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AN ILLNESS THAT IS AGGRAVATED BY NATURE OF WORK ALTHOUGH NOT LISTED AS OCCUPATIONAL ILLNESS MAY BE COMPENSABLE
Social Security System vs. Simacas
G.R. No. 217866, June 20, 2022
Sickness; The Labor Code defines sickness as “any illness definitely accepted as an occupational disease listed by the Commission, or any illness caused by employment subject to proof that the risk of contracting the same is increased by working conditions; Compensability; To be compensable, the Implementing Rules of Presidential Decree No. 626 states that the sickness and the resulting death “must be the result of an occupational disease listed under Annex ‘A’ of these Rules.” If the illness is a non-occupational disease, “proof must be shown that the risk of contracting the disease is increased by the working conditions; If the sickness which caused claimant’s death is not a listed occupational disease, it is incumbent upon claimant’s heirs to demonstrate that the risk of contracting prostate cancer was increased his working conditions; Quantum of proof; For a non-occupational disease to be compensable, substantial evidence must be presented to prove that the risk of contracting the illness was aggravated by the employee’s working conditions. It suffices that the evidence presented establish a reasonable work connection; It is not necessary that a direct causal relation be proven;
Facts:
Irnido L. Simacas (Irnido) worked as a Fabrication Helper at Fieldstar Manufacturing Corporation (Fieldstar) from April 1995 until February 2010 where he assisted the welder and machinist in cutting steel materials.
Two years before retiring, Imido complained of back pains and incessant coughing. He availed the services of Fieldstar’ s health care provider, Intellicare, which cleared him for work after assessment. However, In1ido’s symptoms worsened until he was no longer able to perform his job. In February 2010, he was retired from work by Fieldstar.
On February 20, 2010, Irnido was hospitalized due to back pains, cough, dysuria or painful urination, night sweating, and fever. He was diagnosed “with Benign Prostatic Hypertrophy (BHP) TIC (to consider) Prostatic Cancer and Pneumonia vs. Pulmonary Tuberculosis[.]”
At the time he was hospitalized, he had already been taking medication for Pulmonary Tuberculosis for a month and had also been diagnosed with Hepatitis A. Months later, Irnido was again admitted to the hospital due to severe chest and back pains as well as difficulty in breathing.
On July 13, 2010, Irnido died at the Philippine Orthopedic Center. His death certificate stated that the immediate cause of his death was Cardiopulmonary Arrest probably secondary to Metastatic Prostatic Adenocarcinoma.
Violeta, Irnido’s surviving spouse, filed a claim for employees’ compensation benefits.
SSS Branch Ruling:
The Social Security System Sta. Maria Branch denied the claimmon the ground that the cause of Irnido’s death was a non-occupational disease.
SSS Medical Operations Ruling:
After further evaluation, the Social Security System’s Medical Operations Department also denied Violeta’s claim ruling that prostatic adenocarcinoma or prostate cancer was not considered an occupational disease and had no causal relationship with Irnido’s job as a fabrication helper.
On May 21, 2012, the Medical Operations Department elevated the case to the Employees Compensation Commission.
Employee Compensation Commission’s (ECC) Ruling:
The ECC affirmed the denial of Violeta’ s claim.
It ruled that since prostate cancer is a non-occupational disease, Violeta was required to prove that Irnido’s work increased the risk of him contracting prostate cancer. It noted that considering the nature of
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Irnido’ s work and the etiology of prostate cancer, his work could not have contributed to the development of the disease.
It further held that no evidence was presented by Violeta to establish a causal relation between Irnido’s work and the illness which caused his death.
Aggrieved, Violeta appealed before the Court of Appeals.
CA Ruling:
The Court of Appeals reversed the Commission’s decision and ordered the Social Security System to pay Violeta’s claim for death benefits.
It stressed that Presidential Decree No. 626 is a social legislation designed to protect workers from loss of income by reason of the hazards of disability and illness. It underscored that for this purpose to be realized, the implementing authorities must adopt a liberal attitude in deciding compensability claims.
It applied Government Service Insurance System vs. Court of Appeals, and held that it was impossible for Violeta to present evidence of causal relation since the specific cause for prostate cancer is medically unknown. It decreed that given the present state of scientific knowledge, “the obligation to present such impossible evidence … must, therefore, be deemed void.
Social Security System moved for reconsideration but it was denied on April 8, 2015. Dissatisfied, Social Security System filed a Petition for Review before the Supreme Court.
Issue/s:
Whether or not an illness that is not listed is compensable
Whether or not in the case of prostate cancer present it is impossible to present evidence of causal relation since the specific cause for prostate cancer is medically unknown
Whether or not absence of medical information renders claim of work connection untenable
SC Ruling:
The SC found the petition unmeritorious.
The Labor Code defines sickness as “any illness definitely accepted as an occupational disease listed by the Commission, or any illness caused by employment subject to proof that the risk of contracting the same is increased by working conditions.” [Title II, ch. 1, att. 173(1), cited in the case of Social Security System vs. Simacas, G.R. No. 217866, June 20, 2022]
To be compensable, the Implementing Rules of Presidential Decree No. 626 states that the sickness and the resulting death “must be the result of an occupational disease listed under Annex ‘A’ of these Rules.”
If the illness is a non-occupational disease, “proof must be shown that the risk of contracting the disease is increased by the working conditions.”
Where the sickness is undisputed which caused the employee’s death is not a listed occupational disease, it is incumbent upon the employee as claimant to demonstrate that the risk of contracting prostate cancer was increased by his working conditions.
In establishing compensability, the claimant need only present substantial proof that the nature of the deceased’s work or working conditions increased the risk of them contracting prostate cancer. The degree of proof necessary was discussed in Sarmiento vs. Employees’ Compensation Commission [228 Phil. 400 (1986)].
Strict rules of evidence are not applicable in claims for compensation. There are 119 stringent criteria to follow. 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”.
The claimant must show, at least, by substantial evidence that the development of the disease is brought largely by the conditions present in the nature of the job. What the law requires is a reasonable work-connection and not a direct causal .relation. It is enough that the hypothesis on which the workmen’s claim is based is probable.
Medical opinion to the contrary can be disregarded especially where there is some basis in the facts for inferring a work-connection. Probability not certainty is the touchstone.
In the case of prostate cancer being claimed in the case of Simacas, it is not among the listed illness. Prostate cancer is characterized as a condition where “certain cells in the prostate become abnormal, multiply without control or order, and form a tumor.”
According to the Supreme Court (SC), while it is one of the leading causes of death among men, not much is known about the illness’ etiology or cause. The established risk factors for prostate cancer “are advanced age, ethnicity, genetic factors and family history.”
However, several studies have suggested that work-related exposures to certain substances, such as chromium, have the potential of affecting the risk of getting prostate cancer. A recent study “revealed a small but significant increase in prostate cancer risk for chromium exposure.”
In this case, it is undisputed that the deceased’s work included assisting the welder and machinist in cutting steel materials. It is said that “workers engaged in the manufacturing or handling stainless steel are exposed to chromium in varying degrees.” Thus, it is not unlikely that the work of the deceased employee in the Simaca case increased the risk of him contracting the disease. This probability suffices to warrant the grant of the claimed benefits.
It must be stressed that while Presidential Decree No. 626 has not incorporated “the presumption of compensability and the theory of aggravation prevalent under the ‘Workmen’s Compensation Act,” it continues to be “an employees’ compensation law or a social legislation” which should be liberally construed in favor of labor.
The SC reiterates its statement in Obra v. Social Security System as a final note, we find it necessary to reiterate that P.D. No. 626, as amended, is a social legislation whose primordial purpose is to provide meaningful protection to the working class against the hazards of disability, illness and other contingencies resulting in the loss of income.
Thus, as the official agents charged by law to implement social justice guaranteed by the Constitution, the ECC and the SSS should adopt a liberal attitude in favor of the employee in deciding claims for compensability especially where there is some basis in the facts for inferring a work connection with the illness or injury, as the case may be.
It is only this kind of interpretation that can give meaning and substance to the compassionate spirit of the
law as embodied in Article 4 of the New Labor Code which states that all doubts in the implementation and interpretation of the provisions of the Labor Code including its implementing rules and regulations should be resolved in favor of labor.
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