Cara Claim SOCSO Kemalangan: A Complete HR Guide for Work Accident Claims

When an employee is injured at work, they are not only dealing with pain and stress, they are also worried about hospital bills and lost income. At that moment, HR becomes their main source of help on cara claim SOCSO kemalangan.

By understanding the step-by-step claim process, employers can show they truly care, while ensuring the company meets its responsibilities under Malaysian social security law.

What is SOCSO (PERKESO) Kemalangan?

SOCSO / PERKESO (Pertubuhan Keselamatan Sosial) is a government agency set up under the Employees’ Social Security Act 1969 to provide social security protection to employees. It covers workers who suffer:

Workplace accidents
Commuting accidents (from home to work and back, or during work-related travel)
Emergency accidents (injured while helping during a workplace emergency)
Occupational diseases caused by work conditions

For work-related accidents, employees may receive:

Medical benefits: treatment at SOCSO panel clinics or government hospitals
Temporary or permanent disability benefits: income replacement if they cannot work
Dependants’ benefits: financial help for family if the worker dies from the accident
Rehabilitation and vocational support: therapy, equipment, or retraining so they can work again

SOCSO is a safety net that helps employees recover without bearing the full financial burden themselves.

Eligibility for Claim SOCSO Kemalangan

Before HR starts a claim, check these basic conditions:

Employee is an active SOCSO contributor

Full-time, part-time, and eligible foreign workers who are registered and have monthly contributions.

An accident is work-related, usually under Skim Bencana Pekerjaan, where it happened:

While performing job duties at the workplace.
On the way to or from work, or during approved work-related travel (client visits, site visits, official errands).
During a workplace emergency where the employee was helping others.

Incident is reported within the required timeframe

As a rule of thumb, accidents should be reported to the employer and SOCSO as soon as possible, typically within 48 hours for work accidents.

If any of these are missing (for example, no contributions, or accident clearly unrelated to work), the claim is likely to be rejected.

Step-by-Step Claim Process for Employers/HR

Think of HR’s role as “project manager” for the claim. Here’s the flow from accident to payout.

1. Report the Accident Immediately

Ask the employee (or their supervisor) to inform HR immediately whenever an accident occurs. HR should record key details: date, time, location, what happened, witnesses, and initial injuries. For serious cases or commuting accidents, a police report is usually needed.

This early record will be crucial when filling in SOCSO forms later.

2. Ensure Medical Treatment

Send the employee to a SOCSO panel clinic or government hospital whenever possible. For private clinics, employees may need to claim reimbursement later. Remind the employee and the clinic/hospital to keep all medical reports, MC/medical certificates and bills. These are supporting documents for the claim.

3. Complete the SOCSO Claim Forms

For work-related accidents, there are a few key forms:

Borang 21: Laporan Kemalangan

Usually filled by the employer to report the accident to SOCSO.

Borang 10: Tuntutan Faedah Hilang Upaya

Filled by the employee to claim temporary disablement benefits (loss of income while on MC).

In some cases, SOCSO may also require Borang 34 (Notice and Benefit Claim Form) or additional employer forms (e.g. Borang 16A), depending on the type of claim.

Make sure all sections are filled clearly, especially the “how the accident happened” part.

4. Attach Supporting Documents

To prevent delays, HR should help the employee collect:

Copy of IC/MyKad (or passport for foreign workers)
Latest pay slips/salary statement
Medical report from the treating doctor
MC/sick leave certificates
Police report, if the accident happened on the road or involved vehicles
Any CCTV screenshots, photos of the accident site, or internal incident reports (if available)

Keep a checklist so no document is forgotten.

5. Submit the Claim to SOCSO

Employers or employees can submit the claim:

Through the SOCSO online portal (ASSIST)
At the nearest SOCSO / PERKESO office
Through an admitted agent, where applicable

HR should always:

Keep a copy of all submitted forms and documents
Note down the submission date and any SOCSO reference number

6. SOCSO Review & Approval

SOCSO will:

Check the forms and documents
Verify contribution records
Assess whether the accident is work-related
Request further medical checks or documents if needed

If approved, SOCSO will pay medical costs directly (for panel/government treatment) or reimburse approved expenses or Transfer cash benefits (e.g. temporary disablement) to the employee’s bank account

7. Communicate with the Employee

HR plays a big role in communication:

Update the employee on submission status and SOCSO requests
Confirm bank details used for payment
Explain what benefit they are receiving (temporary vs permanent disablement, etc.)

Good communication helps reduce anxiety and keeps trust high during recovery.

8. Handle Appeals if Rejected

If SOCSO rejects a claim, HR should first review the rejection reason (for example, accident not clearly work-related, incomplete documents, contribution issues). If the company believes the claim is valid, help the employee:

Gather stronger evidence (extra medical details, witness statements, clearer timeline).
Submit an appeal (e.g. Borang 9 to the Social Security Appeals Board).

Important Tips for Employers/HR

A smooth SOCSO claim starts long before any accident happens. These practices make life easier later.

Report Accidents Promptly

Late reporting is one of the most common causes of delay and rejection. Make it standard SOP to:

Report work accidents to SOCSO within 48 hours.
Record even “minor” incidents; some injuries worsen over time.

Maintain Proper Records

Keep:

Contribution records up to date
Attendance logs and duty rosters
Safety and incident reports

These records can support your case if SOCSO needs to verify the situation.

Train HR & Supervisors on SOCSO Procedures

Run short internal workshops so HR, payroll and line managers know which forms to use and what to do in the first 24–48 hours after an accident.

Prepare a step-by-step SOP and place it in shared folders or HR handbooks.

Inform Employees of Their Rights

Employees who know their rights:

Report accidents earlier
Provide documents faster
Are less likely to feel “abandoned” by the company

Include a short SOCSO overview during onboarding and safety briefings.

Processing Timeline

SOCSO processing time depends on the type of claim and whether documents are complete. Based on general guidance:

Workplace accident claims: around 21 working days after all documents are received
Service-related / occupational disease: can take up to 3 months, because it often needs a specialist medical assessment
Temporary disablement benefit (hilang upaya sementara): often processed in about 2 weeks

If documents are incomplete or medical details are unclear, SOCSO may need more time and ask for extra information.

Common SOCSO Benefits

When a SOCSO accident claim is approved, employees may receive one or more of these benefits:

Medical Treatment

Treatment at SOCSO panel clinics or government hospitals. Reimbursement for approved non-panel treatment

Temporary Disablement Benefit

Income replacement (up to 80% of daily wages) when the employee is temporarily unable to work for at least four days.

Permanent Disablement Benefit

Long-term payment (up to 90% of daily wages) if the injury leaves permanent disability.

Funeral Benefit

A lump sum (e.g. RM3,000) to help the family cover funeral expenses if the employee dies due to a work-related accident.

Dependants’ Benefits

Monthly payments to spouse, children or other dependants if the accident leads to death.

Rehabilitation and Vocational Support

Physiotherapy, occupational therapy, prosthetics, assistive devices, and retraining so employees can return to work or start a new job.

SOCSO Claim Form

References / Sources

SOCSO PERKESO Official Website: https://www.perkeso.gov.my/
Employees’ Social Security Act 1969: https://www.perkeso.gov.my/images/imej/akta_dan_peraturan/Act%204-As%20at%201_Feb_2019.pdf
Relevant Malaysian government guidelines

FAQ Section

When can employees claim SOCSO?

Employees can claim SOCSO when they:

Suffer a workplace accident while performing job duties.
Involved in a commuting accident on the way to or from work or during work-related travel.
Develop an occupational disease related to their job.
Become disabled or die due to a work-related incident.

The employee must be an active SOCSO contributor at the time of the incident.

How long does SOCSO take to process claims?

Processing time depends on the type of claim:

Around 21 working days for standard workplace accidents, after documents are complete.
Up to 3 months for occupational disease claims, due to medical assessment.
About 2 weeks for temporary disability benefits in straightforward cases.

Delays usually happen when documents are incomplete or medical reports are unclear.

What should an employer do if a claim is rejected?

If SOCSO rejects a claim:

Review the rejection reason carefully (for example, accident not considered work-related, missing documents, contribution issues).
Collect additional evidence, such as clearer medical reports, witness statements, time sheets, or accident photos.
Assist the employee to submit an appeal (e.g. using Form 9 to the Social Security Appeals Board) within the given timeframe.

Can SOCSO cover medical treatment costs?

Yes. SOCSO’s medical benefits cover:

Treatment at SOCSO panel clinics and government hospitals
Second-class ward treatment and specialist care at government hospitals for serious injuries
Reimbursement of approved treatment at non-panel clinics or hospitals (with receipts and reports)

Employees should always seek treatment at a SOCSO-recognised facility where possible so claims are smoother.

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