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Pursuant to the provisions of R.A. No. 6975, as amended, the National Police
Commission hereby adopts and promulgates the following rules governing the
investigation and adjudication of benefit claims of uniformed PNP members
RI",'LE I
Secfibn 1. Titte of the Rules. * These Rules shall be known and cited as the
"Revr'sed Rules Goveming the lnvestigation and Adjudicatian of Benefit Ctaims of
Uniformed Members of the Philippine National Police (pNp)."
Sec. 2. Coverage. - These Rules shall apply to claims for death and
permanent total disability benefits of the uniformed members of the PNP.
RULE II
DEFINITION OF TERMS
Page 2 of 15
M.C. No. z(Ll 1_-0O9
twenty one (21) years old, provided he is incapable of support for himself
due to mental or physical defects.
e) lnjury - any harmful change in the human organism arising from any
incident sustained at work, while at the work place, or elsewhere
executing an order from the PNP, or sustained by reason of the
performance of duty;
RULE III
Secfrbn 1. Grounds for Compensability. - (a) For the injury and the resulting
or death to be compensable, the injury must be the result of an
disability
employment accident satisfying any of the following conditions:
1) The PNP member must have been injured at the place where his work
requires him to be and must have been performing his official functions;
(b) For the sickness and the resulting disability or death to be compensable,
the sickness must be the result of an occupational disease listed in Rule Vll of this
Rules. Otherwise, proof must be shown that the risk of contracting the disease is
increased by the working conditions.
lnjuries or death involving a PNP member shall be reported to his police office
or unit assignment within twenty four (24) hours from its occurrence and an
investigation relative thereto shall be immediately conducted.
RULE IV
INVESTIGATION AND ADJUDICATION OF APPLICATION
FOR TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS
Seclion 1. Who may File Claim for Disability. - An application for Total
Permanent Physical Disability (TPPD) may be filed by the uniformed PNP member
himself or in case of incapacity, his duly authorized representative.
tn case a uniformed PNP member who has been found to be disabled refuses
to apply for total permanent physical disability retirement, he/she shall be separated
or attrited pursuant to the provision of Section 29 of R.A. No. 8551 as implemented
by Memorandum Circular No. 2008-005 "Prescribing Policies, Procedures and
Guidelines Goveming the Attrition sysfem for Uniformed Personnel of the PNP" .
Sec. 2. Where to file Claim. - (a) All uniformed PNP members assigned with
the National Headquarters, National Support Units (NSUs) and other PNP Special
Units shall submit their individual APPLICATION LETTER FOR TOTAL
PERMANENT PHYSICAL DlSABlLlry OPPD) retirement under oath to the
Directorate for Personnel and Records Management (DPRM) thru the Pension
Retirement and Benefits Administration Service (PRBS) for recording and
appropriate action.
UU9
(b) All other PNP members assigned with the Police Regional Offices shall
submit their individual APPLICATION LETTER FOR TPPD to the Regionat
Personnel and Human Resource Development Divisions (RPHRDD).
After the initial medical screening, the Regional Health Service shall submit its
medical report to the Chief, RPHRDD who shall in turn endorse the application for
TPPD together with the said report to the DPRM.
All results of medical findings in each case are submitted to the Director of the
Health Service. Cases where the applicants are categorized as P4 shall be
indorsed by the Director of Health Service to the Medical Screening Committee for
Physical or Mental lncapacity (MSCPMI) for final medical screening.
0 Certificate from the Chief of Police or Personnel Officer, as the case may
be, indicating the restorable deducted leave credits for absences incurred
by reason of the injury sustained or sickness contracted which the subject
of the claim;
g) Official receipts duly registered with the Bureau of lnternal Revenue for
reasonable medical and hospitalization expenses, necessary
transportation and subsistence incurred on account of service-connected
disability; Purchase of medicines in excess of Php 50.00 shall be
evidenced by doctor's prescription.
Sec.9. lnvestigation and Adjudication of the Ctaim. - (a) Within five (5) days
from receipt of the complete records of the application, the Hearing Officer
designated by the NAPOLCOM Regional Director shall set the hearing of the claim
and shall notify the claimant/s, heirs and other persons whose presence in the
investigation is necessary. ln no case shall the hearing of the claim be conducted
beyond fifteen (15) days from the date of receipt of the records from the Legal Affairs
Service.
(c)
Within fifteen (15) days from the termination of the investigation, the
Hearing Officer/lnvestigator shall submit his Report lnvestigation together with the
complete records of the claim to the Regional Director for adjudication.
(d) The Regional Director shall adjudicate the claim within fifteen (15) days
from receipt of the Report of lnvestigation.
RULE V
INVESTIGATION AND ADJUDICATION OF CLAIM FOR DEATH
BENEFITS
Secfrbn 1. Who may Fite Ctaim/Apptication for Death Beneffs.- A claim for
death benefits may only be filed by the following in the order of precedence:
a) Surviving spouse;
d) Surviving parents;
Sec. 2. Where to File Claim - An application letter under oath for death
benefits shall be filed with the Officc of the NAPOLCOM Provincial Officer of the
province or city where the PNP member is stationed or in the Regional Office of the
Commission having administrative jurisdiction of the unit assignment of the deceased
PNP member.
Certificate from the Chief of police or Personnel Officer, as the case may
be, indicating the restorable deducted leave credits for absences incurred
by reason of the injury sustained or sickness which caused the death of
the PNP member and the subject of the claim.
(c) Withinfifteen (15) days from the termination of the investigation, the
Hearing Officer/lnvestigator shall submit his Report of lnvestigation together with the
complete records of the claim to the Regional Director for adjudication
(d) The Regional Director shall adjudicate the claim within fifteen (15) days
from receipt of the Report of lnvestigation.
RULE VI
BENEFITS AND BENEFICIARIES
1) Gratuity equivalent to the deceased PNP member one year basic salary;
1) Gratuity equivalent to the deceased PNP member one (1) year basic
salary;
Soc. 4. Beneficiaries in Death Claims. - (a) The following are the only
beneficiaries in the order of precedence:
1) Surviving spouse;
4) Surviving parents;
a) Heart stroke
b) Frostbite/Freezing
a) CVA embolism
b) CVA thrombosrs
c) CVA thrombo-embolism
d) CVA hemorrhage
8) Parasitism- Compensability should be based on the principle of.
a) Greater risk of acquiring the disease in the place of work than in the
piace of usual residence.
9) Cardiovascular diseases.
a) Acute myocardial infarction
b) Congestive heart failure class lV-E
1O) Pneumonra
Vrral pneutnonta
Bacterral pneumonta
1 1)
Peptic ulcer diseases - as long as it is not due to chronic alcoholism
12) Atl forms of Psychoses/Schizophrenic disorders
13) Physical traumas resultrng rn.
a) Death
b) Loss of lrmbr/s or its function
c) Blindness
d) Deafness
The following ailments are nol occupational diseases and subject to proof
that the risk of contracting the same are increased by the working conditions:
1. Viral hepatitis
2. Cancer of the liver
3. Cancer of the lungs
4. Cancer of the pancreas
5. Cancer of the stomach and intestine
6. Liver cirrhosis and its complications
RULE VIII
SCOPE OF MEDICAL ATTENDANCE AND
HOSPITALIZATION BEN EFITS
a) Medical
b) Surgrcal
1) Accommodation
2) Ambulance and operating room services
3) Clinical laboratory services
4) Diagnostic services/procedure as may be necessary to diagnose or
effect a cure
d) Supplies
1) Drugs, medication or medical supplies
2) Any other goods or supplies prescribed for medical diagnose, care or
treatment
M.C. No.
-Ze++-Oag
RULE IX
RULES ON THE PAYMENT AND/OR REIMBURSEMENT
OF REASONABLE MEDICAL EXPENSES
Sec 2. Hospital Room Rafe - Hospital room rate shall not exceed Php
1,500.00 per day except in the followtng cases:
The Commission shall pay only reasonable, necessary and relevant services.
Therefore, except in emergency cases, a PNP member may undergo laboratory
work-ups and such other prescription procedures only after he/she has been
examined by the PNP physician or NAPOLCOM Medical Officer who shall then
issue the necessary referrals.
RULE X
Secfrbn 1. Grounds for the Denial of the Claim. - No claim shall be approved
or compensation allowed to a uniformed PNP member or his beneficiaries when the
injury or sickness and the resulting disability or death !s occasioned by any of the
following.
RULE XI
APPEALS
Secfion 1 Appeals. - Wrthin fifteen (15) days from receipt of a copy of the
resolution denying a clatm, the claimant may file an appeal to the Regional Appellate
Board (RAB) by filing a Notice of appeal with the Office of the Regionbl Director.
The Regional Director shall transmit the complete records of the claim to the
Regional Appellate Board (RAB) within five (5) days from receipt of the Notice of
Appeal
The decision of the RAB affirming the resolution of the Regional Director shall
be final and executory
Sec. 2. Automatic Review. - Decision of the RAB reversing the resolution of
the Regional Director denying the claim for benefits shall be subject to automatic
review by the Commission En Banc. The RAB Chairman shall forward the entire
records of the claim to the Commission thru the Chief, Legal Affairs Service within
five (5) days from the release of its decision.
RULE XII
MISCELLANEOUS PROVISIONS
a) The claimant has transferred his residence to another place outside the
jurisdiction of the hearing officer or the regional office;
Sec. 7. Payment of Claims - All claims for benefits shall be paid by the
Regional Offices that issued the adjudications.
However, when there is insufficiency of funds to pay the whole or part of the
benefits, a copy of the adjudication together with such documents supporting the
approval of the claim shall be fonvarded to the Central Office of the Commission for
payment, including the monthly pension, if any.
ADOPTED this .rrsr day of August, 2A11 at Makati city, Metro Manila,
Philippines.
\-..
EDUARDO U. ESCUETA
Commissioner
Vice Chairman and Executive Officer
( ,tL*J,,'1ur-a-\,
LUlSrTg T. PALMERA
Cihissioner
nl
-l"l
CoNSTANC|A/P. DE GUZi|AN, Ph.
Commldsioner
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