562 Phil. 924
CHICO-NAZARIO, J.:
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 23 January 1995.
- Evaluates requests for documentation of approved bank transaction;
- Examines and checks registered documents; and
- Notarizes and reviews various bank transactions.[2]
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.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 23 August 2002, the Chief of the Claims and Loans Division of the GSIS ruled that the claim for compensation under Presidential Decree No. 1146 had already prescribed:
In view of the foregoing, this Office regrets that your claim cannot be noted upon favorably. x x x.[4]
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.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.
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.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]
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.”
The appeal is not meritorious.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.
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 January 1, 1975. Awards of compensation benefits for death or disability can now no longer be made to rest on presumption, but on a showing that the causative disease is among those listed by the ECC, with the conditions set therein satisfied, or on substantial evidence that the risk of contracting said disease is increased by the employees’ working conditions.[7]
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 31 May 2006, the Court of Appeals denied the Motion for Reconsideration filed by petitioner GSIS.
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.
- 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.
- 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]
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.
“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.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:
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]
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.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]
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]