SANTIAGO VICENTE, PETITIONER, VS. WORKMEN’S COMPENSATION COMMISSION AND GONZALO PUYAT & SONS, INC., RESPONDENTS.

Petitioner Santiago Vicente had
been in the employ of respondent as plant mechanic since July, 1952, with a
monthly salary of P150.00. On March 30, 1957, while he was in the performance
of his duties, going up a ladder to clean a boiler gauge, he fell, his chest
and the back of his head hitting a cement wall. He became unconcious
immediately after the fall, but regained the same, after an hour or so, and
continued to work. At the end of two weeks after the said fall, or on April
29, 1957, he informed the respondent, thru Manager Gonzalo Puyat, that he was
not feeling well. He exhibited some loss of memory; he could not work normally
because he could not remember what he was going to do with the work. Mr. Puyat
recommended him to Dr. Limson of the Philippine General Hospital (PGH), for
treatment. From April 29, 1957, he was confined at the PGH, until
August 1, 1957. Petitioner’s illness was diagnosed as cerebral
vascular disease, atherosclerotic with infraction and focal cerebralotrophy
Exh. B, Annex C of petition. From May 9 to May 13, 1958, petitioner was again
hospitalized, as his illness grew progressively worse and was then diagnosed as
“cerebral atrophy with encephalopathy probably secondary to cerebral
arterios clerosis”. He was still having purposeless movements on the right
lower extremity, amnesic of past events and could recall only the immediate
past.

During the period of confinement,
petitioner filed a claim for compensation (Form No. 1), under Act No. 3428, as
amended (R03-WC Case No, 298), with the Regional Office No. 3, of the
Department of Labor, for the injury and consequent disability, resulting from
the accident met on March 30, 1957. On October 31, 1957, respondent company
filed its Employer’s Report of Accident or Sickness (Form No. 3), claiming that
it did not have knowledge of the injury or the accident.

The hearing Officer rendered
judgment, the pertinent portions of which recite—

“When Mr. Santiago Vicente
suffered the fall in March 30, 1957 while working’ in the respondent’s shop he
already had the ‘cerebral arteriosclerosis’. And since, according to Dr.
Apostol, this disease was due to the hardening of the brain arteries which
is the manifestation of the aging process, it could not therefore be held
traceable to the fall. Claimant merely imagined that his present loss of memory
and involuntary movements of extremities was directly caused by his fall in
March 30, 1957, when all the time the cause of such sickness existed even
before the accident. Even Dr. Ceasar Catindig presented by claimant as his
witness who was consulted by Mr. Vicente in November, 1958, agreed with Dr.
Apostol that claimant’s arteriosclerosis was a part of the aging process.

Premises considered we find that
the illness on which the claim is based and resulting disability was not
directly traceable to the fall which hit the claimant’s head in March 30, 1957
while in the course of his employment. The cerebral arteriosclerosis was
part of the aging process and existed as early as January, 1957—long
before the accident. The loss of brain substance and hardening of the brain
arteries had no casual relation whatsoever with the accident that befell the
claimant.

“Wherefore, we regret to have
to decree the dismissal of the instant claim for Insufficiency of evidence to
support the issuance of an award. Without costs.”

On August 5, 1960, the Commissioner
of the WCC affirmed the decision of the hearing officer, stating among others,
the following—

“In this case, the claimant
was able not only to continue his work after his accidental fall without any
ill effects whatsoever, but also for so many days thereafter. He allegedly
exhibited loss of memory only after the lapse of more than two weeks after the
accident. Consequently, we are impelled to conclude that the manifestations of
the illness of the claimant which disabled him for labor was the result of
the natural progress of his cerebral arteriosclerosis and not due to any
aggravation caused by his accidental fall.”

Petitioner moved for a
reconsideration of the above decision and prayed that claimant be allowed to:

1.     

Present additional
evidence to show that his disease or ailment was aggravated by the accident;

2.     

That a joint
examination he conducted on the claimant by an expert, designated by the
parties; and

3.     

The motion for reconsideration
be set for argument for a more vivid ventilation of the issues.

On February 21, 1960, the WCC, en
bane, denied the motion for reconsideration, neither did it allow petitioner to
present additional evidence or to hold a joint examination of claimant.

The case is now before this Court
on a Petition to Review on Certiorari, claimant raising four (4) issues, which
may be summed up into the single proposition of whether or not the Alleged
pre-existing illness of petitioner of cerebral vascular disease, atheroclerotie
with infraction and focal cerebrolotrophy (hardening of the cerebral arteries),
was aggravated by the accident in question.

The Commission, in refusing to
award compensation to petitioner relied mainly on the findings of the PGH that
the principal complaint of petitioner when admitted at the Hospital on April
29, 1957, was “Uncontrollable movements of the right lower extremity”
which allegedly started four (4) months before his admission, or in January
1957. The Commission concluded that disability which manifested itself and
prevented petitioner from performing his work, was independent from the
accident; rather it was the natural progress of his illness of cerebral
arteriosclerosis. Upon the other hand, petitioner contends that his illness
and subsequent disability were the direct result of the accident and/or aggravated
by it and that the conclusions of the Commission are not supported by the
evidence on record.

The Workmen’s Compensation Act,
among others, provide—

“Sec. 2, Grounds for
Compensation. —When an employee suffers personal injury from any
accident arising out of and in the course of his employment, or contracts
tuberculosis or other illness directly caused by such employment, or either
aggravated by or the result of the nature of such employment, his employer
shall pay compensation * * *.”

The findings of the
Commission seem conclusive to the effect that on March 30, 1957, the petitioner
while in the act of going up the ladder to clean a boiler gauge of
respondent’s machine, fell therefrom, causing his chest and back of his head to
strike the cement wall. Respondent and the Commission asserted that there was
no injury, basing such conclusion on the fact that immediately after the fall
(an hour or so after), the petitioner continued to work and it was only until
after two weeks that he complained to the management. The conclusion seem to be
off tangent to the testimonial evidence presented during the hearing, and to
the very nature of things. When claimant-petitioner was confined at the PGH for
the second time (May 9, 1958 to May 13, 1958), the illness was found to be
“cerebral atrophy with encephalopathy probably secondary to cerebral
arteriosclerosis.” Dr. Apostol, explaining the cause or causes of the
illness, testified—

“Q—	style=’font-size:9.5pt;font-family:Verdana’>Such disease of encephalopathy would be due to numerous causes you mentioned before? (encephalopathy—any degenerative disease of the brain).
A—	style=’font-size:9.5pt;font-family:Verdana’>Yes, sir. style=’font-size:9.5pt;font-family:Verdana’>* * *.
Q—	style=’font-size:9.5pt;font-family:Verdana’>So that it is possible that an injury could have caused also this encephalopathy?
A—	style=’font-size:9.5pt;font-family:Verdana’>Yes, sir. It is possible.
	style=’font-size:9.5pt;font-family:Verdana’>What kind of injury?
	style=’font-size:9.5pt;font-family:Verdana’>Quite severe injury.
Q—	style=’font-size:9.5pt;font-family:Verdana’>Traumatic injury is what?
A—	style=’font-size:9.5pt;font-family:Verdana’>As a result of a fall or drop (force effort).
Q—	style=’font-size:9.5pt;font-family:Verdana’>So a traumatic injury could have caused encephalopathy?
A—	style=’font-size:9.5pt;font-family:Verdana’>Yes, sir. Force exerted on the skull or on the Head, (tsn. pp. 31-32, Nov. as, 1958).

Dr. Catindig, Chief Ncurosurgery
Department, V. Luna General Hospital, said—

“Q—	style=’font-size:9.5pt;font-family:Verdana’>According to D11. Apostol, his ailment Is also identified as encephalopathy. Now, my question is, what bearing has that finding to the ailment suffered by Mr. Santiago Vicente?
A—	style=’font-size:9.5pt;font-family:Verdana’>Cerebral atrophy with encephalopathy can he brought about by cerebral arteriosclerosis and it can also be brought about by head injury” (tsn. pp. 16-17, July 17, 1959).

Both Doctors Apostol and Catindig,
shared the opinion that the illness manifested by petitioner was quite abnormal
for his age. Thus, it was declared—

“Q—	style=’font-size:9.5pt;font-family:Verdana’>Now, he also testified that such ailment or manifestation is quite abnormal for Ms age. Do you agree with Dr. Apostol?
A—	style=’font-size:9.5pt;font-family:Verdana’>I really examined him mid he is rather young for this ailment, this arises from 56 to 60 years, and above.” (Testimony of Dr. Catinding, tsn. p. 10, July 17, 1959).

Dr. Apostol, on the same point,
gave a clear answer in stating—

“Q—	So you mean to say then Doctor, that the hardening of the arteries manifested by Mr. Santiago Vicente wits a normal or abnormal change?
A—	Abnormal.
Q—	When you say abnormal, what do you mean to say? Do you mean to say that person of his age would have suffered such degree of arteriosclerosis under normal circumstances?
A—	Yes, sir.” (ten. p. 24, Nov. 28, 1958).

And it has been said:

“* * * Nevertheless, in the
presence of arteriosclerosis, each trivial injury, even a severe strain,
may have serious results * *.” (Reed and Emerson, op. cited, p. 99).

The above testimonies and authority
bring to the fore, the probability that the encephalopathy suffered by
petitioner was the necessary result of the accident or that same accident
was the cause of the aggravation of the arterios clerosis which in turn
developed into encephalopathy. It can be concluded that had petitioner not
met the accident, be could not have suffered the arteriosclerosis of such
degree, which is abnormal to a person of his age, such disease “being very
rare in the young (like petitioner who was 48 at the time of accident), and
common to those over 50 years (Textbook of Medicine, Cevil and Loeb, 1254).

Respondent WCC pointed out that the
arteriosclerosis of petitioner was already in existence before the accident,
and it could be independent to the accident. Granting the same to be true,
still the WCC erred in not awarding compensation. The pre-existence of an
illness is not a ground for disallowance.

“Where a claimant’s chair fell
when he leaned back too far and mental confusion resulted from striking his
head when he fell it was held on conflicting medical testimony that the
disability was due to an aggravation of a pre-existing cerebral
arteriosclerosis and an award of compensation was sustained.” (Oklahoma
Ry. Co. vs. Voss, 187, Okl. 622, 105 p. (2) 218 (1940), cited in Schneider
Textbook on Workmen’s Compensation. Vol. 4, p. 84).

“* * * by reason of an accidental
injury, an employee’s dormant condition of arteriosclerosis was caused to
flare up. It was held that he was entitled to full compensation
notwithstanding the fact that tit the course of time, the disease itself would
have caused a complete disability.” (Gillespie vs. Vermont Hosiery
& Machine Co. et al., cited in supra, p.486).

The fact that the acceleration of
the disease and its development to encephalopathy took place after the
accident, shows, a connection between the accident and the acceleration.

“Where a workman suffering from, chronic
arteriosclerosis, while engaged in the performance of his duties, was
frightened by an explosion and jumped from a ladder injuring himself and
thereby accelerated his condition, he suffered a compensable injury.”
(North western Refining Co. vs. State Industrial Commission, 291, p. 533, 145
Okl. 72).

“Where a, man in an advanced
stage of arteriosclerosis wag struck on the head by a. basketball which
ruptured a blood vessel the evidence was held to sustain a finding that the
injury received at the time of the accident caused his death.” (Milwaukee
vs. Industrial Commission, 151 N.W. 247, 160 Wis. 238).

“Where 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 nature of the claimants work, to the extent of
disability and being laid from work, is compensable.” (Blue Bar Coconut
Co., et al. vs. Boo, G.R. No. L-8920, Sept. 28, 1954) also (Banyero vs.
Atlantic Gulf & Pacific Co., G.R. No. L-12093, cited in Workmen’s
Compensation Law by Morabe & Inton, p. 111).

The Commission, in trying to
disassociate the accident from the illness and subsequent disability, expressed
the opinion that immediately after the fall there were no outward
manifestations that an injury was suffered, This may be true, but whether the
effects of the accident were immediately manifest did not preclude the presence
of internal injury.

“* * *, if it can be shown that the
cerebral hemmorhage followed an injury to the head or an unusual strain,
aggravation of the pre-existing condition should be recognized.” (H.H.
Kesler on Accidental Injuries, 584-870.

“How long a time between the
accident and the Illness and yet the illness be the result of the accident? No
time can be arbitrarily sot down. Many persons who at first suffer a little,
later develop very serious symptoms. If it be shown that, notwithstanding
the existence of arteriosclerosis, the man was in good condition, and that
dating from the accident mental and physical decay began, it is reasonable to
suppose that the injury was the exciting cause,” (Osler & McCrae,
Modern Medicines Its Theory and Practice, p. 649).

Indeed, there was no visible lesion
shown on the petitioner’s anatomy. But here is a person who had been sound and
healthy, for five (5) years during his employment with respondent company; and
soon after his severe fall, he was already suffering from an illness
which crippled him for work. Even a severe strain may have serious results.
There was the smoke, there must have been a fire; the effect itself, showed the
cause; the occurrence told its own tale.

The petitioner’s claim should be
upheld, not only because the presumption of compensability was not destroyed by
respondent company’s evidence, but also because the Workmen’s Compensation Act
is a social legislation designed to give relief to the workman who has been the
victim of an accident in the pursuit of his employment and must be liberally
construed, to attain the purpose for which it has been enacted (Eneria vs.
Atlantic Gulf & Pacific Co., of Manila, 38 Off. Gaz., Sept. 15, 1951).

Having reached the above
conclusion, it is not deemed necessary to pass upon other issues raised in the
appeal.

In view hereof, the decision of the Workmen’s
Compensation Commission, dismissing petitioner’s claim for compensation for
alleged insufficiency of evidence, is hereby reserved, and another entered,
ordering respondent Gonzalo Puyat & Sons, Inc., to pay petitioner such
compensation as the law provides after a computation thereof shall have been
made by the respondent Commission. With costs against respondent company.

Bengzon, C.J., Padilla, Bautista Angelo, Concepcion, Reyes, J,B.L., Barrera, Dizon, Regala and Makalintal, JJ., concur.