RETURN TO WORK

BNOS 2052
Introduction
COURSE OUTLINE
INTRODUCTION
• Definition
• Occupational disease
• Organization and persons involved
DEFINITIONS
 What is Occupational Health?
Health of people at work
Relationship between Occupation (work) & Health

Environment

Occupation (work) Health

Accidents/Exposures
Occupational Health

“Occupational Health is the promotion and maintenance of the

highest degree of physical, mental and social well-being of workers in
all occupations by preventing departures from health, controlling risks
and the adaptation of work to people, and people to their jobs.”

(WHO, 1950)
 Definitions ILO 1993
Occupational diseases
Having a specific or a strong relation to occupation generally with only
one causal agent (physical, chemical, biological or psychosocial) and
recognized as such

Work-related diseases
With multiple causal agents, where factors in the work environment
may play a role, together with other risk factors, in the development of
such diseases, which have a complex etiology

Diseases affecting working populations

Without causal relationship with work but which may be aggravated by
occupational hazards to health
 Occupational Disease

“A disease contracted out of or in

connection with work, that is
characteristic of that work, or
directly related to the risks specific
to that work”

Lois surles accidents du travail et les maladies professionnelles, S. L.R.C., Recueildes loiset des règlementsdu Québec, c. A-3.001 Sess. (2012).
 Four Types

Diseases only occupational in origin

Occupation is one of the causal factors
Occupation is a contributory factor
Occupation is aggravating pre-existing condition
 OCCUPATIONAL DISEASE
Two main elements are present in the
definition of an occupational disease:
the causal relationship between exposure in a
specific working environment or work activity and
a specific disease; and
the fact that the disease occurs among a group of
exposed persons with a frequency above the
average morbidity of the rest of the population
THE BURDEN
 The Hidden Epidemic

http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/presentation/wcms_207663.pdf
 Burden of Occupational Disease -
ILO/WHO
Worldwide
1.9-2.3 million deaths attributed to occupation
1.6 million deaths attributed to work-related
diseases
217 million cases of occupational disease
Costs … Challenging to Determine
In developing countries, occupational injury and
disease rates are much higher than in North
America
Estimation for each year in the United States:
400000 new disabling cases of occupational diseases
100000 death from occupational disease
10 m occupational disease cases occur each year
worldwide
Occupational injuries and diseases, affect many
organ system
 Estimated Annual Incidence of Occupational Injury and
Disease in the World
Occupational Injuries/ Diseases Number of New Cases per Year

Occupational Injuries 100, 688, 000

Occupational Diseases (approximately 10.7 million) 10, 684,000

Musculoskeletal disorders 3,337,000

Chronic respiratory disease 2,631, 000

Skin disorders 1, 895, 000

Noise-induced hearing loss 1,628,000

Pneumoconioses 453,000

Mental disorders 318,000

Cancer 191,000

Other Poisoning 122,000

Pesticide Poisoning 109,000

DETERMINING WORK-RELATEDNESS
 The Occupational History
Description of all jobs held
Work exposures
Timing symptoms
Epidemiology of symptoms or illness among
other workers
Non-work exposures and other factors
 Occupational Hazards
Physical Hazards
Chemical Hazards
Biological Hazards
Mechanical Hazards
Psychosocial Hazards
Position of lateral epicondyle and medial epicondyle
Lateral Epicondyle
Bursitis
Tenosynovitis
Asbestos fiber
 Occupational Diseases
• Occupational diseases have a long
latency period and can be cyclical
•Most occupational diseases pose
challenges
•in assessment and treatment
• In some situations may occur among the
general community as a consequence of
contamination of the environment from
the workplace
•All occupational diseases can be prevented
ORGANIZATION & PERSON INVOLVED
Organization & Person Involved

• Employer
- Employee
- Immediate Supervisor
- RTW Coordinator
• Public organizations
- SOCSO
• NGOs organizations
- disabled people’s organizations
- trade unions
Social Security Organisation of Malaysia

Overview of the
Social Security Organisation, Malaysia
(SOCSO)
 Social Security Organisation of Malaysia
SOCSO
• Statutory Organization governing
Employment Injury Insurance Scheme &
Invalidity Pension Scheme in Malaysia.

• CORPORATE GOAL - To provide

comprehensive social security protection
for Malaysians.

• CORPORATE OBJECTIVE - To ensure

and guarantee the timely and adequate
provision of benefits in a socially just
manner and to promote occupational
health and safety.
Social Security Organisation of Malaysia

SOCSO
• Established in 1971 under the Ministry of
Human Resources.
• To implement, administer and enforce:
 The employees’ Social Security Act, 1969
and
 The employees’ Social Security (General
Regulations), 1971
(applicable to all industries having one or more
employees)
 Social Security Organisation of Malaysia

Employer

Employer

Principal Immediate
Employer Employer
An employer who directly employs an An employer who employs an employee by or
employee under a contract of service through him to perform work under the
or apprenticeship. All matters relating supervision of a principal employer. This
to services and payment of wages are includes a person who has a contract of
handled by them. service with an employee and temporarily
lends or lease the service of that employee to
a principal employer.
Social Security Organisation of Malaysia

Employer’s Responsibility

 Principal and immediate employers who employ one or

more employees are responsible to register and pay
contributions to SOCSO.

 The principal employers are also accountable to ensure

the registration and payment of contributions for all
employees employed by the immediate employer.

 The employer is obliged to report all work related

accident that befalls their workers within 48 hours of
notification.
Social Security Organisation of Malaysia

Employee Eligibility

 All eligible Malaysian citizens and permanent residents

employees are compulsory to register.

 All employees who are employed under a contract of service

or apprenticeship in the private sector and contractual /
temporary staff of Federal / State Government as well as
Federal / State Statutory Bodies need to be registered and
insured under SOCSO.

 Contribution will be capped at monthly remuneration of

RM4,000.00.
Social Security Organisation of Malaysia

SOCSO Eligibility

Employees exempted from Employees’ Social Security

Act 1969 coverage are as follows:
 Federal and State Government permanent employees
 Domestic servants
 Self-employed
 Sole proprietor or owners of partnership
 Spouse/s of a sole proprietor or partners
 Foreign workers (exempted from April 1993 until
December 2018 only)
 SOCSO Eligibility Foreign Workers
• From April 1993, accident compensation for foreign
workers came under the Workmen's Compensation Act
1952 (Act 273) which was enforced by the Department
of Labour.
• With effect from 1 January 2019, SOCSO will take over
the compensation for foreign workers according to the
provision under the Employees’ Social Security Act 1969
(Act 4) covering the Employment Injury Scheme only.
• Benefits under Employment Injury Scheme:
 Medical benefit
 Temporary disablement benefit
 Permanent disablement benefit
 Dependants’ benefit
 Funeral benefit
 Constant-attendance allowance
 Rehabilitation (except for Dialysis, Vocational or
Return to Work Programme)
 SOCSO CONTRIBUTION

FIRST CATEGORY SECOND CATEGORY

RATES OF 1.75% employer’s share and 1.25% of the

CONTRIBUTION 0.5% employee’s monthly employee’s monthly wages
wages solely borne by the
employer.

EMPLOYEES  All employees who have not  All employees who have
attained 60 years of age. attained the age of 60.
 Except those who have  New employee who has
attained 55 years of age and attained 55 years of age.
have no prior contributions
before they reach 55 years.

SCHEME  Employment Injury Scheme  Employment Injury

 Invalidity Scheme Scheme
 RATE OF CONTRIBUTIONS
First Category Second Category
No. Actual monthly wage of the month (Employment Injury Scheme and Invalidity Scheme) (Employment Injury Scheme)
Employer's Employee's Total Contribution Contribution By Employer Only
1. Wages up to RM30 40 cents 10 cents 50 cents 30 cents
2. When wages exceed RM30 but not RM50 70 cents 20 cents 90 cents 50 cents
3. When wages exceed RM50 but not RM70 RM1.10 30 cents RM1.40 80 cents
4. When wages exceed RM70 but not RM100 RM1.50 40 cents RM1.90 RM1.10
5. When wages exceed RM100 but not RM140 RM2.10 60 cents RM2.70 RM1.50
6. When wages exceed RM140 but not RM200 RM2.95 85 cents RM3.80 RM2.10
7. When wages exceed RM200 but not RM300 RM4.35 RM1.25 RM5.60 RM3.10
8. When wages exceed RM300 but not RM400 RM6.15 RM1.75 RM7.90 RM4.40
9. When wages exceed RM400 but not RM500 RM7.85 RM2.25 RM10.10 RM5.60
10. When wages exceed RM500 but not RM600 RM9.65 RM2.75 RM12.40 RM6.90
11. When wages exceed RM600 but not RM700 RM11.35 RM3.25 RM14.60 RM8.10
12. When wages exceed RM700 but not RM800 RM13.15 RM3.75 RM16.90 RM9.40
13. When wages exceed RM800 but not RM900 RM14.85 RM4.25 RM19.10 RM10.60
14. When wages exceed RM900 but not RM1,000 RM16.65 RM4.75 RM21.40 RM11.90
15. When wages exceed RM1,000 but not RM1,100 RM18.35 RM5.25 RM23.60 RM13.10
16. When wages exceed RM1,100 but not RM1,200 RM20.15 RM5.75 RM25.90 RM14.40
17. When wages exceed RM1,200 but not RM1,300 RM21.85 RM6.25 RM28.10 RM15.60
18. When wages exceed RM1,300 but not RM1,400 RM23.65 RM6.75 RM30.40 RM16.90
19. When wages exceed RM1,400 but not RM1,500 RM25.35 RM7.25 RM32.60 RM18.10
20. When wages exceed RM1,500 but not RM1,600 RM27.15 RM7.75 RM34.90 RM19.40
21. When wages exceed RM1,600 but not RM1,700 RM28.85 RM8.25 RM37.10 RM20.60
22. When wages exceed RM1,700 but not RM1,800 RM30.65 RM8.75 RM39.40 RM21.90
23. When wages exceed RM1,800 but not RM1,900 RM32.35 RM9.25 RM41.60 RM23.10
24. When wages exceed RM1,900 but not RM2,000 RM34.15 RM9.75 RM43.90 RM24.40
25. When wages exceed RM2,000 but not RM2,100 RM35.85 RM10.25 RM46.10 RM25.60
26. When wages exceed RM2,100 but not RM2,200 RM37.65 RM10.75 RM48.40 RM26.90
27. When wages exceed RM2,200 but not RM2,300 RM39.35 RM11.25 RM50.60 RM28.10
28. When wages exceed RM2,300 but not RM2,400 RM41.15 RM11.75 RM52.90 RM29.40
29. When wages exceed RM2,400 but not RM2,500 RM42.85 RM12.25 RM55.10 RM30.60
30. When wages exceed RM2,500 but not RM2,600 RM44.65 RM12.75 RM57.40 RM31.90
31. When wages exceed RM2,600 but not RM2,700 RM46.35 RM13.25 RM59.60 RM33.10
32. When wages exceed RM2,700 but not RM2,800 RM48.15 RM13.75 RM61.90 RM34.40
33. When wages exceed RM2,800 but not RM2,900 RM49.85 RM14.25 RM64.10 RM35.60
34. When wages exceed RM2,900 but not RM3,000 RM51.65 RM14.75 RM66.40 RM36.90
35. When wages exceed RM3,000 but not RM3,100 RM53.35 RM15.25 RM68.60 RM38.10
36. When wages exceed RM3,100 but not RM3,200 RM55.15 RM15.75 RM70.90 RM39.40
37. When wages exceed RM3,200 but not RM3,300 RM56.85 RM16.25 RM73.10 RM40.60
38. When wages exceed RM3,300 but not RM3,400 RM58.65 RM16.75 RM75.40 RM41.90
39. When wages exceed RM3,400 but not RM3,500 RM60.35 RM17.25 RM77.60 RM43.10
40. When wages exceed RM3,500 but not RM3,600 RM62.15 RM17.75 RM79.90 RM44.40
41. When wages exceed RM3,600 but not RM3,700 RM63.85 RM18.25 RM82.10 RM45.60
42. When wages exceed RM3,700 but not RM3,800 RM65.65 RM18.75 RM84.40 RM46.90
43. When wages exceed RM3,800 but not RM3,900 RM67.35 RM19.25 RM86.60 RM48.10
44. When wages exceed RM3,900 but not RM4,000 RM69.05 RM19.75 RM88.80 RM49.40
45. When wages exceed RM4,000 RM69.05 RM19.75 RM88.80 RM49.40
Social Security Organisation of Malaysia
Employment Injury
Insurance Scheme
 Employment Injury Scheme provides protection to an employee
against accident or an occupational disease arising out of and in the
course of his employment.
 The protection under this scheme covers the following:
 Industrial accident
 Commuting accident.
 Accident during emergency.
 Occupational diseases. Diseases resulted from his occupation as
described in the Fifth Schedule of Employees’ Social Security Act
1969 such as hearing loss and occupational asthma.
Benefits under Employment Injury
Insurance Scheme
1. Medical Benefit:
 Employees suffering from employment injuries or occupational
diseases may receive free medical treatment at SOCSO’s panel
clinic or Government clinic / hospital until they are fully
recovered.
 For serious injuries, medical care may be obtained from the
Government hospital and the employee is eligible for second
class ward treatment. Specialist treatment will be provided, if
required.

2. Temporary Disablement Benefit

 Temporary Disablement Benefit is paid for the period the
employee is on medical leave certified by a doctor for not less
than 4 days including the day of accident. However, Temporary
Disablement Benefit will NOT be paid for the days for which the
employee works and earns wages during this period.
 The daily rate of Temporary Disablement Benefit is 80% of the
employee’s average assumed daily wage. The minimum rate is
RM30.00 per day while the maximum rate is RM105.33 per day.
3. Permanent Disablement Benefit
 The daily rate of Permanent Disablement Benefit is 90%
of the employee’s average assumed daily wage, subject
to a minimum of RM30.00 per day or a maximum of
RM118.50 per day.
 Claim must be made within 12 months from the last date
of the temporary disablement.

4. Constant-attendance Allowance
 This allowance is paid to an employee who is suffering
from total permanent disablement and is so severely
incapacitated as to constantly require the personal
attendance of another person, certified by Medical
Board or Special Medical Board or the Appellate Medical
Board.
The allowance is fixed at RM500 per month.
5. Facilities for Physical / Vocational Rehabilitation
 Physical rehabilitation that includes:
 Physiotherapy;
 occupational therapy;
 reconstructive surgery;
 supply of prosthetics orthotics and other appliances;
 supply of orthopedics apparatus such as wheelchair,
crutches, hearing aid, spectacles, special shoes and
others
 Vocational rehabilitation that includes: Training in
courses such as electrical, sewing, radio/TV repair, typing
and others.

All expenses incurred for the above rehabilitation facilities will

be borne by SOCSO based on stipulated rates, terms and
conditions.
6. Dependants’ Benefit:
 If an employee dies as a result of an employment injury,
his dependants are entitled to this benefit.
 Daily rate is 90% of the average assumed daily wage
subject to a minimum of RM30.00 per day and a
maximum of RM118.50 per day.
 Dependants and Daily Rate Share
 Widow / widower: 3/5
 Child: 2/5
 Parent: 4/10
 Brother / Sister: 3/10
 Grand parent (if parents passed away): 4/10
7. Funeral Benefit
 Funeral Benefit will be paid to the eligible person if the
employee dies as a result of employment injury or while
he/she is in receipt of Permanent Disablement Benefit.
In the absence of such person, the benefit will be paid
to the person who actually incurs the funeral
expenditure.

The amount paid will be the actual amount incurred or

RM2,000 whichever is lower.

8. Education Benefit:
This benefit is in the form of loans may be provided to a
dependant child of an insured person who:
 Dies as a result of employment injury
 Is in receipt of periodical payments for Permanent
Disablement Benefit
Social Security Organisation of Malaysia

Invalidity Scheme
• The scheme provides 24-hour coverage to employee who
suffers from invalidity or death due to any cause and not
related to his employment.
Benefits under Invalidity Scheme
1. Invalidity Pension
 Payable to the eligible insured persons who have been
certified invalid by the Medical Board or Appellate
Medical Board
 Payable from the date Notice of Invalidity is received or
from the employee’s resignation date if he / she resigns
after the Notice of Invalidity is received by Organisation
 Payable as long as the employee is invalid or until death
 Replaced by Survivors’ Pension if the Invalidity Pension
recipient dies, regardless of his / her age
 The rate of Invalidity Pension for full qualifying period is
from 50% to 65% of the average assumed monthly wage
subject to a minimum pension of RM475 per month.
2. Invalidity Grant
 Invalidity Grant is payable to the eligible Insured
Persons who have been certified invalid by the Medical
Board or Appellate Medical Board but not eligible for
Invalidity Pension due to failure to fulfill any qualifying
conditions.
 The amount for Invalidity Grant is equivalent to the
contributions paid by employee and employer under
Invalidity Scheme with interest. It is a one-time lump
sum payment.
3. Constant-Attendance Allowance
• This allowance is paid to an employee who is suffering from
invalidity and is so severely incapacitated as to constantly
require the personal attendance of another person, certified
by Medical Board or the Appellate Medical Board.
• The allowance is fixed at RM500 per month.
4. Survivors' Pension
 Survivors’ Pension is payable to the eligible dependants
of an Insured Person who dies irrespective of the cause
of death not related to employment.

(If an employee dies and does not leave any widow or

widower or children)
5. Funeral Benefit
 Funeral Benefit will be paid to the eligible person if the
employee dies as a result of employment injury or while
he/she is in receipt of Permanent Disablement Benefit.
In the absence of such person, the benefit will be paid to
the person who actually incurs the funeral expenditure.
 The amount paid will be the actual amount incurred or
RM2,000 whichever is lower.
6. Facilities For Physical Or Vocational Rehabilitation And
Dialysis

• Physical rehabilitation includes: Physiotherapy;

Occupational therapy; Reconstructive surgery; Supply of
prosthetics; orthotics and other appliances; Supply of
orthopaedics apparatus such as wheelchair, crutches,
hearing aid, spectacles, special shoes and others
• Vocational rehabilitation includes: Training in courses such
as electrical, sewing, radio / TV repair, typing and others
• Dialysis facilities for Insured Persons suffering from chronic
renal failure.
• All expenses incurred for the above rehabilitation facilities
will be borne by SOCSO based on stipulated rates, terms and
conditions.
7. Education Benefit
• This benefit is in the form of loans may be provided to a
dependant’s child of an Insured Person who:
Dies while receiving Invalidity Pension
Dies before attaining the age of 60 years but has
completed a full or a reduced qualifying period
Is a Invalidity Pension recipient
Social Security Organisation of Malaysia

UN Convention on the Rights of

Persons with Disabilities (UNCRPD)
Social Security Organisation of Malaysia
UNCRPD
• Adopted on 13 Dec 2006 at UN HQ, New York
• Opened for signature on 30 March 2007
• Entered into force 3 May 2008
• 149 signatories and 103 ratifications to the
Convention
• Malaysia signed on 8 April 2008 and ratified on 19
July 2010
• South Africa signed 30 March 2007 and ratified on 30
November 2007
Social Security Organisation of Malaysia
Social Security Organisation of Malaysia

UNCRPD
• Article 26 - Habilitation and
rehabilitation

• Article 27 - Work and employment

 Social Security Organisation of Malaysia
Article 26 - Habilitation and rehabilitation
1.States Parties shall take effective and appropriate measures, including through
peer support, to enable persons with disabilities to attain and maintain m a x I m u m
independence, full physIcal, mental, socIal and vocatIonal ability, and full inclusion and
participation in all aspects of life. To that end, States Parties shall organize,
strengthen and extend comprehensive habilitation and rehabilitation services and
programmes, particularly in the areas of health,employment, education and social
services, in such a way that these services and programmes:
a)Begin at the earlIest possible stage and are based on the
multidisciplinary assessment of individual needs and strengths;
b)Support participation and inclusion in the community and all aspects of
society, are voluntary, and are available to persons with disabilities as close as
possible to their own communities, including in rural areas.
2.States Parties shall promote the development of initial and continuing training
for professionals and staff working in habilitation and rehabilitation services.
3.States Parties shall promote the availability, knowledge and use of assistive
devices and technologies, designed for persons with disabilities, as they relate to
habilitation and rehabilitation.
 Social Security Organisation of Malaysia
Article 27 – Work and Employment (1)
1. States Parties recognize the right of persons with disabilities to wor k,on an equal
basis with others; this includes the right to the opportunity to gain a living by
work freely chosen or accepted in a labour market and work environment that is
open, inclusive and accessible to persons with disabilities. States Parties shall
safeguard and promote the realization of the right to work, including for those
who acquire a disability during the course of employment, by taking appropriate
steps, including through legislation, to, inter alia:

a) Prohibition discrimination on the basis of disability with regard to all matters

concerning all forms of employment, including conditions of recruitment,
hiring and employment, continuance of employment, career advancement and
safe and healthy working conditions;

b) Protect the rights of persons with disabilities, on an equal basis with others,
to just and favourable conditions of work, including equal opportunities and
equal remuneration for work of equal value, safe and healthy working
conditions, including protection from harassment, and the redress of
grievances;
 Social Security Organisation of Malaysia
Article 27 – Work and Employment (2)
c) Ensure that persons with disabilities are able to exercise their labour and
trade union rights on an equal basis with others;

d) Enable persons with disabilities to have effective access to general

technical and vocational guidance programmes, placement services
and vocational and continuing training;

e) Promote employment opportunities and career advancement for persons

with disabilities in the labour market, as well as assistance in finding,
obtaining, maintaining and returning to employment;

f) Promote opportunities for self-employment, entrepreneurship,

the development of cooperatives and starting one's own
business;

g) Employ persons with disabilities in the public sector;

Social Security Organisation of Malaysia
Article 27 – Work and Employment (3)
h) Promote the employment of persons with disabilities in the private
sector through appropriate policies and measures, which may include
affirmative action programmes, incentives and other measures;

i) Ensure that reasonable accommodation is provided to persons

with disabilities in the workplace;

j) Promote the acquisition by persons with disabilities of work experience

in the open labour market;

k) Promote vocational and professional rehabilitation, job retention and

return-to-work programmes for persons with disabilities.
Social Security Organisation of Malaysia

SOCSO’s Return to Work Program

Social Security Organisation of Malaysia
Chronology
Introduction of Introduction of Additional of International Professional
the RTW 5 Disability Case another 5 Collaboration Certification (15
Program. Managers (Pilot) Disability Case 2 Case CDMPs)
under the Managers Managers were
Appointed Ministerial KPI
Medical & sent to Germany
Service (10 Case
Rehab for 3 months Established as a
Providers with Managers)
Department of RTW Dept.
biopsychosocial Additional of 25
SOCSO Establishment of
rehabilitation Case Managers 3rd RTW
a Job Placement
approach. Covering (Total 35) Conference
Unit
2 States
Focus on Cover all states
Covers 5 States
Physical 1st RTW
Rehabilitation Conference 2nd RTW
Conference

2005 2007 2008 2009 2010

Social Security Organisation of Malaysia
Concept of Case Management
• Case Management is a collaborative process that
facilitates recommended efficient treatment plans to
assure the appropriate medical care is provided to
disabled, ill or injured individuals to ensure that they
return to employment.

• Planning and coordination of health care services

appropriate to achieve the goal of medical
rehabilitation. Medical case management may
include, but is not limited to, care assessment,
including personal interview with the client, and
assistance in developing, implementing and
coordinating medical care plan with healthcare
providers as well as
• the clients and the clients family evaluate of
treatment results while promoting cost-effective
care.
Social Security Organisation of Malaysia
Service Providers Insurer (SOCSO)
Facilitate

RTW

Coordinating Treatment/ Related Stakeholders

Rehabilitation (employers, family, etc)
Social Security Organisation of Malaysia
Legal Mandate
SOCSO was mandated to administer and enforce:

• Employee Social Security Act 1969

• Employee Social Security General Rules 1971
Social Security Organisation of Malaysia
Legal Mandate
Section 40 (1)
The Organization may, in addition to the scheme of
benefits specified in this Act, promote measures or
co-operate with existing institutions for the
improvement of the health, occupational safety and
welfare of insured persons and for the
rehabilitation and re-employment of insured
persons who have been disabled or injured and
may incur in respect of such measures expenditure
from the funds of the Organization within such
limits as may be prescribed by the Minister.
Social Security Organisation of Malaysia
Legal Mandate
Section 57
(1) An insured person suffering from or claiming to
suffer from invalidity or permanent disablement may
be provided by the Organization, free of charge
facilities for physical or
vocational rehabilitation.

(2) Facilities under subsection (1) shall be of such

nature and scale and shall be provided to such
insured persons and on such conditions as may be
specified by the
regulations.
THANK YOU