7.06.2023

Reasons Why SSS Maternity Benefit Claims Are Denied

Updated March 22, 2019

Here are some reasons why SSS maternity benefit claims are denied. These are based on the personal experiences of women SSS members who have commented on our blogs.

1. Birth Certificate of Child was not Authenticated by the local registrar or NSO.




    Do not submit the birth certificate issued by the hospital.  Get your child's birth certificate from NSO, or get a Certified True Copy of your child's birth certificate from your Local Civil Registrar.   

2. Signature in MAT1 is different from Signature in MAT2 because in MAT1, the maiden name is used, and in MAT2, the married name is used, and that SSS has not yet been updated about the change in civil status using SSS E4 form.

   If you want to change your surname as you are processing your claim, it is best to first wait that the change in surname is effected before you submit your MAT2 claim. Check your online SSS account from time to time.

3.  Applicable Contributions are Paid, but Not yet Remitted by Employer or Not Yet Posted

     If you're Employed, before you file your maternity claim, make sure that the 6 monthly contributions that will be considered by SSS in computing your Maternity Benefit are already posted in your SSS account.  Check your online SSS account.

4.  Your Coverage Status in your Record is Different from your Status in your Claim

Example:  You checked VOLUNTARY in your MAT2 form, but your status in your SSS account is  EMPLOYED.

5.  Questions about the Child's Middle Name and Surname

Example:  The child's middle name is different from the mother's surname, and the child's surname is different from the father's surname.  

Remedy for this:  Submit Affidavit to Explain Discrepancy in Names

6.  MAT1 was not submitted to SSS before delivery of the child.  Or maternity notification was not filed online before date of delivery.

If you were not able to submit MAT1 or notify SSS online before delivering your child, attach your letter of explanation to your MAT1 form and ultrasound report or pregnancy test report.

Not all explanations are accepted; it depends on your reason and on the SSS officer evaluating your claim.

7.  Member is not eligible for maternity benefit.

Member has not paid her contributions for at least 3 of the 12 months BEFORE semester of delivery or semester of contingency.

8.  Member delivered her child by CS, but did not submit Operating Room Record

9.  Member had Miscarriage, but did not submit Histopathology Report and Medical Certificate

10. Member recently resigned from work, but did not submit these 3 documents:
        Certificate of Separation
        Certificate of Non-Advancement of Maternity Benefit
        L-501 form

If your date of separation from employment is within 6 months of your date of delivery, you need to submit these 3 documents from your former employer:
 . Certificate of Separation from Employment (must include date of separation)
 . Certificate of Non-Advancement of Maternity Benefit (this means your employer did not advance any amount of maternity benefit to you)
 . 2 copies of Specimen Signature Card (SSS Form L-501)

If the gap between your Date of Separation and Date of Delivery is more than 6 months, but less than 1 year, prepare to submit these 3 documents. The rule mentions 6 months, but there are officers still requiring these documents even if the gap is more than 6 months.

There was one member who commented here, saying that the gap in her case is 11 months and 28 days, and her claim papers were accepted. But later on, her claim was Denied  due to lack of separation papers. She had to wait for her rejected papers, and had to resubmit her claim.

Hindi mo na ba makita ang employer mo? Or nag-AWOL ka ba?
If you can no longer find your former employer, or if you went AWOL and your request for documents is not attended to, you can use this form: Affidavit of Undertaking (English) or
Affidavit of Undertaking (Tagalog) or Affidavit of Undertaking (Visayan).

11.  There's an error in the Certificate of Separation or L-501.

Example: The signatures on the L-501 and Certificate of Separation are not the same. Or there is No Date of Separation in the Certificate of Separation.

12.  It was Certificate of Employment that was submitted. 

Submit Certificate of Separation. These 2 kinds of certificates have almost the same contents, but they have different emphasis.  There have been at least 3 members whose claims were Denied because of this reason. 

13.  The Numbers of Pregnancies or Deliveries or Miscarriages in the Forms or in Previous Maternity Claims are not consistent.

Example:  In your MAT1 form, you wrote 2nd pregnancy, but the Birth Certificate shows 3rd in Birth Order.  Another Example: 3rd pregnancy in MAT1, but MAT2 shows 2 miscarriages and 2 deliveries or the Birth Certificate shows 4 in Total No. of Children Born Alive.

14.  Member has no Date of Coverage.

Usually, a member discovers that she has no Date of Coverage upon submission of MAT1, but there are cases that are not detected early, especially now that MAT1 can be submitted online.

Why are  there members without Date of Coverage (DOC)?
These members without DOC are usually the ones who have been paying their contributions as Voluntary without first registering properly and correctly.

You have a Date of Coverage if:
 . you were reported to SSS by your employer as Employee
 . you registered at an SSS branch as Self-Employed using RS1 form and your Proof of Source of Income       and your application was approved
 . you registered as Non-Working Spouse and your application was approved
 . you registered as OFW and your application was approved

Making your FIRST payment to SSS as Voluntary is not allowed. You become Voluntary only when you stop being an Employee, Non-Working Spouse, Self-Employed or OFW, and you decide to continue making SSS contributions.

15.  Your Employer Has Not Filed Its Sickness and Maternity Benefits Payment Thru the Bank (SMB) form
     
        SSS now requires every employer to file its SMB PB form. SSS will pay your maternity benefit through the SSS-registered bank account of your employer.  If you're Employed, ask your employer if it has filed its SMB PB form before filing your maternity benefit claim.

16.   5th or Subsequent Pregnancy or Miscarriage  ( Hindi na ito)

        Salamat at hindi na rason ito under the New Maternity Leave Law.  Inaantay na lang natin yong Implementing Rules and Regulations (IRR) para malaman natin yong paano ang implementation.

xxxxx Only the first four deliveries or miscarriages are covered under the SSS maternity benefit program.  This policy started on May 24, 1997. Even if you were not able to claim your maternity benefit for your first four deliveries or miscarriages, you can no longer claim for your 5th or subsequent deliveries or miscarriages.xxxxx

Under the new law, kahit pang-ilang pregnancy or miscarriage, covered na.


UPDATE as of June 2016
There's now a separate application form for those EMPLOYED and those NOT EMPLOYED:
Maternity Benefit Application Form for Self-Employed, Voluntary Member and OFW
Maternity Benefit Reimbursement Form for Employed Member

Related posts:
No. of Pregnancies or Deliveries or Miscarriages in Your SSS Maternity Benefit Claim
documents should be consistent

What to Do When Your SSS Maternity Benefit Is Denied 

Previous Comments from Users Can Be Seen Here: Reasons Why SSS Maternity Benefit Claims Are Denied
Comments from July 12, 2013 to May 28, 2014

4.18.2019

SSS Flexi-Fund Earnings Estimates

Here are three SSS Flexi-Fund earnings estimates:

1.  Estimates presented by SSS on its website:

Monthly Savings of 2,00 Pesos



No. of Years
 Total Savings
 Total Benefits
3
72,000
79,455
5
120,000
141,384
10
240,000
328,692
15
360,000
599,989
20
480,000
962,852





2.  Estimates using online calculators







3. Estimates using online calculators


Unposted SSS Contributions

<b>About unposted SSS contributions</b>2/9/16
Hi good morning, please help me make a letter of request for posting contributions 2013. I applied as self employed then paid six months. When I got employed, my employer paid year 2013-2016, and they were not posted. How can I fix it?
ANSWER:
Do you mean you went to SSS, verified your contributions, and your record does not show any contribution? Not even one contribution? Do you have with you SSS the verification slip with SSS note that you have zero contributions?
Bring this note to your former employer and request a copy of receipts and collection lists from 2013 to 2016 in which your name appears so you can bring these documents to SSS.

Together with these documents, submit a letter, something like:
Dear SSS ____ (branch)

My name is _____and my SSS no. is ____________.
Please post my SSS contributions from ____ 2013 to ___ 2016. Attached to this letter are ORs and collections lists from my former employer ______.

These are my payments for my SSS contributions:

 Applicable Month  Date Paid    OR No.  Amount paid
 ________          ________     _____   _________  

Thank you,

For your self-employed contributions, make another letter, attach copies of your receipts.
Xerox your letters and have them signed Received by SSS -- you will use this for your follow-ups.

Deadline for Filing Your Sickness Benefit Claim


Up to when am I allowed to file my SSS sickness benefit claim?

If you were hospitalized, you should file your SSS sickness benefit claim within 1 year from the date you were discharged from the hospital.

If you were treated at home, you should file within 1 year from the start of your illness.

But of course, file your claim as soon as you have completed your documents. In case there are questions about your documents, it will be easier to get back to your doctor or the hospital where you were confined.

What are the deadline for sickness notification?

For employees:
Notify your employer within 5 days 



Deadline for sickness notification by OFWs has been extended


How to Apply for an SSS Salary Loan Online

How to Apply for a Salary Loan via MySSS Online

Applying for a Salary Loan in SSS? Here's a step by step instruction on how to apply through MySSS Online.

1) Go to https://www.sss.gov.ph/ and log in found at the right portion of the website using your registered Username and Password.


2) Hover your mouse on E-SERVICES and Click on "Apply for Salary Loan".


You will see whether you are eligible for the application. See sample below.
Know that to apply for a one-month salary loan, a 36 monthly contribution is needed.


 3) If eligible,