Reasons Why SSS Maternity Benefit Claims Are Denied

By KD With 214 comments:
Updated November 3, 2015

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 is 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.

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.   5th or Subsequent Pregnancy or Miscarriage

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.

16.  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. 

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

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



By KD With 2 comments:
We have received hundreds of comments, so we have to move older comments to Google Drive to give space to newer comments.

Comments from August 14, 2014 to February 26, 2015 -- Comments on Various Articles


How Can I Claim SSS Maternity Benefit if I Was AWOL?

By KD With 8 comments:


Hi, good day. Can I Avail of SSS Maternity Benefit? I was AWOL last December 2015. Then I filed my MAT! last March as a Self-Employed.  I gave birth via C-Section this May. This June, I changed my status and paid my contributions this month.  What requirements should I file so I can avail of maternity benefit? Thank you in advance.


If you've paid at least 3 monthly contributions within Jan 2015 to Dec 2015, you are eligible for SSS Maternity Benefit. 
Submit these documents:
 - Maternity Benefit Application for Self-Employed, Voluntary Member
 - Maternity Notification (signed and stamped by SSS before delivery)
 - Birth Certificate of your baby, from the NSO or Local Civil Registrar
 -  Operating Room Record 
      or Surgical Memorandum
      or Discharge Summary Report
      or Medical/Clinical Abstract
      or SSS ID application stub
      or other valid IDs  
 -  Affidavit of Undertaking (notarized) 
      You will submit this because your delivery date is within 6 months of your last day with your employer
      You can submit this affidavit instead of a Certificate of Non-Advancement of Maternity Benefit from your employer because you went AWOL.  

 - Bring original and photocopies of documents

Related Posts:
Why Some SSS Maternity Benefit Claims are Denied

How Much is Your Maternity Benefit?


Certificate of Separation if Less Than 65 Years Old for SSS Retirement Claim

By KD With No comments:

Am I Required to Submit a Certification of Separation When I Claim My SSS Pension at Age 60?

Question from an SSS Member:

I am an SSS voluntary member. I'd like to know, should I retire at 60 years old, whether I'm required to get a certificate of separation from my last employer, way back 1989.
Since then, upon resumption of my SSS contribution last 2006, I am paying in the capacity of a voluntary member.
Are there any options or alternatives of getting equivalent or other related requirements in lieu of the certificate of separation?
I am just projecting this scenario, though I am only 52 years old at this moment.


If your status is EMPLOYED to VOLUNTARY MEMBER, you will no longer be required to submit a Certificate of Separation.
 Check your member status in your online SSS account.

Others Who Are No Longer Required to Submit a Certificate of Separation or Proof of Cessation of Business:

Self-Employed to Voluntary Member
OFW to Voluntary Member
Self-Emploted to OFW
Employee to OFW

Underground Mineworker 60 years old or older
Employed, Self-Employed or Voluntary Member 65 years old or older

Source:  SSS Citizen's Charter, 2016 Edition (Page 81)


Valid IDs Accepted by SSS

By KD With No comments:
When filing your SSS benefit claim, present your original or actual valid primary IDs and photocopies of your IDs.
You might be required to present more than one ID, depending on the type of ID you have.

Present any one of the following valid primary IDs:

Valid Primary IDs:
  •  Social Security (SSS) ID card
  •  Unified Multi-Purpose ID (UMID) card
  •  Passport
  •  Professional Regulation Commission (PRC) Card
  •  Seaman’s Book (Seafarer’s Identification & Record Book)
Valid Secondary IDs:
If you have no valid primary ID, present any two of the following Valid Secondary IDs:
The two IDs you present should have your signature and at least one should have your photo.

  •  Driver’s License
  •  Voter’s Identification Card or Voter’s Affidavit or
       Voter's Certificate of Registration
  •  School ID
  •  Company ID
  •  Senior Citizen Card
  •  Postal ID Card
  •  Taxpayer’s Identification Number (TIN) card
  •  Philippine Health Insurance Corporation (PHIC) ID Card
  •  Overseas Workers Welfare Administration (OWWA) Card
  •  Credit Card (with name and signature)
  •  Fisherman’s Card issued by the Bureau of Fisheries and Aquatic Resources (BFAR)
  •  Government Service Insurance System (GSIS) Card
          or GSIS Member’s Record or GSIS Certificate of Membership
  •  Health or Medical Card
  •  Firearm License card issued by Philippine National Police (PNP)
  •  ID Card issued by Local Government Units (LGUs, namely barangay, municipality or city)
  •  ID Card issued by professional associations recognized by PRC

Valid Secondary Documents:
If you have no valid primary ID, you can present one of the valid secondary IDs with
signature and photo (see list above) and at least one of the following secondary documents:

Present the original IDs and photocopies.

  •  Marriage Contract or Certificate
  •  Home Development Mutual Fund (Pag-IBIG) Member’s Data Form
  •  Police Clearance
  •  Seafarer’s Registration Certificate issued by the
       Philippine Overseas Employment Authority (POEA)
  •  Student Permit issued by the Land Transportation Office (LTO)
  •  Alien Certificate of Registration
  •  Certificate from any of the following:
    •  Office of the Northern Cultural Community
    •  Office of the Southern Cultural Community
    •  Office of Muslim Affairs
    •  Certificate of Naturalization issued by the Bureau of Immigration
    •  Certificate of Licensure or Qualification Documents from the
              Maritime Industry Authority
    •  Certificate of Licensure or Qualification Documents from the
              Maritime Industry Authority
Remember:  Present your original or actual IDs and photocopies of your IDs