CHAPTER V

BENEFITS

35. Sickness benefit.— (1) A secured person who is certified, by a medical practitioner authorised by the Institution in the manner provided in the regulations to give such a certificate, to be incapable of attending to his work on account of sickness shall, subject to regulations, be entitled to receive sickness benefit at such rate as may be fixed by Government by notification, in consultation with the Institution, if during the six calendar months immediately preceding the date on which his incapacity or work was so certified, contributions in respect of him were paid or payable for not less than ninety days.

[(2) A secured person shall be entitled to receive sickness benefits throughout the period of sickness:

Provided that during a continuous period of three hundred and sixty-five days such benefit shall not be allowed for a period exceeding—

[(a) three hundred and sixty-five days, in case he has been suffering from Tuberculosis or Cancer which render an employee incapable to earn his livelihood]; and

(b) one hundred and twenty-one days, in case he has been suffering from any other disease:

Provided further that he shall not be entitled to receive such benefit for the first two days of his sickness if such sickness does not, within fifteen days, follow the previous period of sickness for which he received or was entitled to receive such benefit.]

36. Maternity benefit.— A secured woman shall, subject to regulations be entitled to receive maternity benefit at such rate as may be fixed by Government by notification, in consultation with the Institution, if contributions in respect of her were paid or payable for not less than one hundred and eighty days during the twelve calendar months immediately preceding the expected date of her confinement as certified by a medical practitioner authorised by the Institution in the manner provided in the regulations to give such a certificate, and such benefit shall be paid for all days on which she does not work for remuneration during a period of twelve weeks, of which not more than six weeks shall precede the expected date of confinement.

37. Death grant.— [(1)] On the death of secured person receiving or entitled to receive injury benefit, sickness or medical care at the time of his death, the surviving widows or needy widower, or if there be no surviving widow, widows or needy widower, the person who provided for the funeral, shall, subject to regulations, be entitled to a death grant equal to the daily rate of sickness benefit multiplied by thirty, but in no case less than [one thousand and five hundred] rupees.

[(2) Where husband of a secured woman dies, she shall, subject to regulations, be entitled to receive iddat benefit equal to the daily rate of her wages during the period of her iddat:

Provided that a secured woman being a seasonal employee shall be entitled to receive iddat benefit in the same manner and to the same extent notwithstanding termination of seasonal employment during the period of iddat:

Provided further that no employer shall refuse leave for the period of iddat and such leave shall not be accounted towards leave provided under any other law for the time being in force.]

38. Medical care during sickness and maternity.— [(1) A secured person and his dependents shall be entitled to medical care in the manner and to the extent provided in the regulations.]

(2) A secured woman shall subject to regulations, be entitled to prenatal confinement and post-natal medical care, if she is entitled to maternity benefit under section 36 or if, during six calendar months immediately preceding her claim, contributions in respect of her were paid or payable for not less than ninety days.

[38-A. Medical care of dependents, etc.— Where a secured person dies other than due to any employment injury, his dependents shall, subject to regulations, be entitled to medical care for one year from the date of death of the secured person:

Provided that the deceased secured person had been in continuous employment of an establishment for not less than twelve months immediately preceding his death:

Provided further that where the deceased secured person was a seasonal employee, his dependents shall be entitled to medical care for six months from the date of death of such secured person:

Provided also that the deceased had been in employment of an establishment for not less than six months during two continuous seasons immediately preceding his death.]

39. Injury benefits.— A secured person shall, subject to regulations, be entitled to receive injury benefit at such rate as may be fixed by Government by notification, in consultation with the Institution, in respect of any day
[* * *] including the day on which, as a result of an employment injury, he is certified by a medical practitioner authorised by the Institution in the manner provided in the regulations to give such a certificate to be incapable of work, but for not more than one hundred and eighty days.

40. Disablement pension.— (1) A secured person who sustains total or partial disablement shall, subject to regulations, be entitled, upon the expiration of his entitlement to injury benefit, to receive disablement pension, according to the degree of disablement determined from time to time, at such rates for different degrees of disablement as may be fixed by Government by notification, in consultation with the Institution.

(2) Disablement pension shall terminate with the death of the recipient or when disablement ceases, or ceases to be total or partial disablement:

Provided that if a disablement pension has been paid for five years it shall be payable for life.

41. Disablement gratuity.— (1) A secured person who sustains minor disablement shall, subject to regulations, be entitled to a disablement gratuity at such rates for different degrees of disablement as may be fixed by Government by notification, in consultation with the Institution.

(2) Where a person receiving disablement pension ceases to suffer from total or partial disablement but continues to suffer from minor disablement he shall, on the termination of his disablement pension, be entitled to disablement gratuity under this section.

42. Survivor’s Pension.— (1) Where a secured person dies as a result of an employment injury, a survivor’s pension shall, subject to regulations, be payable to each of his dependents as follows, that is to say—

(a) to the widow, widows, or needy widower, during life, at a rate equal to three-fifths of the rate of total disablement pension to which the secured person was, or would have been entitled, and where there are two or more widows, the pension shall be divided equally between them;

(b) to each dependent child, at a rate equal to one-fifth of the rate of such total disablement pension:

Provided that if the child is a full orphan, the rate shall be two-fifths of the rate of the total disablement pension:

Provided further that if and so long as the total of the survivor’s pensions would otherwise exceed the rate of such total disablement pension, the pension of each of the survivors shall be reduced proportionately so that the total pensions payable to them does not exceed the rate of the said total disablement pension.

(2) In case the deceased person does not leave a widow, or needy widower, a survivor’s pension shall be payable for life to a dependent father, if he be alive, and if he be not alive, to a dependent mother, if she be alive, at a rate equal to one-fifth of the rate of the total disablement pension to which the secured person was or would have been entitled.

[(2-A) In case the deceased person does not leave a dependent, a survivor’s pension shall be payable for life to a dependent father if he be alive, and if he be not alive, to a dependent mother, if she be alive and if she be not alive, to dependent brothers and sisters in equal shares, at a rate equal to one half of the rate of total disablement pension to which the secured person was or would have been entitled.]

(3) Survivor’s pension shall be payable upon the death of the secured person and shall terminate—

(a) upon the death of the survivor; or

(b) where the survivor is a widow, upon her remarriage; or

[(c) where the survivor is a dependant child—

(i) on attaining the age of nineteen years, in case of a female child; and

(ii) Twenty-one years, in case of a male child],

and in any such case the pensions of the remaining survivors shall, if necessary, be adjusted within the maximum laid down in the second proviso to sub-section (1).

43. Death grant in case of death while in receipt of injury benefit or total disablement pension.— Where a secured person dies while he is in receipt of injury benefit or of a total disablement pension the widow, widows or needy widowers, or, if there is no widow or needy widower, the person who provided for the funeral, shall, subject to regulations, be entitled to a death grant equal to the daily rate of the injury benefit or of the total disablement pension, as the case may be, multiplied by thirty, but in no case less than [one thousand and five hundred] rupees.

44. Medical care in the case of employment injury.— (1) When medical care is required as a result of an employment injury—

(a) no conditions as regards payment of contributions shall apply; [and]

(b) it shall include dental care in addition to the services referred to in section 45; [* * *]

(c) [* * * * * * * * * * * *]

(2) A person in receipt of injury benefit, disablement pension for loss of earning capacity not less than fifty per centum of a survivor’s pension shall be entitled to medical care for so long as the injury benefit, disablement pension or survivor’s pension, as the case may be, continues, and, in the case of a disablement pension being received by the secured person, for six months after the termination of the pension.

45. Extent of medical care.— (1) Medical care shall include—

(a) general practitioner care, including domiciliar visiting;

(b) specialist care in hospitals for in-patients and out-patients and such specialist care as may be available outside hospitals;

(c) essential pharmaceutical supplies as prescribed by a medical practitioner;

(d) hospitalisation where necessary, including cases of pregnancy and confinement;

(e) pre-natal confinement and post-natal care, either by medical practitioners or by qualified midwives.

(2) [* * * * * * * * * * * *]

46. Manner of providing medical care.— (1) Regulations shall specify the manner in which medical care shall be provided.

(2) The Institution may, with the approval of Government, establish and maintain such hospitals, dispensaries and other facilities as it finds necessary for providing medical care in pursuance of the provisions of this Ordinance.

(3) The Institution may buy or import and dispense pharmaceutical supplies direct to the beneficiaries.

(4) The Institution may enter into agreements with Government, any local authority, private body or individual in regard to the provision of medical care to persons entitled to it under this Ordinance.

(5) The Institution may enter into an agreement with an employer who maintains a hospital or dispensary or any other medical facility for the benefit of his employees for the utilisaiton of such hospital, dispensary or facility for the purposes of the Institution and such agreement may, among other things, specify the persons to whom medical care shall be provided, the type of benefit to be made available, the minimum level of such benefit, the conditions under which such benefit shall be provided, the extent of supervision which the Institution may exercise over the hospital, dispensary or other medical facility, the submission of reports to the Institution by the employer, and the extent and manner of re-imbursement to the employer.

47. Institution’s power to promote measures for health, welfare etc. of secured persons.— The Institution may, in addition to the benefits specified in this Ordinance, undertake other measures for improving the health and welfare of secured persons and for the rehabilitation and settlement of such secured persons as may have been disabled or injured, and may for that purpose incur expenditure from the Fund.

48. Manner of claiming benefit.— (1) All claims for benefits under this Ordinance shall be made within such times as may be prescribed, and in such form and manner, and shall be accompanied by such documents, information and evidence as to entitlement as may be provided in the regulations.

(2) Payment in respect of benefits shall be made in such manner, and at such times and places as may be provided in the regulations.

49. Benefit not assignable or attachable.— (1) The right to receive any payment in respect of any benefit under this Ordinance shall not be transferable or assignable.

(2) No benefit payable under this Ordinance shall be liable to attachment or sale in execution of any decree or order of any Court.

50. Exemption from stamp duty.— Notwithstanding anything to the contrary contained in the Stamp Act, 1899 (Act II of 1899), stamp duty shall not be chargeable upon any draft or order or receipt in respect of any benefit payable under this Ordinance.

51. Non-duplication of benefits.— (1) A secured person shall not be paid, for the same period, more than one of the benefits referred to in sections 35, 36 and 39, namely, sickness benefit, maternity benefit and injury benefit, and where any person is entitled to more than one of these benefits shall be given the higher or highest of such benefits.

(2) No person shall be entitled to sickness benefit or maternity benefit or injury benefit for any day for which he receives wages.

52. Repayment of benefit improperly received.— (1) When a person has received any benefit or payment under this Ordinance to which he is not lawfully entitled, he shall be liable to repay to the Institution the value of the benefit or the amount of such payment, and, in the case of his death, his legal heirs shall be liable to repay the same from the assets of the deceased:

Provided that the Institution may waive repayment where there was no mis-representation on the part of the beneficiary and the repayment would cause undue hardship to him, or as the case may be, to his survivors.

(2) For the purposes of this section, the value of any benefit received otherwise than in cash shall be determined in accordance with the regulations.

53. Institution’s right to recover damages from employer in certain cases.— Where, according to the finding of a Court, an employment injury was sustained by a secured person by reason of a wrongful act or omission of the employer or his agent, the employer or his agent shall reimburse to the Institution the actuarial present value of any periodical payment or the amount of any lump sum payment which the Institution is liable to make under this Ordinance and such actuarial value shall be determined in accordance with the regulations.

54. Institution’s right to be indemnified in certain cases.— Where a secured person is entitled to receive or to recover, but has not received or recovered, from any person, compensation or damages in respect of any sickness or employment injury caused under circumstances creating a liability in some person other than, in case of employment injury, the employer or his agent, the Institution shall be entitled to be indemnified by the person so liable.

[54-A. Extent of benefits, etc.— Notwithstanding anything contained in this Chapter, so much of wages of a secured person’s as are in excess of [two hundred rupees per day or five thousand rupees per month] shall not be accounted for the purpose of determining the rate of benefits provided under sections 35, 36, 37, 39, 40, 41, 42 and 43].

55. Recovery of amounts due.— Any amount recoverable by the Institution under this Chapter may be recovered as arrears of land-revenue.

[(CHAPTER V-A

MEDICAL TREATMENT OF DOMESTIC SERVANTS

55-A. Medical treatment of domestic servants.— Every employer of a domestic servant shall be liable to provide at his own cost to the domestic servant medical care to the extent mentioned in section 45.]

CHAPTER VI

DETERMINATION OF QUESTIONS AND CLAIMS

56. Assessment of disablement.— All questions as to the assessment of the degree of disablement shall be determined by a medical board or medical practitioner appointed under section 17.

57. Decisions on complaints, questions and disputes.— If any complaint is received or any question or dispute arises as to—

(a) whether any person is a secured person within the meaning of this Ordinance [* * *]; or

(b) the rate of wages or average daily wages of a secured person for the purposes of the Ordinance; or

(c) the rate of contribution payable by an employer in respect of an employee; or

(d) the person who is or was the employer in respect of a secured person; or

(e) any benefit and the amount and duration thereof; or

(f) any other matter in respect of any contribution or benefit or other dues payable or recoverable under this Ordinance;

the matter shall be decided by the Institution, in such manner, and within such time as the regulations may provide, and the Institution shall notify its decision to the person or persons concerned, in writing, stating therein the reason or reasons for its decisions.

58. Review on account of new facts.— The Institution may, subject to regulations, on new facts being brought to its notice, review a decision given by it under section 57:

Provided that no decision shall be so reviewed without giving the person or persons concerned an opportunity of being heard and adducing evidence in support of or against the decision, as the case may be.

59. Appeal to Social Security Court.— Any person aggrieved by a decision of the Institution under section 57 or on a review under section 58 may appeal to the appropriate Social Security Court.

60. Constitution of Social Security Court.— (1) Government may for purposes of this Ordinance constitute, by notification, a Social Security Court for any Social Security area or areas specified in the notification.

(2) A Social Security Court shall be presided over by a Judge who shall be appointed by Government.

(3) A person shall not be appointed as a Judge of a Social Security Court unless he has—

(a) for a period of not less than three years held a judicial office; or

(b) for a period, or for periods aggregating, not less than seven years, been an advocate or pleader of the High Court.

61. Jurisdiction of Social Security Courts.— (1) Subject to the provisions of sub-section (2), a Social Security Court shall have exclusive jurisdiction to hear and decide appeals from decisions of the Institution under section 57 or review under section 58 in respect of all claims, questions and disputes arising in the appropriate Social Security Area.

(2) Government may, by order in writing, transfer an appeal from one Social Security Court to another, whenever it appears to it that such transfer will promote the ends of justice or tend to the general convenience of the parties and witnesses.

(3) The Social Security Court to which an appeal has been transferred under the provisions of sub-section (2) shall deal with the same as if it had been originally instituted in, or presented to, such Court.

62. Powers of Social Security Court, etc.— (1) A Social Security Court shall have all the powers of a Civil Court for the purposes of summoning and enforcing the attendance of witnesses, compelling the discovery and production of documents and material objects, administering oath and recording evidence, and such a Court shall be deemed to be a Civil Court within the meaning of section 195 of the Code of Criminal Procedure, 1898 (Act V of 1898).

(2) Notwithstanding anything contained in any other law, a Social Security Court may, for the purpose of deciding any appeal, examine such witnesses and take such evidence as it considers necessary.

(3) A Social Security Court may make such order with regard to costs incidental to any appeal as it thinks fit.

(4) An order of a Social Security Court shall be enforceable as if it were a decree of a Civil Court.

(5) A person shall be guilty of contempt of a Social Security Court if he, without lawful excuse—

(a) offers any insult to the Social Security Court or any member thereof while the Court is functioning as such; or

(b) causes any interruption in the work of the Social Security Court; or

(c) fails to produce or deliver a document when ordered by the Social Security Court to do so;

(d) refuses to answer any question of the Social Security Court which he is bound to answer; or

(e) refuses to take oath to state the truth or to sign any statement made by him when required by the Social Security Court to do so;

and the Social Security Court may, without any complaint having been made to it, forthwith try such person for such contempt and sentence him to a fine not exceeding fifty rupees.

63. Appearance by legal practitioners.— Any application, appearance or act required to be made or done by any person to or before a Social Security Court (other than the appearance of a person required for the purposes of his examination as a witness) may be made or performed by a legal practitioner or by an officer of a registered trade union authorised in writing by such person, or, with the permission of the Court, by any other person so authorised.

64. Appeal.— (1) Save as expressly provided in this section, no appeal shall lie from an order of a Social Security Court.

(2) An appeal shall lie to the High Court from an order of a Social Security Court if it involves a substantial question of law.

(3) The period of limitation for an appeal under this section shall be thirty days.

(4) The provisions of sections 5 and 12 of the Limitation Act, 1908 (IX of 1908) shall, apply to appeals under this section.

65. Stay of payment pending appeals.— Where the Institution has appealed against an order of a Social Security Court that Court may, and, if so directed by the High Court shall, pending the decision of the appeal, direct that the payment of any sum required to be paid by the order appealed against shall be withheld.

CHAPTER VII

OFFENCES AND PENALTIES

66. Offences.— (1) If any person—

(a) for the purpose of obtaining the allowance or denial of any payment or benefit under this Ordinance, whether for himself or some other person, or for the purpose of avoiding any payment to be made by himself or any other person under this Ordinance—

(i) knowingly makes or causes to be made any false statement or false representation; or

(ii) produces or furnishes, or causes or knowingly allows to be produced or furnished, any document or information which he knows to be false in a material particular; or

(b) fails to pay any contribution which under this Ordinance he is liable to pay; or

(c) recovers or attempts to recover from a secured person, or deducts or attempts to deduct from his wages the whole or any part of the [* * *] contribution; or

(d) fails or refuses to submit any return required by regulations or makes a false return; or

(e) obstructs any official of the Institution in the discharge of his duties; or

(f) is guilty of any contravention of, or non compliance with, any of the requirements of this Ordinance or the rules or the regulations,

he shall, without prejudice to any action to which he may be liable under section 23 or section 70 or any other provision of this Ordinance, be punished with imprisonment which may extend to three months, or with fine not exceeding one thousand rupees, or with both.

67. Prosecution.— (1) No prosecution under this Ordinance shall be instituted except with the previous sanction of the Commissioner or of an officer authorised by him in writing in this behalf.

(2) No Court inferior to that of a magistrate of the first class shall try any offence under this Ordinance.

(3) No Court shall take cognizance of any offence under this Ordinance except on a complaint made in writing within six months of the date on which the offence was discovered.

(4) [* * * * * * * * * * * *]

CHAPTER VIII

MISCELLANEOUS

68. Contributions, etc., to have priority over other debts.— In any proceedings of insolvency against a person or proceedings for the winding up of a company, any contribution or other amount payable under this Ordinance by such person or company shall be deemed to be included among debts to be paid in priority to all other debts.

69. Exemption from taxes.— Notwithstanding anything contained in any other law, Government may, by order in writing, exempt the Institution from any tax, rate or duty leviable by Government or by a local authority under the control of Government.

70. Levy of special tax.— (1) Where, in respect of any group of undertakings producing a particular type of product or performing a particular type of service this Ordinance is, in accordance with the provisions of sub-section (3) of section 1, applied to some areas or establishment, but not to other areas or establishments, Government may, after consultation with the Institution by a notification levy on the employers in the areas or establishments to which the Ordinance is not applied, notwithstanding anything contained in this Ordinance, a special tax, to be paid to the Institution, at such rate, not exceeding five per centum of the total wages paid by the employer, at such times and subject to such conditions, as may be prescribed.

[(2) For the purposes of subsection (1), the total wages paid by the employers shall mean the total wages which have accrued to all his employees not taking into account so much of an employee’s wages as are in excess of one hundred and twenty rupees per day or three thousand rupees per month.]

(3) The proceeds of the special tax shall be paid into the Fund and shall be utilized for capital expenditure towards building up and improving the medical facilities available for the provision of medical care under this Ordinance.

(4) All provisions of this Ordinance and rules or regulations relating to contributions, with the exception of section 26 and the rules made thereunder, shall apply to the special tax as if it were a contribution payable under section 20.

71. Review and modification of wage limits, contribution and benefits.— (1) In January of each year, the Governing Body shall review the wage limits specified in [clause (f) of sub-section (8) of section 2] and the rates of contribution and benefits provided under this Ordinance in the light of any changes in wage levels or living costs and shall submit a report thereon together with its recommendations to Government.

(2) Government may, after considering the said report and recommendations, by notification, enhance or reduce the wage limits specified in [clause (f) of sub-section (8) of section 2] or the rates of benefits payable under this Ordinance.

72. Employers not to dismiss or punish employee during the period of sickness, etc.— (1) No employer shall dismiss, discharge or reduce or otherwise punish an employee during the period in which the employee is in receipt of sickness benefit, maternity benefit, injury benefit or medical care.

(2) No notice of dismissal or discharge or reduction given to an employee during the period specified in sub-section (1) shall be valid or operative.

73. Bar on benefits under other law.— When a person is entitled to any of the benefits provided by this Ordinance, he shall not be entitled to any similar benefit under any other law.

74. Suit for damages in a Civil Court.— No suit for damages shall be instituted by secured person against the employer in any Civil Court in respect of employment injury covered by this Ordinance.

75. Members and servants of the Institution to be public servants.— The members of the Governing Body and all officers and servants of the Institution shall be deemed to be public servants within the meaning of the Pakistan Penal Code (Act XLV of 1860).

76. Removal of difficulties.— (1) If any difficulty arises in giving effect to the provisions of Chapters III and V, Government may, by order notified in the official Gazette, make such provision or give such direction as appears to it to be necessary for the removal of the difficulty.

(2) Any order made under sub-section (1) shall have effect notwithstanding anything inconsistent therewith in any rules or regulations.