PCL 5-SOCSO and psychosocial factors

Social Security Organization (SOCSO)
- established in 1971 under the Human Resources Ministry to implement and administer the social security schemes
- under this scheme, workers are protected against industrial accident including accident occurred while working, occupational diseases, invalidity or death due to any cause

Function:
• registration of employer and employee
• collecting contribution
• processing benefit claims and make payment to the injured worker and their dependents.
• provide vocational and physical rehabilitation benefits and enhance occupational safety and health awareness of workers.

SOCSO’s Protection Schemes
- administer two types of social protection schemes :

Employment Injury Insurance Scheme
- provides protection to employees who are involved in accidents arising out of and in the course of his employment occupational diseases and also commuting accident.

COVERAGE
The Employment Injury Insurance Scheme protects employees from:
1) Accidents which occur while in the course of the work.
• Accident which occurs while working at the work place and was caused by the employee's job.
2) Accidents which occur while traveling
• On a route between his place of residence and his place of work.
• On a route between his place of work and the place where he takes his meal during any authorized recess.
• On a journey made for any reason which is directly connected to his employment. (on condition the accident does not occur during any interruption or deviation of the journey).
3) Accident during an emergency
• Accident which occurs during an emergency at the employer's premises while in the course of assisting, rescuing, or protecting other people from disasters such as a fire breakout.
4) Occupational Disease
• Disease that results from his occupation. Examples:
Loss of hearing due to exposure to continuous excessive noise.
Respiratory diseases or industrial asthma as a result of exposure to dust for employees in sawmills, powder factories, flour mills, and others.

THE BENEFITS PROVIDED UNDER THE SCHEME
• Medical Benefit
• Temporary Disablement Benefit
• Permanent Disablement Benefit
• Constant Attendance Allowance
• Rehabilitation Benefit
• Dependent's Benefit
• Funeral Benefit
• Education Benefit

Invalidity Pension Scheme
- provides twenty four (24) hours coverage for workers from invalidity or dies irrespective of the cause of death.
- The other objective is to ensure payments are made to workers and dependants when an unexpected incident occurs.

EMPLOYER'S LIABILITY
The principal and immediate employer who employs one or more employees is required to register and contribute monthly to SOCSO for all employees under the Employee's Social Security Act, 1969. The principal employer is also liable to ensure all employees employed by the immediate employer have been registered and their contributions have been paid.

EMPLOYEE
Under the Act, an employee is defined as a person who has been employed by an employer under a contract of service or apprenticeship.
1. Employees Earning Less Than RM3,000 must compulsorily contribute to SOCSO. SOCSO's coverage is only for employees who are Malaysian citizens and who are Permanent Residents.
2. Employees Earning More Than RM3,000 and who had not previously registered or paid contributions to SOCSO are given an option to be covered under the Act. Both the employer and employee have to consent to the coverage, by submitting 3 copies of the Notice of Election and Form 2 to the relevant SOCSO office. That particular employee will only be covered under the Act from the date the relevant SOCSO office accepted the notice.
3. Principle Of "Once In Always In" Employees who have been previously registered with SOCSO and now earn more than RM3,000 must compulsorily continue to contribute in line with the principle of "once in always in" under the First Schedule of the Act. Once an employee is eligible under the Act, he will always be eligible for coverage irrespective of his next monthly wage. All employees eligible for coverage under the Act must register and contribute to SOCSO.
Categories of employees exempted from SOCSO's coverage:
• Government employees
• Domestic servants
• Self- employed persons
• Foreign workers
• Business owner and spouses of sole-proprietorship or partnership

Contribution
- The principal employer must pay monthly contribution for each eligible employee according to the rates specified under the Act
- the rates of contribution are based on the total monthly wage paid to the employee

Types and Categories of Contributions
• First Category (Employment Injury Scheme and Invalidity Pension Scheme)
• For employees below 55 years of age. The contribution is paid by both the employer and employee for Employment Injury Scheme and Invalidity Pension Scheme.
• Second Category (Employment Injury Scheme Only)
• For employees above 55 years of age and still working.
• For employees above 50 years of age when first registered and contributed to SOCSO;
• For an Insured Person receiving Invalidity Pension who is still working and receiving wages which is less than1/3 of the average monthly wage before invalidity. Under this category contributions are only paid by the employer for protection under the Employment Injury Scheme.

Definition Of Wages
All renumeration payable in money to an employee is taken into account as wages for the purposes of SOCSO contributions. These include the following payments:
• Salary
• Overtime payments
• Commission
• Payments for leave such as annual, sick and maternity leave, rest day, public holidays
• Allowances such as incentive, good behaviour, cost of living (COLA)
• Service Charge
- Contribution to be paid to SOCSO is RM30.40 (Refer the Attachment A-Contribution Table) However, the following payments are not considered as wages:
• Payments by employer to any pension or provident fund for employees
• Mileage claims
• Gratuity payment(s) for dismissal or retrenchments
• Annual bonus

INTEREST ON LATE PAYMENTS OF CONTRIBUTIONS (ILPC).

- Employers who fail to pay the monthly contribution within the specified period will be liable for ILPC as stipulated under Regulation 33 of the Employee's Social Security (General) Regulations, 1971.
- The interest imposed will be imposed at a rate of 6% per annum in respect of each day delayed or default in payment of contribution after the given period ends provided that:-
• If the amount of interest calculated is less than RM5.00, then the interest payable shall be RM5.00 in respect of each month part of month;
• If the month of interest exceeds RM5.00, then the interest payable shall be calculated to the next highest multiple of RM5.00 in respect of each month or part of a month.

PENALTY
Under the Employee's Social Security Act, 1969, an employer may be fined not more than RM10,000 or two years' imprisonment or both if he is found guilty for the following offences:
• Default or delay in registering the business /company
• Default or delay in registering eligible employees
• Default or delay in paying monthly contributions




Psychosocial factors
- There is good evidence that certain psychosocial factors are associated with an increased risk for persistent back pain
- functional improvement and return to work were more strongly predicted by employment and psychosocial factors (job tenure, physical work demands, self-rated pain and mood) than by health history or physical examination

Psychosocial factors that suggest increased risk for persistent pain and that should be evaluated include :
 Poor control of one's job environment
 Short job attachment (recent hire)
 Limited work skills/experience
 Depression
 Fear avoidance behaviours (apprehension about reactivation). Examples include: guarded movements , changing position to get up due to fear of pain recurrence.
 Substance use.


- These psychosocial factors are more likely to predict prolonged disability than the nature of the low back injury

- For physicians, it is important to inquire :
o whether a claim is being made, to whom (workers' compensation, private disability insurance or social security disability), the claim's current status and whether litigation (a lawyer) is involved
o A key part of any disability claim involves a period of time (varying by jurisdiction) before the claim can be filed. The adjudication period for a pending claim can be stressful, especially for patients who are temporarily without income. The clinician should be sensitive to the potential for financial or psychological stress related to the pending claim.
o When low back pain interferes with a patient's ability to work, the physician may need to address factors beyond the standard medical evaluation. These can include financial issues, timing of return to work, the need for work accommodations, and third party disability issues.