ART. 191 TEMPORARY TOTAL DISABILITY ART. 192 PERMANENT TOTAL DISABILITY ART. 193 PERMANENT PARTIAL DISABILITY
1. DISABILITY
Disability – does not refer to the injury nor to the pain and suffering it has occasioned
- it refers to the loss or impairment of earning capacity
- there is disability when there is a loss or diminution of earning power because of actual absence from work due to the injury or illness arising out of and in the course of employment.
- The basis of compensation is reduction of earning power
- As long as the employee goes on working (even if he suffers service-connected injury or illness) without any reduction whatsoever in his earning capacity, there is no disability and , therefore, he is not entitled to any income benefit.
Art. 167 (n) – defines ‘disability’ as loss or impairment of a physical or mental function resulting from injury or sickness.
2. CATEGORIES OF DISABILITY
Case: Vicente vs. ECG (Jan. 23, 1991)
3 Distinct Categories of of Employee’s Disability: 1. temporary total disability
2. permanent total disability 3. permanent partial disability
TOTAL DISABILITY - may either be: a. permanent b. temporary - does not mean a state of absolute helplessness
- means disablement of an employee to earn wages in the same
kind of work, or a work of similar nature, that he was trained
for or accustomed to perform, or any kind of work which a
person of his mentality and attainment could do.
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Granting Compensation Temporary Disability To compensate the laborer
or employee for what he might have earned during the period of the treatment of his injury
Permanent Disability To compensate the injured laborer or employee for the actual and permanent loss of a member of the body, or the use thereof
Kind of Disability Descriptions 1. TEMPORARY
TOTAL - employee is unable to perform any gainful occupation for a continuous period not exceeding 120 days, except as otherwise provided in Rule X of these Rules. - income benefit equivalent to 90 percent of his average daily salary credit, subject to the following conditions:
1. the daily income benefit shall not be less than P10 or more than P90 nor paid longer than 120 days for the same disability, unless the in jury or sickness requires more extensive treatment that lasts beyond 120 days, but not to exceed 240 days from onset of
disability, in which case he shall be paid benefit for temporary total disability during the extended period.
2. the monthly income benefit shall be suspended if the employee fails to submit a monthly medical report certified by its attending physician.
- Maximum Daily Income Benefit : P200.00
- Paid beginning on the 1st day of disability.
- The system may declare the total and permanent status at any time after 120 days of continuous temporary disability as may be warranted by the degree of actual loss or impairment of physical or mental functions as determined by the system.
Note:
-After an employee has fully recovered from an illness, the period covered by any relapse he suffers, or recurrence of his illness shall be considered independent of, and separate from, the period covered by the original disability. Such a period shall not be added
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to the period covered by his original disability in the computation of his income benefit for temporary total disability. 2. PERMANENT
TOTAL -employee is unable to perform… for a continuous period exceeding 120 days except as otherwise provided for in Rule X of the ECC Rules.
- incapacity to perform gainful work which is expected to be permanent.
- does not require a condition of complete helplessness
PERMANENT TOTAL DISABILITIES (ART. 192):
1. Temporary total disabilities lasting continuously for more than 120 days;
2. Complete loss of sight of both eyes;
3. Loss of two limbs at or above the ankle or wrist; 4. Permanent complete
paralysis of two limbs; 5. Brain injury resulting in
incurable imbecility and insanity; and
6. Such cases as determined by
the System and approved by the Commission.
- The full monthly income benefit shall be paid for all compensable months of disability. The monthly income benefit shall be guaranteed for 5 years, except as otherwise provided.
GROUNDS FOR CANCELLATION OF PTD:
1. Failure of employee to present himself for examination at least once a year upon notice by the System;
2. Failure to submit a quarterly medical report certified by his attending physician as required under Sec. 5 of Rule IV hereof; 3. Complete or full recovery
from his permanent disability; or
4. Upon being gainfully employed. (ECC Rules) Amount of Benefits:
a. SSS- monthly income benefit as defined in Sec. 9 (a), Rule VI
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b. the number of months of paid coverage shall be the number of monthly contributions remitted to the System including contributions other than for Employees’ Compensation if paid before March 31, 1975. The full monthly income benefit shall be paid for all compensable months of disability. c. The first day preceding the semester of temporary total disability shall be considered for purposes of computing the monthly income benefit for permanent total disability.
Note:
-Each dependent child, but not exceeding 5, counted from the youngest and without substitution, shall be entitled to 10% percent of the monthly income benefit of the employee.
-Except the benefit to dependent children under Sec.4 of this Rule, 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 as of
the date of his permanent total disability.
3. PERMANENT
PARTIAL -employee suffers a permanent partial loss of the use of any part of his body
- see art. 193 (body parts/period) -monthly income benefit for the number of months indicated in art. 193
- If the indicated number of months exceeds 12, the income benefits shall be paid in monthly pension; otherwise, the System may pay income benefit in lump sum or in monthly pension.
- a covered employee shall continue to receive the income benefits provided thereunder even if he is gainfully employed and receiving his wages or salary. Permanent Total vs. Permanent Partial
Permanent Total Permanent Partial -results in an employee’s
loss of work or inability to perform his usual work -Test to determine whether
-occurs when an employee loses the use of any particular anatomical part of his body which disables him to continue
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or nor an employee suffers from Permanent Total: a showing of the capacity of the employee to continue performing his work notwithstanding the disability he incurred.
with his former work.
Permanent Total Disability Cases:
1. Orlino vs. Employees’ Compensation Commission Ruling: He is considered permanently and totally disabled to work when he was incapacitated or disabled to perform any substantial amount of labor in the line of work where he was formerly engaged, or any other kind of work to which he could be assigned.
2. Vicente vs. ECC
Ruling: The test of determining whether or not 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. It does not mean an absolute helplessness but rather an incapacity to perform gainful work which is expected to be permanent.
Conversion from Permanent Partial to Permanent Total 1. GSIS vs. CA
Ruling: A person’s disability may not manifest fully at one precise moment in time but rather over a period of
time. It is possible that an injury which at first was considered to be temporary may later on become permanent or one who suffers a partial disability becomes totally and permanently disabled from the same cause.
NOTE:
-The compensation paid in 1936 on account of the amputation of an employee’s foot, below the knee, should NOT be deducted from the compensation due for the dsability resulting from the amputation of the left leg, above the knee in 1857.
CHAPTER VII