Republic of the Philippines

SUPREME COURT
Manila

SECOND DIVISION

G.R. No. L-56259 March 18, 1983

SYLVIA F. PANANGUI and OLIVIA F. PANANGUI, Minors, represented by ALBERTHA FERRER,

petitioners,
vs.
THE EMPLOYEES' COMPENSATION COMMISSION and THE GOVERNMENT SERVICE INSURAN
SYSTEM, respondents.

Fajardo, Lagunzad & Santiago for petitioners.

The Solicitor General for respondents.

MAKASIAR, J.:

This petition seeks the reversal of the December 11, 1980 decision of the Employees' Compensation
Commission in ECC Case No. 1107 affirming the decision on the Government Service Insurance Syste
denying the claim for death benefits under P.D. No. 626, as amended (pp. 5 & 16, rec.; p. 34, ECC rec

Petitioner Albertha V. Ferrer who represents the minors Sylvia and Olivia Panaqui is the sister of Lilia F
Panangui who died on September 8, 1976 of acute congestive heart failure, rheumatic heart disease c
with seven-month pregnancy, premature labor, bon leakage (pp. 13 & 15, rec. pp. 3 & 21, ECC rec.).

The records disclose that petitioner's late sister joined the government service on April 2, 1965 as cleri
(emergency status) in the Philippine Constabulary, Office of the Judge Advocate (p. 5, rec.; p. 4, ECC
the time of her death, decedent was already a clerk in the aforenamed office assuming a permanent st
July 9, 1971 (p. 4, ECC rec.). The attending physician's certification reveals that decedent suffered from
rheumatic heart disease which she contracted in 1967 (p. 13, rec.; p. 21, ECC rec.).

It appears that sometime in August, 1976 or about a month before her death on September 8, 1976 an
she was in her seventh month of pregnancy, the deceased was confined at the Constabulary Hospital
Crame for three days for "threatened miscarriage." She reported back for work after such confinement.
evening of September 7, 1976, she complained of severe abdominal pains accompanied by bloody vag
discharge. She was brought by petitioner to the V. Luna Medical Center where, in spite of emergency t
she died of acute congestive heart failure and rheumatic disease (pp, 5 & 72, rec.; p. 3, ECC rec.).

On October 22, 1976, petitioner filed on behalf of decedent's two minor children, her claim with the GS
death benefits under P.D. No. 626, as amended. Said claim was denied on November 2, 1976 (pp. 11
pp. 22 & 6, ECC rec.

Petitioner requested for reconsideration of aforesaid denial on August 2, 1977 (p. 15, rec.; p. 7, ECC re
letter of August 3, 1977, the GSIS upheld its previous denial of the claim (p. 9, ECC rec.),

On July 21, 1978, petitioner filed with the Ministry of Labor her second appeal for reconsideration (p. 1
rec.). In its letter of August 4, 1978, the GSIS again denied reconsideration of its previous action and e
the records of this claim to the Employees' Compensation Commission for review (p. 15, ECC rec.).

Respondent Commission, in its decision dated December 11, 1980, affirmed the denial of the claim by
The Commission thus ruled:

In the instant case, it is clear that the predisposing factors responsible for the dece
death could not be ascribed to her employment as it was her troubled pregnancy w
resulted in various complications, which caused her death. The records showed th
decedent had been on sick leave due to her abnormal pregnancy, and was on bed
the time she suffered severe abdominal pain and bloody vaginal discharge. ...

Appellant's claim that the decedent's cause of death was employment- connected
therefore conjectural and bereft of medical or legal basis. No evidence could subs
that the decedent's employment as clerk played a role in the decedent's death. As
pointed out by the respondent System, the decedent's pregnancy, rather than the
her work precipitated her heart failure. ...

Much as we commiserate with the appellant for the premature demise of her belov
we cannot reverse the decision of the respondent System as the evidence on reco
disclose that the decedent's death due to congestive heart failure was principally c
her pregnancy and not by reason of her employment (p. 16, rec.; p. 34, ECC rec.).

Hence, this petition.

Petitioner contends that her sister was then healthy and used to be a track and field athlete during her
youth, particularly in her high school and college days (p. 20, ECC rec.) and that decedent has had rhe
heart disease since 1967. Petitioner specifically alleges:

As stated in the attending physician's certification (Annex B), the decedent has rhe
heart disease since 1967. However, the records show that since the time of her
employment, she was never confined of any critical ailment, much more of a heart
except her latest confinement in 1976 which caused her death. It was also duly pro
the decedent had three (3) normal deliveries in full term before her fourth pregnan

In alleging compensability of this claim under the Workmen's Compensation Act, petitioner relies on Ou
ruling in the Marta Avendano case (L-48593, April 30, 1980, 97 SCRA 464) that rights accrued and ves
a statute is in force survive its repeal. Likewise, she anchors her claim for death benefits on Our prono
in the Corales case (L- 44063, Feb. 27, 1979, 88 SCRA 547) that rights accrued and vested while a sta
in force ordinarily survive its repeal.

Respondent Commission, thru the Solicitor General, maintains, however, that "the cause of decedent's
chronic congestive heart failure and rheumatic heart disease complicated by her pregnancy, had nothin
with her employment as clerk in the office of the Constabulary Judge Advocate and, therefore, does no
within the compensable coverage of the law" (pp. 34 & 75, rec.); that the illness which caused Mrs. Pan
death is not an occupational disease (pp. 35 & 76, rec.); that decedent's death was due to troubled or a
pregnancy which caused complications like congestive heart failure and rheumatic heart disease (pp. 3
rec.); and that since said illness which caused her death occurred when P.D. No. 626 was already in e
provisions should be applied and not the old Workmen's Compensation Act (pp. 38 & 80, rec.).

WE find petitioner's claim meritorious.

As We have consistently and even persistently stated before in numerous cases, We have always view
treated compensation claims on a much broader perspective and have always resolved such claims on
of the fundamental and well-entrenched Constitutional precepts of social justice and protection to labor

If only to emphasize Our position on the matter, We find it indispensable to present the harsh realities o
prevailing conditions. Thus, it is now judicially acknowledged that labor in the private agricultural, indus
service sectors of the economy, as well as in the government service, together with their families form
majority of our 50 million population. Also, it has long been recognized that labor, on confrontation with
management is at once at a disadvantage for it is management which dictates the levels of income and
benefits due to labor. For this reason, Section 9, Article II of the New Constitution declares as a matter
principle that the State shall afford protection to labor and guarantee the rights of workers to just and h
conditions of work. To implement this principle, the State enacted and revised the Labor Code and re-o
social legislations like the GSIS law for government workers, the SSS for private workers, the Medicare
Employees' Compensation Compensation and State Insurance Fund and other similar laws in order to
and counter-balance the disadvantageous status of labor before management.

WE are well aware that any kind of work or labor produces stresses and strains which normally result i
and tear of the human body. It should thus be noted that workers or employees struggle daily to board
overloaded public transportation vehicles in going to work and in coming home. And if they reside in th
they travel long distances which usually take an hour or so. In many cases, they have to take two or th
These, alone, produce a great deal of physical strain and tension caused by the fear of tardiness and t
resulting disciplinary measure, plus the anxiety for their personal safety along the way. Workers and em
go through the ordeal of the so-called " rush hour. " For those who are healthy, it is deleterious to their
those who have ailments and weak resistance, it aggravates their illness and such ordeal exposes them
contraction of diseases. With the "rush hour" problem plus the atmospheric pollution, the heat and rain
discomfort in public transportation particularly in overloaded buses, one can really imagine the tediousn
suffered by the ordinary worker.

Then, too, while at work, the worker or employee experiences more stresses in an effort to produce the
quantity and quality of work, in meeting deadlines and worrying over his job security, the prospects of g
and higher income or worries generated by reprimands, admonitions or reminders from superiors for m
oversights in the performance of his duties.

Taking all of the foregoing into consideration, We find it necessary here and now to reiterate Our traditi
that compensation claims should be liberally interpreted in favor of labor.

In the instant case, decedent, who was a former athlete, joined the service as a strong and healthy per
April 2, 1965. She contracted rheumatic heart disease in 1967. She underwent treatment for the said h
ailment from 1970 but the same progressively worsened. She finally succumbed to acute congestive h
failure, rheumatic heart disease and troubled pregnancy.

From the report of findings by the ECC medical officer (p. 28, ECC rec.) the following definition should
crucial:

Congestive heart failure is a clinical syndrome which develops eventually in 50-60

patients with organic cardiovascular disease. It is defined as the clinical state resu
inability of the heart to expel sufficient blood for the metabolic demands of the bod
failure may therefore be present when cardiac output is high, normal or low, regard
the absolute level, the cardiac output is reduced relative to metabolic demands. Th
common underlying causes of cardiac insufficiency are hypertension, coronary
atherosclerosis, rheumatic heart disease (valvular diseases), congenital heart dise
syphilitic aortic insufficiency, calcific aortic stenosis, cardiomyopathies and bacteri
endocarditis. Numerous arteriovenous fistula, myocarditis, beriberi, and myocardia
involvement by tumors or granulomas. In 50% of cases there are demonstrable pr
diseases or factors. The commonest of these are arrhythmias, respiratory infection
myocardial infarction, pulmonary embolism, rheumatic carditis excessive or rapid
administration of parenteral fluids, pregnancy, thyrotoxicosis, anemia, and excess
intake (Emphasis supplied).

Rheumatic heart disease is a disease resulting from rheumatic fever, marked by inflammation and disf
of the heart valves. The heart valves are flap-like structures which like one-way doors, stand in the ope
between the chambers of the heart. Their function is to allow the passage of blood only forward. Howe
deformed by disease, they no longer form a perfect fit for the openings, and blood flows backward as w
forward during the contraction of the heart. The amount of blood which flows backward is lost to the for
stream. The heart must, therefore, work much harder to supply the body with the normal amount of blo
in turn, leads to other complications (p. 689, Schmidt's Attorney's Dictionary of Medicine, 1965 Ed.).

It must be noted that decedent was found physically and mentally fit for employment as of April 2, 1965
she first entered the service. This fact is borne out by the medical records as certified to by Medical Of
Col. Jovellanos of the Philippine Constabulary Medical Company (p. 11, ECC rec.). She initially worked
clerical aide on April 2, 1965 (per service record, p. 4, ECC rec.). During her employment for more than
(11) years, decedent was assigned in and serviced two divisions of the Philippine Constabulary. As su
took charge of the filing of various documents, papers, laws, directives, circulars and other legal mater
pertaining to military affairs; typed drafts of legal opinions and finalized the same relative to death and
claims of PC personnel and other employment benefits; prepared the budget of the office; followed up
of funds and prepared the payroll of civilian employees; paid said employees after cashing the checks
corresponding to their pay; and made available treasury warrants to an officers and men every 15th an
each month. Aside from the aforesaid functions, she still rendered overtime work for more than one ye
declaration of martial law. Decedent had to cope with the increased volume of workload caused by the
increase of activities and tasks of the Philippine Constabulary (per certification of the Executive Officer
Constabulary Judge Advocate, p. 13, ECC rec.).

Evidently, therefore, decedent who was an athletic and healthy person, contracted rheumatic heart dis
in 1967 or two years after she joined the Office of the Judge Advocate Philippine Constabulary, as cler
There is no doubt that her heart ailment supervened during the course of her employment and the sam
aggravated by the working conditions then prevailing. As aforestated, she was assigned to perform num
duties in two divisions. After declaration of martial law, she was even required to render overtime work
than one year. At such point, decedent should have complained of her heart condition before her supe
and should have slowed down in her work but she did not and could not because she had to keep her
employee with a rheumatic heart, decedent was unjustly overworked. The progressive worsening of he
disease is confirmed by the medical certificate of the Commanding Colonel, MC of the PC Station Hos
pertinent portions of said certificate are thus quoted:

This is to certify that the late Mrs. Lilia F. Panangui formerly a civilian employee of
Philippine Constabulary had been my patient for numerous times since 1970. I kno
fact that she actually consulted medical officers in this hospital and was confined s
times for the same illness.

When she consulted me for the first time I diagnosed her as having valvular heart
secondary to Rheumatic Heart Disease. The disease progressively became worse
of treatment so that the latter part of 1975 and in 1976 she had Congestive Heart F
Cardiac Decompensation due to Valvular Defect secondary to Rheumatic Heart D
5, ECC rec.; Emphasis supplied).

Clearly, the cause of action thus accrued as early as 1967 when the late Lilia Panangui initially contrac
rheumatic heart disease and which imperceptively progressed and affected her fourth pregnancy and w
turn precipitated the acute congestive heart failure. Consequently, such accrual of the cause of action
reckoned as of the time when the New Labor Code had not yet taken effect.

Hence, in Corales vs. ECC, et al., supra, WE ruled:

Petitioner's claim having accrued prior to the New Labor Code, the presumption of
compensability, the principle of aggravation, the award of attorney's fees and the p
administrative fees must be observed and applied. And the Employees' Compensa
Commission as the successor of the defunct Workmen's Compensation Commiss
bound to observe and apply the foregoing principles in passing upon worker's
compensation. Moreover, as an agency of the State, the Employees' Compensatio
Commission, like the defunct Court of Industrial Relations and the Workmen's Com
Commission, is under obligation at all times to give meaning and substance to the
constitutional guarantees in favor of the workingmen, more specially the social jus
guarantee; for otherwise, these guarantees would be merely, a lot of meaningless
 (Santos vs. WCC, 75 SCRA 371 [1977]).

In re-affirmation, We declared in the recent case of Barrameda vs. ECC, et al. (L-50142, August 17, 19
SCRA 621):

The Balatero case also brought to the fore the same objection raised in the case a
the ailment of petitioner falls outside the compensable ambit of Presidential Decre
because said Decree, particularly Sec. 1, par. (c) of the Implementing Rules, cove
injury or sickness that occurred on or after January 1, 1975. WE ruled then and W
to the same ruling that the governing law in the prosecution of the cause of action
accrued prior to the effectivity of a new law shall be the law enforced at the time of
accrual of the said action. In the Balatero case, on June 1, 1974, since the Workm
Compensation Law was then in fun force and effect, then it should be the governin
based on the principle that 'rights accrued and vested' while a statute was in force
survives its appeal.

It should be recalled that Section 44 of the former compensation law clearly provided that in any proce
the enforcement of the claim for compensation, it shall be presumed, in the absence of substantial evid
the contrary, that the claim comes within its provisions. Said section unequivocally established a presu
compensability although disputable by substantial evidence. It then becomes the duty of respondent em
show that the claim does not come within the coverage.

Consequently, once the basic or jurisdictional facts are prima facie established, the statutory presumpt
into operation and work into play in favor of the claimant. The burden rests on the employer to overcom
with the degree of contrary proof required by law (Batangas Trans. Co. vs. Riviera L-7658, May 8, 195
Likewise, it must be stressed that the function of a presumption is to dispense with the need for proof.
burden to overthrow the presumption and to disconnect, by substantial evidence the injury or sickness
employment, is laid by the statute at the door of the employer (Magalona vs. WCC & NASSCO, L-2184
11, 1967, 21 SCRA 1199).

It then becomes unquestionable that once the illness supervened at the time of the employment, there
rebuttable presumption that such illness arose out of the employment or was at least aggravated by su
employment. The claimant is relieved from the burden of proving causation where the illness is shown
arisen in the course of employment (Magalona vs. WCC & NASSCO, supra, citing Justiniano vs. WCC
Nov. 21, 1966).

Thus, too, it should be borne in mind that "aggravation" as an element of compensability was incorpora
bring Our law on workmen's compensation in conformity with the American statutes and jurisprudence
recognize the compensability of illness aggravated by the nature of employment (Quiazon & Fernande
Law Series, Vol. IV, p. 40).

Hence, in the early case of Blue Bar Coconut Co., et al. vs, BOO (L-8920, Sept. 28, 1954), We ruled th
the claimant was infected prior to his engagement by the company or subsequent thereto, or during his
employment, an infection, not detected by the company or insurance physicians, if aggravated by the n
the claimant's work, is compensable. And We even went further when We held that while there is that p
that factors other than the employment of the claimant may also have contributed to the aggravation of
illness, this is not a drawback to its compensability. For, under the law, it is not required that the emplo
the sole factor in the growth, development or acceleration of claimant's illness to entitle him to the bene
provided for. It is enough that his employment had contributed, even if in a small degree, to the develo
the disease. It has been repeatedly held that under the Workmen's Compensation Law, it is not necess
claimant to carry the burden of proof to establish his case to the point of demonstration. It is sufficient t
that the hypothesis on which he bases his claim is probable (Abaña, et al. vs. Quisumbing, L-23489, M
1968, citing MRR vs. WCC, et al., 72 SCRA 260).

And in the later case of Vda. de Laron vs. WCC, et al. (L-43344, Sept. 29, 1976), We declared that the
presumption of compensability where working conditions contributed to the general weakening of bodil
of the employee and lessening of his resistance to the growth of the malignancy.

And finally, in the following recent cases, We reiterated thus:

In any case, whether his claim was based on the first illness in 1959 or the last
hospitalization in 1973, it is not disputed that his illness supervened in the course o
employment and the same was never controverted by his employer. Hence, under
Workmen's Compensation Act, petitioner is freed from the burden of proving that h
or injury was caused or aggravated by the nature of his work. In fact, the cause of
ailment is immaterial; what is important is that it occurred or was aggravated in the
employment and disabled the workman from pursuing his ordinary occupation G.B
Francisco, Inc. vs. Workmen's Compensation Commission, 87 SCRA 23, 30). The
presumption of compensability had already set in ... 'Because once an illness, sub
of a compensation claim is shown t have supervened in the course of employme
arises in favor of the claimant the rebuttable presumption that the said illness eithe
out of or at least was aggravated by, the nature of claimant's employment; and
consequently, the burden to show by substantial evidence the contrary lies with th
employer. And the ultimate result of that principle is that the presumption, rebuttab
inception, becomes conclusive upon the failure of the respondent employer to des
same' (Enriquez vs. Workmen's Compensation Commission, et al., GR No. L-4264
28, 1979)" [Cañeja vs. ECC, et al., L-46992, March 31, 1980, 96 SCRA 896, 897].

It is undisputed that the deceased contracted his ailment during his employment a
epidemiological aide of respondent employer. Accordingly, petitioners have in thei
disputable presumption that when the illness supervenes during employment, it is
presumed that the sickness either arose out of, or was at least aggravated by the
conditions of his work and is compensable. With this presumption, the burden of p
to the employer and the employee is relieved of the burden to show causation. To
employer then is shifted the burden of proof to establish compensability. In the pre
respondent employer has failed to overthrow by substantial evidence the statutory
presumption" (Villason vs. Republic of the Philippines, L-47075, April 8, 1981, 104
102).

Significantly, decedent's employer which is the Judge Advocate General, Philippine Constabulary, nev
opposed nor questioned this claim. On the contrary, said office has always been supportive of petitione
by supplying the needed information confirming the fact that decedent performed numerous duties in tw
divisions and that she had to render overtime work for more than a year. Instead of controverting this c
employer's attestation clothed it with conclusive presumption of compensability.

It must also be noted that the medical head of the Constabulary Station Hospital attested to the fact tha
decedent had been treated for valvular heart disease since 1970 and that such heart disease progress
worsened in spite of said treatment. His medical certificate, as against the medical report of responden
should be given more credence since the same was issued by the army doctor who directly and person
attended to her from 1970 to 1976. And as We have stated in the case of Marte vs. ECC, (L-46362, Ma
1980), as against the reports of petitioner's attending physician, respondent GSIS had not produced an
concrete evidence to support its allegations. It merely relied on the evaluation of its medical officer whi
based on first-hand or personal examination of petitioner.

It appears that decedent (per account of her sister-petitioner) had three previous normal childbirths des
rheumatic heart disease and her work and domestic conditions. She was obviously the breadwinner of
since her alleged husband was not around nor was he involved during the critical events leading to her
Normally, he would have directly or personally attended to his wife's hospitalization. It was the petitione
attended to her late sister. Even after her death, their children have been cared for by decedent's famil
alleged husband seemed to be unconcerned; otherwise, he should have been the proper claimant in th
may thus be suspected, even presumed, that something was wrong in their relationship. This serious d
problem added to the fact that decedent had to carry on in spite of her disabling ailment in order to sur
heavily taxed her already weakened heart. She even had to walk a kilometer to and from Camp Crame
she could save the measly fare money for her more urgent needs.

Clearly, therefore, rheumatic heart disease which decedent contracted during her employment and wh
gradually weakened her heart due to the pressure of her working conditions was the real and proximat
her death. Had it not been for such heart disease, she would have had a normal pregnancy. And pregn
women with underlying heart disease has been medically found as a precipitating cause of heart failure
quote thus:

Thyrotoxicosis and pregnancy — Like anemia, these conditions require an increas

output. The development or intensification of heart failure may actually be one of t
clinical manifestations of hyperthyroidism in a patient with underlying heart disease
Similarly, heart failure not infrequently occurs for the first time during pregnancy in
with rheumatic ualvutar disease,- in such women the condition of the heart may re
normally compensated for many years following delivery, after the excessive burde
been eliminated (p. 1117, Harrison's Principles of Internal Medicine, Seventh Ed.,
supplied).

Significantly, American courts have declared compensability of claims based on work-connected heart
resulting in death. Thus:

It is generally recognized that a heart attack of heart injury Colo.— Black Forest Fo
v. Garrett, 134 P. 2d. 332, 110 Colo. 323 such as coronary thrombosis, Idaho.-In r
 133 P. 2d 723, 64 Idaho 389 — Aranguena v. Triumph Mining Co., 126 P 2d 17, 6
769, acute dilation of the heart, Ill. — Fittro v. Industrial Commission, 37 N.E. 2d 1
532, or some other injury to the heart, such as Myocarditis, N.Y.- Seebold v. Inake
Fuel & Supply Corp. 103 N.Y. 2d 37, 278 App. Din. 730, or coronary occlusion, wh
in disability or death may be compensable as an accident or accidental injury whe
due to unusual or extraordinary conditions in the employment, or was due to over
excessive strain in performing the duties of the employment; and the test to determ
whether compensation may be awarded in such situations is whether the unusual
excessive strain precipitated the death or disability so as to bring it about at a time
would not have occurred normally. Minn. — Faholtz v. Balkan Min. Co., 0 N.W. 2d
Minn. 73.

Compensation may be awarded where the immediate precipitating cause of an em

death or disability is a heart attack due to exertion in the performance of the duties
employment even though the attack was delayed for a time and did not occur until
exertion had come to an end; Ga. — Maddox v. Buice Transfer & Storage Co., 59
329, 81 Ga. App. 503, and if the exertion or strain in the employment was sufficien
the heart attack, it is not necessary that the result of the exertion or strain that is, t
disability or death, develop at the time or scene of the employment, La. — Krasme
Jahncke Services, App., 83 So. 2d 916.

Nevertheless, where a reasonably prudent employee innocently aggravates the ha

effects of the original injury, the original cause is not interrupted but is held to acco
final result; N.J. — Hartman v. Federal Shipbuilding & Drydock Co. 78 A. 2d 846, 1
Super. 611, in fact it has been held under some of the statutes that compensation
allowed in these circumstances regardless of the employee's imprudence, Wash.
Anderson v. Industrial Ins. Commission of Washington, 199 P.747, 116 Wash. 421

Acceleration of a diseased bodily condition to the point where it constitutes a perso

by reason of strain or exertion of the employment, constitutes an injury arising out
employment. Ark.— Sturgis Bros. v. Mays, 188 S. W. 2d, 208 Ark 1017. Death or d
arises out of the employment where it results from the exertion involved in his emp
operating on his diseased or weakened condition, Ariz.—Jones v. Industrial Comm
306 P. 2d 277, 81 Ariz. 352, without regard to the degree of exertion or the conditi
employee's health, Ga.-Globe Indem. Co. v. Simonton, 76 S.E. 2d 837,88 Ga. App
S.E. 2d 83O 88 Ga. App. 648" (99 C.J.S. 184; 205-206, 212, Emphasis supplied).

Social justice commands the allowance of legitimate and just claims of government workers especially
decedent who was a lowly, exploited and struggling employee who also contributed to the GSIS funds.

IN VIEW OF THE FOREGOING, THE DECISION OF RESPONDENT EMPLOYEES' COMPENSATION

COMMISSION IS HEREBY SET ASIDE AND THE PHILIPPINES PINE CONSTABULARY IS HEREBY
DIRECTED

1. TO PAY HEREIN PETITIONER, IN REPRESENTATION OF THE TWO MINOR CHILDREN, THE S

SIX THOUSAND (P6,000.00) PESOS AS DEATH BENEFITS;

2. TO REFUND PETITIONER'S MEDICAL AND HOSPITAL EXPENSES DULY SUPPORTED BY PRO

RECEIPTS: AND

3. TO PAY PETITIONER BURIAL BENEFITS IN THE AMOUNT OF TWO HUNDRED (P200.00) PESO

SO ORDERED.

Concepcion Jr., Guerrero, Abad Santos, De Castro and Escolin JJ., concur.

Aquino, J., is on leave.

The Lawphil Project - Arellano Law Foundation

.R. No. 213279

C.F. SHARP CREW MANAGEMENT, INC., BLUE OCEAN SHIP MANAGEM

LTD., and/or WILLIAM S. MALALUAN, Petitioners
vs.
WILLIAM C. ALIVIO, Respondent

D E C I S I O N

BRION, J.:

We resolve the present petition for review on

certiorari1seeking the reversal of the January 30, 2014
decision2 and June 26, 2014 resolution3 of the Court of
Appeals in CA-G.R. SP No. 124006.

The Antecedents

On August 18, 2010, the respondent William Alivio filed a

complaint for disability benefits, reimbursement of medic
expenses, damages, and attorney's fees,4 against the
petitioners C.F. Sharp Crew Management, Inc. (agency), it
Crew Manager William Malaluan and its principal Blue Ocea
Ship Management, Ltd. The petitioners re-hired Alivio as
for nine months starting January 7, 2009 for the vessel
Phyllis N.5 He had been under successive contracts with B
Ocean since November 1991, starting as General Purpose (G
then Able Seaman (AB), until he was made bosun in 1999.

Alivio alleged that prior to boarding Blue Ocean’s vessel

(including the Phyllis N), in the course of his employmen
with the petitioners, he passed all his pre-employment me
examinations (PEMEs), although sometime in October 2006,
was diagnosed to have high blood pressure. He claimed he
prescribed medications for it. He further claimed that he
been continuously hired as bosun because of his fitness t
work.

Alivio signed off from the Phyllis N on October 3, 2009 f

"finished contract," but before he disembarked, he allege
experienced undue fatigue and weakness, with nape pains.
October 5, 2009, he consulted a Dr. Raymund Jay Sugay who
diagnosed him with hypertension. Dr. Sugay advised him to
"rest at home for one or two days to prevent further
morbidity."6

On January 8, 2010, the agency asked Alivio to undergo a

prior to a possible re-deployment. The PEME revealed that
was suffering from cardiomegaly or enlarged heart and his
electrocardiography (ECG) showed that he had left ventric
hypertrophy with strain. He was diagnosed with hypertensi
cardiovascular disease and was declared "unfit for sea du
The petitioners did not engage Alivio due to his delicate
health condition.
Alivio sought a second opinion from Hi-Precision Diagnost
which arrived at essentially the same diagnosis. He also
consulted with occupational health specialist Dr. Li-Ann
Orencia who certified that his illness is work-related,
permanent in nature, and compensable.8 He then demanded
permanent total disability compensation from the petition
but they refused, leaving him no option but to file his
present complaint.

The petitioners denied liability, contending that Alivio

not entitled to his claim because (1) his disability resu
from an illness which is not work-related and therefore n
compensable under the Philippine Overseas Employment Stan
Contract (POEA-SEC), as he acquired the illness after the
expiration of his contract with them; (2) his failure to
submit himself to a post-employment medical examination b
company doctor disqualified him from claiming disability
benefits; and (3) he is not entitled to damages and attor
fees since their denial of his claim was in good faith.

The Compulsory Arbitration Rulings

In her decision9 of February 25, 2011, Labor Arbiter (LA)

Cellan found merit in the complaint, holding that Alivio’
hypertensive cardiovascular disease developed during his
employment with the petitioners and was aggravated by his
engagement for the Phyllis N. LA Cellan further held that
Alivio’s failure to report for post-employment medical
examination to the company-designated physician did not n
his entitlement to disability compensation. She awarded h
US$60,000.00 in permanent total disability benefits, plus
attorney’s fees.

On appeal by the petitioners, the National Labor Relation

Commission (NLRC) set aside LA Cellan’s award.10 It found
Alivio was repatriated not for an illness he suffered dur
the term of his contract, but due to the expiration of th
contract. The NLRC was not convinced by his argument that
already felt symptoms of his illness onboard the vessel,
since his contract was already due to end, he opted to ju
let his engagement expire, instead of being medically
repatriated. Further, the NLRC held that Alivio’s failure
report for post-employment medical examination upon his
repatriation, as mandated by the POEA-SEC, resulted in th
forfeiture of his right to claim disability compensation.

The foregoing notwithstanding, the NLRC recognized that t

work of a seaman "is difficult to say the least and it is
unlikely that his work contributed, if it did not give ri
to, his illness."11 It therefore deemed it proper to awar
Alivio financial assistance of ₱250,000.00.

Alivio moved for reconsideration, but the NLRC denied the

motion in its resolution of January 12, 2012.12 He then s
relief from the CA through a Rule 65 petition for certior

The CA Decision

In its decision of January 30, 2014,13 the CA set aside t

NLRC ruling and reinstated LA Cellan’s award. Like LA Cel
the CA held that even if Alivio was not medically repatri
he was not precluded from claiming disability benefits fr
his employer. It stressed that he should not be blamed fo
failure to report for his post-employment medical examina
because he thought that the "discomforts" he suffered onb
the vessel were caused by his hypertension.14 Nonetheless
CA added, Alivio was able to prove that his cardio-vascul
disease was a consequence of his work as a bosun onboard
petitioners’ vessel and therefore work-related.
The Petition

With their motion for reconsideration denied by the CA, t

petitioners now seek the CA rulings’ review by this Court
contending that the appellate court seriously erred when
(1) ruled that Alivio is entitled to permanent total
disability compensation; (2) ordered the payment of attor
fees to Alivio; and (3) held that Malaluan is solidarily
liable for the award.

The petitioners submit that the NLRC committed no grave a

of discretion in ruling that Alivio’s hypertension was no
duly proved and its causation was not established. Sectio
A (11) of the POEA-SEC, they argue, considers a cardio-
vascular disease as occupational only if it was contracte
under the following conditions:

(a) If the heart disease was known to have been present d

employment, there must be proof that an acute exacerbatio
clearly precipitated by the unusual strain by reason of t
nature of his work.

(b) The strain of work that brings about an acute attack

be of sufficient severity and must be followed within 24
by the clinical signs of a cardiac insult to constitute c
relationship.

(c) If a person who was apparently asymptomatic before be

subjected to strain at work showed signs and symptoms of
cardiac injury during the performance of his work and suc
symptoms and signs persisted, it is reasonable to claim a
causal relationship.

They add that for Alivio’s hypertension to be considered

occupational disease, it must satisfy the following requi
under Section 32-A (20) of the POEA-SEC:

20. Essential Hypertension

Hypertension classified as primary or essential is consid

compensable if it causes impairment of function of body o
like kidneys, heart, eyes and brain, resulting in permane
disability; Provided, that the following documents
substantiate it: (a) chest x-ray report, (b) ECG report,
blood chemistry report, (d) funduscopy report, and (e) C-
scan.

The petitioners assert that Alivio failed to prove the wo

causation of his illness as the evidence showed that he d
not suffer any injury or illness while onboard the Phylli
The CA erred, they argue, when it declared that he suffer
from a compensable illness based on his pre-employment me
examination, conducted three months after his repatriatio
Relying on NYK-FIL Ship Management, Inc., v. NLRC,15 they
submit that the PEME could not have divulged his illness
the examination is merely exploratory.

Moreover, the CA’s reliance on "work-aggravation" in awar

disability benefits, they argue, is misplaced considering
the POEA-SEC makes the employer liable only for a "work-
related" injury or sickness. They stress that Alivio’s
hypertension and cardio-vascular disease are not work-rel
as they were obviously acquired prior to his contract of
employment and were caused by pre-existing conditions. Th
cite his medical history where it was revealed that he is
known hypertensive with blood pressure elevations even be
his deployment to the Phyllis N.

The petitioners additionally stress that Alivio disembark

from the vessel for finished contract and not for medical
reasons, which explains his failure to report to the agen
within 72 hours from disembarkation for post-employment
medical examination, a mandatory requirement under the PO
SEC.

The petitioners also dispute the award of attorney’s fees

Alivio, insisting that they acted in good faith in consid
his claim, in accordance with their contractual obligatio
him. Lastly, they maintain that Malaluan cannot be held
personally liable in the case because there was no showin
that he knowingly participated or exceeded his authority
denying Alivio’s "unwarranted claims."16

The Case for Alivio

In his October 3, 2014 Comment,17 Alivio prays for dismis

of the petition for lack of merit.

He argues that "as long as the illness is contracted duri

the employee’s employment, the employer’s obligation
subsists."18 He insists that he is entitled to full disab
benefits, despite the fact that he failed to report to th
agency for post-employment medical examination upon his
disembarkation. He considers the requirement "not absolut
it accepts of exceptions, when reason dictates, like in t
case at bar, where the seafarer does not know that he is
already disabled and seriously ill."19

He takes exception to the petitioners’ contention that hi

medical condition is not work-related, asserting that he
contracted his illness during his employment with them. H
cited the stress, limited dietary option, imposition of
staying on board the vessel after working hours, and expo
to the hazardous life at sea as among the conditions whic
gave rise to his illness. In any case, he argues, the wor
connection of his medical condition was not an issue befo
the labor tribunals and it cannot now be raised by the
petitioners.

Alivio bewails the petitioners’ refusal to grant him

attorney’s fees considering that he was compelled to liti
to protect his rights. Lastly, he submits that Malaluan i
solidarily liable for his claim since the agency is engag
the business of providing maritime manpower, and as such,
agency and its principal officer are clearly liable under
law.

The Court’s Ruling

We find merit in the petition.

First. Alivio was repatriated for "finished contract," no

medical reasons. He chose to complete his employment cont
with the petitioners instead of being medically repatriat
even as he claimed he experienced fatigue, weakness and n
pains shortly before his disembarkation on October 3, 200
Yet, he did not report his "discomforts," as the CA put i
the ship authorities for onboard examination and treatmen
necessary, or to the agency for post-employment medical
examination, as required by the POEA-SEC.

Alivio’s omission to report his health problem at the tim

could only mean that it was not serious or grave enough t
require medical attention. In fact, his physician of choi
Dr. Sugay, whom he consulted two days after he disembarke
October 3, 2009, diagnosed him to have hypertension and
required him only to rest for one to two days.20 In
Villanueva, Sr. v. Baliwag Navigacion, Inc.,21 the Court
with approval the CA conclusion that the fact that the
seafarer was repatriated for finished contract and not fo
medical reasons weakened, if not belied, his claim of ill
on board the vessel.22
Second. Alivio’s claimed cardio-vascular disease was not
related23 and therefore not compensable. Although conside
as an occupational disease, his heart ailment did not sat
the conditions under the POEA-SEC to be considered
occupational, as quoted above.24 These conditions provide
two possibilities (1) the heart disease is present during
employment and there is proof that an acute exacerbation
precipitated by the unusual strain of the seafarer’s work
was followed within 24 hours by the clinical signs of a
cardiac arrest or, (2) the seafarer, who is asymptomatic
before being subjected to the strain of work, shows signs
symptoms of cardiac injury during the performance of his
and such symptoms persist.

Nowhere in the case record does it appear that any of the

above conditions were present during the whole term of
Alivio’s previous engagements up to the last employment w
the petitioners. The evidence showed that his cardiomegal
discovered three months after he finished his last contra
with Phyllis N

In fact, Alivio could only point to two episodes that cou

considered of medical significance during his entire
employment with the petitioners.

The first one occurred sometime in 2006 when he was diagn

with high blood pressure and was advised to take prescrib
medication; despite his condition, he was found fit to wo
and had been continuously hired by the petitioners as bos

The second one happened before he disembarked from the Ph

N on October 3, 2009, when he claimed he experienced undu
fatigue, weakness with nape pains.26 But instead of repor
to the agency for medical examination, he consulted Dr. S

These two episodes, however, did not trigger Alivio’s hea

disease as on both occasions, he suffered no cardiac inju
cardiac arrest.1âwphi1 In the same Villanueva, Sr. case,
Court said: "We find no reversible error in the CA ruling
affirming the denial of Villanueva’s claim for disability
benefits. We find it undisputed that he was repatriated f
finished contract, not for medical reasons. More importan
while the 2000 POEA-Standard Employment Contract (Section
[11]) considers a heart disease as occupational, Villanue
failed to satisfy by substantial evidence the condition l
down in the Contract if the heart disease was known to ha
been present during employment, there must be proof that
acute exacerbation was clearly precipitated by the unusua
strain brought by the nature of his work."27

The circumstances leading to Alivio’s disembarkation and

shortly thereafter, lend credence to the petitioners’
submission that his medical condition was pre-existing an
could not have developed during his employment with them.
is supported by his own admission that even after being
diagnosed with hypertension in October 2009, he had been
continuously engaged as bosun because of his continuing
fitness to work.

In this light, especially the failure to satisfy the

conditions laid down under the POEA-SEC, we find that Ali
cardiomegaly, discovered three months after his repatriat
for "finished contract," is not work-related and is there
not compensable. Alivio’s argument that the work-connecti
his heart ailment is a non-issue because it was not raise
before the labor tribunals is of no moment as the POEA-SE
which governs his employment expressly provides that the
employer is liable only for a work-related injury or illn
suffered by the seafarer.28

Third. Even if we were to consider that Alivio was repatr

for health reasons, his failure to submit himself to a po
employment medical examination by a company-designated
physician within three working days upon his return milit
against his claim for disability benefits. It results in
forfeiture of his right to the benefits.29

The CA justified Alivio’s failure to report to the agency

his disembarkation with the observation that "he signed o
from the vessel due to finished contract," and that "whil
may have suffered discomforts before his contract with Ph
N ended, petitioner thought that it was just his hyperten
x x x."30 We are not convinced by the appellate court’s
justification. On the one hand, it stressed that Alivio w
repatriated for completion of his contract without raisin
medical problem with the ship management which could have
the basis of a disability compensation claim. On the othe
hand, it acknowledged the discomforts that Alivio experie
shortly before his disembarkation, clearly a medical issu
which should have been reported to the petitioners.

As we noted earlier, the reason why Alivio did not bring

discomforts to the petitioners’ attention was the fact th
they were not grave enough to require medical treatment.
was confirmed by his chosen physician, Dr. Sugay, whom he
consulted two days after his disembarkation on October 3,
and who merely required him to rest for one to two days,
following the doctor’s diagnosis that he had hypertension

In sum, we find that the CA based its rulings on the wron

legal and factual considerations and therefore effectivel
abused its discretion in reviewing the June 15, 2011 NLRC
decision. The NLRC ruling should thus stand.

WHEREFORE, premises considered, we hereby SET ASIDE the

January 30, 2014 decision and June 26, 2014 resolution of
Court of Appeals, and REINSTATE the June 15, 2011 decisio
the National Labor Relations Commission.

The complaint is DISMISSED for lack of merit.

SO ORDERED.

ARTURO D. BRION
Associate Justice

WE CONCUR:

ANTONIO T. CARPIO
Associate Justice
Chairperson

(On Official Leave)

MARIANO C. DEL CASTILLO
JOSE CATRAL MENDOZA*
Associate Justice
Associate Justice
MARVIC M.V.F. LEONEN
Associate Justice

A T T E S T A T I O N

I attest that the conclusions in the above Decision had b

reached in consultation before the case was assigned to t
writer of the opinion of the Court’s Division.

ANTONIO T.CARPIO
Associate Justice
Chairperson

C E R T I F I C A T I O N

Pursuant to the Section 13, Article VIII of the Constitut

and the Division Chairperson’s Attestation, I certify tha
conclusions in the above Decision had been reached in
consultation before the case was assigned to the writer o
opinion of the Court’s Division.

MARIA LOURDES P.A. SERENO

Chief Justice

Footnotes

*On official leave.

1 Rollo, pp. 3-31; filed pursuant to Rule 45 of t

Rules or'Court.

2 Id. at 36-52; penned by Associate Justice Romeo

Barza with Associate Justices Hakim S. Abdulwahid
Roman A. Cruz concurring.

3 Id. at 51-52.

4 Id. at 135-136.

5 Id. at 69.

6 Id. at 71.

7 Id. at 72.

8 Id. at 85; Alivio’s Reply to petitioners’ Posit

Paper, p. 3, pars. 11 & 12.

9 Id. at 138-154.

10 Id. at 209-216; June 15, 2011 Decision penned

Presiding Commissioner Benedicto R. Palacol and
concurred in by Commissioners Isabel G. Panganiba
Ortiguerra and Nieves Vivar-De Castro.

11 Id. at 215; NLRC Decision, p. 7, par. 1.

12 Id. at 242-243.

13 Supra note 2.

14 Id. at 13, par. 1.

15 503 SCRA 595 (2006).

16 Supra note 1, at 25, par. 61.

17 Rollo, pp. 268- 281.

18 Id. at 269; Comment, p. 2, par. 6, citing Itog

Suyoc Mines v. Dulay, 118 Phil. 1032, 1037 (1963)

19 Id. par. 8, citing Wallem v. NLRC and Inductiv

Phil. 738, 748 (1999).

20 Supra note 6.

21 G.R. No. 206505, July 24, 2013, 702 SCRA 311.

22 Id. at 314.

23 2002 POEA-SEC, Section 20 (B) Introductory

Paragraph: The liabilities of the employer when t
seafarer suffers work-related injury during the t
of his contract are as follows: x x x.

24 Section 32-A (11).

25 Supra note, 2, at 2, par. 3.

 26 Id., par. 4.

27 Supra note 21, at 315; underscoring supplied.

28 Supra note 23.

29 POEA-SEC, Section 20 (B) 3 which provides: "Up

sign-off from the vessel for medical treatment, t
seafarer is entitled to sickness allowance equiva
to his basic wage until he is declared fit to wor
the degree of his permanent disability has been
assessed by the company-designated physician but
case shall this period exceed one hundred twenty
days.

For this reason, the seafarer shall submit hi

to a post-employment medical examination by a
company-designated physician within three wor
days upon his return except when he is physic
incapacitated to do so, in which case, a writ
notice to the agency within the same period i
deemed as compliance. Failure of the seafarer
the seafarer to comply with the mandatory rep
requirement shall result in his forfeiture of
right to claims the above benefits.

If a doctor appointed by the seafarer disagre

with the assessment, a third doctor may be ag
jointly between the Employer and the seafarer
third doctor’s decision shall be final and bi
on both parties.

30 Supra note 2, at 13, par. 1.

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