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SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia)

SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia)

Section 26 Employees' Social Security Act 1969 — Employer Accident Notification to PERKESO

BORANG 34 — LAPORAN KEMALANGAN / PENYAKIT PEKERJAAN

Pertubuhan Keselamatan Sosial (PERKESO) — Employer Accident / Occupational Disease Notification

Seksyen 26 Akta Keselamatan Sosial Pekerja 1969 / Section 26 Employees' Social Security Act 1969

Date of This Report: [Report Date]

IMPORTANT: This report must be submitted to PERKESO within 48 hours of the employer becoming aware of the accident or occupational disease diagnosis.

BAHAGIAN A — BUTIRAN MAJIKAN / PART A — EMPLOYER DETAILS

Employer Name: [Employer Name]

PERKESO Employer No.: [PERKESO Employer No]

Business Address: [Employer Address]

Industry: [Industry Sector]

BAHAGIAN B — BUTIRAN PEKERJA / PART B — INJURED EMPLOYEE DETAILS

Employee Full Name: [Employee Name]

NRIC / Passport No.: [Employee NRIC]

PERKESO Membership No.: [PERKESO Member No]

Date of Birth: [Employee DOB]

Job Designation: [Job Designation]

Monthly Wages: [Monthly Wages]

BAHAGIAN C — BUTIRAN KEMALANGAN / PART C — ACCIDENT DETAILS

Type of Incident: [Accident Type]

Date of Accident / Diagnosis: [Accident Date]

Time of Accident: [Accident Time]

Location: [Accident Location]

How the Accident Occurred: [Accident Description]

Nature of Injury / Body Part Affected: [Injury Description]

BAHAGIAN D — BUTIRAN RAWATAN / PART D — MEDICAL TREATMENT DETAILS

Hospital / Clinic: [Hospital Name]

Date of First Treatment: [Treatment Date]

Type of Treatment: [Treatment Type]

Witnesses: [Witness List]

PERISYTIHARAN MAJIKAN / EMPLOYER DECLARATION

I, the authorised representative of [Employer Name], hereby report the above employment injury / occupational disease to the Social Security Organisation (PERKESO) in accordance with Section 26 of the Employees' Social Security Act 1969.

I understand that failure to report within 48 hours of becoming aware of this incident is an offence under Section 99 of the ESSA 1969, punishable by a fine not exceeding RM 10,000 or imprisonment not exceeding 2 years, or both.

NOTE: Employers must also submit the relevant DOSH notification (Borang JKKP 6) to the Department of Occupational Safety and Health (DOSH) under the Occupational Safety and Health (Notification of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease) Regulations 2004 (NADOPOD Regulations), which is a separate obligation from this PERKESO report.

Authorised Representative (Employer)

________________

Signature

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What Is a SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia)?

A SOCSO Borang 34 — Accident / Occupational Disease Report in Malaysia sets out the income, deductions, and tax position to be reported to the authority.

Borang 34 activates the PERKESO Employment Injury Scheme claims process. Upon receipt, PERKESO assigns a claims reference number and initiates assessment of the employee's entitlement to medical benefit, temporary disablement benefit (TDB), permanent disablement benefit (PDB), and other benefits under Sections 19 to 57 of the ESSA 1969. The employer's obligation to report under Section 26 is separate from and in addition to the employer's obligation to report accidents under the Occupational Safety and Health Act 1994 (OSHA 1994) and the Factories and Machinery Act 1967 (FMA 1967) — both of which have their own separate notification forms and timelines.

Borang 34 is also used to notify PERKESO of accidents in the circumstances defined as commuting accidents under Section 23 of the ESSA 1969 — injuries sustained while the employee is traveling by a usual route between their place of residence and their place of work. Commuting accidents attract the same Employment Injury Scheme benefits as on-site workplace accidents.

The reporting obligation under Section 26 of the ESSA 1969 applies even if the employer disputes whether the incident constitutes an employment injury — the employer's duty is to report, not to adjudicate. PERKESO's Medical Board conducts its own assessment of causation and disability. Failure to report within 48 hours is an offence under Section 99 of the ESSA 1969, punishable by a fine up to RM 10,000 or imprisonment not exceeding 2 years, or both.

The legal framework governing the SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) in Malaysia draws on several key statutes and regulatory bodies. Under Malaysian law, the Contracts Act 1950 (Act 136) governs contractual obligations. The Companies Act 2016 (Act 777) regulates corporate entities through the Companies Commission of Malaysia (SSM). The Employment Act 1955 (Act 265) and the Department of Labour govern employment matters. The Personal Data Protection Act 2010 (Act 709) and the Personal Data Protection Department protect personal data. The Inland Revenue Board of Malaysia (LHDN) administers tax obligations. The Industrial Court adjudicates employment disputes under the Industrial Relations Act 1967 (Act 177). Parties executing a SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) in Malaysia should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Employment Act 1955 (Act 265) sets the foundational requirements.

When Do You Need a SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia)?

A SOCSO Borang 34 is required in Malaysia within 48 hours of any of the following events affecting an insured employee under the Employees' Social Security Act 1969.

Borang 34 is required immediately when an employee suffers an accident at the workplace — including factory accidents, construction site injuries, office accidents, or any incident arising out of and in the course of employment under Section 22 of the ESSA 1969 — resulting in bodily injury, incapacity, or death.

Borang 34 is needed when an employee is involved in a commuting accident — an accident sustained while travelling between the employee's home and their usual place of work by a direct and usual route under Section 23 of the ESSA 1969. The employer must report even though the accident occurred off-premises.

Borang 34 is required when a PERKESO-panel physician or government hospital physician diagnoses an employee with an occupational disease listed in the Third Schedule of the ESSA 1969, such as lead poisoning, silicosis, noise-induced hearing loss, or other work-related diseases. The 48-hour reporting period runs from the date the employer is informed of the diagnosis.

Borang 34 is needed when an employee dies as a result of an employment injury. Fatal accidents trigger the Dependants' Benefit provisions under Sections 36 to 41 of the ESSA 1969, and prompt Borang 34 submission is critical to allow dependants to lodge their claims without delay.

Borang 34 is required when an employee suffers a recurrence of a previously certified employment injury that results in renewed incapacity or additional permanent disablement. Recurrence claims under the ESSA 1969 require a fresh Borang 34 report from the employer to PERKESO.

Parties in Malaysia should prepare a SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Malaysian law, the Contracts Act 1950 (Act 136) governs contractual obligations. The Companies Act 2016 (Act 777) regulates corporate entities through the Companies Commission of Malaysia (SSM). The Employment Act 1955 (Act 265) and the Department of Labour govern employment matters. The Personal Data Protection Act 2010 (Act 709) and the Personal Data Protection Department protect personal data. The Inland Revenue Board of Malaysia (LHDN) administers tax obligations. The Industrial Court adjudicates employment disputes under the Industrial Relations Act 1967 (Act 177). Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

What to Include in Your SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia)

A complete and accurate SOCSO Borang 34 for Malaysia must include the following elements as required by PERKESO under Section 26 of the Employees' Social Security Act 1969.

Employer particulars: Full company name, PERKESO employer registration number, SSM or business registration number, industry sector (relevant for occupational disease risk assessment), and the name and contact details of the person completing the form on behalf of the employer.

Injured employee details: Full name, PERKESO membership number, NRIC or passport number, date of birth, gender, job designation and nature of work performed, and monthly wages in RM at the time of the accident. Accurate wages are critical as temporary and permanent disablement benefits under the ESSA 1969 are calculated as a percentage of the insured daily wage.

Accident details: Date, time (in 24-hour format), and location of the accident. A precise description of how the accident occurred, including the work activity being performed, the equipment or machinery involved (if any), and the immediate cause of the injury. For commuting accidents, the route taken and the departure and arrival points must be described.

Nature of injury: A description of the bodily injury sustained — fracture, laceration, burns, chemical exposure, hearing loss, or other — and the part of the body affected. Medical diagnosis from the initial treating physician (government hospital or PERKESO-panel clinic) should be attached.

Medical treatment: Name and address of the hospital or clinic where the employee first received treatment, the date of first treatment, and whether the employee is hospitalised or receiving outpatient treatment. PERKESO's medical benefit under Section 29 of the ESSA 1969 covers all treatment costs at PERKESO-panel facilities.

Witnesses: Names and designations of any witnesses to the accident, whose statements may be required by PERKESO during the claims investigation. For fatal accidents, the names of next of kin and dependants eligible for Dependants' Benefit under Section 36 of the ESSA 1969 must also be provided.

Additional compliance elements for a SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) used in Malaysia include: Under Malaysian law, the Contracts Act 1950 (Act 136) governs contractual obligations. The Companies Act 2016 (Act 777) regulates corporate entities through the Companies Commission of Malaysia (SSM). The Employment Act 1955 (Act 265) and the Department of Labour govern employment matters. The Personal Data Protection Act 2010 (Act 709) and the Personal Data Protection Department protect personal data. The Inland Revenue Board of Malaysia (LHDN) administers tax obligations. The Industrial Court adjudicates employment disputes under the Industrial Relations Act 1967 (Act 177). Forms-legal.com provides this template as a starting point for Malaysia-compliant documentation.

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APA

Forms Legal. (2026). SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) (Malaysia) [Legal document template]. Forms Legal. https://forms-legal.com/malaysia/employment/forms/socso-borang-34-malaysia

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"SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) (Malaysia)." Forms Legal, 2026, https://forms-legal.com/malaysia/employment/forms/socso-borang-34-malaysia.

BibTeX
@misc{formslegal-socso-borang-34-malaysia,
  author       = {{Forms Legal}},
  title        = {SOCSO Borang 34 — Accident / Occupational Disease Report (Malaysia) (Malaysia)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/malaysia/employment/forms/socso-borang-34-malaysia}},
  note         = {Free legal document template. Based on Employment Act 1955 (Act 265)}
}

Frequently Asked Questions

Based on Employment Act 1955 (Act 265) — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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