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Sickness form sss sample

Sickness form sss sample 2026

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The document is a form from the Social Security System of the Republic of the Philippines, designed for reporting accidents or sicknesses related to employment. It requires details such as the employee's information, employer's name, accident date and time, job description, and a brief description of the incident. Additionally, it mandates signatures from both the immediate supervisor and personnel manager.

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Click ‘Get Form’ to open the sickness form sss sample in the editor.
Begin by entering your SS Number at the top of the form. This is essential for identification purposes.
Fill in your name as the employee, including your last name, first name, and middle initial.
Next, provide the name of your employer and your SS ID number to ensure proper processing.
Complete your address and job description or occupation to give context about your employment.
Indicate the date and exact time of the accident or sickness occurrence.
Specify whether it occurred during regular working hours or overtime by checking the appropriate box and filling in the times.
Document the date you last reported for work and when you returned, if applicable.
Provide a brief description of the accident or sickness to give clarity on the situation.
Finally, ensure that both your immediate supervisor and personnel manager sign and date the form before submission.

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How can I apply for a SSS sick leave form?

Submission of documents over the counter is no longer necessary. Log in to your My.SSS account. Click Submit Sickness Benefit Application under the E-Services tab. Read the important reminders, then click Proceed to continue.

How do I file an SSS sickness claim?

Application Notify employer or SSS within 5 days of illness. Fill out the official Sickness Benefit Application Form. Attach medical certificates and proof of incapacity. Employer files for employees; self-employed and OFWs file directly with SSS. Wait for approval before payment release.

How long does it take to process a SSS sickness benefit?

How long will it take to get my SSS sickness benefit? Crediting of benefit payments shall be made within five 5 banking days from date of settlement.

How to get SSS sickness form?

This form can also be downloaded thru the SSS website (.sss.gov.ph). For home confinement, the claim for reimbursement by Three (3) years from the date of sickness/injury the employer must be filed within one (1) year immediately after the start of illness.

When to file sickness in SSS?

Sickness Benefit Application Form must be submitted to SSS within five (5) calendar days after the start of confinement. Sickness. Benefit Application Form must be submitted, to SSS within sixty (60) calendar days after lifting of the ECQ/ GCQ.

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What is a sickness notification form?

A sickness notification form is generally required for the department managers to inform human resources or payroll. With this form, managers note which sicknesses the employees have and when employees quit work.

How much to claim SSS sickness benefit?

Calculate ADSC: Divide the total MSC by 180 days to obtain the average daily salary credit. Compute Daily Allowance: Multiply the ADSC by 90% to determine the daily sickness allowance. Calculate Total Benefit: Multiply the daily allowance by the number of approved confinement days, up to a maximum of 120 days per year.

What documents are needed for SSS sickness benefit?

What are the documents needed for SSS Sickness Benefit? Duly accomplished Sickness Benefit Application form (SBA) SSS ID or UMID card or any of the following valid primary IDs: Drivers license. Passport. Voters ID. NBI clearance. Postal ID. Supporting medical documents: Laboratory. Xray. ECG. Other diagnostic results.