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.

pregnant woman waits SSS maternity benefit


1.  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.

2.  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.

3. Birth Certificate of Child was not Authenticated by the local registrar or PSA (formerly NSO).

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

4. 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 the SSS Member Data Change Request E-4 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.

MAT1 = Maternity Notification
MAT2 = Maternity Benefit Application for Self-Employed, Voluntary
                                                               or Separated Members
               or
               Maternity Benefit Reimbursement for Employed Members

5.  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.

6.  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

7.  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.

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.  Hindi na ito -->>  5th or Subsequent Pregnancy or Miscarriage  

        Salamat at hindi na rason ito under the New Maternity Leave Law.  

Dati, merong ganitong rule: 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.

Under the new law, UNLIMITED na. Kahit ilang pregnancies or miscarriages, covered na lahat.


UPDATE: 
Since June 2016, there have been already 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 

You might like to learn some interesting things from Previous Comments from Users:  Reasons Why SSS Maternity Benefit Claims Are Denied
Comments from July 12, 2013 to May 28, 2014

Comments from 

Photo Credit for Photo of Pregnant Woman Above: 
Image by Fernando Zamora from Pixabay


This post on Reasons for SSS Maternity Benefit Rejection has received more than a thousand comments over the years, so I had to move the comments to Google Drive and to another post. 

If you like, you can go to the links above to see these comments.

Here below are some of the most helpful or interesting comments:

From Unknown 10/6/17:  

Hello! Just to share my experience, I got pregnant August 2014 and went AWOL January 2015 from my employer. Mula noon nagvoluntary member ako sa SSS and filed my maternity notification. Upon filing nakita ko sa requirements na kailangan ko ng Certificate of Separation, Certificate of Non-Advancement of Maternity Benefit and L-501 form. It was impossible for me na makuha yung mga documents dahil sa status ko na AWOL so hindi na ako nag-abala na magpasa ng MAT-2 after ko manganak ng May 2015. Pero, recently upon searching sa internet I learned na pwede palang gumamit ng AFFIDAVIT OF UNDERTAKING for cases like mine na hindi makakuha ng documents from past employer dahil ng AWOL status ko. It just cost me 100 pesos para ipanotarize yung affidavit together with all other requirements for Voluntary/Separated member CS delivery such as Certified True copy Operating Room Record, Discharge Summary, Clinical History, ipinasa ko na lahat ng pwede just to assure na hindi madedeny yung application ko and luckily after 3 weeks of waiting when I checked my maternity benefit claim status sa sss website, it was already SETTLED and as of now I am waiting na mareflect na sa account ko yung maternity benefit ko.

From Michelle 10/1/17:
Hi po...nakunan po ako nung september 20..10 weeks pregnant po ako nun..na raspa po ako... kaya lang po hindi po ako nakapag pasa ng MAT1 at wala din po akong ultrasound before ako makunan.. pwede pa po kaya ako makakuha ng maternity? Thank you po sa pag sagot.

From Unknown in reply to Michelle above 10/12/17:

Same tayo michelle. Mat 2 nlng po i file nyo sa sss.. Yan din ung sinabi ng sss sakin.. Need lang ng ultrasound before and after ka nakunan yan ung requirements nila

From shania 4/24/17: 
HI MS KD, Patulong naman. ito reply sakin ng previous Company ko. Wala talaga akong natanggap na any amount. online-accepted status ko sa sss website. Rule ng Company, hindi pwedeng mag walk in sa kanila previous employee. May portal/website sila for us. Please enlighten me sa dapat gawin. Its been 3yrs. Im lacking L501. Di kasi nila maprovide.

Upon carefully checking our records, we have seen that you were able to receive your Mat-1 claim Cash Advance. However, the cash advance was not deducted from your final pay. Thus, we cannot provide a certificate of Non cash advance, as well as the L501 form and your Maternity documents. We can offer you two options for that, one is that you can submit the lacking documents for your Mat-2 claim so that we can process the reimbursement of the Maternity claim. We will then notify you once we receive the reimbursement so that you can claim the second half of your Maternity claim. The second option is to provide an Authority to deduct form for us to be able to deduct the Mat-1 claim from your final pay for us to be able to process the requested Certificate of Non Cash Advance.

Kindly let us know your decision by creating another ticket.

KD 4/24/17: Hi shania: Ano yong option 2 nila? Hindi mo pa ba nakukuha ang final pay mo from them? Or ang ibig nilang sabihin ay isoli mo yong inadvance nila na one-half? If you don't remember any cash advance, ask them through their portal if they gave you your cash advance through payroll (payslip) or through a check.
Kung hindi pa nabigay ang final pay mo, I suggest choose their option 2, so you can file your own claim directly with SSS

From shania 4/25/17
Hi KD. thanks for replying.
Bale. 8k lang nakuha ko thru atm. Backpay ko yun. Yung mat ko is 33k yung approved amount approved ng SSS. So kung first half nakuha ko roughly 15k sana. Nasakin lahat ng MAT2 FORMS. Diko binigay sa kanila kasi nga theyre saying na nag cash advance daw ako. Wala ako nareceive. And separated status ko. I resigned AUG then DEC 2014 ako manganak. Wala talaga sila maadvance.

I secured L501, CERT OF NON ADVANCEMENT, AND CERT OF SEPARATION FROM EMPLOYER bago ako magresign. Yung HR admin pinirmahan yung 2 except L501.
So dinala ko sya sa SSS. Sabi ng SSS meron lang daw mga tao from my company na dapat pumirma dun hindi ang Hr na yun. Pagbalik ko, since separated employee nako. Nirefer ako sa portal. Tho andun yung mga tao na dapat pipirma. Hindi po gumagana ang portal nila. Never gumana. Im losing hope na talaga.

ilang beses nako bumalik. Wala naman sila mapresent sakin na documentation na nag cash advance ako. And wala akong any check or anything na pinirmahan sa kanila. Gusto ko nalang magfile ng complaint talaga. :(

Danzel 4/22/17: 
Hi denied yung Maternity claims ko. I submitted all the documents na hinihingi nyo and yet yung processing dept. Ganun ganun nlang magdenied. Bago namin ipasa mga documents dumaan na yan muna sa staff kung anong kulang at sila na mismo nagconfirm na kumpleto. Binalikan ko yung staff na tumanggap sa documents ko kung anong reason. Sabi ng staff nyo yung nasa data na reason hindi accurate at wala silang maibigay na explanation at para ma ibalik ang mga documents ko after 1 month pa!!! Ano to naglolokohan tayo!! 3weeks process tapos ibabalik after 1 month pa wala pang explain kung bakit tapos di pa matawagan hotline nyo.

Majo 4/20/17:
Hi gusto ko lng po itanung kung makukuha ki pa ang mat 2 ko kse po nag pasa ako ng mat 2sa employer ko ngaun mo ung sa birth certificate ng anak ko nde pang apat ko na sya pero sa mat 1 ko ang nakalagay po dun ay pangatlo palng ang ipinag bubuntis ko tapos hininingan po ako ng
Obstetrical history ngaun po nde ren po ako mabigyan ng ospital ng o.h kse po nun nag lalabor po ako ang sinabe ko po dun ay pangatlo paren po ang anak ko na lalabas pero ang totoo po pang apat ko na po un nahiya po kse ako sabihen na 4na anak sa idad na 23 apat na anak ko ayoko den po kse sermonan sa ospital kya pinababa ko po ang bilang ng anak ko sana po matulungan nyo ko slamat po

KD 4/24/17
Hi Majo: Yong sa MAT2 mo ba ay inilagay mo na 4 ang Number of Pregnancies mo? Yong sa birth certificate ba ay nakalagay na 4th ang birth order? Kung oo, bale pareho yong birth cert at MAT2 mo na tama. Yong MAT1 lang ang naiba. Subukan mong mag-submit ng claim sa ibang branch, baka hindi mapansin yong 3 sa MAT1 mo. Kapag mapansin, sabihin mo na nalito ka. Kung ayaw tanggapin, tanungin mo kung anong puede mong gawin para matanggap ang documents mo.

Unknown 4/13/17:
Hi KD, My situation is a bit different. I have 3 miscarriages and D & C in a row. First is June 2016, second is Nov 2016 and the third is just last month, March 2017. The first one is already reimbursed by SSS in July 2016. However up to now, I am not sure of the status second one. There is nothing reflected whenever I check online. Documents were filed by my employer in Dec 2016 and we learned in Feb 2017 that SSS Main is asking for additional document (discharge summary) which we submitted also 2 days after knowing. Now SSS Eastwood (the branch where we file) is saying my claim is already approved and no additional documents need to be submitted. If approved, why it is not being reflected online til now? I am concerned, have you known a case of disapproval because the 12 months prior to the semester of contingency overlaps? My pregnancies are close to each other since it all resulted to miscarriages so some months in the first pregnancy overlaps with the second and almost all months of the third overlaps with the second.

Leesa 3/29/17:
Good day! Tanong ko lang po sana kung anung pwede kong gawin.naghulog po ako sa sss ko as voluntary nung march 2016 tapos po employed po ako from june 2016 to august 2016 pero po ang naipost lang na contribution ng employer ko ay july 2016. Pinapaayos ko po sa employer ko yung contribution ko for the month of june, april 2017 po yung expected due date ko. Tanung ko lang po sana kung kapag naipost na po ba yung contribution ko ng june e pwede ba akong magclaim ng maternity benefits? Salamat po

Unknown in reply to Leesa: 3/29/17
Ang alam ko kasi mas maganda sana kun jan2016 to dec2016 ka naghulog para sure na may makuha ka kasi ako completo un last year ko due date ko ngayun june2017 nag inquire ako sa may online sss nakita ko na eligibility ako pwedi ako makakuha ng maternity dahil sa contribute ko ..ask mo rin sa sss kun kaylangan mo pa maghulog para hangat di kapa nanga2nak maasikaso muna para makakuha ka ng maternity

Leesa 3/29/17: 
Last time kasi na naginquire ako sa sss sabi saken basta daw maipost yung contribution ko ng month of june makakakuha daw ako ng maternity benefits. Kaso ang probkema ko lang is 'til now di pa naaayos ng employer ko yung contribution ko. Anytime kasi pwede na kong manganak pero di pa rin ako nakakapagpasa ng mat1 baka kasi di na pwedeng ayusin yun pag nanganak na sayang naman.

Unknown in reply to Leesa 3/29/17:
Lakarin mo muna agad yung mat 1 mo ..ako last year ko pa nalakad ..tapos pag wala pa rin hulog ng june 2016 mo tanung mo kung pwedi ikaw na lang maghulog sayang kasi..

16 Comments

  1. How can I fix my mat1 and mat2? In mat1 I'm still employed but I resigned before may pregnancy. How can i make my mat1 from employed to voluntary so that when I file my mat2 they will just same as mat1.

    ReplyDelete
  2. Hello, pay at least 1 month contribution as Voluntary so your status will become Voluntary. June 1 na ngayon, bayaran mo yong earliest month na puede mo pang bayaran. Example, kung puede mo pang bayaran ang January. By the way, when is your expected delivery date? At kelan yong month na huli kang merong SSS contribution as employee?

    ReplyDelete
  3. Hi po! Tanong Lang po if pwde p poba ako mg file ng sss maternity notification sa employer ko po now na mg 4 months n po pregnancy ko? Thank u po.

    ReplyDelete
  4. Hi, oo, puedeng-puede. Mag-file ka na. Ang deadline naman is before delivery. Gusto lang ng mga employers na mas maaga mag-notify para makapaghanda sila sa pag-maternity leave ng employee nang matagal.

    ReplyDelete
  5. Pano po kung naka limutan po na ilagay na pang second pregnancy napo sa mat1? Wala napuba maga2wang paraan para hinde madenied? Ngayon kulang po kc naalala na dko nalagay sa pinasa ko na mat1 ung last pregnancy ko kc nabasa kopo d2 .Waladin po kc cnbi ang employer ko kung ano napo balita sa mat leave ko Jan kopa po pinasa sakanila ung mat1 form kopo. Sana po may makasagot. Salamat

    ReplyDelete
    Replies
    1. Hi, parang mas okay yata na wala kang nailagay kesa mali yong nailagay mo. Enrolled ka ba sa SSS online? Mag-enroll ka para ma-check mo kung meron kang existing maternity notification. Madali lang mag-enroll ngayon. Una muna is dapat mag-create ka ng gmail address mo, kung wala ka pa nito, at i-take note mo yong user name and password mo kasi dian ipapadala ng SSS yong email nila sa iyo para ma-verify mo yong enrollment mo.

      Delete
  6. Hi po tanong ko Lang employed po ako Wala po ako natanggap Mula SA employer ko ngayon mag file ako Ng maternity reimbursement ko pinapa open account Yung employer ko para dun daw ideposit Wala po ba ibang option para saakin direct ibigay benefits ko SA maternity

    ReplyDelete
    Replies
    1. Hi, yan ang mahirap sa mga Employers na hindi makasunod sa tama. Ok lang kung taghirap talaga sila. Pero kung madamot lang, yon ang pangit. Thru banks kasi ang SOP ng SSS -- pag Employed, sa Employer's bank account nila idinedeposit yong benefit, kasi ang alam nila is nag-advance na yong Employer sa yo. Tanungin mo ang Employer mo kung naka-enroll na ba sila sa Sickness and Maternity Benefits Payment thru-the-Bank (SMB-PB) Program.
      Self-employed at voluntary lang ang diretso ang maternity or sickness benefit.

      Delete
  7. Yes po nakakapag open napo ako thrue sss app. kaso dkopo makita dun kung nanotify na ni employer si sss about sa pregnancy kopo. Pano puba makikita dun sa app kung may maternity notification nako sa sss?? Thank you po

    ReplyDelete
    Replies
    1. Hi, incomplete pa kasi ang app. Pumunta ka sa sss.gov.ph and login. Choose "Inquiry" and click "Submit Maternity Notification" kung anong isasagot. Check mo lang, huwag mong i-fill-up kasi ang alam ko kapag Employed, dapat sa online account ng Employer ang notification. Makita mo doon na kung online notification ang ginawa ng Employer mo, wala naman doon yong kung pang-ilan na ang pregnancy.

      Delete
  8. Hi. Kelan po makukuha ang maternity claim benefit? Bago po ba manganak pdeng makakuha ng half of it? Employed po ako dati ngbayad ang employer ko until February 2020 then itinuloy ko ung contribution ko as voluntary na this March. Thanks po

    ng March

    ReplyDelete
    Replies
    1. Hi, sad to say, wala ka nang employer kaya wala nang magbibigay ng advance benefit sa iyo. Ang SSS ay hindi nag-a-advance. If the gap between the date of your separation from your employer and the date of your delivery is less than 6 months, call your former employer and request for a certification that they did not advance to you your maternity benefit.

      Delete
  9. Hi miss nora. Thanks for that clarification. Yes po nbgyan na nila ako ng certificate ng no cash advance. Isinama ko po un nung nagnotify ako sa kanila. After ko pa po pala manganak ko makukuha ang benefit ko. Miss Nora pde ko na po din kaya babaan ang share ko monthly? Sinced wala na din po akong work. Hindi po kaya makakaaffect un sa makukuha kong maternity benefit? 2400 po ang share ko until this month of March. Kht feb po ang last payment ng employer ko. Thank you in advance.

    ReplyDelete
    Replies
    1. Hi, yong certificate of no advance ay isasama mo sa pag-claim mo. Sana meron ka pang kopya. Bakit kaya hindi nila isinoli sa yo? Kasi malabong mahanap pa nila yon later on sa dami ng files nila. If you'll deliver this July or Aug or the months following, okay na kung babaan mo, wala nang effect sa benefit mo ngayon. Kung meron kang online SSS account, icheck mo kung lahat ng contributions mo ay naka-post na sa SSS.

      Delete
  10. Hi miss Nora. Meron pa po akong copy kc po thru email Lang din ipinadala saken ng company ko dati due to pandemic po. Miss Nora how about po ung sa online sss account kelan magaappear doon ung maternity notification ko sa kanila? Or meron man po after ko na ba xa maclaim dun pa lang me magaapear sa online sss account ko? Thank you

    ReplyDelete
  11. Lahat namn po ng contributions ko is nakapost na sa online account ko. Pero sabi po ng nakausap ko ang Jan- March contribution ko po is d na maisasama sa computation dahil late ko na po nabayaran ang month of March. Bale po miss Nora, from January 2019- March 2020 eto po ang mga contributions ko.
    Jan 2019- 1760
    Feb2019- 1760
    March2019-1760
    April2019-2400
    May2019-2400
    June2019- 0
    July2019-0
    August2019-480
    Sept2019- 2400
    Oct2019-2400
    Nov2019-2400
    Dec2019-2400
    Jan2020-2400
    Feb2020-2400
    March2020-2400
    Sa mga naihulog ko po na qualified po ba ako sa maximum benefit na 70k? Thank you in advance




    ReplyDelete

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