GOVERNMENT
SERVICE INSURANCE SYSTEM,
Petitioner, - versus - Respondent. |
G.R. No. 185035
Present: Quisumbing,
J., Chairperson,
CARPIO-MORALES, *CHICO-NAZARIO, **LEONARDO-DE CASTRO, and brion, JJ. Promulgated: July 15, 2009 |
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D E C I S I O N |
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BRION, J.: |
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Before the Court is the petition for review on
certiorari[1]
filed by the Government Service Insurance System (GSIS) to seek the
reversal of the decision[2]
and the resolution[3] of
the Court of Appeals (CA) in CA-G.R. SP No. 100375 entitled “Salvador
A. De Castro v. Government Service Insurance System and Employees' Compensation
Commission.”
THE ANTECEDENTS
Respondent Salvador De Castro (De
Castro) rendered service in the Philippine Air Force (PAF) from
On
On
De Castro retired from the service on
In a decision dated
THE
ECC DECISION
At its meeting on
De Castro sought relief from the CA
through a petition for review under Rule 43 of the Rules of Court. Relying on Dominga A. Salmone v. ECC,[7]
De Castro argued that the causal relation between his illness and the resultant
disability, on the one hand, and his work, on the other, is not that essential;
it is enough that his illness is listed as an occupational disease. He disputed
the findings of the ECC that hypertension or high blood pressure (which causes
CAD) may have been caused by his cigarette smoking and drinking habits. He posited that other factors, such as stress
brought about by the nature of his work, could have caused his illness. He claimed that the positions he held in the
PAF, the last being First Sergeant, were comparable to a managerial position in
the civilian business community because it served as an extension of the office
of his commanding officer in the management, administration, and supervision of
his fellow enlisted personnel within the unit.
In response to the petition, the GSIS maintained
that hypertensive cardiovascular disease and CAD are not inherent occupational
hazards, nor are they concomitant effects of De Castro’s employment with the
PAF. It argued that there was no
significant causal or contributory relationship between De Castro’s duties as a
soldier and his ailments.
THE CA DECISION
The CA granted the petition.[8] It noted that, as found by the ECC itself, De
Castro’s illnesses are listed as occupational diseases in Annex “A” of the Amended
Rules of the Employees’ Compensation Commission (Amended ECC Rules). It explained that under the same rules, the
sickness must be the result of an occupational disease under Annex “A” in order
for the illness and the resulting disability or death to be compensable.[9]
The
CA further explained that it is not necessary that there be proof of causal
relation between the work and the illness which resulted in De Castro’s
disability. Citing GSIS v. Baul,[10]
it held that in general, a covered claimant suffering from an occupational
disease is automatically paid benefits.
While it noted that the exact etiology of hypertension which led to De
Castro’s cardiovascular ailments cannot be accurately traced, it stressed that
medical experiments tracing the etiology of essential hypertension show a
relationship between this illness and the nature and conditions of work. The CA found significant the statement in De
Castro’s Certificate of Disability Discharge that his CAD and hypertensive
cardiovascular diseases were aggravated during active service; were not
incurred while on AWOL; did not exist prior to entry into service; were
incident to service; were not incurred by private avocation; were not due to
misconduct; and, were incurred while in line of duty. The appellate court, therefore, brushed aside
the findings a quo that De Castro’s illnesses might have been caused by
his smoking and drinking habits.
THE
PETITION
GSIS’ present petition
presents the following issues: (1)
whether the CA erred in reversing the decisions of the ECC and the GSIS that
denied De Castro’s claim for disability benefits; and (2) whether De Castro
proved that his heart ailments are work-related and/or have been precipitated
by his duties with the Armed Forces of the Philippines (AFP).
The GSIS asks for a reversal of the CA’s
1. If the heart disease was known to have been present
during employment, there must be proof that an acute exacerbation was clearly
precipitated by the unusual strain by reasons of the nature of his work.
2. The strain of work that brings about an acute attack
must be of sufficient severity and must be followed within 24 hours by the
clinical signs of a cardiac insult to constitute causal relationship.
3. If a person who was apparently asymptomatic before
being subject to strain at work showed signs and symptoms of cardiac injury
during the performance of his work and such symptoms and signs persisted, it is
reasonable to claim a causal relationship.
Given the above conditions, the GSIS
posits that it is incumbent on De Castro to prove that there was an unusual and
extraordinary strain in his work when his chest pain developed, or that there
was causal connection between his working condition and heart ailments. The GSIS then submits that De Castro failed
to discharge the burden of presenting evidence that his heart ailments were caused
by his work. It brushes aside De
Castro’s reliance on his certificate of disability discharge,[13] contending that it was
issued relative to his separation from the AFP; the tests and findings on which
the certificate was based are not conclusive or binding in the determination by
the GSIS and the ECC of the compensability of De Castro’s illness under the law
– Presidential Decree No. 626, as amended, and the ECC Rules of Procedure for
the Filing and Disposition of Employees’ Compensation claims. It maintains that under Rule 2, Section 1 of these
rules, the GSIS (in the public sector), and the Social Security System (in the private sector) have original and
exclusive jurisdiction, and the ECC, the appellate jurisdiction, to settle any
dispute with respect to coverage, entitlement to benefits, collection, and
payment of contributions and penalties.
The GSIS further argues, relying on GSIS v. CA,[14] that the proceedings in
the AFP and the administrative machinery tasked by law to handle the government’s
employees compensation program are separate and distinct from one another;
thus, the AFP’s conclusions may not be used as basis in the determination of the
compensability of De Castro’s ailments.
It thus objects to the CA’s rejection of the ECC's findings of fact on
the nature of the heart ailments of De Castro, stressing that the decision of
the ECC clearly elaborated on what CAD is and why De Castro is not entitled to the
employees’ compensation. The ECC
decision, it explains, was based on well-respected and often quoted medical
references;[15]
its medical evaluations revealed that De Castro’s heart illnesses were related
to his drinking and smoking habits. Finding further support in the declarations
of the American Heart Association,[16] it maintains that the ECC
is correct in taking into consideration De Castro’s lifestyle, particularly his
smoking and drinking habits, in denying his claim for compensation. The GSIS concludes that based on the findings
of the ECC, De Castro’s ailments were not acquired by reason of his employment
with the PAF and were, therefore, not work-connected.
THE CASE FOR DE
CASTRO
In his
1.
No further proof of work
connection is necessary since his illnesses are listed as occupational
diseases.
2.
There is substantial
evidence to prove the work connection of his illnesses.
3.
The factual findings of
the CA are not subject to review.
De Castro submits that under Annex “A”
of the Amended ECC Rules, CAD and essential hypertension are listed as
occupational diseases;[18]
once an ailment is so listed, the causal relation between the ailment and the
resultant disability and his work is not essential to declare his disability compensable,
citing in this regard the Court’s ruling in Dominga A. Salmore v. ECC.[19]
Further, De Castro contends that the GSIS’
theory that his drinking and smoking habits must have caused his hypertension
is unwarranted; this theory conveniently and arbitrarily disregarded other
factors or causes that might have contributed to his illnesses, such as the
stress brought about by the nature of his work.
De Castro posits that as the Court held in GSIS v. Baul,[20]
the presence of other factors that are work-related makes his ailments
compensable; what is required is
reasonable work connection and not direct causal relation.
De Castro stresses that the conditions
laid down under Item No. 18 of Annex “A” of the Amended ECC Rules, are
alternative, not concurrent, pointing out that
the caption of the rule states: “Any
of the following conditions,” meaning, any one of the conditions mentioned
in the rule. He argues that the diagnosed
ailments that resulted in his separation from the service never existed prior
to his entry into the service (as indicated in his certificate of disability
discharge),[21] and
were, therefore, incurred while he was in the military service; the same
document also states that his illnesses were incident to and aggravated by the
service. He claims that the circumstances under which he incurred his illnesses
satisfy the requirements under No. 18a of the cited rule.
De Castro posits that substantial evidence exists
to prove that his ailments were caused by his employment with the PAF. He reiterates that the duties he performed at
the PAF as non-commissioned officer-in-charge for operational security, Asst.
First Sergeant, and ultimately, as First Sergeant, contributed to the progress
of his ailments and, eventually, led to his separation from the service. He contends that the CA upheld his position
when it ruled that he contracted CAD and hypertensive cardiovascular diseases
in the course of his employment with the PAF, and these were brought about by the
stress and the nature of his work.
While De Castro does not dispute that
the GSIS has original and exclusive jurisdiction and the ECC has appellate
jurisdiction over disputes on compensation benefits,[22]
he stresses that neither the GSIS nor the ECC subjected him to any separate
medical examination. He argues that the
GSIS and the ECC only made a paper evaluation of his condition, based on the
medical findings and diagnoses of the V. Luna General Hospital, AFPMC. These hospital findings underwent review by
the AFP Disability and Separation Board (DSB) before his discharge for
disability was approved. The GSIS and
ECC did not take into account his service with the AFP and the nature of his
assignments which greatly contributed to the development of his ailments.
Finally, De Castro argues that, procedurally, the CA’s findings that his ailments are service-connected are no longer reviewable. Rule 45 of the Rules of Court – the petitioner’s chosen mode of review, only allows a review of legal issues.[23]
THE COURT’S RULING
We
first resolve the procedural question De Castro raised on whether the present
petition is appropriate; De Castro alleges that a Rule 45 petition should
involve only questions of law, while the present petition places in issue the
CA’s factual findings. In effect, De Castro claims that the present petition
should be dismissed outright under the terms of Rule 45 of the Rules of Court.
De Castro’s procedural objection has no
merit. A question of law is involved when
a doubt or controversy exists on what the law is or how it applies to a given
set of facts; a question of fact exists when the doubt or difference arises on
the truth or falsehood of given facts, or on the existence or non-existence of claimed
facts.[24]
In this case, the set of facts on which
the CA decision is anchored is largely undisputed. De Castro experienced chest pains while on
duty; he was medically examined and diagnosed to be afflicted with CAD and
hypertensive cardiovascular disease. For
this reason, he was separated from the service and given a certificate of disability. The findings and evaluation of the military
physicians, while indicating that De Castro smoked and drank, showed a work
connection with De Castro's ailments.
These findings were affirmed by the AFP's DSB.[25] The GSIS and the ECC refused to be bound by
the findings of the military physicians, invoking in this regard their
exclusive jurisdiction over employees’ compensation cases. They ruled out compensation for De Castro on
the ground that his ailments were not work-related because of De Castro’s
drinking and smoking; the CA held otherwise.
The issue before us is whether, under our
present laws and jurisprudence, the conclusions of the CA on compensability are
correct, based on the facts before it.
In other words, the facts of the case are given and laid out; our task
is to determine the validity of the conclusions drawn from the given facts from
the point of view of compensability. This task involves a determination of a
question of law and is appropriate for a petition under Rule 45 of the Rules of
Court.
We find no merit in the petition.
Other than the
given facts, another undisputed aspect of the case is the status of the
ailments that precipitated De Castro’s separation from the military service – CAD
and hypertensive cardiovascular disease.
These are occupational diseases.[26] No less than the ECC itself confirmed the
status of these ailments when it declared that “Contrary to the ruling of the System, CAD is a form of cardiovascular
disease which is included in the list of Occupational Diseases.”[27] Essential hypertension is also listed under
Item 29 in Annex “A” of the Amended ECC Rules as an occupational disease.
Despite the compensable character of
his ailments, both the GSIS and the ECC found De Castro’s CAD to be non-work
related and, therefore, non-compensable.
To use the wording of the ECC decision, it denied De Castro’s claim “due to the presence of factors which are
not work-related, such as smoking and alcohol consumption.”[28] De Castro’s own
military records triggered this conclusion as his Admitting Notes,[29]
made when he entered the V. Luna General Hospital due to chest pains and
hypertension, were that he was a smoker and a drinker.
As the CA did, we cannot accept the
validity of this conclusion at face value because it considers only one side –
the purely medical side – of De Castro’s case and even then may not be
completely correct. The ECC itself, in
its decision,[30]
recites that CAD is caused, among others, by atherosclerosis of the coronary
arteries that in turn, and lists the following major causes: increasing age; male gender; cigarette smoking; lipid
disorder due to accumulation of too much fats in the body; hypertension or high
blood pressure; insulin resistance due to diabetes; family history of CAD. The minor factors are: obesity; physical
inactivity; stress; menopausal estrogen deficiency; high carbohydrate intake;
and alcohol.
We find it strange that both the ECC and
the GSIS singled out the presence of smoking and drinking as the factors that
rendered De Castro’s ailments, otherwise listed as occupational, to be non-compensable. To be sure, the causes of CAD and
hypertension that the ECC listed and explained in its decision cannot be
denied; smoking and drinking are undeniably among these causes. However, they are not the sole causes of
CAD and hypertension and, at least, not under the circumstances of the present
case. For this reason, we fear for the implication
of the ECC ruling if it will prevail and be read as definitive on the effects
of smoking and drinking on compensability issues, even on diseases that are
listed as occupational in character. The ruling raises the possible reading
that smoking and drinking, by themselves, are factors that can bar compensability.
We ask the question of whether these
factors can be sole determinants of compensability as the ECC has apparently
failed to consider other factors such as age and gender from among those that
the ECC itself listed as major and minor causes of atherosclerosis and,
ultimately, of CAD. While age and gender
are characteristics inherent in the person (and thereby may be considered
non-work related factors), they also do affect a worker’s job performance and
may in this sense, together with stresses of the job, significantly contribute
to illnesses such as CAD and hypertension.
To cite an example, some workplace activities are appropriate only for
the young (such as the lifting of heavy objects although these may simply be
office files), and when repeatedly undertaken by older workers, may lead to
ailments and disability. Thus, age
coupled with an age-affected work activity may lead to compensability. From
this perspective, none of the ECC’s listed factors should be disregarded to the
exclusion of others in determining compensability.
In any determination of compensability, the
nature and characteristics of the job are as important as raw medical findings
and a claimant’s personal and social history. This is a basic legal reality in
workers’ compensation law.[31]
We are therefore surprised that the ECC
and the GSIS simply brushed aside the disability certification that the
military issued with respect to De Castro’s disability, based mainly on their
primacy as the agencies with expertise on workers’ compensation and disability
issues.
While ECC and GSIS are admittedly the
government entities with jurisdiction over the administration of workers’ disability
compensation and can thus claim primacy in these areas, they cannot however
claim infallibility, particularly when they use wrong or limited considerations
in determining compensability.
In the present case, they should at
least have considered the very same standards that they stated in their own
decisions, and should not have simply brushed aside as incorrect the basis for
disability that the AFP, as home agency, used in passing upon De Castro’s separation
from the service and discharge for disability. In saying this, we are not unmindful that neither
the GSIS nor the ECC conducted a medical examination of De Castro on their own;
they merely relied on the results of De Castro's medical examination conducted
at the V. Luna General Hospital, a government military hospital. It was from these same medical findings that
the GSIS and ECC derived their conclusion that De Castro's drinking and smoking
habits and personal lifestyle caused his ailments. We are aware, too, that De Castro’s discharge
based on disability was not the sole result of the AFP medical findings; the
medical findings were further reviewed and deliberated upon by the AFP’s DSB which
certified on the causes of De Castro’s separation from the service and his disability.
The military’s disability certification
clearly states that De Castro’s ailments were: (1) aggravated by active
service, (2) incident to service, (3) not incurred while on AWOL, (4) never
existed prior to entry to military service, (5) not due to misconduct, (6) not
incurred by private avocation and, (7) in line of duty. De Castro further stated in the course of
this case that the positions he occupied as the PAF-Non-Commissioned
Officer-in-Charge for Operational Security, Asst. First Sergeant and First
Sergeant of the 577th CS, 570th CTW stationed at Puerto
Princesa, Palawan were positions comparable to managerial positions in the
private business sector; he served as the extension of his commanding officer
in the management, administration, and supervision of the activities of his
fellow enlisted soldiers within the unit – tasks whose urgency and sensitivity
resulted in job stress. While the task
before the GSIS and the ECC was to determine compensability, not merely the
fact of disability that justifies a separation from the service, still, these
agencies should not have simply glossed over the findings of the military on
the matters they certified to, as these are the same facts that are material to
compensability. The health of De Castro
upon entry into the service and how his work affected his health are very
relevant facts that should not have been disregarded in favor of singled out
facts that the GSIS and the ECC considered as conclusive indicators of incompensability.
The ECC and the GSIS, in short, did not
seriously look at all the relevant factors determinative of compensability and
thereby decided De Castro’s case based on
incomplete, if not wrong, considerations.
This is a reversible error that requires rectification.
In contrast, the assailed CA ruling was
sensitive to all these concerns and found reasonable work connection between De
Castro’s ailments and his duties as a soldier for 32 years without at all disregarding
De Castro’s drinking and smoking habits that could have contributed to his
afflictions. On the latter concerns, we
quote with approval the following CA observations:
Intoxication
which does not incapacitate the employee from following his occupation is not
sufficient to defeat the recovery of compensation, although intoxication may be
a contributory cause to his injury.
While smoking may contribute to the development of a heart ailment,
heart ailment may be cause by other factors such as working and living under
stressful conditions. Thus, the
peremptory presumption that petitioner’s habit of smoking heavily was the
wilfull act which causes his illness and resulting disability, without more,
cannot suffice to bar petitioner’s claim for disability benefits.[32]
We consider it significant that De
Castro entered military service as a fit and healthy new soldier. We note, too,
De Castro’s service record and the medals, awards, and commendations he earned,[33]
all attesting to 32 years of very active and productive service in the
military. Thus, the CAD and the hypertension came while he was engaged in these
endeavors. To say, as the GSIS and the ECC did, that his ailments are
conclusively non-work related because he smoked and drank, is to close our eyes
to the rigors of military service and to the demands of De Castro’s specific
positions in the military service, and to single out factors that would deny
the respondent’s claim. This is far from the balancing that the GSIS
invokes between sympathy for the workingman and the equally vital interest of
denying underserving claims.[34] Thus, based on
the totality of the circumstances surrounding De Castro’s case, we are
convinced that his long years of military service, with its attendant stresses
and pressures, contributed in no small measure to the ailments that led to his
disability retirement. We, therefore, agree
with the CA when it concluded that De Castro's “illness was contracted
during and by reason of his employment, and any non-work related factor that
contributed to its aggravation is immaterial.”
We close by reiterating that what the
law requires is a reasonable work connection and not direct causal relation.[35]
Probability, not the ultimate degree of certainty, is the test of proof in
compensation proceedings.[36] For, in interpreting and carrying out the
provisions of the Labor Code and its Implementing Rules and
Regulations, the primordial and paramount consideration is the employee's
welfare. To safeguard the worker's
rights, any doubt on the proper interpretation and application must be resolved
in favor of labor.[37]
We reiterate these same principles in
the present case. Accordingly, we hold
that De Castro's ailments – CAD and hypertensive cardiovascular disease – are
work-connected under the circumstances of the present case and are, therefore,
compensable.
WHEREFORE, premises considered,
the petition for review on certiorari filed by the Government Service
Insurance System (GSIS) is hereby DENIED for lack of merit. The challenged decision and resolution of the
Court of Appeals in CA-G.R. SP No. 100375 are hereby AFFIRMED.
SO ORDERED.
ARTURO D. BRION
Associate
Justice
WE CONCUR:
LEONARDO
A. QUISUMBING
Associate Justice Chairperson |
|
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CONCHITA CARPIO-MORALES Associate
Justice |
MINITA V.
CHICO-NAZARIO Associate Justice |
TERESITA J.
LEONARDO-DE CASTRO
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
CERTIFICATION
REYNATO
S. PUNO
Chief
Justice
* Designated additional Member of the Second Division
effective
** Designated additional Member of the
Second Division effective
[1] Rollo, pp. 3-27; filed under Rule 45 of the Rules of Court.
[2] Id., pp. 33-52; promulgated on July 16, 2008, penned by Associate Justice Celia C. Librea-Leagogo, and concurred in by Associate Justice Mario L. Guariña IV (retired) and Associate Justice Ricardo R. Rosario.
[3]
[4] Rollo, p. 129.
[5]
[6]
[7]
G.R. No. 142392,
[8] Supra.
[9] Section 1(5), Rule III, Amended ECC Rules.
[10]
G.R. No. 166556,
[11] Supra note 2.
[12] Supra note 10.
[13] Supra note 5.
[14]
G.R. No. 128523,
[15]
[16] Rollo, pp. 22-23.
[17]
[18] Nos. 18 & 29, respectively.
[19] Supra note 8.
[20] Supra note 11.
[21] Supra note 5.
[22] Section 1, Rule 2, Rules of Procedure for the Filing and Disposition of Employees’ Compensation Claims.
[23] Rule 45, Section 1.
[24] Estate
of Encarnacion vda. De Panlilio, et al. v. Gonzalo Dizon, et al., G.R. No.
148777 and Reynaldo Villanueva, et al. v. Court of Appeals, G.R. No.
157598, October 18, 2007, 536 SCRA 565; see also Pilar Dev. Corp. v. IAC, et
al., G.R. No. L-72283,
[25] Supra
note 5.
[26] Supra note 19.
[27] Rollo, p. 58.
[28] Supra note 7.
[29] Rollo,
p. 101.
[30] Supra
note 6.
[31] Narazo
v. Employees Compensation Commission, G.R. No. 80157,
[32] Rollo,
p. 49.
[33]
[34]
[35] Supra note 11.
[36]
Government Service Insurance
System v. Cuanang, G.R. No. 158846,
[37]
Quizon v. Employees' Compensation Commission, G.R. No. 87590,