty (60), except where the month
of death or permanent disability falls within eighteen (18) calendar months
from the month of coverage, in which case, it is the result obtained by
dividing the sum of all monthly salary credits paid prior to the month of
contingency by the total number of calendar months of coverage in the same
period.
"Average daily salary credit"
in the case of the SSS means the result obtained by dividing the sum of the six
(6) highest monthly salary credits in the twelve-month period immediately
preceding the semester of sickness or injury by one hundred eighty (180),
except where the month of injury falls within twelve (12) calendar months from
the first month of coverage, in which case it is the result obtained by
dividing the sum of all monthly salary credits by thirty (30) times the number
of calendar months of coverage in the period.
In the case of the GSIS, the average
daily salary credit shall be the actual daily salary or wage, or the monthly
salary or wage divided by the actual number of working days of the month of
contingency.
"Quarter" means a period of
three (3) consecutive months ending on the last days of March, June, September
and December.
"Semester" means a period of
two consecutive quarters ending in the quarter of death, permanent disability,
injury or sickness.
"Replacement ratio" - The sum
of twenty percent and the quotient obtained by dividing three hundred by the
sum of three hundred forty and the average monthly salary credit.
"Credited years of service" -
For a member covered prior to January, 1975, nineteen hundred seventy-five
minus the calendar year of coverage, plus the number of calendar years in which
six or more contributions have been paid from January, 1975 up to the calendar
year containing the semester prior to the contingency. For a member covered on
or after January, 1975, the number of calendar years in which six or more
contributions have been paid from the year of coverage up to the calendar year
containing the semester prior to the contingency.
"Monthly income benefit" means
the amount equivalent to one hundred fifteen percent of the sum of the average
monthly salary credit multiplied by the replacement ratio, and one and a half
percent of the average monthly salary credit for each credited year of service
in excess of ten years: Provided, That the monthly income benefit shall in no
case be less than two hundred fifty pesos.
Chapter II
COVERAGE AND LIABILITY
Article 168. Compulsory
coverage. Coverage in the State Insurance Fund shall be compulsory
upon all employers and their employees not over sixty (60) years of age:
Provided, That an employee who is over (60) years of age and paying
contributions to qualify for the retirement or life insurance benefit
administered by the System shall be subject to compulsory coverage.
Article 169. Foreign
employment. The Commission shall ensure adequate coverage of Filipino
employees employed abroad, subject to regulations as it may prescribe.
Article 170. Effective date
of coverage. Compulsory coverage of the employer during the
effectivity of this Title shall take effect on the first day of his operation,
and that of the employee, on the date of his employment.
Article 171. Registration. Each
employer and his employees shall register with the System in accordance with
its regulations.
Article 172. Limitation of
liability. The State Insurance Fund shall be liable for compensation
to the employee or his dependents, except when the disability or death was
occasioned by the employee’s intoxication, willful intention to injure or kill
himself or another, notorious negligence, or otherwise provided under this
Title.
Article 173. Extent of
liability. Unless otherwise provided, the liability of the State
Insurance Fund under this Title shall be exclusive and in place of all other
liabilities of the employer to the employee, his dependents or anyone otherwise
entitled to receive damages on behalf of the employee or his dependents. The
payment of compensation under this Title shall not bar the recovery of benefits
as provided for in Section 699 of the Revised Administrative Code, Republic Act
Numbered Eleven hundred sixty-one, as amended, Republic Act Numbered
Forty-eight hundred sixty-four as amended, and other laws whose benefits are
administered by the System or by other agencies of the government. (As amended
by Presidential Decree No. 1921).
Article 174. Liability of
third party/ies.
When the disability or death is caused by
circumstances creating a legal liability against a third party, the disabled
employee or the dependents, in case of his death, shall be paid by the System
under this Title. In case benefit is paid under this Title, the System shall be
subrogated to the rights of the disabled employee or the dependents, in case of
his death, in accordance with the general law.
Where the System recovers from such third
party damages in excess of those paid or allowed under this Title, such excess
shall be delivered to the disabled employee or other persons entitled thereto,
after deducting the cost of proceedings and expenses of the System.
Article 175. Deprivation of
the benefits. Except as otherwise provided under this Title, 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 granted under this Title. Existing medical services being provided by
the employer shall be maintained and continued to be enjoyed by their
employees.
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