Hi LYN friends,

I have a question. I am temporarily unemployed after former employer made me take VSS after working for 15 years. So I am not working and no salary and no socso payments. Then last week, I had an accident and got a fracture and so have been going to gomen hospital. Doctor suggested surgery to make the fracture heal faster but I was saying that prefer to just do simen/cast since cheaper. Doctor told me that actually I can claim the surgery as medical treatment under socso even though unemployed. I am trying to find out if this is true.
I have been reading http://www.perkeso.gov.my/en/medical-benefit.html

which says:
Reimbursement of Medical Claims
In the case of medical treatments received from non SOCSO’s panel clinics, employees or employers are eligible to make reimbursement of medical claims, subject to such condition as maybe determined by the Organisation.
Claims need to be supported with the following documents:
Claim for medical treatments (Form PKS (P) 24)
Claim for general expenses (Form PKS (P) 26)
Original receipts
A copy of the Appointment Card
A copy of the medical report (if needed)

But I think every page talks about employment. So seems like since I am unemployed, I cannot get anything.

Anyone have any advice/experience on this?

Thanks.

Quick query - How did you get injured?
Just to provide perspective.

i think ur better go talk direct to perkeso
better chance get legit info than asking here for advice

good luck and all the best

Please note that SOCSO/PERKESO only covers injury sustained at work, or on the journey to/from work and at lunch time. If you broke your radius falling in your bathroom before going to work or after coming home from work, no cover. If you get in an accident while on leave going "balik kampung", no cover.

Temporary workers are covered. But of course, the employer have to make SOCSO deductions. If they're supposed to, but did not, ... I don't know. You should ask SOCSO about this.

If it's just a fracture, then cast might be fine. But for actual breaks, casts are no good. The bone would likely not align perfectly. Nowadays they use nails, pins, and plates to make sure the bones don't heal crooked.

I've broken my arm twice, and thigh once, plus two other fractures. The first time 3 decades ago. And even then, they didn't just use casts.

I don't think you can claim while your are unemployed.
Socso need employer to fill up one of your your claim form with company chop n signature, so I don't think there is a way.
Unless of course ur previous employer willing to chop n sign knowing is cheating from Socso.

I thought only can entitle to claim during employment?

So far based on what I read, I believe you are correct. Socso won't help unemployed / self-employed even if you paid socso monthly for 15 years before.

Thanks. I believe you are correct on both the socso issue and the cast.

hanya boleh claim waktu kerja

some kes r....boss send the worker out station..when shit happen...worker cannot claim ..bcos boss putar halim....newspaper also ada report.

During one very unfortunate Hari Raya / balik kampung season, one small company of about 80 employees suffered two extremely serious casualties. The second most senior floor staff was killed when the car she was in with her husband and two childred was involved in an accident. They were already quite near to their home town by then. Her family were only slightly injured. No SOCSO claim could be made as she was clearly not at work, nor going to/from work. The presence of the two children in the car, and the fact that they are so far away from her workplace is clear proof that she isn't at work.

The second staff was on a motorcycle traveling by himself, also on his way back to his own home town. He lost an arm and a leg, and was left permanently disabled. The employer then proceeded to lie and collude with his family to concoct a false tale about how he was sent to collect some spare parts from a supplier's office in Penang to bring back to KL. The salesman from one of the major suppliers was roped in to generate a supporting letter and other relevant documentation like invoices and DOs. His SOCSO claim was successful, and he was put on permanent disability. I am not sure how much he gets monthly from SOCSO, but it was a good portion of his monthly income, enough for him to live on, he later said. He was only 25. This means he will be receiving this payment for many many years. I don't know if the payment is inflation adjusted. For all we know, by the time he turns 50, the value of the RM would have depreciated enough that it would no longer be enough to live on.

How do I know? My story is that I was very junior staff back then, and I merely watched from the sidelines, and did not participated in the insurance fraud. And I'm sticking by my story.

This post has been edited by zeb kew: Nov 8 2016, 05:59 PM

if u contribute more than 60 times yes u can claim socso ....my BIL met with an accident during unemployment, try claim socso now rcve monthly pension

I think it's better you go directly to Socso instead of asking here, since you have made the minimum contributions.