Malaysia

27% of claims rejected, mostly non-work injury cases, Socso says

The agency says no issue of stricter regulations or limited funds, rejection based on existing provisions

Updated 5 years ago · Published on 22 Oct 2020 1:00PM

27% of claims rejected, mostly non-work injury cases, Socso says
The Social Security Organisation last year rejected some 27% of total claims applications, mostly due to non-employment injury cases. – The Vibes pic, October 22, 2020

by Amar Shah Mohsen

KUALA LUMPUR – Close to 75% of claims made by contributors to the Social Security Organisation (Socso) were approved last year, confuting suggestions that a large number of workers are having difficulty seeking aid. 

This appears to disprove claims, including those by the Malaysian Trades Union Congress, that the government agency may have tightened its approval process owing to a supposed lack of funds, stemming from a low contribution rate by employers and employees. 

In an email to The Vibes, Socso said those who have had their claims rejected were mainly due to their failure to fulfil requirements as stipulated under existing provisions. 

“In 2019, a total of 113,657 claims were processed, of which only 27% were declined, mostly due to non-employment injury cases or for not attaining invalidity status. 

“The processes for claims approval have not changed since the Employees’ Social Security Act (Essa) 1969 came into force. 

“Therefore, there is no issue of Socso adopting a more stringent approval process.” 

Socso’s response comes amid complaints by contributors who have permanent injuries, but have had their claims for assistance rejected, some of them multiple times. 

Lorry driver M. Tewarajan, 61, has undergone a head surgery for an unspecified illness and has difficulty walking due to weak lower limbs. He tried twice to claim for Socso benefits but was rejected both times. The Vibes met him at Human Resources Minister Datuk Seri M. Saravanan’s event on October 1. – The Vibes pic, October 22, 2020
Lorry driver M. Tewarajan, 61, has undergone a head surgery for an unspecified illness and has difficulty walking due to weak lower limbs. He tried twice to claim for Socso benefits but was rejected both times. The Vibes met him at Human Resources Minister Datuk Seri M. Saravanan’s event on October 1. – The Vibes pic, October 22, 2020

The Vibes was able to speak to a number of complainants who attended an event hosted by Human Resources Minister Datuk Seri M. Saravanan on October 1 to share their grouses and seek for assistance on matters relating to the ministry. 

Many of them were there to bring up Socso’s rejections of their applications for assistance. 

Socso is under the purview of the Human Resources Ministry.

The organisation said the approval for claims for invalidity are based on the level of impairment of the individuals. 

Claims for employment injuries, meanwhile, will be assessed based on the cause of injury or diseases, and if they were sustained during work-related activities. 

These are based on the requirements stipulated by the relevant sections in Essa 1969, the Employees’ Social Security (General) Regulations 1971, Self-Employment Social Security Act 2017 and Employment Insurance System Act 2017. 

“To ensure that fair assessment is made for each claim, the Essa 1969 stipulates that all decisions regarding impairment level and invalidity are to be decided by a medical board gazetted by law, comprising medical practitioners and specialists in government hospitals. 

“So, although the law provides for workers insured by Socso to make a claim, it will be assessed by an independent body, regardless of the state of the social security fund. 

“This arrangement provides for a fair decision on compensation awarded to those who fulfil the requirements that the social security fund is intended for,” Socso said. 

Socso’s explanation is in line with Saravanan’s statement earlier this month that decisions on qualifications for benefits are made by independent lawyers and doctors. 

The minister had said it was unfair for the public to blame Socso for rejecting claims, stressing that the organisation is merely an implementing agency. 

“If the independent lawyers and doctors said no (to approving claims), that certain individuals are not qualified, we cannot say otherwise. But many of those affected may not understand this,” he said. 

In response to Saravanan’s statement, National Union of Banks Employees (NUBE) general secretary J. Solomon had said it was Socso’s responsibility to provide protection to workers who suffered injuries or disabilities, particularly where there was evidence to back their claims. 

He blamed Socso’s “extremely meticulous and strict requirements and procedure” as the reason behind many failed claims. – The Vibes, October 22, 2020

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