GOVERNMENT SERVICE G.R. No. 154385
INSURANCE
SYSTEM,
Petitioner, Present:
QUISUMBING,
J.,
Chairperson,
CARPIO,
- versus -
CARPIO MORALES,
TINGA, and
VELASCO,
JR., JJ.
MERLITA PENTECOSTES,
Substituted
by Jaime R. Pentecostes,
Respondent. Promulgated:
x----------------------------------------------------------------------------x
Tinga,
J.:
In this Petition for Review[1]
under Rule 45 of the 1997 Rules of Civil Procedure, petitioner Government
Service Insurance System (GSIS) assails the Decision[2]
dated
Following are the factual and
legal antecedents, as culled from the decision of the Court of Appeals.
Respondent Merlita
Pentecostes (Merlita) was 32
years old when she joined the government service in 1980 as a public school
elementary teacher assigned to the remote and mountainous barangay
elementary schools of the towns of Basud, Imelda, Labo and Jose Panganiban, all in
the
From
Merlita’s
left kidney also failed because of Nephrolithiasis
(Renal Stones or Urolithiasis). On account of her
condition, she underwent hemodialysis (a procedure
where blood with the excretory products is removed and replaced with fresh
blood) two (2) times a week which is an expensive procedure done not to cure
the disease but to ease the pain, to lessen the retention of fluids, to
minimize further complications, and to lengthen the chance of survival of Merlita.[8]
Merlita’s condition
constrained her to retire from service in April 1998. Her medical examiners
considered her disability as total and permanent.[9]
On account of her illness, Merlita filed a claim with
GSIS for compensation benefits which was denied on the ground that Urolithiasis is not work-related. Merlita
sought reconsideration, but it was similarly denied. On appeal, the Employees’
Compensation Commission (ECC) likewise rejected Merlita’s
claim,[10]
the pertinent portions of whose decision read:
Viewed against the foregoing, we can safely
conclude that the development of appellant’s Urolithiasis
was not due to factors present in her workplace or the nature of her employment
as a teacher. Familial or hereditary predisposition have been noted in the
development of this disease, thus, we believe that the respondent System
correctly ruled against compensability.
WHEREFORE, premises considered,
the decision of the respondent System appealed from is hereby AFFIRMED, and the instant case is dismissed for lack of merit.[11]
Aggrieved, Merlita
interposed an appeal in December 1999 before the Court of Appeals insisting
that the conditions of her work greatly increased the risk of contracting the
ailment.[12]
A couple of days later, Merlita died and was
substituted by her husband and six (6) children.[13]
The Court of Appeals sustained Merlita’s position, reversed the decision of the ECC, and declared
her heirs entitled to the compensation benefits under Presidential Decree (P.D.)
No. 626, as amended.[14]
The appellate court stated:
It can be stressed that Merlita
Pentecostes, when she commenced her career as a
public school elementary teacher, first as a substitute classroom teacher from
1980 to 1984, then as a regular classroom teacher up to the time she went out
of service in 1998 because of her serious kidney disease was, at the age of 32
years, young and in good perfect healthy condition. In the fourteen (14) years
of teaching she was assigned in the arid, rural, tropical and mountainous barangays of Basud, Labo, Imelda and Jose Panganiban,
all far-flung towns of Camarines Norte where the
petitioner has to regularly walk daily an exhausting, dehydrating, and
lung-busting six (6) kilometers stretch to and from the barangay
elementary school and place of her temporary residence in the Poblacion of the municipality of said towns. A daily
routine for fourteen (14) years which strained her kidneys coupled with
drinking unchlorinated and uncertain
impurities-filled water from deep and shallow water wells and the stress of working
away from the loving arms and bliss of her family who lived in Daet, Camarines Norte. This
dehydrating condition of walking six (6) kilometers to and from the arduous and
hot mountainous barangays on the aforesaid towns of Camarines Norte put heavy toll on petitioner’s kidneys by
reducing urine volume and higher secretion and concentration of insoluble
sediments-predisposing factors which contributed and increased the risk of
petitioner’s contracting Urolithiasis (a renal
disease attributed to the development of calcium, oxalates, uric acid and/or cystine stones, in the calyces, papillae, ureter, urinary bladder and other renal parts). This undue
strain on petitioner’s kidneys predisposed petitioner to develop this malady, Urolithiasis, which as a consequence suppressed the kidney
functions by way of renal failure. This
predisposing factor of chronic dehydration which contributed and increased the
risk of the petitioner to develop Urolithiasis and
Renal Failure has been confirmed by medical experts and authorities in their
respective fields in medicine x x x.[15]
x x x x
Moreover, since the cause or causes of Urolithiasis is or are still unknown, no proof can be
presented because the law does not require the impossible.[16]
In the instant petition, GSIS reiterates its
previous submission that Merlita failed to discharge
the burden of presenting evidence that her ailment was caused by her work.[17]
Moreover, it states that the sad plight and the deterioration of the GSIS State
Insurance Fund should not be aggravated by approving claims of ailments not
intended by law to be covered.[18]
In her Comment[19]
dated 20 January 2003, Merlita maintains that the
development of urolithiasis as being secondary to
chronic renal failure has no clear etiologic factor so as to a create a
conclusive causal connection leading to the disease. Since the cause or causes
of the disease is or are still unknown, no proof can be presented because the
law does not require the impossible.[20]
In a Resolution[21]
dated 19 March 2007, the Court noted the death of Merlita’s
husband and substitute respondent, Jaime P. Pentecostes,
Sr. He was substituted by one of his children, Jaime R. Pentecostes,
Jr., as party respondent.
The sole issue before the Court is whether Merlita is entitled to compensation benefits under P.D. No.
626, as amended.
After a thorough evaluation of the case and
assessment of the arguments of the parties, the Court finds for Merlita and affirms the challenged decision of the Court of
Appeals.
Section 1(b), Rule III implementing
P.D. 626, as amended, provides:
For the sickness and the resulting disability or
death to be compensable, the sickness must be the result of an occupational
disease listed under Annex “A” of these Rules with the conditions set therein
satisfied, otherwise, proof must be shown that the risk of contracting the
disease is increased by the working conditions.
Under the above Rule, for Merlita’s
sickness and resulting disability to be compensable, there must be proof that
(a) her sickness was the result of an occupational disease listed under Annex
“A” of the Rules of Employees’ Compensation, or (b) the risk of contracting the
disease was increased by her working conditions. This means that if the claimant’s
illness or disease is not included in Annex “A,” then he is entitled to
compensation only if he can prove that the risk of contracting the illness or
disease was increased by his working conditions.[22]
The law does not require that the connection be established with absolute
certainty or that a direct causal relation be shown. It is enough that the
theory upon which the claim is based is probable. Probability, not certainty,
is the touchstone.[23]
Pertinently, the Court stated
in the case of Employees’ Compensation Commission v. Court of Appeals:[24]
Despite the abandonment of the presumption of compensability established
by the old law, the present law has not ceased to be an employees’ compensation law or a social
legislation; hence, the
liberality of the law in favor of the working man and woman still prevails, and
the official agency charged by law to implement the constitutional guarantee of
social justice should adopt a liberal attitude in favor of the employee in
deciding claims for compensability, especially in light of the compassionate
policy towards labor which the 1987 Constitution vivifies and enhances. Elsewise stated, a humanitarian impulse, dictated by no
less than the Constitution itself under the social justice policy, calls for a
liberal and sympathetic approach to legitimate appeals of disabled public
servants; or that all doubts to the right to compensation must be resolved in
favor of the employee or laborer.
Verily, the policy is to extend the applicability of the law on
employees’ compensation to as many employees who can avail of the benefits thereunder.[25]
Concededly, Merlita’s illness, urolithiasis,
is not among those listed in the table of occupational diseases embodied in
Annex “A” of the Rules on Employees’ Compensation. Nevertheless, the Court
agrees with the Court of Appeals in its finding that Merlita
was able to prove by substantial evidence that her working conditions increased
the risk of contracting the disease. Substantial evidence is the amount of
relevant evidence which a reasonable mind might accept as adequate to justify
the conclusion.[26]
Urolithiasis
is the process of forming stones in the kidney, bladder and/or urethra (urinary
tract).[27]
It is the formation of urinary calculi at any level of the urinary tract.
Urinary calculi (stones) are worldwide in its distribution but are more common
in some geographic areas as in parts of
The 15th Edition of Smith’s
General Urology states that fluid intake and urine output may have an effect on
urinary stone disease. It also states that individuals living in hot climates
are prone to dehydration, which results in an increased incidence of urinary
stones. Although heat may cause a higher fluid intake, sweat loss results in
lowered voided volumes. Hot climates usually expose people to more ultraviolet
light, increasing vitamin D3 production. Increased calcium and oxalate
excretion has been correlated with increased exposure time to sunlight.[30]
Those who become dehydrated due to strenuous physical activity are also
particularly at risk of developing stones.[31]
According to the 13th Edition of Harrison’s
Principles of Internal Medicine, Vol. 2. (International Edition,
1994), urinary stones usually arise because of the breakdown of a delicate
balance. The kidneys must conserve water, but they also must excrete materials
that have a low solubility. These two opposing requirements must be balanced
during adaptation to diet, climate and activity.[32]
The foregoing medical reports
establish that the environment (climate and geographical location), water or
fluid intake and activity are important factors in the development or inhibition
of urinary stone disease. The regularity of urination likewise plays an
important role since withholding urine for sometime may disturb the balance.[33]
Merlita was assigned to schools located in
mountainous barangays which required her to walk daily
a considerable distance. Considering the climate, the location of her
workplace, i.e. mountainous and far-flung,
and the strenuous walk she had to daily endure, she was prone to dehydration
which could have led to the formation of urinary stones. Additionally, in said
place the only available drinking water was the water taken from the deep well which
in all probability was hard water, containing minerals which contribute to the
formation of kidney stones.
Merlita could also have
missed the important habit of
regular urination. Teachers have a
tendency to sit for hours on end, and to put off or postpone emptying their
bladders when it interferes with their teaching hours or preparation of lesson
plans.[34]
Thus, while the Court concedes that the nature of Merlita’s
work as a teacher does not per se
ordinarily cause urolithiasis, the risk of contracting
the same in this case was aggravated by the peculiar conditions and location of
her workplace, which required her to undergo a five-day week schedule of
strenuous and protracted walking.
Finally, it is well to recall the
Court’s exhortation in Vicente v. Employees’ Compensation Commission[35] reiterated
in the case of Employees’ Compensation Commission v. Court of Appeals[36] wherein the Court
ruled that therein private respondent’s job as an NBI Engineer, which included
field work, increased her risk of contracting uterelothiasis,
also a urinary stone disease, to wit:
The court takes this occasion to stress once
more its abiding concern for the welfare of government workers, especially the
humble rank and file, whose patience, industry, and dedication to duty have
often gone unheralded, but who, in spite of very little recognition, plod on
dutifully to perform their appointed tasks. It is for this reason that the
sympathy of the law on social security is toward its beneficiaries, and the
law, by its own terms, requires a construction of utmost liberality in their
favor. It is likewise for this reason that the Court disposes of this case and
ends a workingman’s struggle for his just dues.[37]
WHEREFORE, the Decision dated
SO
ORDERED.
DANTE O. TINGA Associate Justice
WE CONCUR:
LEONARDO A. QUISUMBING
Associate Justice
Chairperson
ANTONIO T. CARPIO CONCHITA CARPIO MORALES
Associate Justice Associate
Justice
PRESBITERO J. VELASCO,
JR.
Associate Justice
ATTESTATION
I attest that the conclusions in the above
Decision had been reached in consultation before the case was assigned to the
writer of the opinion of the Court’s Division.
LEONARDO A. QUISUMBING
Associate Justice
Chairperson, Second Division
CERTIFICATION
Pursuant to Section 13, Article VIII
of the Constitution, and the Division Chairperson’s Attestation, it is hereby
certified that the conclusions in the above Decision had been reached in
consultation before the case was assigned to the writer of the opinion of the
Court’s Division.
REYNATO S. PUNO
Chief Justice
[2]
[13]
[23]Barrios v. Employees’
Compensation Commission, G.R. No. 148089,
[27]Definition of Urolithiasis, Medicine.
Net.Com, http://www.medterms.com/script/main/art.asp?articlekey=6649
(visited
[28]Epidemiological
Risk Factors and Composition of Urinary Stones in Riyadh Saudi
[29]Clinical
Epidemiology of Urolithiasis in Tropical Areas,
Leonardo R. Reyes Rabanal, M.D., Instituto
de Nefrologia,
[32]Page 1330, cited in Employees’
Compensation Commission v. Court of Appeals, 332 Phil. 278, 290 (1996).
[33]Employees’ Compensation
Commission v. Court of Appeals, G.R. No. 121545,