THIRD
DIVISION
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GOVERNMENT SERVICE INSURANCE SYSTEM,
Petitioner, - versus
- JAIME K. IBARRA, Respondent. |
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G.R. No. 172925 Present: YNARES-SANTIAGO, J., Chairperson, AUSTRIA-MARTINEZ,
CHICO-NAZARIO, NACHURA, and
REYES, JJ. Promulgated: |
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CHICO-NAZARIO, J.:
This is a
Petition for Review on Certiorari
under Rule 45 of the Rules of Court, seeking to reverse and set aside the
Decision,[1]
promulgated on
The factual
and procedural antecedents of the case are as follows:
On
1.
Evaluates
requests for documentation of approved bank transaction;
2.
Examines and
checks registered documents; and
3.
Notarizes and
reviews various bank transactions.[2]
Respondent
Ibarra claims that from the inception of his work with the bank up to the
present, his principal work has been to read and analyze voluminous
documents. During the course of his
employment, he allegedly developed high blood pressure and cataracts on both
eyes, which were eventually extracted on
In early
2000, respondent Ibarra again experienced blurring of vision. After seeking medical help, he was diagnosed
to be suffering from retinal detachment in his left eye. This retinal detachment was later improved by
surgery. However, sometime before
November 2001, respondent Ibarra again suffered retinal detachment, this time
in his right eye. This was,
unfortunately, never corrected despite repeated surgery that spanned several
years, leading eventually to the total blindness of said right eye.
Believing
that his ailment was acquired because of his job, respondent Ibarra filed a
claim for compensation benefits under Presidential Decree No. 626,[3]
as amended. However, petitioner GSIS
denied his claim via a letter dated
Please be informed that on the basis of
the proofs and evidences submitted to this Office, our Medical Evaluation and
Underwriting Department (MEUD) found your ailment, Retina Detachment (R) Eye
non-occupational disease as contemplated under the above-mentioned decree.
In view of the foregoing, this Office regrets
that your claim cannot be noted upon favorably.
x x x.[4]
However, while
respondent Ibarra’s claim under Presidential Decree No. 626 was denied, his
illness was found by the Medical
Evaluation and Underwriting Department (MEUD) to be a compensable contingency
benefit under Presidential Decree No. 1146.[5] Nevertheless, in a letter dated
Your claimed ailment, Cataract OU; Retinal
Detachment OD S/P ECE w/ PCIOZ OU, which was evaluated by our Medical Services
Group as Permanent Partial Disability was nevertheless, found not to be
work-connected as contemplated under PD 626.
It was instead, recommended as a compensable contingency but governed by
the provisions of PD 1146, the law which grants benefit to a member due to the
loss or reduction in earning capacity caused by a loss or impairment of the
normal function of his/her physical and/or mental faculties as a result of an
injury or disease.
However, may we invite you to the
provision of the Implementing Rules & Regulations of PD 1146 under Section
7 (c) which states that:
“An application for disability benefit must be filed
with the Manila Office or in any of the Branch Offices of the System within one
(1) year from the date of the occurrence of the contingency, fully supported by
supporting papers & documents as prescribed by the System.
Failure to file a claim within one (1) year from the
date of the occurrence of the contingency, with the proper papers and documents
as prescribed herein, shall operate as a bar to the right to enjoy the
benefit.”
Since the occurrence of your contingency
happened in February 1995, it is regretted that we cannot act favorably on the
above-mentioned claim for disability due to rules on prescription.[6]
On 3
October 2002, respondent Ibarra filed with petitioner GSIS an Offer of
Clarificatory Evidence with Manifestation, arguing that his claim had not prescribed,
alleging that: (1) he was suffering from hypertension when he sustained his
retinal detachments and, (2) the retinal detachment occurred in November 2001
as borne out by a certification of a doctor.
Apparently,
acting favorably on respondent Ibarra’s Offer of Clarificatory Evidence and
Manifestation, petitioner GSIS wrote respondent Ibarra advising him to submit a
certification of leave without pay. On
25 November 2002, petitioner GSIS partially paid respondent Ibarra his
permanent partial total disability benefits under Presidential Decree No. 1146
for the period covering 12 November 2001 to 11 February 2003. Per GSIS voucher, the next payment covering
On
Believing
that his loans were already settled with the GSIS by set-off, respondent Ibarra
availed himself of the Enhanced Salary Loan Program (ESLP). To his surprise, respondent Ibarra learned
that the GSIS would still make deductions from the new loan he was applying
for. This prompted respondent Ibarra to
write the GSIS to give him an accurate presentation of the real status of his
account.
In a letter
dated P193,349.23.
Respondent
Ibarra thereafter elevated to the ECC the
The
appeal is not meritorious.
A perusal of Retinal Detachment in Textbook of Opthalmology by Fajardo, Romeo
M.D. shows the following discussion to wit:
“Retinal Detachment or retinal separation may either
be primary (idiopathic) or secondary. In
the primary type, for which the cause is not known, there is actually
separation of the inner sensory layer of the retina from the outer pigmentary
layer. Primary retinal detachment is
always associated with a break in the retina either as a tear or a hole. Vitreous fluid seeps in through the retinal
break and initiates the separation and detachment of the retina. The secondary type of retinal detachment is
due to some disease process of the retina or its neighboring structures – the
vitreous and choroids. This could be due
to a history of trauma, prior cataract extraction, inflammatory process or
exudes (choroiditis, Harada’s disease), tumor cells or traction on the retina.”
Medical science has established that
trauma to the eyes may precipitate the development of Retinal Detachment. In this
case, however, the records are bereft of any proof that the deceased (sic) suffered
an injury on his right eye while he was performing his duty. Thus, this Commission cannot conclude that
his job as a division chief must have substantially contributed to the
development of his eye ailment.
The presumption that an illness causing
death or disability arose out of the employment or was at least aggravated by
such employment is now a thing of the past.
It was abolished upon the effectivity of the new law – PD 626 on
Respondent
Ibarra filed with the Court of Appeals a Petition for Review under Rule 43 of
the Rules of Court, assailing this Decision of the ECC.
On
The Court
of Appeals found the Certification issued by the DBP’s resident doctor to the effect
that respondent Ibarra had been under the company doctor’s care “for
hypertension since 1995 to date,” is sufficient to establish that he indeed was
suffering from such ailment during his employment.
As regards
petitioner’s objection that said Certification from the DBP resident doctor was
presented only on appeal to the Court of Appeals, the appellate court ruled
that “it would be contrary to conscience to deny a person of his much needed
means for medical upkeep because of belated submission of proof of illness.”[10] The Court of Appeals added that it was not
poised to rule that respondent Ibarra’s claim of hypertension was a mere
afterthought, for even while the case was still pending before the ECC,
respondent Ibarra had already manifested before the ECC in his Offer of
Clarificatory Evidence and Manifestation that he had been suffering from
hypertension owing to stress at work.
The Court
of Appeals, however, also held that petitioner GSIS was not remiss for having
applied respondent Ibarra’s benefits to his outstanding loans, as shown by the
letter of petitioner GSIS outlining in detail respondent Ibarra’s outstanding
loan and payments. Thus, the Court of
Appeals disposed of the Petition as follows:
WHEREFORE, in light of the foregoing, the
decision subject of this petition is REVERSED and SET ASIDE. Accordingly, the respondent GSIS is hereby
ordered to pay the petitioner the appropriate benefits under PD 626, subject,
however, to set-off of his outstanding and unpaid loans with GSIS.[11]
On
Petitioner
GSIS thus instituted the present recourse, submitting the following issues for
our consideration:
1. Whether or not the Honorable Court of
Appeals committed error of judgment by reversing the decision of the Employees’
Compensation Commission denying the claim for compensation benefits under P.D.
No. 626, as amended, of respondent Jaime K. Ibarra, due to his ailment, RETINAL
DETACHMENT.
2. Whether or not petitioner GSIS and ECC
erred in denying respondent’s claim for compensation benefit under R.A. (sic) 626,
as amended, due to his ailment, Retinal Detachment.[12]
Presidential Decree No. 626, as amended, defines
compensable sickness as “any illness definitely accepted as an occupational
diseases listed by the Commission, or any illness caused by employment subject
to proof by the employee that the risk of contracting the same is increased by
the working conditions.” In this
connection, Section 1(b), Rule III of the Implementing Rules of
Presidential Decree No. 626, as amended, provides that a disease and the
resulting disability or death is compensable when it is included in the list of
Occupational Diseases under Annex “A” of the Rules, subject to the satisfaction
of certain conditions prescribed for the particular disease. On the other hand, ECC Board Resolution No.
93-08-0068 dated 5 August 1993, provides that an illness not included in the
list may be considered compensable if the same, as shown by proofs, is caused
or precipitated by factors inherent in the employee’s nature of work and
working conditions.
Respondent
Ibarra’s ailment, retinal detachment, is not one of the listed occupational
diseases. Consequently, respondent
Ibarra must prove with substantial evidence that his retinal detachment was
caused or precipitated by factors inherent in nature of his work and working
conditions.
Petitioner
GSIS reiterates the explanation of retinal detachment in Dr. Fajardo’s book as
quoted by the Court of Appeals:
Retinal Detachment or retinal separation
may either be primary (idiopathic) or secondary. In the primary type, for which the cause is
not known, there is actually separation of the inner sensory layer of the
retina from the outer pigmentary layer.
Primary retinal detachment is always associated with a break in the
retina either as a tear or a hole. Vitreous
fluid seeps in through the retinal break and initiates the separation and
detachment of the retina. The secondary
type of retinal detachment is due to some disease process of the retina or its
neighboring structures – the vitreous and choroids. This could be due to a history of trauma,
prior cataract extraction, inflammatory process or exudes (choroiditis,
Harada’s disease), tumor cells or traction on the retina.[13]
Petitioner
GSIS argues that since the cause is not known for the first type of retinal
detachment, the ailment must be conclusively presumed as not work-connected,
pursuant to the Decisions of this Court in Sante
v. ECC,[14]
and Raro v. ECC,[15]
where we held:
The law, as it now stands requires the claimant to
prove a positive thing – that the illness was caused by employment and the risk
of contracting the disease is increased by the working conditions. To say that since the proof is not available,
therefore, the trust fund has the obligation to pay is contrary to the legal
requirement that proof must be adduced.
The existence of otherwise non-existent proof cannot be presumed.
On the
other hand, the second type of retinal detachment could be caused by prior
cataract extraction, inflammatory process or exudates, tumor cells or traction
on the retina, or trauma. Petitioner GSIS
argues that among these causes, only trauma can be attributable to one’s work,
and that no proof was adduced by respondent Ibarra that any injury in his right
eye was suffered while he was at work.
As regards
respondent Ibarra’s claim that he had suffered hypertension because of the
nature of his work, petitioner GSIS argues that no evidence was presented to
show any medical findings of his being hypertensive. According to petitioner GSIS, the medical
certificate, which was issued by “a mere company physician,” and which plainly
states that respondent Ibarra was then under the care of said doctor for
hypertension since 1995, is questionable, there being no previous medical
record or diagnostic result presented to confirm the veracity of the doctor’s
statement. Petitioner GSIS further
argues that introduction of evidence for the first time on appeal is
proscribed.
Finally,
GSIS argues that respondent Ibarra’s contention that he experienced stress and
tension in the performance of his duties remains uncorroborated and
unsubstantiated, and should be treated merely as a self-serving allegation. As such, it could not warrant a finding of
the causal connection between respondent Ibarra’s ailment and the nature of his
work.
We find in
favor of respondent Ibarra.
It is true
that, pursuant to the cases cited by petitioner GSIS, we have already abandoned
the presumption of compensability.
However, this only means that the employee no longer enjoys the initial
or preliminary notion that his illness is compensable. Instead, the law now imposes upon the
claimant the burden to prove by substantial evidence that his work has
increased the risk of contracting the illness.
Therefore, respondent Ibarra must prove reasonable connection between
his ailment and his employment.[16]
As stated
above, respondent Ibarra produced for this purpose a medical certificate to the
effect that respondent Ibarra has been under the company doctor’s care “for
hypertension since 1995 to date.” In
several cases involving the old Workmen’s Compensation Act, we held that a
medical report may be received in evidence to prove the fact in dispute.[17] While there are several distinctions between
the Workmen’s Compensation Act and Presidential Decree No. 626, the
availability of a medical report to be received in evidence for disability
claims is not one of them.
While it is
true that the medical certificate presented by respondent Ibarra is
uncorroborated, it is equally true, that it is uncontroverted. Neither petitioner GSIS nor the ECC denies
the genuineness or due execution of said medical certificate, except probably
the disparaging remark of petitioner GSIS that it was issued by a “mere company
physician.” However, as we have held in
many cases, a doctor’s
certification as to the nature of claimant’s disability may be given credence,
as he or she would normally not make an untruthful certification. No physician in his right mind and who is
aware of the far-reaching and serious effect that his or her statements would
cause on a money claim against a government agency would vouch for those
statements indiscriminately, without regard for his own interests and
protection.[18]
The work connection
between respondent Ibarra’s hypertension and his retinal detachment had been conclusively
settled by this Court in the cited case Bonilla
v. Court of Appeals,[19]
which is on all fours with this case:
“Rhegmatogenous Retinal Detachment” from which
petitioner suffered is not listed as an occupational disease. However, this will not bar petitioner’s claim
for benefits under the law if claimant adduces substantial evidence that the
risk of contracting the illness is increased by the working conditions to which
an employee is exposed to. In short,
petitioner must show proof of reasonable work-connection of the ailment and her
employment.
In
this case, petitioner has shown by uncontroverted evidence that since 1988, in
the course of her employment with the Senate as Legislative Staff Officer V,
not Legislative Legal Officer, as stated by the Government Service Insurance
System in denying her claim, she suffered from hypertension caused by stress
and tension during employment as court stenographer and legislative staff
officer, which is an admitted cause of retinal detachment. Consequently, the very nature of petitioner’s
ailment substantiates its work-connection and increased risk. Reasonable work connection suffices for
compensability. Probability, not
certainty is the touchstone.
Consequently,
the Court of Appeals erred in ruling that there was no relevant evidence
supporting the finding that petitioner’s illness was a disease proven as work
connected or the risk of contracting the disease was increased by her working
conditions, compensable under P.D. No. 626, as amended. Strict rules of evidence are not applicable
in claims for compensation. The degree
of proof required under P.D. 626, is merely substantial evidence, which means,
“such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.”[20]
By the
pronouncement in Bonilla that the very nature of the ailment in
said case (hypertension) substantiated its work connection and increased risk, Bonilla likewise dismantles petitioner
GSIS’s contention that respondent Ibarra’s allegation of stress in the
performance of his duties is a mere self-serving allegation. Otherwise stated, we are taking judicial
notice that hypertension, by its very nature, is usually work-connected. As further observed by the Court of Appeals:
It could be noticed that in the Bonilla
case where the High Court granted the benefits being claimed, the employee
concerned was a Legislative Staff in the senate. On the other hand, the petitioner in the case
at bench served as a division chief before he eventually became a bank attorney
for DBP. All reasonable attempt at
comparison would suggest that petitioner’s work in this case is equally, indeed
if not more, toxic and stress laden than the claimant’s in the Bonilla
case. Concededly, the petitioner’s
employment involves decisions which have a direct consequence on the bank’s
operations. His work is therefore more
tension filled and more cerebrally demanding because his job imposes bigger
responsibilities.
Considering that the nature of
petitioner’s work entails the preparation of complicated reports and analysis
of voluminous documents, stress is hardly a setback that is alien to his
profession.[21]
What the
law requires is a reasonable work connection, and not direct causal
relation. It is enough that the
hypothesis on which the workman’s claim is based is probable.[22] Probability, and not the ultimate degree of
certainty, is the test of proof in compensation proceedings.[23]
Presidential Decree No.
626, as amended, is indeed said to have abandoned the presumption of
compensability and the theory of aggravation prevalent under the Workmen’s
Compensation Act. Nonetheless, the
Supreme Court ruled in Employees’
Compensation Commission v. Court of Appeals,[24]
that 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.
Consequently, the presumption in favor of labor still prevails. “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]
WHEREFORE, the Petition is DENIED.
The Court of Appeals Decision is AFFIRMED.
SO
ORDERED.
|
|
MINITA V. CHICO-NAZARIOAssociate Justice |
WE
CONCUR:
CONSUELO YNARES-SANTIAGO
Associate Justice
Chairperson
Associate Justice
Associate Justice
RUBEN T. REYES
Associate Justice
ATTESTATION
I attest that the conclusions in the above
Decision were reached in consultation before the case was assigned to the
writer of the opinion of the Court’s Division.
CONSUELO
YNARES-SANTIAGO
Associate Justice
Chairperson, Third 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 were reached in
consultation before the case was assigned to the writer of the opinion of the
Court’s Division.
REYNATO S.
PUNO
Chief Justice
[1] Penned by Associate Justice Bienvenido
L. Reyes with Associate Justices Godardo A. Jacinto and Regalado E. Maambong,
concurring. Rollo, pp. 36-45.
[2] Rollo, p. 48.
[3] Presidential Decree No. 626 (as
amended by Presidential Decree No. 850, Presidential Decree No. 865-A, Presidential
Decree No. 891, Presidential Decree No. 1368, Presidential Decree No. 1641, Presidential
Decree No. 1692, Presidential Decree No. 1921, Executive Order No. 126 and Executive
Order No. 179) is entitled “FURTHER AMENDING CERTAIN ARTICLES OF PRESIDENTIAL
DECREE No. 442 ENTITLED "LABOR CODE OF THE PHILIPPINES.” The law amended Title
II of Book IV on Employees' Compensation and State Insurance Fund of the Labor
Code of the
[4] Rollo, p. 38.
[5] Presidential Decree No. 1146, Amending, Expanding, Increasing and
Integrating the Social Security and Insurance Benefits of Government Employees
and Facilitating the payment thereof under Commonwealth Act No. 186, as
amended, and for other purposes.
[6] Rollo, pp. 38-39.
[7]
[8] 395 Phil. 162 (2000).
[9] Rollo, p. 41.
[10]
[11]
[12]
[13]
[14] G.R. No. 84415,
[15] G.R. No. 58445,
[16] Acosta v. Employees’ Compensation Commission, 195 Phil. 760, 766 (1981).
[17] Guillen
v. Workmen’s Compensation Commission, G.R. No. L-46692,
[18] Ijares
v. Court of Appeals,372 Phil. 9, 20 (1999); Loot v. Government Insurance System, G.R. No. 86994, 30 June 1993,
224 SCRA 54, 59-60; Bejerano v.
Employees’ Compensation Commission, G.R. No. 84777, 30 January 1992, 205
SCRA 598, 603-604; Vicente v. Employees’
Compensation Commission, G.R. No. 85024, 23 January 1991, 193 SCRA 190, 196
and Abaya, Jr. v. Employees’ Compensation
Commission, G.R. No. 64255,
[19] 395 Phil. 162 (2000).
[20]
[21] Rollo, p. 42.
[22] Castor-Garupa
v. Employees’ Compensation Commission, G.R. No. 158268,
[23] Government
Service Insurance System v. Cuanang, G.R. No. 158846,
[24] 332 Phil. 278, 286-287 (1996).
[25]