If you live in Malaysia and have ever been involved in an accident at work, you might be wondering how you can get help. This is where SOCSO, the Social Security Organization, or Pertubuhan Keselamatan Sosial (PERKESO) in Malay, comes in.
SOCSO is there to support you when things go wrong, especially when it comes to accidents. Whether you're just starting your first job or have been working for years, understanding how to make a SOCSO claim can make a big difference when you need it most.
How to claim SOCSO for accidents?
Claiming SOCSO for accidents might seem complicated, but it’s actually straightforward once you know the steps. Here are the steps on how you can do it:
Report the accident
First, if you’re involved in an accident at work or while commuting to or from work, you need to inform your employer as soon as possible. They are required to report the accident to SOCSO within 48 hours. You should also keep a record of the accident and any medical treatment you receive.
Visit a panel clinic or hospital
After the accident, you’ll need to get medical treatment. It’s important to visit a SOCSO panel clinic or hospital. If it’s an emergency, you can go to any nearby hospital, but you should later follow up with a SOCSO-approved clinic or hospital for further treatment.
Fill out the claims forms
Next, you’ll need to fill out the necessary claim forms. Your employer will usually help you with this, but it’s good to know what’s involved. The main form you’ll need is Form 21 (Borang 21), which details the accident and the injuries you’ve sustained. You might also need to submit Form 10 (Borang 10) if you’re claiming temporary disablement benefits.
Submit the documents
Once you’ve filled out the forms, you’ll need to submit them along with any supporting documents, such as medical reports and receipts, to your nearest SOCSO office. Your employer can help with this, or you can submit them yourself.
Wait for approval
After submitting your claim, SOCSO will review your case. If everything is in order, they’ll approve your claim and start providing the benefits you’re entitled to, whether it’s medical care, compensation for lost wages, or other types of support.
Follow up
Sometimes, SOCSO may ask for additional information or documents. It’s important to follow up promptly to avoid delays. You can contact SOCSO or check your claim status online.
By understanding and following these steps, you’ll be better prepared to handle the situation if you ever need to make a SOCSO claim for an accident.
How much can SOCSO claim for accidents?
When you’re involved in an accident and make a SOCSO claim, you might wonder how much you can actually receive. The amount you can claim depends on a few factors, including the type of injury and how long you’ll be unable to work. Here’s a breakdown to help you understand what to expect:
Temporary disablement benefit
If you’re injured and can’t work for a while, SOCSO provides a temporary disablement benefit. This benefit pays you 80% of your average daily wages for each day you're unable to work, starting from the fourth day after the accident.
So, if you usually earn RM100 a day, you would get RM80 a day from SOCSO during your recovery period. The rate however is set at a minimum of RM30 to a maximum of RM132 per day.
Permanent disablement benefit
If your injury leads to a permanent disability, you may be eligible for a permanent disablement benefit. The amount depends on how severe your disability is. SOCSO calculates this based on a percentage of your average monthly wages.
For example, if you suffer a 30% disability and your average monthly wage is RM3,000, you could receive a lump sum or monthly payments based on that percentage.
Employees can receive up to 90% of their average daily wage for this benefit with a minimum of RM30 and a maximum of RM118.50 per day.
Dependents' Benefit
In the unfortunate event that an accident leads to death, SOCSO provides a dependents' benefit to your family. This benefit is usually 90% of your average monthly wages and is paid to your dependents, like your spouse, children, or parents. The benefit is set at a minimum rate of RM10 per day.
Medical Benefits
SOCSO also covers your medical expenses related to the accident. This includes doctor visits, hospital stays, surgeries, and even rehabilitation services. You don’t have to worry about paying for these out of pocket as long as you go to a SOCSO-approved clinic or hospital.
Funeral Benefit
If an accident results in death, SOCSO offers a funeral benefit to help cover funeral expenses. This is a one-time payment of the amount incurred made to the family or RM2,000, whichever is lower.
If you ever need to make a SOCSO claim, it’s important to understand what you’re entitled to so you can make the best of a difficult situation. For personalised advice or assistance with your claim, reach out to Douglas Loh as we can guide you through the process and ensure you get the support you deserve.
Can we claim medical expenses from SOCSO?
Yes, you can claim medical expenses from SOCSO if you’re injured or become sick due to work-related accidents or occupational diseases. Here’s how it works:
Free treatment at SOCSO panel clinics and government hospitals
If you’re hurt at work or develop an occupational disease, SOCSO covers your medical expenses, but there are a few things you need to do. First, you’ll need to get treatment at a SOCSO panel clinic or a government hospital.
To be eligible for free treatment, you or your representative need to bring an Accident Report (Form 21) or an Identification Letter from your employer. If your condition is related to an occupational disease, you’ll need to submit Report of Occupational Diseases Form 68 and Form 69.
SOCSO will handle the medical bill directly, so you don’t have to worry about paying out of pocket. It’s important to continue your treatment at the same SOCSO panel clinic until you’re fully recovered, or until you’re referred to a government hospital for more specialised care.
Treatment for serious injuries
In cases of serious injury, you should go to the nearest government hospital immediately. SOCSO will cover your treatment there, and if you need to stay in the hospital, you’re eligible for second-class ward treatment. If you require specialist treatment, SOCSO will also cover this, but it must be done at a government hospital.
Reimbursement for non-panel clinics
If you end up getting treatment at a non-SOCSO panel clinic, you can still submit your medical expenses for consideration, but it’s better to stick to SOCSO-approved facilities whenever possible to ensure your costs are fully covered.
Conclusion
Understanding SOCSO and how to make claims after an accident is crucial for ensuring you get the support you need when it matters most. From covering medical expenses to providing financial benefits for temporary or permanent disablement, SOCSO is there to help you navigate tough situations. Knowing the steps to claim and what benefits are available can make a big difference in your recovery and peace of mind.
If you ever find yourself needing to make a SOCSO claim and want to ensure everything is handled correctly, our professionals at Douglas Loh can help you with it. We provide personalised advice and guide you through the process to make sure you receive the support you need in trying times.
FAQ
What is covered under SOCSO?
As we had outlined in the article above, a lot of important benefits are covered to help you if you get injured at work or develop a work-related illness. Here’s what you can expect:
a. Medical expenses
b. Temporary disable benefit
c. Permanent disablement benefit
d. Dependent’s benefit
e. Funeral benefit
f. Rehabilitation
SOCSO is there to support you when you need it most, covering a wide range of benefits to help you and your family.
What is not included in SOCSO?
SOCSO covers work-related injuries and illnesses, but here’s what it doesn’t include:
a. Personal accidents outside of work.SOCSO doesn’t cover accidents that happen during your personal time.
b. Non-occupational diseases. Illnesses not related to your job, like the flu or chronic conditions, aren’t covered.
c. Cosmetic treatments. Elective procedures, like plastic surgery, aren’t included.
d. Certain medical supplies. Some medical supplies not directly tied to your recovery may not be covered.
Knowing these exclusions helps you prepare for situations where you might need additional insurance or savings.
How do you submit a SOCSO claim?
To submit a SOCSO claim, start by gathering all the necessary documents, such as the Accident Report (Form 21), medical reports, and any other required forms. You can then visit your nearest SOCSO office in person, where you can hand over your documents and get help with filling out any forms if needed.
Alternatively, you have the option to submit your claim online through the SOCSO website, where you’ll need to upload scanned copies of your documents.
After submitting your claim, be sure to follow up and keep track of its status. SOCSO might contact you for additional information, so stay alert for any updates.
Who is entitled to SOCSO?
Here are those working in Malaysia that are entitled to SOCSO claims:
a. Employees: If you have a job and your employer pays into SOCSO, you're covered. This includes both full-time and part-time employees.
b. Self-employed workers: Certain self-employed people, like those in specific high-risk industries, can also be covered if they choose to join SOCSO.
c. Domestic workers: If you work as a domestic helper, you might also be eligible for SOCSO coverage, depending on your employment agreement.
d. Employees on leave: Even if you're on leave, such as maternity or medical leave, you’re still covered by SOCSO as long as you were contributing before the leave.
To sum up, if you're employed in Malaysia and your employer is making SOCSO contributions, you’re generally covered. If you’re not sure about your status, it’s a good idea to check with your employer or SOCSO directly.
What is SOCSO form 34 and where can I get it?
SOCSO form 34, also known as Borang 34, is used to claim benefits for temporary or permanent disability due to work-related accidents or occupational diseases.
You can get this form by visiting your nearest SOCSO office or regional office, downloading it from the SOCSO website, picking it up at a SOCSO panel clinic, or asking your employer for a copy.
Make sure to complete it accurately to ensure your claim is processed smoothly.
6. What is the claim period for SOCSO?
For SOCSO claims, report your accident or disease within 48 hours and submit your claim forms within 6 months from the incident or the start of symptoms. Acting quickly ensures you get the benefits you’re entitled to without delays.
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