Benefits Paid Under The Program

It is of interest to note that while the total Social Security contributions paid on behalf of an employee is 12.75% of his Average Weekly Insurable Earnings (AIWE), the minimum pension which he may qualify for is 30% his AIWE. Additionally, the Short-term benefits he may qualify for is paid at the rate of 60% of his AIWE

Short Term Benefits

These are benefits that are generally payable for a short duration of time (not exceeding 26 weeks or 6 months), and are meant to partially replace employment income lost as a result of temporary absence from work. Qualifying claimants are paid a maximum 60% of their average income during the period of time that they are medically certified to be incapable of work. A person in receipt of Short-term benefit is responsible for informing the DSS office if there is any change of circumstances affecting his continued rights to such benefit.

  • Sickness
  • Maternity
  • Maternity Grant

Sickness Benefits

Sickness Benefit is a benefit payable to an Insured Person who is rendered temporarily incapable of work as a result of a specific disease or bodily or mental disablement. The benefit is payable at the rate of 60% of the Claimant’s Average Weekly Insurable Earnings for a maximum period of 6 months of medically certified illness.

Following are the requirements which must be satisfied for an Insured Person to qualify for Sickness Benefit:

  • A Medical Certificate must be presented certifying that the Claimant will be incapable of work for at least 4 days.
  • A Sickness Benefit Application form must be duly completed by the Claimant.
  • The Claimant must have been insured with the DSS for at least 13 weeks.
  • He must have been employed for at least 8 weeks in the last 13 weeks immediately prior to the start of the illness.
  • He must have been at work on the day immediately preceding the illness.
  • He must not have engaged in any activity which could result in the Disqualification of his claim.

All Claims for Sickness benefit must be submitted to the DSS within 4 working days of the date of issue of the Medical Certificate, and the Employer Certificate (found on the reverse side of the Medical Certificate) must be duly completed by the employer before the claim is submitted.

Maternity Benefit

Maternity Benefit is a periodical payment made to a woman who is rendered incapable of work as a result of her pregnancy and confinement. The benefit is payable at the rate of 60% of the Claimant’s Average Weekly Insurable Earnings for a maximum period of 3 months.

Following are the requirements which must be satisfied for an insured woman to qualify for Maternity Benefit:

  • Present a Medical Certificate certifying that she is pregnant, and expected to confine by a specific date.
  • Complete and submit a Maternity Benefit Application form.
  • Have been insured with DSS for at least 30 weeks.
  • Have been in insurable employment for at least 20 weeks in the last 30 weeks immediately prior to the commencement of maternity leave.
  • Not have engaged in any activity which could result in the Disqualification of her claim.

All Claims for Maternity benefit must be submitted to the DSS within 3 weeks from the Expected date of Confinement, and the Employer Certificate (found on the reverse side of the Medical Certificate) must be duly completed by the employer before the claim is submitted.

Maternity Grant

Upon confinement, $500.00 in respect of each child is payable to:

  • An insured woman
  • The Uninsured spouse of an insured man

To qualify for the grant the insured woman or her spouse (as the case may be), must satisfy the following conditions:

  • The Claimant must present a Certificate of Confinement stating the date of confinement.
  • A Maternity Grant Application form must be duly completed by the Claimant.
  • The Claimant must have paid contributions for at least 26 weeks in the last 52 weeks immediately preceding date of confinement.

Where the Claimant has insufficient Contributions to qualify for a Maternity Grant, the combined contributions of the husband and wife, or spouses living in association for a period of not less than 3 years may be used to meet the required number of Contributions.

Please note that all Claims for Maternity Grant must be submitted to the DSS within 15 days from the date of Confinement. In the absence of a claim for Maternity Benefit, the Employer Certificate (found on the reverse side of the Confinement Certificate) must be duly completed by the employer before the claim is submitted.

Please note that the Maternity Grant is not payable after 12 months have elapsed and—where the claimant owes the hospital—the Maternity Grant is used to pay the outstanding debt and the difference, if any, is paid to the claimant.

Employment Injury Benefit

This is is a benefit payable to an Insured person as a result of an injury sustained on the job, or an occupational disease directly attributed to the job. The benefit is generally paid for a short duration of time (not exceeding 6 months), and is meant to partially replace employment income lost as a result of temporary absence from work. Qualifying claimants are paid a maximum of 60% of their Average Income during the period of time that they are medically certified to be incapable of work.

Following are the requirements which must be satisfied for an Insured Person to qualify for Employment Injury Benefit:

  • He must present a medical certificate stipulating the nature of his injury as well as the number of days for which he will be incapable of work.
  • An Employment Injury Benefit Application form must be duly completed by the Claimant.
  • He must have been in insurable employment when injury was sustained.
  • He must provide proof that the injury or occupational disease was sustained in the course of his employment. In this regard, he should obtain a written statement from his employer, or from the person who witnessed the accident.
  • He must not have engaged in any activity which could result in the Disqualification of his claim.

All Claims for Employment Injury benefit must be submitted to the DSS within 4 working days from the date of issue of the Medical Certificate, and the Employer Certificate (found on the reverse side of the Medical Certificate) must be duly completed by the employer before the claim is submitted.

Disablement Benefit

Disablement Benefit is payable to an Insured person who has exhausted his entitlement to Employment Injury benefit (which is payable for a maximum period of 26 weeks), and is payable for the duration of the disability. In order to qualify for Disablement Pension the insured person must satisfy the following conditions:

  • He must present a medical report in support of his claim;
    A Disablement Benefit Application form must be duly completed by the Claimant.
  • His degree of disability must be medically certified as being no less than 30%.
  • The DSS reserves the right to have the beneficiary reviewed periodically by one or more Medical Referees appointed by the DSS Board to determine continued eligibility to the benefit.
  • He must not engage in any activity which could result in the Disqualification of his claim.
  • A person in receipt of Disablement pension is required to complete a Certificate of Life form every year as proof that he is alive, and in receipt of his pension.

All Claims for Disablement benefit must be submitted to the DSS within 3 months from the date on which the Claimant became entitled to it.

Disablement Grant

Where at the expiration of payment of the Employment Injury Benefit, or anytime thereafter, the Insured person is medically assessed as being less than 30% disabled as a result of the relevant incapacity, a disablement grant is payable.

Medical Expenses Benefit

Medical Expenses Benefit is a refund of medical expenses incurred by an Insured person in relation to a particular Employment Injury. The maximum Medical expenses refundable is $6,000.00.

Death Benefit

Death Benefit is payable to the spouse and dependent children (including adopted and step children) of an Insured person who died as a direct result of Employment Injury. Where there is no spouse and/or dependent children, the benefit may be payable to dependent parents and, if there are none, to dependent grand-parents of the deceased; provided that the parents or grand-parents as the case may be are over the age of 60, and were dependent on the Insured Person. The surviving spouse is paid one half of the amount the deceased would have received as Injury Benefit had he submitted a claim. Each of the surviving children is paid 1/6 of the remainder of the available benefit. However, where the pension available for distribution in respect of all the children is insufficient to enable payment to be made to each child, the Board shall decide to which of the children the benefit should be paid.

Conditions to be satisfied by the widow or widower, children, parents, or grand-parents of the deceased:

  1. The widow or widower must have been wholly or mainly maintained by the deceased at the time of death.
  2. Eligible children must be below the age of 18; wholly or mainly maintained by the deceased at the date of death, unemployed, and unmarried.
  3. If at the time of death there were no surviving spouse or dependent children, a dependent parent or, if there is no such parent, a dependent grand-parent shall be entitled to one half of the available pension, provided that such parent or grand-parent had already attained the age of 60. If there is more than one parent or grand-parent as the case may be, the available pension will be shared equally among them. Such pension is payable for life.
  4. Death Benefit payable to a widower or widow shall cease on his/her remarriage or cohabitation with a woman or man as husband or wife as the case may be.
  5. A person in receipt of Death benefit is responsible for informing the DSS office if there is any change of circumstances affecting his continued rights to such benefit.
  6. A person in receipt of a Death benefit is required to complete a Certificate of Life form every year as proof that he is alive, and is in receipt of his benefit.

Documents to be presented by persons claiming Death Benefit:

  1. A Death Benefit Application form must be duly completed for each Claimant (including children, or parents, or grand parents as the case may be)
  2. A Birth Certificate in respect of each claimant.
  3. The Death Certificate of the deceased.
  4. The Social Security card of the deceased.
  5. The Marriage certificate.
  6. Any other evidence prescribed by the Director.

Where the couple was not married, but living together in a common-law union for at least three years, the surviving partner must present a notarized document certifying the union.

All Claims for Death benefit must be submitted to the DSS within 3 months from the date on which the Claimant became entitled to it.

Long-Term Benefit

Long Term Benefits are generally payable for a longer duration of time than Short-term Benefits which are payable for a maximum period of 26 weeks. The quantum of benefit payable is a function of the number of Contributions (or Credits) which a person has recorded against his account, and his average income for the best 3 years of the last 10 years prior to his date of eligibility. Having determined the Claimant’s Average earnings, the Claimant is usually paid a percentage of that Average Earnings. The percentage payable depends on the number of Credits which the person has earned during his insurable years. Please see the Pension Percentage Computation Chart for the percentage equivalency.

The Long-term benefits being paid by DSS are as follows:

 

Age Pension
is payable to an Insured person who has attained the Retirement Age and had paid a minimum of 500 Credits.

Documents to be presented:

  • A completed Age Benefit Application form
  • The Claimant’s Birth Certificate
  • The Claimant’s Social Security Card
  • A Bank Payment Order indicating which bank you wish to have your pension lodged at
  • Any other document required by the Director

All claimants are required to indicate whether they worked in any other Caricom country during their working lifetime. Where this is the case, all other Social Security/NIS cards should also be submitted, since it may be necessary to totalize all contributions paid in the different territories as provided by the Caricom Reciprocal Agreement on Social Security.

All persons in receipt of Age benefit are required to complete a Certificate of Life form every year as proof that he is alive, and in receipt of his pension. All Claims for Age benefit must be submitted to the DSS within 3 months from the date on which the Claimant became entitled to it.

 

Age Grant
is a lump sum amount payable to the Insured Person who has attained the Retirement Age, but who has only paid 50 to 499 Credits. The Age Grant payable is equivalent to three times the Average Weekly Insurable Earnings for each 50 contributions paid by, or credited to him, and is represented by the following formula:

“3 x AWIE x the Number of blocks of 50 Credits paid.”

For example, if his average weekly Insurable earnings were, say, $350.00, and he had paid a total of 400 contributions, he will receive an Age Grant of $8,400.00. (i.e. 3 x 350.00 x 8 = 8,400.00). Note that there are 8 blocks of 50 contributions in a total of 400 contributions.

 

Invalidity Benefit
is payable to a person who is medically certified to be suffering from a physical or mental disability which is likely to remain permanent and which prevents him from working. Invalidity benefit is also payable where a Claimant has exhausted his entitlement to Sickness Benefit. Benefit is payable for as long as the condition lasts, or until the age of 60, whichever condition arises first.

In order to qualify for an Invalidity Pension the insured person must be below the age of 60, and must have paid a minimum of 150 Credits.

Documents to be presented:

  • A completed Invalidity Benefit Application form
  • A medical certificate certifying that the Claimant is suffering from a physical or mental condition which is likely to remain permanent. (Please note that the DSS reserves the rights to send the claimant to its Medical Referee for an evaluation)
  • The Claimant’s Birth Certificate
  • The Claimant’s Social Security Card

Conditions for Continued Entitlement:

  1. He must not engage in activities which are likely to retard or worsen his condition
  2. He must not undertake paid labor
  3. He must not leave his place of residence without leaving word where he can be found
  4. He must submit himself to a medical examination when asked to do so by the Director
  5. Invalidity pensions are payable as long as incapacity remains, or until the Claimant attains the age of 60, which ever condition arises first
  6. A person in receipt of an Invalidity pension is required to complete a Certificate of Life form every year as proof that he is alive, and in receipt of his benefit

All Claims for Invalidity benefit must be submitted to the DSS within 3 months from the date on which the Claimant became entitled to it.

 

Invalidity Grant
is a lump sum amount payable to an Insured Person who is deemed to be permanently incapable of work, but who has only paid 50 to 149 Credits. The Invalidity Grant payable consists of three times the Average Weekly Insurable Earnings for each 50 contributions paid by, or credited to him, and is represented by the following formula:

“3 x AWIE x the Number of blocks of 50 Credits paid.”

For example, if his average weekly Insurable earnings were, say, $400.00, and he had paid a total of 140 contributions, he will receive an Invalidity Grant of $2,400.00. (i.e. 3 x $400.00 x 2 = 2,400.00). Note that there are 2 blocks of 50 contributions in a total of 140 contributions.

 

Survivors’ Benefit
is payable to the spouse and Dependent Children of a deceased Insured person. The surviving spouse is paid one half of the pension the deceased was receiving, or would have received had he submitted a claim. The remainder of the available benefit is distributed amongst the surviving children. However, where the rate obtained by such division is less than $50.00 per month, the Board shall decide to which of these children the pension should be awarded. Where there is no spouse and, or dependent children, a benefit may be payable to dependant parents, and, if there are none, to dependant grand-parents of the deceased; provided that the parents or grand parents as the case may be are over the age of 60, and were wholly or mainly dependent on the Insured Person.

In order to qualify for Survivors’ Pension the deceased insured person must have satisfied the following conditions prior to his/her death:

  • He must have paid a minimum of 150 contributions
  • He must have been in receipt of an Invalidity or Age pension

Conditions to be satisfied by the widow or widower, children, parents, or grandparents of the deceased:

  1. The widow or widower must have been wholly or mainly maintained by the deceased at the time of death
  2. If the widower or widow is 50 years or older, he or she will be paid a pension for life
  3. If the widower or widow is less than 50 years old, the pension is payable for one year. However, where the person has children of the deceased Insured Person in his/her care, the pension is payable until the last child attains the age of 18
  4. Eligible children must be below the age of 18; wholly or mainly maintained by the deceased at the date of death, unemployed, and unmarried, however; if, prior to attaining the age of 18 the child is working, and, or married, the pension shall cease upon employment or marriage
  5. If at the time of death there were no surviving spouse or dependent children, a dependent parent, or, if there is no such parent, a dependent grandparent shall be entitled to one half of the available pension, provided that such parent or grand parent had already attained the age of 60. If there is more than one parent or grand parent as the case may be, the available pension will be shared equally amongst them. Such pension is payable for life
  6. Survivors Benefit payable to a widower or widow shall cease on his/her remarriage or cohabitation with a woman or man as husband or wife as the case may be
  7. A person in receipt of Survivors benefit is responsible for informing the DSS office if there is any change of circumstances affecting his or her continued rights to such benefit
  8. A person in receipt of a Survivors benefit is required to complete a Certificate of Life form every year as proof that he is alive, and is in receipt of his benefit

Documents to be presented by persons claiming Death Benefit:

  1. A Survivors Benefit Application form must be duly completed for each Claimant (including children, or parents, or grand parents as the case may be)
  2. A Birth Certificate in respect of each claimant
  3. The Social Security card of the deceased
  4. The Marriage certificate. Where the couple was not married, but living together in a common-law union for at least three years, the surviving partner must present a notarized document certifying the union
  5. Any other evidence prescribed by the Director

All Claims for Survivors benefit must be submitted to the DSS within 3 months from the date on which the Claimant became entitled to it.

 

Survivors’ Grant
is a lump sum amount payable to the dependants of a deceased Insured Person who paid 50 to 149 Credits. The Survivors Grant is equivalent to three times the Insured Person’s Average Weekly Insurable Earnings for each 50 contributions paid by, or credited to him, and is represented by the following formula:

“3 x AWIE x the Number of blocks of 50 Credits paid.”

For example, if his average weekly Insurable earnings were, say, $550.00, and he had paid a total of 140 contributions, the Dependants will receive a Survivors Grant of $3,300.00.
(i.e. 3 x 550.00 x 2 = 3,300.00). Note that there are 2 blocks of 50 contributions in a total of 400 contributions.

Where the deceased left no surviving spouse or dependent children, a dependent parent, or, if there is no such parent, a dependent grandparent shall be entitled to one half of the available Grant, provided that that parent or grand parent had already attained the age of 60. If there is more than one such parent or grand parent as the case may be, the available Grant will be shared equally amongst them.

Persons Missing at Sea
Where an Insured Person is reported missing, a claim for Survivors benefit can be made from the date of such disappearance. However, payment cannot be made until seven years have elapsed, and the person officially declared dead.

Such claims must be supported by an official report from the police confirming such disappearance, and, at the expiration of seven years, a letter confirming that the person has not been see or heard of since.

 

Funeral Grant
is a lump sum provided to assist with the burial expenses of an Insured Person, his or her spouse, and/or their dependent children. The Grant is payable to the person(s) who has met, or is liable to meet the burial expenses.

In order to qualify for a Funeral Grant the deceased insured person must have satisfied the following conditions prior to death:

  • Must have been in receipt of a Short-Term or Long-Term benefit
  • He or she had satisfied the conditions for qualifying for any Short-Term or Long-Term benefit

Amounts payable as Funeral Grants

  • On the death of an Insured Person, a maximum amount of $2,000.00
  • On the death of a dependant spouse, a maximum amount of $1,680.00
  • On the death of a dependant child, a maximum amount of $840.00

Documents to be presented by persons claiming a Funeral Grant:

  1. The Death certificate
  2. The Social Security number of the deceased
  3. Receipts of the burial expenses
  4. Where the burial expenses were carried out on a credit basis, invoice(s) showing liability to pay should be obtained from the creditor
  5. If the person who met the expenses wishes to have the Grant paid to a different party, a letter of authorization should be obtained from such person

All Claims for Funeral Grant must be submitted to the DSS within 6 months from the date of death of the deceased.

 

Grounds for Disqualification of Benefits
An Insured person claiming or entitled to Sickness, Maternity, Employment Injury, Disablement or Invalidity benefit shall be disqualified for receiving benefit if he or she:

  1. Refuses the request of the Director to submit himself to a medical examination
  2. Behaves in any manner calculated to retard his recovery
  3. Is absent from his place of residence without leaving word where he may be found
  4. Undertakes work for which remuneration is, or would ordinarily be payable