PERKESO Disability Benefit Claim Form

PERKESO Disability Benefit Claim Form: Streamlined Support for Malaysian Workers

When a work-related injury or occupational disease affects your ability to work, navigating the PERKESO (Social Security Organisation or SOCSO) disability benefit claim process can feel overwhelming. This PERKESO Disability Benefit Claim Form template is designed specifically for Malaysian workers, employers, and HR departments to submit complete, accurate claims for temporary or permanent disability benefits, medical board assessments, and rehabilitation support.

What is PERKESO and Why This Form Matters

PERKESO provides social security protection to Malaysian workers under the Employees' Social Security Act 1969. The Employment Injury Insurance Scheme covers disability resulting from workplace accidents or occupational diseases, offering financial support, medical treatment, and rehabilitation services. Filing a proper claim ensures workers receive the benefits they're entitled to while their employer maintains compliance with Malaysian labour regulations.

This form template simplifies the entire claim submission process, whether you're claiming for temporary disablement, permanent disablement (partial or total), or seeking rehabilitation assistance. It captures all the essential information PERKESO requires—from employee and employer details to comprehensive medical documentation and medical board assessment outcomes.

Who Should Use This PERKESO Disability Claim Form?

This template is ideal for:

• Human Resources teams managing workplace injury claims and employee welfare
• Injured workers or their representatives filing disability benefit claims
• Employers fulfilling their duty of care and regulatory obligations under Malaysian law
• Occupational safety officers documenting incidents and coordinating with PERKESO
• Insurance administrators handling employment injury claims
• Legal and compliance teams ensuring proper documentation for labour audits

Key Features of This Template

Complete Employee & Employer Information: Capture MyKad (IC number), employee number, contact details, job role, salary information, and employer's SSM registration number and PERKESO reference number—all the identifiers PERKESO needs to process your claim efficiently.

Detailed Incident Documentation: Record the date, time, location, and circumstances of the workplace accident or onset of occupational disease. Clear incident reporting helps establish causation and speeds up claim approval.

Comprehensive Medical Evidence Section: Upload medical reports, specialist assessments, hospital discharge summaries, diagnostic imaging, and medical board assessment certificates. The form supports multiple file uploads so all supporting documentation stays organized in one place.

Medical Board Assessment Details: Document the medical board's findings, degree of permanent disablement (if applicable), assessment date, and recommendations. This critical information determines benefit eligibility and amount.

Rehabilitation Support Request: Indicate whether the claimant requires vocational rehabilitation, physical therapy, occupational therapy, assistive devices, workplace modifications, or retraining programs. PERKESO's Return to Work Programme can provide significant support, and this form ensures those needs are clearly communicated.

Employment Status & Return to Work Information: Specify current work status (on medical leave, light duties, unable to work, or returned to work), expected return date, and any workplace accommodation needs—helping both PERKESO and your employer plan appropriate support.

Bank Account Details for Benefit Payment: Secure collection of bank information ensures disability benefits are paid directly and promptly to the claimant's account.

Why Choose Paperform for Your PERKESO Claims?

Paperform makes managing PERKESO disability claims straightforward and professional:

• Document-style editor lets HR teams customize the form to match specific workplace policies or add company branding
• File upload fields accept medical reports, certificates, and supporting documents in one secure submission
• Conditional logic shows or hides rehabilitation questions based on disability type, keeping the form relevant
• Integration with Google Sheets, Airtable, or your HRIS means claim data flows automatically into your records without manual data entry
• Email notifications alert HR, safety officers, and PERKESO liaisons immediately when a claim is submitted
• Secure, SOC 2 Type II compliant infrastructure protects sensitive employee medical and financial information
• Mobile-friendly design allows injured workers to complete the form from anywhere, even while recovering at home

For HR departments managing multiple claims or injury cases, you can connect this form to Stepper to automate your entire PERKESO claim workflow—send acknowledgment emails, create case tracking records, notify relevant stakeholders, schedule follow-ups, and keep employees informed throughout the process, all without manual work.

If your claim requires signatures from the injured worker, witnesses, or HR representatives, Papersign lets you turn form submissions into legally binding eSignature documents, maintaining a complete audit trail for compliance and record-keeping.

Supporting Malaysian Workplaces and Workers

Malaysia's commitment to worker welfare through PERKESO is an essential safety net, but the claim process requires careful documentation and attention to regulatory detail. This form template brings professionalism and clarity to what can be a stressful situation for injured workers and busy HR teams alike.

Whether you're a manufacturing facility, construction company, logistics provider, healthcare institution, or any Malaysian employer with PERKESO-registered employees, having a standardized, comprehensive disability claim form demonstrates your commitment to employee welfare and regulatory compliance.

Start using this PERKESO Disability Benefit Claim Form template today and give your team—and your injured workers—the support and efficiency they deserve during challenging times. With Paperform's flexibility and automation capabilities, you can focus on what matters most: helping employees recover and return to work safely.