soc leg geek notes II (before death benefits)

8/7/2019 soc leg geek notes II (before death benefits)

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INCREASED RISK JOBS

Among the jobs enumerated asincreasing the risk of assault are:

a. Jobs having to do with KEEPING THEPEACE OR GUARDING PROPERTY

b. Jobs having to do with KEEPING OR

CARRYING OF MONEY (increasedtemptation to robbery)c. Jobs which expose the employee to

DIRECT CONTACT WITH LAWLESS ANDIRRESPONSIBLE MEMBERS OF THECOMMUNITY (bartenders)

d. Work as DRIVERS OR CONDUCTORS

Case:Batangas vs. Vda. De RiveraMay 8, 1956

F: While the employee-driver was drivingthe bus, a passenger boarded it and satdirectly behind the driver. After about 30minutes, during which the passenger and thedriver never so much as exchanged a word, thepassenger shot the driver to death and fled.There was no competent proof as to the causeof the assault, though there were intimationsthat the incident arose from a personal grudge.

I: Compensability of the drivers death

H: The drivers death was COMPENSABLE.The incident arose out of the employment.There are employments, which increase therisk of assault on the person of the employeeand it is that sense that an injury or harmsustained by the assaulted worker arises out ofthe employment, because the increased risk toassault supplies the link or connection betweenthe injury and employment.

PRESUMPTIVE COMPENSABILITY

Case:Quebec vs. GSISNov. 9, 1988

F: P/Lt. Quebec, INP, entered into a BilliardCenter in Northern Samar, and read komikswhile other persons were playing billiard onthree tables. When almost all of the playershad left, he was shot by an unidentified person.Then, another unidentified person went in thecenter and again shot Quebec twice. Aftersensing that he was already dead, he took thedead policemans service firearm and left.

The deceased was survived by 7 minorchildren. In behalf of these children, the fatherof the deceased filed a claim for incomebenefits with the GSIS. The claim, however,was denied on the ground that it failed tosatisfy the condition for compensability.

I: Compensability of the policemansdeath.

H: His death was compensable. The deathof the deceased was a result of an accidentarising out of and in the course of employment.Police officers, like any other military men aretargets of the NPA hitmen and Agar ArmasGang. It has ben observed lately thatpolicemen and military personnel were killedfor no other reason than the fact that they aremilitary personnel and policemen.

The moment an AFP member suffers acontingency, the presumption is that because of the nature of his work. This policy isadopted because of certain serious peace andorder problems of the country. Members of theAFP have become marked men insofar asinsurgents and other lawless elements

concerned, and are, therefore, killedinsurgents at every opportunity. The problem is true to the members of the policeforce.

Quebec was gunned down because hewas a police officer and the killers were afterhis service firearm. The fact that reading komiks at that time was incidental. The death of Quebec is clearly theresult of an accident arising out of and in thecourse of employment.

WHEN COMPANY RULES ARE VIOLATEDCases:Davao Gulf vs. Del RosarioDec. 29, 1960

F: Victor Soriano was a truck driver andemployee of Davao Gulf. In a trip to deliverlumber from the sawmill to Davao City, Sorianobrought along his wife and 3 minor children, inviolation of a company regulation. During thetrip, the trucks gear and malfunctioned, and the truck was gspeed. His son became scared and suddenlyjumped to his arms. He lost control of thewheels which caused the truck to kilometer post and then overturned. Sorianoand his son was killed instantly.

I: Compensability of Sorianos death.

H: The death was compensable. As to thepresence of members of his family in the

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vehicle, supposing it was in violation ofcompany regulations, it is not certain that itcaused the accident.Indeed, as his wife andchildren were present, this driver must havebeen extremely careful, not reckless. Whathappened must have been unforeseen; it mayonly be blamed upon the worn-out condition of

the motor transport or to "accident," for whichthe employer is responsible, it having arisenout of and in the course of the deceased'sregular duties as driver.

Marinduque vs. WCCJune 30, 1956

F: The deceased, a laborer of Marinduque,rode the haulage trucked owned by the latter.The act was in violation of the company rules.During the tripe, the truck, while trying toovertake another truck in the company road,turned over and hit a coconut tree. He diedduring that incident.

I: Compensability of his death

H: The death was compensable. Mereriding on a haulage truck or stealing a ridethereon is not negligence ordinarily. It is notdangerous per se. It may be a possibleevidence of negligence. Besides, theprohibition has nothing to do with the personalsafety of the rider. Further, there is seriousdoubt that the employee knew the prohibition.

Chavez vs. AmmenApril 30, 1955F: Appellant is a company engaged in landtransportation, operating buses therefor. It hada subsidiary station in the municipality ofTigaon, Albay, provided with a shop for the

repair of the company's buses. Felipe Chavez,by occupation a mechanic, was employed assuch in this subsidiary station, which was undermanagement of Emilio Esperida. At betweenhalf past five and six o'clock on the afternoonof September 10, 1951, mechanic Chavez wasexamining an automobile placed in the grease-

rack of the shop when its spring broke loose,the pieces scattering, some of which hitChavez. Shortly thereafter, the car fell off thegrease-rack and caught Chavez under it Later,he was removed dead from underneath.

It is contended that it did not arise outof and in the course of the employment ofFelipe Chavez because the repair was not inthe furtherance of the business of thedefendant as the deceased was only tasked torepair vehicles of the company.

I: Compensability of his death.

H: Compensable. In the present case, therepair work given to Chavez by Esperida wasstrictly within the scope of his employment asa mechanic. That was the work for which hewas being paid. Could he, a mere mechanic,question the propriety of Esperida's action inaccepting Governor Trivio car, and tell hismanager that it was in open violation of thecompany's rule and that, consequently, he(Chavez) refused to make the repairs? IfChavez did that, how long could he have kepthis job?

If the repair work attempted by Chavez hadbeen done in a manner contrary to the regularprocedure followed in similar cases, that is tosay, more dangerous to the mechanic, or

where said work had been done outside thepremises and facilities of the employer andunder circumstances involving more risk to themechanic, or where the repair work had beendone at this instance and on his own accountand for his sole exclusive profit, all this, inviolation of the rules of the company, if may

yet be said that the injury did not occur in lineof duty and did not arise out or in the course ofthis employment. But in the present case, theviolation of the company's rule that only motorvehicles of the company may be repaired inthe shop, was by Manager Esperidperhaps in furtherance of the interests of thecompany whom he represented. The repair jobwas being done within the premises of thecompany and with its own facilities. In doingthe repair job such as putting the car on thegrease rack, Chavez was presumably followingthe usual and standard procedure. There is noshowing that by making the repair job on thecar, Chavez was going to receive additionalcompensation, except perhaps extra pay forovertime work which he was ordinarily entitledto under the law.

It was surely not Chavez's concern whether therules and regulations of the company in thismatter for one reason or another, are relaxedand not strictly enforced. Let us taken anexample. Supposing that one of the buses ortrucks of the defendant company through thenegligence of its chauffeur collides private car and causes damage. The car owneris willing to waive compensation if the damage

to the engine of his car was repaired by thecompany or at the company's expense. Couldnot the company well have the repairs madeby its mechanic and in its shop where all the

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facilities are available, and could Chavez inthat case refuse to make the repairs justbecause the car did not belong to hiscompany? The answer is obvious. If he didrefuse, he might be accused of insubordinationand lack of cooperation and may have to lookfor work elsewhere.

Hawaiian vs. WCCMay 25, 1955

F: Romeo, a policeman of Hawaiian, wasshot dead by Duazo. Duazo also shot himselfimmediately after the incident by placing themuzzle of his shot gun under his chin. Asubordinate of the two deceased testified thatthey (the deceased) were good friends, andthey were just joking around when the incidenthappened, and that Romeo was accidentallyshot and the Duazo committed suicide afterrealizing that he killed the former.

I: Compensability of their deaths

H: Compensable. The death arose out oftheir employment. The peculiar nature of theirwork exposed them to the risks incidental tothe handling of said firearms, including theaccidents which may occur while engaged inhorseplay with each other. It is a naturaltendency for normal people to indulge inoccasional foolery.

COMPENSABLE ILLNESS/SICKNESSART. 167 (i) DEPENDENTS means the

a. Legitimate, legitimated, legally adopted,or acknowledged natural child who is

a. Unmarried, not gainfullyemployed, and not over 21 yearsof age, or

b. Over 21 years of age providedhe is incapacitated andincapable of self-support due toa physical or mental defectwhich is congenital or acquiredduring minority;

b. Legitimate spouse living with theemployee; and

c. Parents of said employee whollydependent upon him for regularsupport.

AEC, RULE IIISec. 1 (b) For the sickness and the resultingdisability or death to be compensable, thesickness must be the result of an occupationaldisease listed under Annex A of these Ruleswith the conditions set therein satisfied;otherwise, proof must be shown that the risk ofcontracting the disease is increased by theworking conditions.

Sec. 2. Occupational diseases. A. The diseases listed in Annex A of

these Rules are occupational when thenature of employment is as describedtherein.

B. The employer shall require pre-employment examination of allprospective employees, provide periodicmedical examination to employees whoare exposed to occupational diseases,and take such other measures as maybe necessary.

C. The periodic medical examination forthe early detection of occupational

diseases shall be in accordance with theminimum standards prescribed in AnnexB hereof.

Cases:Galanida vs. ECC

F: Petitioner Eulalio Galanida staworking for the government on November 8,1948 as a messenger/janitor at the Bureau ofAgricultural Extension Office in Tagbilaran City.Subsequently, he was promoted to Clerk and,finally, to Administrative Officer II Ministry of Agriculture until he retirDecember 10, 1983. Galanida's merecords reveal that sometime in 19complained of facial distortion and numbnessaccompanied by the blurring of vision andheadache. According to the petitionersuffered irregular sleep and heart palpitation,as well as pain in both extremities for several

years. From May 15 to 29, 1972, he wasconfined at the Bohol Provincial Hospital forhemorrhoidectomy which was performed by Dr.Miguel C. Froilan.

On January 18, 1983, the petitioner filed aclaim for disability benefits under PresidentialDecree No. 626 with the GSIS. On March 9,1983, the GSIS disapproved the claim on theground that the claimant's ailments are notoccupational diseases and there wasshowing that his work had increased the risk ofcontracting the same. The petitioner elevatedhis case to the ECC and on November 27,

1984, the ECC affirmed the decision of theGSIS.

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The petitioner's ailments were diagnosed to bethe following:

(1) Bells Palsy - is an acute lower Motor NeuronPalsy of the facial nerve, characterized by pain,weakness or paralysis of the affected side ofthe face (2) Anxiety Neurosis - is a progressive

disintegration of personal instability arising inthe course of the intercurrent illness. (3)Peripheral Neuritis - is a syndrome of sensorymotor, reflect and basomotor reflex symptomsproduced by lesion of nerve root on peripheralnerves.

I: W/N his illness is compensable

H: No. The above-mentioned diseases arenot among those listed as occupationaldiseases under Annex "A" of P.D. 626 nor hasthe petitioner shown proofs that the risk of 'contracting the diseases was increased by his

employment's working conditions asAdministrative Officer II of the Ministry ofAgriculture in Manila as provided by Sectionl(b), Rule III, Amended Rules on Employees'Compensation. As we have repeatedly held,the doctrines of aggravation and presumptionof compensability under the former Workmen'sCompensation Act are no longer provided bylaw under the present social insurance scheme.

Considering that the illnesses are notoccupational diseases, it was, therefore,necessary for the petitioner to present proofthat he contracted them in the course of his

employment at the Ministry of Agriculture.Unfortunately, he failed in this regard. In hispetition for review submitted to the Employees'Compensation Commission dated May 16,

1983, the petitioner alleges that the "cleaningof rooms as janitor and subsequently theamount of paperwork thereby forcing him torender overtime, increased the risk ofcontracting said ailments." This is a mereallegation which needs to be proved. He whoalleges a fact has the burden of proving it anda mere allegation is not evidence. (People vs.Lumayok, 139 SCRA 1) Despite the requestmade by the respondent (letter dated July 9,1983, rollo, p. 39) the petitioner failed tosubmit evidence or proofs such as acertification signed by the employer as toinclusive dates of leave of absences or sickleaves, medical certificates, hospital recordsand/or clinical records ofconfinement/consultation so as to substantiatehis claim for compensation under P. D. 626.There is absolutely no showing how the work ofa janitor increase the risk of contracting thepetitioner's ailments. Moreover, the petitioner'sattending physician, Dr. Segundo Rachocategorically stated that the petitioner'sailments are not work-connected.

Menez vs. ECCApril 25, 1980

F: Menez was a school teacher. She retiredunder the disability retirement plan at the ageof 54 after 32 years of teaching, due torheumatoid arthritis and pneumonitis. Sheclaimed for disability benefits which the GSISdenied on the ground that her ailments werenot occupational diseases taking intoconsideration the nature of her particular work.

I: Compensability of her disease

H: Her disease is compensable. occupational disease is one which results fromthe nature of the employment, and by nature ismeant conditions to which all employees of aclass are subject and which producdisease as a natural incident of aparticularoccupation, and attach to that occupation ahazard which is unusual and in excess of thehazard attending the employment in general. Itis also one which develops as a result ofhazards peculiar to certain occupations, due totoxic substances, radiation, repeamechanical injury, emotional strain, etc.

In this case, her emotional tension isheightened by the fact that the high school inwhich she teaches is situated I a tough area(Binondo) which is inhabited by thugs andother criminal elements and pollution. Even ifrheumatoid arthritis and pneumonitis are notoccupational diseases, there is ample proofthat petitioner contracted such ailments byreason of her occupation as a teacher due toher exposure to the adverse working conditionsabove mentioned.

GENERAL RULE ON COMPENSABILITY RULE III, SECTION 1 (B) AEC, TABLE OF

OCCUPATIONAL DISEASE (ANNEX A OFRULES ON EMPLOYEES COMPENSATION)

EXCEPTION TO THE GENERAL RULE ONCOMPENSABILITY, THEORY OF INCREASED

RISK; DEGREE OF PROOF REQUIRED

Cases:Dabatian vs. GSIS

April 8, 1987

F: The widow of the deceased filed a claimfor death benefits with the GSIS. The deceased

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was a garbage truck driver. He was assignedmostly in night shift and he was a heavy coffeedrinker which was his way to ward offsleepiness. He died of peptic ulcer.


H: It is not compensable. Since peptic ulceris not included in the list of occupationaldiseases, the claimant has the burden ofproving that the nature of her deceasedhusbands work increased the risk ofcontracting the disease. Aside from the factthat the deceased is a heavy coffee drinker, noevidence was ever adduced to bolster thetheory that her husbands work increased therisk of contracting the ailment.

Being a heavy coffee drinker may haveaggravated his peptic ulcer, but aggravation ofan illness is no longer a ground forcompensation under the present law.

Nazaro vs. ECCFeb. 6. 1990

F: The deceased was a Budget Examiner inthe Office of the governor. The nature of hiswork dealt with the detailed preparation of thebudget, financial reports and review and/orexamination of the budget of other provincialand municipal offices. Full concentration andthorough study of the entries of accounts in thebudget and/or financial reports werenecessary, such that the deceased had to sitfor hours, and more often than not, delay andeven forego urination in order not to interrupt

the flow of concentration. He died of Uremiadue to obstructive nephropathy and benignprostatic hypertrophy. It is a toxic clinicalcondition characterized by restlessness,

muscular twitching, mental disturbance,nausea, and vomiting, associated with utenalinsufficiency brought about by the retention inblood of nitrogenous urinary waste products.


H: Compensable. The cause of death of theclaimants husband is work connected, i.e., therisk of contracting the illness was aggravatedby the nature of the work.

Mirasol vs. ECCApril 28, 1980

F: He was a public school teacher. He waslater appointed as district food productioncoordinator and attendant teacher. Later, hebecame a district green revolution coordinatorand attendant teacher. The district wascomposed of 48 school, 18 of which wre inmountainous areas which could only bereached on foot. Eight (8) schools were 30 kmaway, and the nearest was 10 km fromheadquarters. Sometime later, he experiencesymptoms of malignant hypertension andrheumatoid arthritis. His retirement wasbrought about by ailments diagnosed as high-blood pressure and rheumatoid arthritis onboth knees.

I: Compensability of his illness

H: Compensable. There is sufficientsubstantial evidence to show that his ailmentswere caused by the duties of his employment

and that the risk of contracting the saidailments was increased by the workingconditions.

Raro vs. ECCApril 27, 1989

F: The petitioner states that she was inperfect health when employed as a clerk by theBureau of Mines and Geo-Sciences at its Daet,

Camarines Norte regional office on March 17,1975. About four years later, she suffering from severe and recurrent headachescoupled with blurring of vision. Forced to takesick leaves every now and then, she soughtmedical treatment in Manila. She was then aMining Recorder in the Bureau.

The petitioner was diagnosed at the MakatiMedical Center to be suffering fromtumor. By that time, her memory, sense oftime, vision, and reasoning power had beenlost.

A claim for disability benefits filed by hehusband with the Government SeInsurance System (GSIS) was denied. A motionfor reconsideration was similarly denied. Anappeal to the Employees' CompensCommission resulted in the Commisaffirming the GSIS decision.

I: Compensability of his illness

H: Not Compensable. he key argument ofthe petitioner is based on the fact that medicalscience cannot, as yet, positively identify thecauses of various types of cancer. It is a

disease that strikes people in general. Thenature of a person's employment appears tohave no relevance. Cancer can strike a lowlypaid laborer or a highly paid executive or one

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who works on land, in water, or in the bowels ofthe earth. It makes the difference whether thevictim is employed or unemployed, a whitecollar employee or a blue collar worker, ahousekeeper, an urban dweller or a resident ofa rural area.

It is not also correct to say that all cancers arenot compensable. The list of occupationaldiseases prepared by the Commission includessome cancers as compensable, namely

Occupational Diseases Nature ofEmployment

xxx xxx xxx xxx

16. Cancer of stomach and otherWoodworkers, wood products lymphaticand blood forming vessels; industrycarpenters, nasal cavity and sinuses and

employees in pulp and paper mills andplywood mills.

17. Cancer of the lungs, liver Vinyl chlorideworkers, and brain plastic workers.

(Annex A, Amended Rules on EmployeesCompensation)

The petitioner questions the above listing. Wesee no arbitrariness in the Commission'sallowing vinyl chloride workers or plasticworkers to be compensated for brain cancer.

There are certain cancers which are reasonablyconsidered as strongly induced by specificcauses. Heavy doses of radiation as inChernobyl, USSR, cigarette smoke over a long

period for lung cancer, certain chemicals forspecific cancers, and asbestos dust, amongothers, are generally accepted as increasingthe risks of contracting specific cancers. Whatthe law requires for others is proof.

The first thing that stands in the way of the

petition is the law itself.

Presidential Decree No. 422, as amended, theLabor Code of the Philippines defines"sickness" as follows:

ART. 167. Definition of Terms. As used inthis Title unless the context indicatesotherwise:

xxx xxx xxx

(1) Sickness means any illness definitelyaccepted as an occupational disease listedby the Commission, or any illness causedby employment subject to proof by theemployee that the risk of contracting thesame is by working conditions. For thispurpose, the Co on is empowered todetermine and approve occupational andwork- related illnesses that may beconsidered compensable sable based onhazards of employment. (PD 1368, May 1,1978).

Section 1 (b), Rule III of the Amended Rules onEmployees Compensation clearly defines whoare entitled. It provides:

SECTION 1.

xxx xxx xxx

(b) For the sickness and the disability or death to be compensable, thesickness must be the result occupational disease under Annex these rules with the conditions set therein

satisfied; otherwise, proof must be shownthat the risk of contracting the disease isincrease by the working conditions. (

The law, as it now stands requires the claimantto prove a positive thing the illness wascaused by employment and the rcontracting the disease is increased by theworking conditions. To say that since the proofis not available, therefore, the trust fund hasthe obligation to pay is contrary to the legalrequirement that proof must be adduced. Theexistence of otherwise non-existent cannot be presumed .

WHEN DISABILITY AND DEATH ARE COMPENSABLE

ART. 172 . The State Insurance Fund shallbe liable for compensation to the employee orhis dependents, except when the disability ordeath was occasioned by the empintoxication, willful intention to injure or killhimself or another, notorious negligence, orotherwise provided in this title.

Cases:Mabuhay Shipping vs. NLRC

Jan. 21, 1991

F: Romulo Sentina was hired as a 4Engineer by petitioner Mabuhay Shi

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Services, Inc. (MSSI) for and in behalf of co-petitioner, Skippers Maritime Co., Ltd. to workaboard the M/V Harmony I for a period of oneyear. He reported for duty aboard said vesselon July 13, 1987.

On January 16, 1988 at about 3 p.m., while the

vessel was docked alongside Drapetona Pier,Piraeus, Greece, Sentina arrived aboard theship from shore leave visibly drunk. He went tothe messhall and took a fire axe andchallenged those eating therein. He waspacified by his shipmates who led him to hiscabin. However, later he went out of his cabinand proceeded to the messhall. He becameviolent. He smashed and threw a cup towardsthe head of an oiler Emmanuel Ero, who wasthen eating. Ero touched his head and noticedblood. This infuriated Ero which led to a fightbetween the two. After the shipmates brokethe fight, Sentina was taken to the hospitalwhere he passed away on January 17, 1988. 1

Ero was arrested by the Greek authorities andwas jailed in Piraeus.

I: The employer is exempted from liabilityfor burial expenses for a seaman who commitssuicide. How about in a case of one who ranamuck or who in a state of intoxicationprovoked a fight as a result of which he waskilled? Is the employer similarly exempt fromliability?

H: Not compensable. The mere death of

the seaman during the term of his employmentdoes not automatically give rise tocompensation. The circumstances which led tothe death as well as the provisions of the

contract, and the right and obligation of theemployer and seaman must be taken intoconsideration, in consonance with the dueprocess and equal protection clauses of theConstitution. There are limitations to theliability to pay death benefits.

When the death of the seaman resulted from adeliberate or willful act on his own life, and it isdirectly attributable to the seaman, such deathis not compensable. No doubt a case of suicideis covered by this provision.

By the same token, when as in this case theseaman, in a state of intoxication, ran amuck,or committed an unlawful aggression againstanother, inflicting injury on the latter, so that inhis own defense the latter fought back and inthe process killed the seaman, thecircumstances of the death of the seamancould be categorized as a deliberate and willful

act on his own life directly attributable to him.First he challenged everyone to a fight with anaxe. Thereafter, he returned to the messhallpicked up and broke a cup and hurled it at anoiler Ero who suffered injury. Thus provoked,the oiler fought back The death of seamanSentina is attributable to his unlawfulaggression and thus is not compensable.

Interorient vs ECCSept. 16, 1996

F: Retarded seaman, while beingrepatriated back to the Philippines, sneaked

out from the plane during a stopover inThailand, attacked a Thai policeman with aknife. The policeman shot him in the processand he died.

I: Compensability of the seamans death.

H: Compensable. The POEA Administratorruled, and this Court agrees, that since Pinedaattacked the Thai policeman when he was no

longer in complete control of his faculties, the aforequoted provision ofStandard Format Contract of Employexemption the employer from liability shouldnot apply in the instant case. Firstly, the factthat the deceased suffered from disorder at the time of his repatriation meansthat he must have been deprived of the full useof his reason, and that thereby, his will musthave been impaired, at the very least. Thus, hisattack on the policeman can in no wise becharacterized as a deliberate, willfuvoluntary act on his part. Secondly, and apartfrom that, we also agree that in light of thedeceased's mental condition, petition"should have observed some precautiomeasures and should not have allowed saidseaman to travel home alone", 16 and theirfailure to do so rendered them liable for thedeath of Pineda. Indeed, "the obligations andliabilities of the (herein petitioners) do not endupon the expiration of the contracted period as(petitioners are) duty bound to repatriate theseaman to the point of hire to effectiterminate the contract of employment." 17

The instant case should be distinguished fromthe case ofMabuhay, where the deceased,

Romulo Sentina, had been in a intoxication, then ran amuck and iinjury upon another person, so that the latter inhis own defense fought back and in the process

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killed Sentina. Previous to said incident, therewas no proof of mental disorder on the part ofSentina. The cause of Sentina's death iscategorized as a deliberate and willful act onhis own life directly attributable to him. Butseaman Pineda was not similarly situated.

NAESS Shipping vs. NLRCSept. 4 1987

F: While plying the seas from Brazil toEgypt, Dublin, the vessels chief steward,fatally stabbed Fernandez, the second cook,during a quarrel. Dublin then ran to the deckfrom which he jumped or fell overboard. TheBody was never recovered.

Under the special agreement, acrewman of the vessel is entitled tocompensation for loss of life. The widowcollected the amount of 75,000 Clause A of theITF Collective Bargaining Agreement. She alsofiled with the POEA a complaint against NAESSfor payment of death benefits totaling over$74,000 under both the Special agreement andwhat she claimed to be also the applicableSingapore Workmens CompensationOrdinance. The POEA ruled in favor of her.NLRC affirmed POEAs decision.

I: Compensability of the seamans deatheven if it was suicide.

H: There is no question that NAESS freelybound itself to a contract which on its facemakes it unqualifiedly liable to paycompensation benefits for Dublin's death whilein its service, regardless of whether or not itintended to make itself the insurer, in the legalsense, of Dublin's life. No law or rule has been

cited which would make it illegal for anemployer to assume such obligation in favor ofhis or its employee in their contract ofemployment.

It makes no difference whether Dublinintentionally took his own life, or he killedhimself in a moment of temporary aberrationtriggered by remorse over the killing of thesecond cook, or he accidentally fell overboardwhile trying to flee from imagined pursuit,which last possibility cannot be ruled outconsidering the state of the evidence.

It is also argued that to compel payment ofdeath benefits in this case would amount notonly to rewarding the act of murder orhomicide, but also inequitably to placing onNAESS the twin burdens of compensating boththe killer and his victim, who allegedly had alsobeen employed under a contract with a similardeath benefits clause. This argument, in

confusing the legal implications and effects oftwo distinct and independent agreements,carries within itself the seeds of its ownrefutation. On Dublin's part, entitlement todeath benefits resulted from his death whileserving out his contract of employment; it wasnot a consequence of his killing of the secondcook, Rodolfo Fernandez. If the latter's death isalso compensable, that is due to the solitaryfact of his death while covered by a similarcontract, not precisely to the fact that he metdeath at the hands of Dublin That both deathsmay be related by cause and effect and NAESSis the single obligor liable for compensation in

both cases must, insofar as the factual andlegal bases of such liability is concerned, beregarded as purely accidental circumstances.NAESS would have had no reason whatsoever

to introduce into the present dispumatter of compensation benefits for Fernandezhad Dublin after killing Fernandez, succumbedto a stroke or a heart attack inallegedly taking his own life, becaucontract of Fernandez, if the same as that ofDublin as regards death benefits, unquestionably cover death by murdemisadventure. There would still be no reason todo so, that is, relate the killing of Fernandez tothe present compensation claim, merely on theassertion, even if true, that Dublicommitted suicide.

Paez vs. WCCMarch 30, 1963

F: Paez and his wife were engaged in thebusiness of buying palay. In August, 1953, Paezhad been buying palay in Isabela. For suchpurpose, he employed agents, two

drivers and two truck helpers, all of whom werepaid on commission basis. In bringing the palaypurchased by his agents to Nueva Ecija orTarlac, the same had to be ferried in bancasacross the Magat River in Aurora, Isatowards the other bank, which is Cabatuan;from Cabatuan side to Guimba, the palay werehauled by truck which was regularly driven byValentin Lagman. Respondent's truck driver onthe Aurora side was Primitivo Apolonio, whoalso collected all the palay on said side hauledthem to the river bank (Aurora side), where heengaged boatmen to ferry the palay to theCabatuan side and where Lagman would take

them and bring them to Guimba or Victoria, asthe case may be. On August 1, 1953, becausehis child became seriously ill, Lagman engagedthe services of Marciano Barawid to substitute

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him in undertaking the trip to Isabela, with theunderstanding that he (Barawid), was toreceive his (Lagman's) pay during the latter'sabsence. On August 2, 1953, Barawid droverespondent's truck up to the Cabatuan side ofthe Magat River to await for the palay thatwere to be ferried from the Aurora side. On thesame date, instead of awaiting the palay onthe Cabatuan side, Barawid crossed the MagatRiver and joined Apolonio on the Aurora side inhauling the palay. After having collected all thepalay on the Aurora side, Apolonio and Barawidreached the river's bank at about 9:00 o'clockin the evening, and both helped in loadingthree (3) bancas. Apolonio advised Barawid notto ride the third banca because same wasalready fully loaded, but to take another toGuimba, as he had to drive a new truck of hisbrother-in-law. While in the midst of the MagatRiver, the banca capsized and sunk, andBarawid was drowned.

I: Compensability of Barawids death. Wasthere notorious negligence?

H: There was no notorious negligence.Notorious negligence is something more thanmere or simple negligence, or contributorynegligence; it signifies a deliberate act of theemployee to disregard his own personal safety.In the case at bar, there is no showing at allthat deceased Barawid had deliberatelydisregarded his safety; no intention wasattributed to him to end his life or that hewantonly courted death. The deceased wantedto return home as it was getting late, and even

helped in the loading and unloading of thepalay to the banca and truck, to finish the workthat day. It is claimed that the deceasedwanted to return home, because he was to

drive the new truck of his brother-in-law, andhe was in such a hurry that he unheeded thesuggestion of his companion not to embark anymore, as it was dark and the banca was fullyloaded. Conceding this to be true, for thepurpose of argument, (Barawid can no longercontradict it, his lips having been sealed bydeath), still the disregard of the warning, cannot be considered as a notorious negligence.Disobedience to rules, orders and/orprohibition, does not in itself constitutenotorious negligence, if no intention can beattributed to the injured to end his life. And if inthe case at bar, there was any negligence atall, the same can not be considered notoriousor evident. The deceased did not act with thefull knowledge of the existence of a dangerthat ordinary prudence would counsel him toavoid such a case. That a banca loaded withpalay and 3 persons, at night time, would sinkif one person more was added to its weight,constituted merely a miscalculation on the part

of such person, if he thought it would be safefor him to embark, the alleged overloadingnotwithstanding Barawid's promptness inaccomplishing his duties, to enable him toattend his personal interest thereafter, cannotbe a valid reason to deny him the right to becompensated.

Ramos vs. PobleteOct. 8, 1941

F: While riding as a laborer in a freighttruck owned and driven by the petitioner, enroute from Silang, Cavite, to Manila, in the

early morning of January 26, 1937, AgripinoPoblete noticed that a buri sack fell from thevehicle, and shouted for the driver to stop.Before the truck came to a full stop, Poblete

got off in an effort to retrieve the sack. In sodoing he was caught and run over by the rearright wheel of the vehicle and died shortlythereafter.

I: Was there notorious negligence?

H: There was none. We do not believe thatAgripino Poblete was guilty of nonegligence. Granting that Poblete was not freefrom blame in alighting from the truck before itwas brought to a stop, yet his fault did notamount to a notorious negligence. The speedof the truck had slackened and excitement Poblete very likely forgot that bygetting off he ran the risk of being injured orkilled. There was no time to reflect, and in hismind there was no time to wait. It was dark anda little more delay might spell the loss of thearticle that had fallen, picked up and carriedaway by someone who might happen to passor be near by. Then the deceased was spurredin his eagerness to recover the sack not by anythought of personal benefit but by a desire toprotect his employer's property, an unselfishattitude that should deserve commendationrather than condemnation from the defendant.

The Workmen's Compensation Act is asocial legislation designed to give relief to theworkman who has been the victim accident in the pursuit of his employment andmust be liberally construed to attapurposes for which it has been enacted. In linewith this principle "the correct presumption tobe followed is that . . . the laborer by hisinstinct of self-preservation takes precaution toavoid such danger unless an intent

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attributed to him to end his life." The sameidea was expressed by the Supreme Court inthe case ofFlores vs. Mindanao LumberCompany, G.R. No. 43096, saying: "As is wellknown, the Workmen's Compensation Law isgiven a liberal interpretation and constructionby the courts. Pursuant to such interpretationand construction, notorious negligence is

something more than simple or contributorynegligence. As a result, failure to avoid aknown danger by a laborer engrossed in hiswork who momentarily forgets it is notnegligence. Also, failure to exercise incessantvigilance in avoiding a known danger is notnegligence. The reason for such holdings is thevery obvious deduction that no man in hissenses would deliberately court death.

RECOVERY OF BENEFITS, LIMITATIONSART. 173. EXTENT OF LIABILITY

Unless otherwise provided, the liabilityof the State Insurance Fund under this Titleshall be exclusive and in place of all otherliabilities of the employer to the employee, hisdependents or anyone otherwise entitled toreceive damages on behalf of the employee orhis dependents. The payment of compensationunder this Title shall not bar the recovery ofbenefits as provided for in Section 699 of theRevised Administrative Code, Republic Actnumber 1161, as amended, CommonwealthAct 186, as amended, Republic Act 610, asamended, and other laws whose benefits areadministered by the System, or by otheragencies of the government.

RECOVERY UNDER THE LABOR CODE ANDTHE CIVIL CODE

Case:DM COnsunji vs. CAApril 20, 2001

F: Jose Juego, a construction worker of D.M. Consunji, Inc., fell 14 floors from theRenaissance Tower, Pasig City to his death.

PO3 Rogelio Villanueva of the Eastern PoliceDistrict investigated the tragedy and filed areport dated November 25, 1990, stating that:

x x x. [The] [v]ictim was rushed to [the]Rizal Medical Center in Pasig, MetroManila where he was pronounced deadon arrival (DOA) by the attendingphysician, Dr. Errol de Yzo[,] at around2:15 p.m. of the same date.

Investigation disclosed that at the given

time, date and place, while victim JoseA. Juego together with Jessie Jaluag andDelso Destajo [were] performing theirwork as carpenter[s] at the elevatorcore of the 14th floor of the Tower D,Renaissance Tower Building on board a[p]latform made of channel beam(steel) measuring 4.8 meters by 2meters wide with pinulid plywoodflooring and cable wires attached to itsfour corners and hooked at the 5 tonchain block, when suddenly, the bolt orpin which was merely inserted toconnect the chain block with the

[p]latform, got loose xxx causing thewhole [p]latform assembly and thevictim to fall down to the basement ofthe elevator core, Tower D of the

building under construction thercrushing the victim of death, save histwo (2) companions who luckily jumpedout for safety.

It is thus manifest that Jose A. Juegowas crushed to death when [p]latform he was then on board andperforming work, fell. And the falling ofthe [p]latform was due to the removalor getting loose of the pin which wasmerely inserted to the connepoints of the chain block and [p]latformbut without a safety lock.1

On May 9, 1991, Jose Juegos widow,Maria, filed in the Regional Trial Court (RTC) ofPasig a complaint for damages against thedeceaseds employer, D.M. Consunji, Inc. Theemployer raised, among other defenses, thewidows prior availment of the benefits from

the State Insurance Fund.I: W/N the widow is precluded claiming damages under the civil code for thedeath of her husband against the employer after having availed of the deathbenefits provided by the Labor code.

H: In this case, the widow is not precludedfrom claiming damages under the civil code forthe death of her husband against the lattersemployer.

As a rule, an injured worker hachoice of either to recover from the employerthe fixed amounts set by the WoCompensation Act or to prosecute an ordinarycivil action against the tortfeasor for higher

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damages but he cannot pursue both courses ofaction simultaneously.

However, the exception is where aclaimant who has already been paid under theWorkmens Compensation Act may still sue fordamages under the Civil Code on the basis ofsupervening facts or developments occurring

after he opted for the first remedy.In this case, the choice of the first

remedy was based on ignorance or a mistakeof fact, which nullifies the choice as it was notan intelligent choice. There is no proof thatprivate respondent knew that her husband diedin the elevator crash when on November 15,1990 she accomplished her application forbenefits from the ECC. The police investigationreport is dated November 25, 1990, 10 daysafter the accomplishment of the form.Petitioner filed the application in her behalf onNovember 27, 1990.

There is also no showing that private

respondent knew of the remedies available toher when the claim before the ECC was filed.On the contrary, private respondent testifiedthat she was not aware of her rights. Thus,there was no waiver of the remedy she haswith the courts.

RECOVERY UNDER THE LABOR CODE ANDTHE SOCIAL SECURITY LAW

Simultaneous recovery of benefitsunder the employees compensation programof the Labor Code and under the SSS Law isallowed.

LIABILITY OF 3RD PARTYART. 174.

a. When the disability or death is causedby circumstances creating a legal

liability against a third party, thedisabled employee or the dependents incase of his death shall be paid by theSystem under this Title. In case benefitis paid under this Title, the system shallbe subrogated to the rights of thedisabled employee or the dependents incase of his death, in accordance with

the general law.b. Where the System recovers from such

third party damages in excess of thosepaid or allowed under this Title, suchexcess shall be delivered to thedisabled employee or other personsentitled hereto, after deducting the costof proceedings and expenses of theSystem.

EMPLOYEES COMPENSATION COMMISSION ADMINISTRATION

Art. 176. Employees CompensationCommission.

a. To initiate, rationalize, and coordinatethe policies of the employeescompensation program, the EmployeesCompensation Commission is herebycreated to be composed of five ex-officio members, namely: the Secretaryof Labor and Employment as Chairman,the GSIS General Manager, the SSSAdministrator, the Chairman of thePhilippine Medical Care Commission,and the Executive Director of the ECC

Secretariat, and two appointivemembers, one of whom shall representthe employees and the other, theemployers, to be appointed by the

President of the Philippines for a term ofsix years. The appointive member shallhave at least five years experience inworkmens compensation or socialsecurity programs. All vacancies shallbe filled for the unexpired term only. (Asamended by Section 19 [c], ExecutiveOrder No. 126)

b. The Vice Chairman of the Commission

shall be alternated each year betweenthe GSIS General Manager and the SSSAdministrator. The presence of fourmembers shall constitute a quorum.Each member shall receive a per diemof two hundred pesos for every meetingthat is actually attended by him,exclusive of actual, ordinary andnecessary travel and representationexpenses. In his absence, any membermay designate an official of theinstitution he serves on full-time basisas his representative to act in hisbehalf. (As amended by Section 2,Presidential Decree No. 1368)

c. The general conduct of the operationsand management functions of the GSISor SSS under this Title shall be vested inits respective chief executive officers,who shall be immediately responsiblefor carrying out the policies of theCommission.

d. The Commission shall have the statusand category of a governmentcorporation, and it is hereby deemedattached to the Department of Laborand Employment for policy coordination

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and guidance. (As amended by Section2, Presidential Decree No. 1368)

Art. 177. Powers and duties. TheCommission shall have the following powersand duties:

a. To assess and fix a rate of contributionfrom all employers;

b. To determine the rate of contributionpayable by an employer whose recordsshow a high frequency of workaccidents or occupational diseases dueto failure by the said employer toobserve adequate safety measures;

c. To approve rules and regulationsgoverning the processing of claims andthe settlement of disputes arisingtherefrom as prescribed by the System;

d. To initiate policies and programs towardadequate occupational health andsafety and accident prevention in theworking environment, rehabilitationother than those provided for underArticle 190 hereof, and other relatedprograms and activities, and toappropriate funds therefor; (Asamended by Section 3, PresidentialDecree No. 1368)

e. To make the necessary actuarial studiesand calculations concerning the grant of

constant help and income benefits forpermanent disability or death and therationalization of the benefits forpermanent disability and death under

the Title with benefits payable by theSystem for similar contingencies:Provided, That the Commission mayupgrade benefits and add new onessubject to approval of the President:and Provided, further, That the actuarialstability of the State Insurance Fundshall be guaranteed: Provided, finally,

That such increases in benefits shall notrequire any increases in contribution,except as provided for in paragraph (b)hereof; (As amended by Section 3,Presidential Decree No. 1641)

f. To appoint the personnel of its staff,subject to civil service law and rules,but exempt from WAPCO law andregulations;

g. To adopt annually a budget ofexpenditures of the Commission and itsstaff chargeable against the State

Insurance Fund: Provided, That the SSSand GSIS shall advance on a quarterlybasis, the remittances of allotment ofthe loading fund for the Commissionsoperational expenses based on itsannual budget as duly approved by theDepartment of Budget andManagement; (As amended by Section3, Presidential Decree No. 1921)

h. To have the power to administer oathand affirmation, and to issue subpoenaand subpoena duces tecum inconnection with any question or issue

arising from appealed cases under thisTitle;

i. To sue and be sued in court;

j. To acquire property, real or personal,which may be necessary or expedientfor the attainment of the purposes ofthis Title;

k. To enter into agreements or contracts

for such services and as may be neededfor the proper, efficient and stableadministration of the program;

l. To perform such other acts as it maydeem appropriate for the attainment ofthe purposes of the Commission andproper enforcement of the provisions ofthis Title.

CONTRIBUTIONS

Art. 183. Employers contributions.

a. Under such regulations as the Systemmay prescribe, beginning as of the lastday of the month when an employeescompulsory coverage takes effect andevery month thereafter during hisemployment, his employer shall prepareto remit to the System a contributionequivalent to one percent of hismonthly salary credit.

b. The rate of contribution shall bereviewed periodically and subject to thelimitations herein provided, may be

revised as the experience in risk, cost ofadministration and actual or anticipatedas well as unexpected losses, may

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require.

c. Contributions under this Title shall bepaid in their entirety by the employerand any contract or device for thedeductions of any portion thereof fromthe wages or salaries of the employeesshall be null and void.

d. When a covered employee dies,

becomes disabled or is separated fromemployment, his employers obligationto pay the monthly contribution arisingfrom that employment shall cease atthe end of the month of contingencyand during such months that he is notreceiving wages or salary.

Art. 184. Government guarantee.TheRepublic of the Philippines guarantees thebenefits prescribed under this Title, andaccepts general responsibility for the solvency

of the State Insurance Fund. In case of anydeficiency, the same shall be covered bysupplemental appropriations from the nationalgovernment.

TITLE TWOEMPLOYEES COMPENSATION AND STATE

INSURANCE BENEFITS UNDER THE ECC

MEDICAL BENEFITS

Art. 185. Medical services.Immediatelyafter an employee contracts sickness orsustains an injury, he shall be provided by theSystem during the subsequent period of his

disability with such medical services andappliances as the nature of his sickness orinjury and progress of his recovery mayrequire, subject to the expense limitationprescribed by the Commission.

Art. 186. Liability. The System shall have theauthority to choose or order a change ofphysician, hospital or rehabilitation facility forthe employee, and shall not be liable forcompensation for any aggravation of theemployees injury or sickness resulting fromunauthorized changes by the employee ofmedical services, appliances, supplies,hospitals, rehabilitation facilities or physicians.

Art. 187. Attending physician.Anyphysician attending an injured or sickemployee shall comply with all the regulationsof the System and submit reports in prescribedforms at such time as may be requiredconcerning his condition or treatment. Allmedical information relevant to the particularinjury or sickness shall, on demand, be madeavailable to the employee or the System. Noinformation developed in connection withtreatment or examination for whichcompensation is sought shall be considered asprivileged communication.

Art. 188. Refusal of examination ortreatment. If the employee unreasonablyrefuses to submit to medical examination ortreatment, the System shall stop the paymentof further compensation during such time as

such refusal continues. What constitutes anunreasonable refusal shall be determined bythe System which may, on its own initiative,determine the necessity, character and

sufficiency of any medical services furnished orto be furnished.

Art. 189. Fees and other charges. All feesand other charges for hospital semedical care and appliances, inclprofessional fees, shall not be higher thanthose prevailing in wards of hospitsimilar services to injured or sick persons ingeneral and shall be subject to the regulationsof the Commission. Professional fees shall onlybe appreciably higher than those prescribedunder Republic Act Numbered sixthundred eleven, as amended, otherwise knownas the Philippine Medical Care Act of 1969.

Art. 190. Rehabilitation services.

a. The System shall, as soon aspracticable, establish a continuingprogram, for the rehabilitation of injured

and handicapped employees who shallbe entitled to rehabilitation services,which shall consist of medical, surgicalor hospital treatment, includingappliances if they have beenhandicapped by the injury, to help thembecome physically independent.

b. As soon as practicable, the System shallestablish centers equipped and staffedto provide a balanced program ofremedial treatment, vocationalassessment and preparation designedto meet the individual needs of each

handicapped employee to restore himto suitable employment, includingassistance as may be within itsresources, to help each rehabilitee to

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develop his mental, vocational or socialpotential.

RULE VIII, SEC 1, AEC. CONDITION TOENTITLEMENT

Any employee shall be entitled to suchmedical services, appliances and supplies asthe nature of his disability and the progress ofhis recovery may require, subject to theexpense limitation as contained in annex Chereof, if all of the following conditions aresatisfied:

1. He has been duly REPORTED to theSystem;

2. He SUSTAINS an INJURY or CONTRACTSSICKNESS; and

3. The System has been duly NOTIFIED ofthe injury or sickness.

DURATION

Cases:

Centeno vs. WCCJuly 26, 1976

F: The respondent Commission affirmedthe decision of the referee "adjudging theclaimant's illness of Pulmonary Tuberculosis ascompensable and ordering the respondentBatangas Laguna Tayabas Bus Company to paythe claimant Wenceslao Centeno the sum ofP6,000.00 as disability compensation underSection 14 of the Workmen's Compensation Actand to provide the claimant with services,appliances and supplies in accordance withSection 13 of the Act." The respondentCommission, in its challenged order statesthat:

.....On November 26, 1975, the claimantreceived from the respondent Bank of thePhilippine Island Check No. 2137 for theamount of P6,000.00 and executed a FullSatisfaction of Decision.

On December 10, 1975, claimant's counselfiled a Motion for Execution alleging, amongothers, that the claimant was still undertreatment and, in fact, confined at the SPCMedical Center and that the Medical andhospitalization expenses for said treatmentamounted to P1,959.15, the receiptstherefore (sic) were submitted.

The Acting Referee below scheduled thesaid motion for a conference on January 13,1976 at which no representative of therespondent appeared. Consequently, adecision was rendered on January 20, 1976by Amado A. Enriquez, Assistant Chief ofthe Workmen's Compensation Unit ofRegion 5, San Pablo City, directing therespondent to reimburse the claimant thesum of P2,047.53 representing medical andhospital expense and to provide suchservices, appliances and supplies as thenature of his disability and the process ofhis recovery may require.

The private respondent Bus Company appealedto the Commission, which reversed the refereeon the ground that the decision of theCommission dated September 17, 1975 hadalready become final and executory; that theregional office (referee) had lost jurisdictionover the case; and that the claimant executedon November 26, 1975 a "Full Satisfaction ofthe Decision" by way of amicable settlement.

I: W/N the employer is still liabmedical and hospitalization services despite ofthe amicable settlement and the fact that theemployer-employee relationship has bterminated.

H: The employer's liability for medical andhospitalization services lasts during the periodof disability as long as the employee is sick of acompensable disease and this duty does notend when employment terminates. The lawdoes not require employer-emplorelationships as a condition for the employer'sliability. As long as the illness is contractedduring the employee's employment, employer's obligation subsists. Consequently,respondent Workmen's CompensatiCommission was in error in denying the motionfor execution to recover medical hospitalization expenses.

Orillaneda vs. WCCJuly 26, 1978

F: Petitioner herein, Juan Orillaneda, wasformerly employed as senior storekeDivision of Ports & Harbors, Bureau of PublicWorks. In the course of his employment, hecontracted "diabetes with secondhypertension, nephritis" which caused temporary total disability from labor January 1, 1973 to March 21, 1973, inclusive,and permanent partial disability of 50% N.S.D.,for which he was awarded by Regional OfficeNo. 4, Department of Labor, diCompensation benefits on March 22, 1973,amounting to P5,243, under Sections 14 and

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18 of the Workmen's Compensation Act.1

Orillaneda accordingly retired from the service.

Petitioner herein subsequently filed a claim forreimbursement of medical expensesamounting to P8,248.99, claiming that thisamount was spent at the time that he washospitalized in the San Juan de Dios Hospitalfor medicines bought by him as a result of hisailment.

The foregoing claim for reimbursement wasdenied by the hearing officer on October 2,1975, on the ground that there were noreceipts to substantiate the alleged medicalexpenses.

I: May petitioner be granted his claim formedical expenses for an ailment other thanthat which caused his disability and separationfrom the government service?

H: No, he cannot. The law covers asituation wherein the disabled employee orworker requires medical services in the processof recovery and to restore to the maximumlevel his physical capacity, from the ailmentwhich caused his disability. Said section doesnot applyto medical expenses incurred afterseparation from work for an ailment separateand distinctfrom the one which caused hisdisability.

Hence, had petitioner herein during his period

of disability required hospitalization ormedicines for the treatment of his diabeteswith hypertension and nephritis, he would beentitled to reimbursement for expenses

incurred in relation thereto. But wherepetitioner, under Sec. 13, seeks reimbursementfor expenses incurred for treatment ofpneumonitis which allegedly occurred in thecourse of employment but which admittedlydid not disable him from work, and forbronchiectasis which appeared after hisseparation from the Bureau of Public Works,

We rule that his claim does not come withinthe letter, the spirit and intent of Sec. 13 of theWorkmen's Compensation Act.Pneumonitisand bronchiectasis are diseases of the lungswhile nephritis is a disease of the kidney whichmay result in diabetes with hypertension or anabnormally high asterial blood pressure.

Cebu Portland vs. WCCFeb. 29, 1964

F: Uldarico de los Reyes filed in theRegional Office of the Department of Labor, a

notice of injury or sickness and claim forcompensation, against the Cebu PortlandCement Co., claiming that by reason of thenature of his work therein, he contractedpulmonary tuberculosis; that the company wasinformed of such illness through its companyphysician; that as a result he was retired fromthe service and was given a gratuity pay ofP200.00.

before being allowed to work, he wasexamined by the company physician, and inthe Quezon Institute, and was found physicallyfit; that as checker, he counted the sacks ofcement brought in and out of the company's

bodega at North Harbor and Baraca; that hehad to do his job outside even when it wasraining; that it was only at the latter period of

his employment that he was provided with adust mask; that the warehouse wheworked was poorly ventilated and temperature therein above normal; that onSeptember 19, 1950, the company physicianfound claimant to be suffering from moderatelyadvanced pulmonary tuberculosis from apex tofirst interspace of the left lung; t

condition of claimant's illness was also testifiedto by Drs. Tengzon and De Jesus who attendedto him; that he was retired on September 30,1950. Thus, it was declared that the claimantswork and working conditions activated andaggravated his tuberculosis and his illness washeld compensable.

After the award in the decision of May26, 1959 was fully satisfied by the company,the claimant filed a petition with the regionaloffice in the same case for payment of medicalexpenses, claiming that he was still undertreatment for the same ailment anavailed of medical services and in

expenses amounting to P3,821.46. The HearingOfficer ruled in favor of the laborer.

I: whether the respondent employer maystill be required to pay for medical expensesincurred by the claimant for the period of fromSeptember 1, 1958 to December 31, 1959.

H: Yes, the employer is still required topay. Section 13 of the Workmen'sCompensation Law (Act 3428), as amended,provides:

SEC. 13. Medical attendance. Immediately after an employee suffered an injury or contr

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sickness and during the subsequentperiod of disability, the employer shallprovide the employee with suchmedical, surgical and hospital servicesand supplies as the nature of the injuryor sickness may require.

The pecuniary liability of the employer

for the necessary medical, surgical, andhospital services and supplies shall belimited to the amount ordinarily paid inthe community for such treatment of aninjured person of the same standard ofliving if the treatment had to be paid forby the injured person himself.

If it is shown before the Commissionerthat the injured employee voluntarilyrefused to accept the services of acompetent physician or surgeon orvoluntarily rejected the medical,surgical, and hospital services andsupplies provided by the employer, orvoluntarily obstructed the physician orsurgeon or the medical, surgical orhospital services, such refusal on thepart of the employee shall be construedas a waiver of all or part of his rights tothe medical, surgical, and hospitalservices paid for by the employer ... .(As amended by Act 3812, Com. Act210, and Rep. Act 772.)

It may be observed that the law, in imposingon the employer the obligation to providemedical attendance to an injured or sickemployee, unlike those provisions relating tocompensation for disability1 does not providemaximum either in the amount to be paid or

the time period within which such right may beavailed of by the employee. On the contrarythe law imposes on the employer theobligation to "provide the employee withsuch medical, surgical, and hospitalservices and supplies as the nature of theinjury or sickness may require."Theimplication is that, such medical expenses

as may be necessary until the work-connected injury or sickness ceases, maybe charged against the employer. In theUnited States, from where our laborcompensation law is derived, the two kinds ofbenefits for physical injury or sickness are, likein our law, treated differently. The wage-losspayments based on the concept of disabilityare invariably limited in both amount andduration, while payments of medical benefits,that is, hospital and medical expensesoccasioned by any work-connected injury,regardless of wage-loss or disability, vary inthe different states of the Union. In twelve

states such benefits are unlimited as toduration and amount; in nineteen, thepreliminary limits are subject to extension bythe administrative agency for indefinite periodsas the case warrants; in eight, there are fixedlimits subject to extension for limited additionalperiods; and in nine, there are fixed limits withno provision for extension.2 In construing thecompensation act's provision requiring theemployer to furnish medical, surgical andhospital services "reasonably required to cureor relieve the employee from the effects of theinjury", it was there held that "in the absenceof express statutory authority, this court is

powerless to place a definite limitation uponthe time such medical, surgical and hospitalservices shall be rendered in any particularCase.3 This was based on the theory that

workmen's compensation acts are a humanelaw of a remedial nature, and wconstruction is permissible, their langshould be liberally construed in favor of theemployee. And, this is supported bprevailing rule in compensation cases.

RIGHT TO REIMBURSEMENT

Case:Republic vs. WCCFeb 25, 1971

F: Leonor M. Aldaba was a public schoolteacher of the Bureau of Public Schools. Sherendered services, as such, in San Teodoro,Oriental Mindoro, for almost fifteen (15) years,up to her death on March 9, 1967. Aside frombeing a classroom teacher, she discharged

duties as physical education teacher,scouts leader, and music teacher. conducting her physical education classes, inthe morning of January 10, 1967, she wasovertaken by rain and got wet. Later that day,she returned home complaining of headache and fever. Her husband, Fernando P.Aldaba, sent for Dr. Sulit, the municipal healthphysician, who examined and treated Despite her condition, she continued workingup to January 25, 1967. Her rheadaches, however, constrained her to be onsick leave on January 26 and 27, 1967, afterwhich she resumed her work up to February 6,

1967, when, due to her illness, sbrought to Calapan, Oriental Mindoro, whereshe was examined and treated by Dr. Cuizon.

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The latter diagnosed her illness as pneumonia.When her condition improved, she wasallowed, on February 21, 1967, to return to herhometown, with the advice that she continuetaking her medicines. Upon her return to SanTeodoro, she complained once again of severeheadaches. This time, Mr. Aldaba brought herto the U.S.T. Hospital, in Manila, where she was

confined and treated by Dr. Roger Baissas, fortwo (2) days. No sooner had Mrs. Aldaba leftthe hospital, than she had another attack, inview of which she was confined at the RizalProvincial Hospital, where she died on March 9,1967. The cause of her demise was certified as"pulmonary edema and cerebral edema."

Her heirs filed a corresponding claim forcompensation which was granted. The decisionwas appealed with the WCC; such decision wasaffirmed by the same.

I: Whether the claim for benefits, being a

personal right, has been extinguished upon thedeath of the deceased.

H: No, the claim for benefits has not beenextinguished upon the death of the deceased.

The first assignment of error ispredicated upon the theory that the right toindemnity for medical services is purelypersonal in nature and that, as such, it isextinguished upon the death of an employee.In support of this view, it is argued that"nowhere in Act 3428, as amended by Republic

Act 4119, can we find any provision to theeffect that legal dependents of the deceasedmentioned in Sections 8 and 9 can validly

receive the medical benefits which thedeceased had incurred during his lifetime."Neither has appellant pointed out, however,any legal provision declaring that theemployee's right of reimbursement for medicalexpenses is extinguished upon his death.Moreover, the rights of action of a deceasedperson are, in general, transmitted to his legal

heirs, unless they are essentially personal innature or the law declares them to be so.Appellant has failed to show that said right ofreimbursement comes under any of theseexceptions.

Then, again, the law imposes upon theemployer the duty to "provide the employeewith such services, appliances and supplies asthe nature of his disability and the process ofhis recovery may require." It further providesthat:

The word "services" used herein shallinclude medical, surgical, dental, hospitaland nursing attendance and treatment aswell as the proper fitting and training in theuse of appliances and the necessarytraining for purposes of rehabilitation;"appliances" shall include crutches, artificialmembers and other devices of the samekind, and the replacements or repairs ofsuch artificial members or such devicesunless the replacements or repair is madenecessary by the lack of proper care by theemployee; and "supplies" shall includemedicines, as well as medical, surgical anddental supplies.

In case the employer or insurance carriercannot furnish the aforementioned

services, appliances and supplies promptly,the injured or sick employee may acquirethe same at the expense of the employer orinsurance carrier.

It should be noted that "the aforementionedservices, appliances and supplies" maacquired in the event of failure of the employer

to furnish the same "promptly", "at theexpense of the employer." The righreimbursement for those services, appliancesand supplies is thusunqualified. Upon theother hand, they would notbe "at the expenseof the employer" under the appellant's theory,if the employee dies.

In any event, the claim under consideration isuncontroverted. Indeed, the officers oBureau of Public Schools knew of the illness ofMrs. Aldaba, she having applied for a sick leaveon January 26 and 27, 1967. They, also, knewthat she died on March 9, 1consequence of said illness. In fact, her schoolprincipal and the Division Superintendent ofSchools for Oriental Mindoro attendedfuneral. Yet, her employer did not file therequisite report "on or before the fourteenthday of disability", which was February 6, 1967according to the "Employer's ReporAccident or Sickness", "or within ten days aftehe (the employer) has knowledge" thereof.Worse still, the "Employer's Report of Accidentor Sickness," filed on September 21, 1967,stated that the claim for compensation wouldnot be controverted. As a consequence, theemployer is deemed to have renounced its

right to controvert said claim.

DISABILITY BENEFITS

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Art. 191. Temporary total disability.

a. Under such regulations as theCommission may approve, anyemployee under this Title who sustainsan injury or contracts sickness resultingin temporary total disability shall, foreach day of such a disability or fractionthereof, be paid by the System anincome benefit equivalent to ninetypercent of his average daily salarycredit, subject to the followingconditions: the daily income benefitshall not be less than Ten Pesos normore than Ninety Pesos, nor paid for acontinuous period longer than onehundred twenty days, except asotherwise provided for in the Rules, andthe System shall be notified of the injuryor sickness. (As amended by Section 2,Executive Order No. 179)

b. The payment of such income benefitshall be in accordance with theregulations of the Commission. (Asamended by Section 19, PresidentialDecree No. 850)

Art. 192. Permanent total disability.

a. Under such regulations as theCommission may approve, anyemployee under this Title who contracts

sickness or sustains an injury resultingin his permanent total disability shall,for each month until his death, be paid

by the System during such a disability,an amount equivalent to the monthlyincome benefit, plus ten percent thereoffor each dependent child, but notexceeding five, beginning with theyoungest and without substitution:Provided, That the monthly incomebenefit shall be the new amount of the

monthly benefit for all coveredpensioners, effective upon approval ofthis Decree.

b. The monthly income benefit shall beguaranteed for five years, and shall besuspended if the employee is gainfullyemployed, or recovers from hispermanent total disability, or fails topresent himself for examination at leastonce a year upon notice by the System,except as otherwise provided for inother laws, decrees, orders or Letters ofInstructions. (As amended by Section 5,

Presidential Decree No. 1641)

c. The following disabilities shall bedeemed total and permanent:

1. Temporary total disability lastingcontinuously for more than onehundred twenty days, except asotherwise provided for in theRules;

2. Complete loss of sight of botheyes;

3. Loss of two limbs at or above theankle or wrist;

4. Permanent complete paralysis oftwo limbs;

5. Brain injury resulting in incurableimbecility or insanity; and

6. Such cases as determined by theMedical Director of the System

and approved by theCommission.

d. The number of months of paid coverageshall be defined and approximated by aformula to be approved by theCommission.

Art. 193. Permanent partial disability.

a. Under such regulations as theCommission may approve, anyemployee under this Title who contractssickness or sustains an injury resultingin permanent partial disability shall, foreach month not exceeding the perioddesignated herein, be paid by theSystem during such a disability anincome benefit for permanent totaldisability.

b. The benefit shall be paid for not morethan the period designated in thefollowing schedules:Complete and permanent No. of Monthsloss of the use ofOne thumb - 10

One index finger - 8One middle finger - 6One ring finger - 5

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One little finger - 3One big toe - 6One toe - 3One arm - 50One hand - 39One foot - 31One leg - 46One ear - 10

Both ears - 20Hearing of one ear - 10Hearing of both ears - 50Sight of one eye - 25

c. A loss of a wrist shall be considered as aloss of the hand, and a loss of an elbowshall be considered as a loss of the arm.A loss of an ankle shall be considered asloss of a foot, and a loss of a knee shallbe considered as a loss of the leg. A lossof more than one joint shall beconsidered as a loss of one-half of thewhole finger or toe: Provided, That such

a loss shall be either the functional lossof the use or physical loss of themember. (As amended by Section 7,Presidential Decree No. 1368)

d. In case of permanent partial disabilityless than the total loss of the memberspecified in the preceding paragraph,the same monthly income benefit shallbe paid for a portion of the periodestablished for the total loss of themember in accordance with theproportion that the partial loss bears tothe total loss. If the result is a decimal

fraction, the same shall be rounded offto the next higher integer.

e. In cases of simultaneous loss of morethan one member or a part thereof asspecified in this Article, the samemonthly income benefit shall be paid fora period equivalent to the sum of theperiods established for the loss of themember or the part thereof. If the resultis a decimal fraction, the same shall be

rounded off to the next higher integer.

f. In cases of injuries or illnesses resultingin a permanent partial disability notlisted in the preceding schedule, thebenefit shall be an income benefitequivalent to the percentage of thepermanent loss of the capacity to work.(As added by Section 7, PresidentialDecree No. 1368)

g. Under such regulations as theCommission may approve, the incomebenefit payable in case of permanent

partial disability may be paid in monthlypension or in lump sum if the periodcovered does not exceed one year.

Cases:GSIS vs. CadizJuly 8, 2003

F: Leo L. Cadiz was appointed as aProvincial Guard of Negros Oriental on July 1,1968. On March 16, 1974, he entered thepolice service and was promoted to severalranks until he became a Police Major. In 1991,he was absorbed by the Philippine NationalPolice (PNP), with a rank of Police ChiefInspector. On July 17, 1992, respondents rank

was adjusted to Police Chief Superintendent,the position he held until his retirement onMarch 19, 1999 at the age of 55.3

The medical records of respondent revealedthat on October 11, 1996, he suffered a heartattack and was hospitalized. He was anotherhospital where he was diagnosed

suffering from "AF with CHF Class 1-E T/A Sec.to Cardio embolic Sec. to AF, Chronic CAD,"4 aheart ailment. Thereafter, respondent was alsoadmitted at another hospital for chest pain,palpitation and abnormal. Consequently, applied for early retirement due to "an ailmentcausing [paralysis of the] left han[slurred] speech, rendering him unfdischarge further his duties and responsibilitiesas a police officer." Dr. Silahis Rocardiologist and attending physician respondent, testified before the National PoliceCommission that the latters ailmenunstable angina and chronic atriol fibrillation,

which means a chronic irregularity of the heartcausing a congestive heart failure.7 After itsown examination of respondent, the Medicaland Dental Service, PNP, declared him "UNFITFOR POLICE SERVICE".8 Hence, on March 19,1999, he was retired from service and grantedpermanent total disability benefits.9

Subsequently, respondent filed a disaclaim with the GSIS which was However, The Medical Service Group of GSIS,Pasay City, however, directed Dr. Estrada torevise her recommendation. The benefits to bereceived was eventually down graded, from

total disability to 8 months disability.

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I: Is Cadiz entitled to permanent disabilitybenefits?

H: Yes, he is entitled. Permanent totaldisability does not mean a state of absolutehelplessness, but means disablement of anemployee to earn wages in the same kind ofwork, or work of similar nature, that he was

trained for, or any work which a person ofsimilar mentality and attainment could do.

In denying respondents claim for permanenttotal disability benefits, the ECC held:

Based on the ECC Schedule ofCompensation, appellant was alreadyawarded the maximum benefitscommensurate to the degree of hisdisability. Moreover, the primary criterionset for permanent total disability in thiscase was not met, that is: permanentparalysis of two limbs; complete loss ofsight of both eyes; brain injury resulting inincurable imbecility; and loss of two limbsat or above the ankle or wrist.

Clearly, the ECC did not state its reason fordeclaring that the benefits awarded by theGSIS to respondent are those that arecommensurate to the degree of his disability.The fact that the latter did not lose the use ofany part of his body does not justify the denialof his claim for permanent total disability.

In the case at bar, respondentsentitlement to permanent total disability wasestablished by his medical records and by theinvestigation of the very agency he worked for,the PNP, which found him "UNFIT FOR POLICE

SERVICE".18 Even the initial findings of Dr.Gervillana B. Estrada, Medical Officer of theGSIS, Dumaguete City evinced that respondentis really qualified for permanent total disabilitybenefits. Most of all, the decision of the PNP toretire him at the age of 55 for being unfit forpolice service is a clear indication that his heartailment rendered him incapable of effectively

and competently performing his job as a PoliceChief Superintendent without seriousdiscomfort or pain and without material injuryor danger to his life.

Vishney vs. Empire61 Phil 592

H: Where after the period of temporarytotal disability had ceased, an employee wasfound to be suffering from a permanent partialdisability, he was entitled to an award basedupon partial disability permanent in character.

Vicente vs. ECCJan. 23, 1991F: The petitioner, Domingo Vicente, wasformerly employed as a nursing attendant atthe Veterans Memorial Medical Center inQuezon City. On August 5, 1981, at the age offorty-five, and after having rendered more thantwenty-five years of government service, heapplied for optional retirement giving as reasontherefor his inability to continue working as aresult of his physical disability. The petitionerlikewise filed with the Government ServiceInsurance System (GSIS) an application for"income benefits claim for payment." The

doctor diagnosed him as suffering fromOsteoarthritis, Hypertensive CardiovascularDisease, Cardiomegaly, and Left VentricularHypertrophy, and classified him as under

permanent total disability. The petitioapplication for income benefits claim paymentwas granted but only for permanent partialdisability (PPD) compensation or for a period ofnineteen months starting from August 16, 1981up to March 1983.

I: Whether his disability is permane

total or permanent partial

H: Permanent total disability. W"permanent total disability" invariably resultsin an employee's loss of work or inability toperform his usual work, "permanent partialdisability," on the other hand, occurs when anemployee loses the use of any panatomical part of his body which disables himto continue with his former work. otherwise, the test of whether or not anemployee suffers from "permanent totaldisability" is a showing of the capacity of

the employee to continue performing hiswork notwithstanding the disability heincurred. Thus, if by reason of the injury orsickness he sustained, the employee is unableto perform his customary job for more than 120days and he does not come witcoverage of Rule X of the Amended Rules onEmployees Compensability (which, in a moredetailed manner, describes what constitutestemporary total disability), then the employee undoubtedly suffers f"permanent total disability" regardless whether or not he loses the use of any part ofhis body.

In the case at bar, the pepermanent total disability is establ

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beyond doubt by several factors andcircumstances. Noteworthy is the fact thatfrom all available indications, it appears thatthe petitioner's application for optionalretirement on the basis of his ailments hadbeen approved. The decision of the respondentCommission even admits that the petitioner"retired from government service at the age of

45."13

Considering that the petitioner was only45 years old when he retired and still entitled,under good behavior, to 20 more years inservice, the approval of his optional retirementapplication proves that he was no longer fit tocontinue in his employment. For optionalretirement is allowed only upon proof that theemployee-applicant is already physicallyincapacitated to render sound and efficientservice.

Further, the appropriate physicians of thepetitioner's employer, the Veterans MemorialMedical Center, categorically certified that the

petitioner was classified under permanent totaldisability. On this score, "the doctor'scertification as to the nature of the claimant'sdisability may be given credence as henormally would not make a false certification."16 And, "[N]o physician in his right mind andwho is aware of the far-reaching and seriouseffect that his statements would cause on amoney claim filed with a government agency,would issue certifications indiscriminatelywithout even minding his own interests andprotection."

GSIS vs. CA

January 29, 1998

F: Balais, the employee, suddenlyexperienced chills, followed by loss ofconsciousness. At the hospital, she wasdiagnosed to be suffering from SubarachnoidHemorrhage Secondary to Ruptured aneurysm.After undergoing craniotomy, she was finallydischarged from the hospital. Despite heroperation however, the employee could not

perform her duties as efficiently as she didbefore her illness. Thi forced her to retire at theage of 62.

GSIS granted her temporary totaldisability benefits, and subsequentlypermanent partial disability benefits for 9months. She subsequently requested GSIS forthe conversion of the classification of herdisability from Permanent partial to Permanenttotal. Her request was denied.

I: Is she entitled for such conversion?

H: Yes, she is. While it is true that the

degree of her physical condition at the time ofher retirement was not considered aspermanent total disability, yet, it cannot bedenied that her condition subsequentlyworsened after her head operation andconsequent retirement. In fact, she sufferedsome ailments afterwards like, headaches,dizziness, weakness, inability to sleep and walkproperly and inability to regain her memory. Allthese demonstrate the seriousness of herconditions.

A persons disability may not manifestfully at one precise moment in time but ratherover a period of time. It is possible that an

injury which at first was considered to betemporary may later on become permanent orone who suffers a partial disability becomes

totally and permanently disabled fromcause.

Permanent total disability is the lack ofability to follow continuously substantially gainful occupation without seriousdiscomfort or pain and without material injuryor danger to life. It is therefore clear fromestablished jurisprudence that the loss of ones

earning capacity determines the disacompensation one is entitled to.

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Documents

soc leg geek notes II (before death benefits)