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Any claim for income benefit arising out of work-connected disability or death must be filed with the SSS
or GSIS (as the case may be) and not with the Employees'
Compensation Commission. ECC handles only appealed cases i.e. claims
disapproved by either the GSIS or the SSS but which the claimant believes is
compensable because it is work-connected. The claim can be filed by the employee, or by any of his/her dependents
or anyone on his/her behalf, within three years from the occurrence of the accident
or illness.
The System shall process the claim upon receipt, and determine if the contingency
is compensable within five (5) days from submittal of the complete
requirements. The decision either denying or awarding compensation
shall be made promptly by the System.
If the supporting papers are insufficient, the System may require the submission of
additional proofs from the employee or his/her dependents, or from any
office, entity or agency, having knowledge of the contingency. It is important
that the claimant sees to it that all the papers needed to prove that the illness
or accident is work-connected or caused by work or by the working environment are
submitted. The correct evaluation on the compensability of the claimed
contingency shall depend on the sufficiency of these supporting papers.
In case of denial, the claimant may file a request for reconsideration, through a simple
letter, within ten days from the receipt of the letter of denial.
If the System affirms the denial, the claimant may then appeal to the Employees'
Compensation Commission. He/She may thus inform the System in writing
of his/her desire to make such an appeal, within 30 days from receipt
of the letter of denial.
The System shall then forward, within five (5) working days, the entire records of
the case to the ECC, which shall review and decide on the appealed
case within a month's time.
Unlike in other jurisdictions, the claimant does not have to hire lawyer in making the appeal.
Should the ECC affirm the System's decision, the claimant, as a last resort, may
still appeal to the Supreme Court. This is the only time when the claimant shall
need
legal services.
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