MARIANO R. BASA, PETITIONER, VS. WORKMEN’S COMPENSATION COMMISSION AND REPUBLIC OF THE PHILIPPINES (DEPARTMENT OF JUSTICE), RESPONDENTS.

Mariano R. Basa, retired municipal judge of Calapan,
Oriental Mindoro, seeks the review of the December
12, 1975 decision of the Workmen’s Compen­sation Commission
in WC Case No. C-958, which affirmed the October 14, 1975 order of the acting chief of Unit, Regional Office No. 5,
Department of Labor, at San
Pablo City,
denying his second claim for reimburse­ment of medical expenses incurred in
relation with his heart ailment.

On July 26, 1969,
petitioner suffered a heart attack that incapacitated him from further
performing his function as municipal judge, and which forced him on October 16, 1969 to retire from the
service.  Consequently, he filed a claim
for compensation under the Workmen’s Compensation Act, as amended and was
awarded on October 26, 1970
permanent and total disability benefits and reimbursement of medical expenses
incurred.

On January 26, 1975 or after a period of almost six (.6) years
from his initial heart attack on July 26, 1969, petitioner suffered his second
heart attack which proved more severe, causing loss of his power of speech and
the weakening of his body.

On June 26, 1975, he filed with the Workmen’s Compensation Unit
of the Department of Labor, Regional Office No, 5, at San Pablo City, a claim
for reimburse­ment of medical expenses incurred in connection with his
aforesaid second heart attack; but the same was denied on October 14, 1975 by
the acting chief of unit for lack of merit, reasoning that petitioner had been
awarded benefits under Section 15 of the Workmen’s Compensation Act, as
amended, for permanent and total disability, plus reimbursement of medical
expenses.

Petitioner duly filed his motion for reconsideration, invoking
Section 13 of the Workmen’s Compensation Act, as amended.

On December 27, 1976,
respondent Commission rendered a decision affirming the decision of its acting
chief of unit, thus:

“It appears that claimant of this case has previously been
awarded compen­sation under Section 15 of the Act and the instant case was
subsequently filed in relation thereto only for the sole purpose of seeking
reimbursement under Section 13.

“We cannot sustain claimant’s view.  The claimant has already been declared
totally disabled in the previous award. 
That being so, no claim for reimbursement of subsequent and further
medical expenses may be entertained or awarded, in accordance with the policy
of this Commission.”

Hence, this recourse.

The parties are agreed that the sole issue in this case is
whether or not petitioner is entitled to recover subsequent and further medical
expenses for the same permanent and total disability which had already been the
subject of a maximum compensation benefits under Section 15 of the Workmen’s Compensation Act, as amended, and for
reimbursement of medical expenses
already then incurred under Section 13 thereof.

I

The issue as framed
admits the causal relation­ship of petitioner’s 1969 heart attack to his 1975
heart attack.  As a matter of fact,
respondent employer did not allege and there was no evidence presented that
petitioner had fully recovered from his first heart, attack in 1969 when
his second heart attack occurred
in 1975.  Moreover, petitioner’s
attending physician testified that once the patient has been subjected to this
kind of disease, and there is already
exclusion in the blood because of the previous thrombosis, the patient
will be in serious condition because the area in the brain will be involved (TSN, September 26, 1975, pp.
17-18, rec.).

The members of this
Tribunal are aware of death induced by a second heart attack even after the
lapse of many years from the first attack.

Consequently, petitioner’s second attack, being causally linked
with his first heart attack which was already declared compensable by the
Workmen’s Compensation Commission, may be the source of a claim for further
compensation benefits.  In the recent
case of Enriquez versus Workmen’s Compensation Com­mission (93 SCRA 366 [1979]),
WE stated that “x x x
the right to compensation extends to disability due to disease supervening upon
and proximately and naturally resulting from a compensable injury (82 Am Jur 132).  Where the
primary injury is shown to have arisen in the course of employment, every
natural consequence that flows from the injury likewise arises out of the
employment, unless it is, the result of an independent intervening cause
attributable to claimant’s own negligence or misconduct (I Larson Workmen’s
Compensation Law 3-279 [1972]).  Simply stated, all the medical
consequences and sequelae that flow from the primary
injury are compensable (ibid.).”

II

Petitioner’s case therefore comes within the ambit of the 1980
precedents-setting decision of the Supreme Court En Banc in Biscarra vs. Workmen’s Compensation Commission (G.R. No.
L-43425, January 22, 1980), where IT sustained the right of an ailing employee
under Section 13 of the Workmen’s Compensation Act, as amended, to continuous
medical treatment and therefore reimbursement for subsequent medical expenses
incurred even after he is declared permanently disabled.  The Court En Banc, passing upon
the same issue and arguments raised in this present
case, compassionately ruled:

“The Law applicable is Section 13 of the Workmen’s
Compensation Act, as amended on June 20, 1964, which provides, in part:

‘SEC. 13. 
Services, appliances and supplies.  – Immediately after an employee has suffered
an injury or contracted sickness and during the subsequent period of
disability, the employer or insurance
carrier shall provide the employee with such services, appliances and supplies
as the nature of his disability and the process of his recovery may require;
and that which will 
promote his early restoration to the maximum level of  his physical capacity.

‘The word “services” used herein shall include medical,
surgical, dental, hospital and nursing attendance and treatment as well as the
proper fitting and training in the use of appliances and the necessary training
for purposes of rehabilitation; “appliances” shall include crutches,
arti­ficial members and other devices of the same kind, and the replacements or
repairs of such artificial members or such devices unless the replacement or
repair is made necessary by the lack of proper care by the employee; and
“supplies” shall include medicines, as well as medical, surgical and
dental supplies.’ (Underlined portions are amendments
introduced by Section 7 of Republic Act 4119 of June 20, 1964).

“As will be seen from this law, it imposes upon the employer
the obligation ‘to provide the employee with such services, appliances and
supplies as the nature of his disability and the process of his recovery may
require; and that which will promote his early restoration to the maximum level
of his physical capacity.’ This law does not provide a maximum either as to the
amount to be paid or the time within which such rights may be availed of.  To sustain therefore, the proposition that
petitioner’s disability being total and permanent, respondent’s liability to
furnish him with further medical and hospital expenses is terminated, would, in
effect, qualify Section 13, supra, by adding what is not provided in the
law or subtracting what is therein embodied which is legally
impermissible.  This would constitute
‘judicial fiat’.  This Court, therefore,
shall limit itself to the clear intendment of the law.

“Before the 1964 amendment, but as amended by Republic Act 772
on June 20, 1952, Section
13 reads:

‘Sec. 13. 
Medical attendance.? Immediately after an
employee has suffered an injury or contracted sickness and during the
subsequent period of disability, the employer shall provide the employee with
such medical, surgical, and hospital services and supplies as the nature of the
injury or sickness may require.

‘The pecuniary liability of the employer for the necessary medical,
surgical, and hospital services and supplies shall be limited to the amount
ordinarily paid in the community for such treatment of an injured person of the
same standard of living if the treatment had to be paid for by the injured
person him­self.’

“Under the above-quoted 1952 amendment – prior to the 1964
amendment – WE already ruled that the employer’s liability for medical services
subsists during the period of disability or ‘lasts as long as the employee is
sick.’

“Thus, on October
19, 1961, WE ruled in La Mallorca-Pambusco
vs. Isip,
et al. (L-16495, Oct. 19, 1961 3 SCRA 242, 244):

‘We are inclined to uphold this contention of respondent.  In the first place, in the order of the
Commission dated November 20, 1955
acting favorably on the claim of respondent it was expressly stated that
petitioner should provide him “further medical, surgical and
hospital services and supplies as the nature of his sickness may require until
it is cured or arrested.” Said order became final for lack of protest
or appeal on the part of petitioner. 
Then we have the document signed by respondent entitled
“satisfaction of Award or Decision”, dated February 7, 1956, which
embodies the so-called compromise agreement entered into between them, and from
this document we find that while respondent received the sum of P5,302.05 in full satisfaction of the award, the same is
qualified by the following condition: “except with respect  to further hospital or medical treatment,
whenever necessary.” Finally, we have the provisions of Section 13 of Act
No. 3428, as amended (Workmen’s Compensation Act), which postulate, among
others, that “during the subsequent period of disability the
employer shall provide the employee with such medical, surgical and hospital
services and supplies as the nature of the injury or sickness may
require.” These provisions justify the subsequent award made by the
Commission.

‘It is true that under the Workmen’s Compensation Act the amount of compensation to which an injured employee is entitled
in case of disability shall not in any case exceed the total sum of P4,000.00, but this limitation only applies to the
compensation for disability, and not to medical attendance (Sections 12, 14,
16, 18, Act No. 3428, as amended).  In
fact, this subject is governed by a different section of law (Section 13, Idem.)’ [3 SCRA 242, 244; under­scoring supplied].

“Then on September 31, 1963, WE reiterated the aforesaid
ruling in Itogon­-Suyoc, Inc. vs. Fruto
Dulay, et al. (L-18974, Sept. 31, 1963, 9 SCRA 199,
202-203):

‘The decision orders peti­tioner “to provide him (Fruto Dulay) with continuous
medical and hospital service and supplies until his illness is cured or
arrested, pursuant to Section 13 of the Act.” Petitioner assails this
portion of the decision on the ground that Dulay is
no longer in its employ and that its liability for medical care cannot extend
beyond 208 weeks.  There is no merit in
the contention.  Section 13 does not
require employer-employee relationship as a condition for the employer’s
liability.  As long as the illness was contracted during
the employee’s employment, the employer’s obligation sub­sists.  This obligation for as long as the employee is sick.  The
limit of 208 weeks, like the limit of P4,000.00, refers
to the liability  of the employer for compensation (Secs. 12, 14, 16, 18, Act No. 3428, as
amended) and has no reference at all
to the employer’s liability for medical care (Sec.
13) which lasts during the
“period of  disability” (See La Mallorca-Pambusco
vs. Isip, et al., G.R. No. L-16495, Oct. 19, 1961) [underscoring
supplied].

“And again, on February 29, 1964, in the case of Cebu Portland Cement Co. vs. WCC, et al. (L-19164, Feb. 29, 1964 10 SCRA 420, 423-425) WE
ruled:

‘It may be observed that the law, in imposing on the employer the
obligation to provide medical attendance to an injured or sick employee, unlike
those provisions relating to compensation for disability (Secs.
14, 16, 17 and 18 of Act No. 3428, as amended) does not provide maximum either
in the amount to be paid or the time period within which such right may be
availed of by the employee.  On the
contrary the law imposes on the employer the obligation to “provide the
employee with such medical, surgical,
and hospital services and supplies as the nature of the injury or sickness may
require.” The implication is that, such medical expenses as may
be necessary until the work-connected injury or sickness ceases, may be charged
against the employer.  In the United
States, from where our labor
compensation law is derived, the two kinds of benefits for physical injury or
sickness are like in our law treated differently.  The wage-loss payments based on the
concept of disability are invariably limited in both amount and duration while
payments of medical benefits that is, hospital and medical expenses occasioned
by any work-connected injury, regardless of wage-loss or disability vary in the
different states of the Union.  In twelve
states such benefits are unlimited as to duration and amount; in nineteen,
the preliminary limits are subject to
extension by the administrative agency for indefinite periods as the case
warrants; in eight, there are fixed limits subject to extension for limited
additional periods; and in nine, there are fixed limits with no provision for
extension (Arthur Larson on “The Law of Workmen’s Compensation”, Vol.
2 [1952], p. 82).  In construing the contact s provision requiring the employer to furnish medical, surgical and hospital services
“reasonably required to cure or relieve the employee from the effects of the injury”, it was there
held that “in the absence of express statutory authority, this court is powerless to place a definite
limitation upon the time such medical, surgical and hospital shall be rendered
in any parti­cular case”
(W.J. Newman v. Industrial Commission, 187 N.E. 137, 353 Ill. 190, 88 A.L.R.,
1188).  This was based on the theory
that workmen’s compensation acts are a humane law of a remedial
nature, and wherever construction
is permissible, their language should be
liberally construed in favor of the employee. 
And, this is supported in compensation cases.

“Acts not containing any limitation as to the period during
which the employer may furnish or pay for medical, surgical, or hospital
services have been construed as imposing liability on the employer as long as
such services are required to cure or relieve the injured employee from the effects of his
injury” (Florczak
v. Industrial Commission, 187 N.E. 137, 353 Ill. 190, 88 A.L.R. 1188).

‘Thus, an employee who contracted tuberculosis while employed at
a state tuberculosis hospital, and where the infection was never arrested from
the time it was con­tracted until his death, was declared entitled to continued
treatment the governing statute not having limited the time of treatment (Carrol v. State, 64 N.Y. 2d 166, 242 Minn. 70) [underscoring supplied].’

“xx     xx         xx         xx.

“xx     xx         xx         xx.

“The Office of the Solicitor General, however, contends that
since the petitioner had been declared to be totally and permanently disabled,
the liability of the employer to furnish medical, surgical and hospital services
ceases, citing 10 Workmen’s Compensation Text, Schneider, page 109, that:

‘Where the evidence discloses that further medical, surgical, and
hos­pital services would not definitely improve the condition of an injured
employee, the liability of an employer to furnish reasonable medical and
hospital services, as and when needed, ceases (Paulsen vs. Glenn L. Martin
Nebraska Co. 26 N.W. 2d. 11, Jan. 31, 1947, citing Wilson vs. Brown-McDonald
Co. 278 N.W. 264, 256, March 4, 1938).’

“But the foregoing 1947 Nebraska
decision was based on the old Nebraska
law providing for limited liability. 
Thereafter, said law was amended allowing unlimited liability as to time
and amount, thus making Nebraska one of the 12 states providing for such
unlimited liability as to time and amount even for total and permanent
disability, together with California, Connecticut, District of Columbia,
Hawaii, Idaho, Illinois, Minnesota, New York, North Dakota, Puerto Rico and
Wisconsin (see Samuel B. Horovitz “Injury and
Death under Workmen’s Compensation Laws”, 1948 ed., p. 294; see also
Larson, supra).

“From 1948 to 1975, the number of states in the American Union
providing for medical benefits which are unlimited as to duration and amount,
has increased from 12 to 43:

‘61.11 Statutory summary

‘An integral and important part of the benefit scheme of all
compensation acts is the provision of hospital and medical benefits.  These benefits account for about one-third of
the total benefits paid to injured workmen.

‘In forty-three states
such benefits are essentially unlimited as to duration and amount; in one there is a fixed limit subject to
extension for a limited additional amount; in three there are fixed limits with
no provision for extension; and in three, there are limits only as to silicosis
and related diseases.

‘It is interesting to observe
that in the space of about thirty years
the number of states providing full medical coverage has risen from about a
dozen to almost four times that number. 
This appears to evince agreement with the finding of an authoritative study that “it is impossible fully to relieve pain
and to assure restoration of seriously disabled persons when medical care is
arbitrarily limited.  Equally important is the convincing evidence that unlimited
medical benefits are economically the soundest benefit; that over the long term, they become the least expensive”
(Sec. 61.11, Larson, The Law of Workmen’s Compensation, 1976 ed., underscoring
supplied).

“Larson continues to state that  ‘medical
benefits ordinarily include not only medical, and hospital services, but
necessary incidentals such as transportation, apparatus, and nursing care,
which may be compensable even when supplied at home by a member of claimant’s
family.  Palliative measures are
included under the decisions of most jurisdictions, to
relieve pain even after all hope of cure is gone.  Rehabilitation is an increasingly important
part of the compensation program, under such provisions supplying
additional maintenance and com­pensation during the rehabilitation period as
well as curative and retraining centers to restore earning power to handicapped
workers’ (Sec. 61, Larson, The Law of Workmen’s Compensation, 1976 ed.,
underscoring supplied).

“To repeat, the prevailing interpretation of Section 13 is
consistent with the law and jurisprudence of the States of Hawaii, Minnesota
and New York (see Table 14, 4
Larson, The Law of Workmen’s Compensation,
574-10-574.11 [1979]), upon whose compensation statutes our own compensation
act was patterned.  It was originally
adopted by our Philippine Legislature in Spanish from the Statutes of the Territory
of Hawaii (Nava v. Ynchausti Steamship Co. 57 Phil. 751 [1932]; Fernando and Quiason, Labor Standards and Welfare Legislation, 401
[1964]; Pucan and Besinga,
Comments and Annotations on the Workmen’s Com­pensation Act, as amended, 5-6
[1971]).

“Section 13 of our compensation law mandates the employer to
provide the employee medical benefits immediately after he has suffered an
injury and during the subsequent period of disability ‘as the nature of his
disability and the process of his recovery may require; and that which will
promote his early restora­tion to the maximum level of his physical capacity’,
regardless of whether the disability is permanent or temporary.

“In Hawaii, the
obligation of the employer to provide the employee medical benefits subsists
‘during resulting period of disability’; in Minnesota,
‘during disability as long as necessary to cure and relieve’; and in New York, ‘as
long as necessary’.

“The present jurisprudence in these states sanctions unlimited
medical benefits, both in time and in amount.

“In Florida, the pertinent compen­sation statutes require the
employer ‘to furnish remedial treatment — for such period as the nature of the injury or the process of recovery may
require’ but ‘all rights for remedial attention –shall be barred unless a claim therefor is filed or the commission acts on its own
initiative within two years after the date of the last remedial treatment or —
payment of compensation.’ Applying said provisions in the case of Platzer v. Burger, 144 So. 2d 507
(Fla. 1962), where the evidence indicated that the claimant would need periodic
medical treatment consisting of dilation of the urethra, medical prescriptions,
and treatment for prostatitis for the rest of his
life, the court ordered medical benefits for the lifetime of the claimant.

“It is true that
‘throughout the Workmen’s Compensation Act, the intention of the
legislator to limit payable compensation to P6,000.00
is redolent.’ But this refers only to compensation for loss of income proper or
income benefit which is fixed or computed on the basis of the average weekly
wages of the claimant; never to medical benefits.  For it is likewise pervasive in the law that
the legislature has intended a separate and different treatment for medical
benefits as shown by the fact that it provided for separate provisions for
medical benefits.  If the intention of
the lawmakers were to put a limit to medical benefits then they would have
merged or lumped the two benefits in all the
applicable provisions of the law.  That
they did not, simply means that they intended a
different treatment thereof.

“It must be re-emphasized that under the Workmen’s
Compensation Act, benefits for disability are of two general types:  (1) Indemnity benefits in the form of cash
payments which is designed to compensate the worker for the loss of wages due
to disability sustained or for his death; and (2) medical benefits in the form
of medical services, hospitalization, medicine and other matters related to the
treatment of the compensable injury or disease (Fernandez and Quiason, Labor Standards and Welfare Legislation, 597-598
[1964]).  The first, indemnity or
compensation benefits for loss of wages, is limited both as to time and as to
amount; while the second, medical benefits, is unlimited both as to duration
and to amount.

“xx     xx         xx         xx.

“xx     xx         xx         xx.

“The suggestion that
the ‘period of disability’ used in
Section 13 of the Act refers to
the number of weeks fixed in Sections 12, 14, 16 and 18, was already rejected
in the aforecited cases.  Thus, in the Itogon-Suyoc
case, this Court rules:

‘The decision orders petitioner: “to provide him (Fruto Dulay) with con­tinuous medical and hospital services
and supplies until his illness is cured or arrested, pursuant to Section 13 of
the Act.” Petitioner assails this portion of the decision on the ground
that Dulay is no longer in its employ and that its
liability for medical care cannot extend beyond 208 weeks.  There is no merit in the contention.  Section 13 does not require employer-employee
relationship as a condition for the employer’s liability.  As long as the illness was contracted during
the employee’s employment, the employer‘s
obligation subsists.  This obligation
lasts for as long as the employee is sick. 
The limit of 208 weeks, like the limit of P4,000.00, refers to the liability of the employer for compensation (Secs.
12, 14, 16, 18, Act No. 3428, as amended) and has no reference at all to
the employer s liability for medical
care (Sec. 13) which lasts during the “period fo
disability.”‘

“Sections 22 and 29 refer to dis­ability compensation or
indemnity benefits; not to medical benefits. 
Section 22 speaks of compensation fixed by law, referring to the
amounts fixed in Sections 12, 14, 16 and 18; not to Section 13 on medical
benefits which have no fixed or definite amount.  Likewise, Section 29 speaks of ‘the same
amount of compensation as that prescribed
by this Act’, referring to Sections 12, 14, 16 and 18.

“It must likewise be noted that the initial text of Section 13
before its amendment by Republic Act 4119 in 1964 imposed a limitation as to
the amount of medical benefits, thus: ‘The pecuniary liability of the employer for the necessary medical,
surgical, and hospital services and supplies shall be limited to the amount
ordinarily paid in the community for such treatment of an injured
person of the same standard of living if the treatment had to be paid for by
the injured himself.’ That such discriminatory and
degrading limitation was amended out of the Act is clearly indicative of the
intention of the lawmakers to provide unlimited medical benefits.

“xx     xx         xx         xx         xx.

“The findings of the Workmen’s Compensation Commission, that
petitioner is ‘totally and
permanently disabled for labor’, is no proof that further medical, surgical and
hospital services would not definitely improve petitioner’s condition, at the
very least, relieve him of his pain or other injurious effect of his ailment.  Thus, even assuming that further medical
treatment would not return the employee
to work or cure him, further treatment may still relieve him of his pain
or its injurious effects.  This is the
doctrine laid down in W.J.
Newman Co. vs. Industrial Commission (187 N.E. 137, June 22, 1933), thus:

‘[1-37] This is a novel and exceptional case.  Under such circumstances caution is required
in the construction of the particular statute so as not to extend it or affect its general
application to the thousands of other cases not presenting such unusual
features.  In construing paragraph (a) of
Section 8, since the curing of Nee is admittedly impossible, two
principal questions con­front us, viz:  First, whether the services rendered or to be
rendered are reasonably necessary to relieve the employee from the effects of
his injury; and, secondly, if such services are necessary, whether power is
conferred upon this court to say when such services shall be terminated.  Reference to the record clearly shows that
Nee is beyond hope of cure from medical skill. 
It further shows that the medical, surgical, and hospital services he
had been and is now receiving are not only necessary but also adequate to
relieve him, as far as possible, from the effects of his injury.  The findings of the Industrial Com­mission on
this phase of the question are unquestionably in accord with the manifest
weight of the evidence.  We are there­fore
left solely with the question whether, by a construction of paragraph (a) of
Section 8 of the Workmen’s Compensation Act, this court can say, not only in
this case but in other cases of exceptional nature hereafter presented, that
the medical, surgical and hospital services rendered by an employer where no
cure is possible, may with justice both to the employer and the injured
employee, be terminated after a reasonable length of time, to be determined
according to the varying circumstances of each particular case.  In other words, can it be said that the last
phrase of paragraph (a) should be interpreted to mean that when an employer has
done that which is reasonably required to cure an injured employee from the
effects of his injury and medical advice indicates that a cure is hope­less,
the employer is thereafter relieved from any further liability, under the act,
to furnish medical, surgical, and hospital
services.  We cannot adopt any such
literal or strained construction of para­graph (a) as plaintiff in error urges in this case, to the effect that the words “cure” and
“relieve” mean virtually the same thing.  A workman who is cured is, of course, relieved from the effects of his injury, but one who is
incurable, as in the present
case, may still need skillful attention to relieve him of pain or other
injurious effects caused by his injury. 
This is only the natural and usual meaning of the words used.  It is a construction in accordance with the
general spirit and humane purpose of the act. 
The Workmen’s Compensation Act is a humane law of a remedial nature, and
wherever construction is permissible its
language should be liberally construed. 
City of Chicago vs. Industrial Commission, 291 I11. 23,
125 N.E. 705; Chicago Cleaning Co. vs. Industrial Board, 283
Ill. 177, 118 N.E. 989.  A
strained construction not fairly within the provisions of the act cannot be supported.  Berry Co. vs. Industrial
Commission, 318 Ill. 312, 149 N.E. 278. 
There was no denial by the employer of liabi­lity, and it has been
repeatedly held by this court that the furnishing of medical, surgical, and
hospital services must be regarded as the payment of compensation under the
act.  Goodman Mfg. Co. v. Industrial
Commission, 316 Ill. 394, 147
N.E. 394, and cases cited.

xx           xx         xx         xx

‘[47] By these successive amendments it may be seen that the
legislature deemed inadequate the original limitation of eight weeks’ time and
$200 in amount as to medicine and hospital services, as the amendment of 1919
enlarged the hospital services from two weeks to extend “during the period
for which compensation may be payable,” and also removed any financial limit,
except as to medical or surgical services. 
The amendment in 1925 went further by removing all time or money
limitation upon medical and surgical services, and limited medical, surgical,
and hospital services to such as might be “reasonably required to cure or
relieve from the effects of the injury.” In the absence of express
statutory authority this court is therefore powerless to place a definite
limitation upon the time such medical, surgical and hospital services shall be
rendered in any particular case.  As we
have said before, the proof here shows that medical and hospital services are
necessary to relieve Nee from the effects of his injury and that such services
cannot be rendered in his home.  There is
no proof indicating any malingering or feigned sickness in this case, or any
other circumstance which would enable
us to say that further services are not reasonably necessary to relieve
Nee from the effects of his injury.

‘As the Legislature has seen fit to amend paragraph (a) of section 8 and to successively
omit the former limitations therein imposed upon the furnishing of medical,
surgical and hospital services, it would be nothing short of judicial
legislation for this court now, in an exceptional case, to impose such a
limitation.  The limitations of the
section in question cannot be definitely fixed except by the Legislature, and the only reasonable interpretation which
we are able to place upon it, as
said above, is that the employer’s liability continues so long as
medical, surgical, and hospital services are required in order to relieve the
injured employee from the effects of his injury.’

“Indeed, to follow the modern trend of medical care, the
direction is for increased medical liability to be the ‘third phase of
medicine’, from ‘preventive medicine’ and ‘definitive or curative medicine or
surgery’, to the dynamic concept of ‘medical rehabilitation’, one principal
objective of which is to reduce or alleviate the disability to the greatest
possible degree (Injury and Death under Workmen’s Compensation Law, Samuel B. Horovitz, p. 297; Medical Hand­book on Workmen’s
Compensation and Principles of Disability Evaluation, by Guilatco,
1967 ed., pp. 264-265).

“xx     xx         xx         xx         xx.

“In much the same way that euthanasia is not even prescribed
as the extreme remedy for what appears to be a terminal case, WE should not be
oblivious to the possibility that medical science may devise somehow, sometime
during the lifetime of the disabled employee, a remedy to banish his pain and
to completely rehabilitate him physically, mentally and socially.

“After devoting the best years of their lives to the service
of the State, it is only fair and just that the State should take care of its
civil servants until they are relieved completely from the effects of an
ailment incurred by reason of their employment.’

“Denial of medical benefits to an employee who is disabled
permanently, is to accord more rights to an employee who is suffering only
temporary disability or incapacity; because the latter is entitled to
continuous medical, surgical and hospital services and appliances as the nature
of his injury or ailment may require (Section 13, Workmen’s Compen­sation Act,
as amended); x x x x x.

“xx     xx         xx         xx         xx.

“It certainly would be anomalous and would do violence be
natural reason and logic as well as it would be an act of inhumanity to favor
the temporarily disabled more than the one deemed permanently incapacitated by
illness or injury contracted or sustained during his employment.

“An employee, whether temporarily or permanently disabled, is
entitled (1) to continuous hospital, medical and/or surgical services to
relieve the painful effects of his disability; (2) to relief from, or
alleviation of the humiliating effects of his injury, like plastic surgery
after the first operation that may leave an ugly scar or deformity; (3) to be
provided with such facilities, supplies
or equipment that will restore the normal use of his senses, faculties,
or limbs, such as improved models of wheelchairs, crutches, artificial limbs or
hearing or visual aids; and (4) to rehabilitation of his morale and spirit by
eliminating the psychological effects of the trauma caused by the ailment or
injury so that he can join, and be accepted by, the mainstream of society and
lead a normal life.

“After the disability benefits have been paid, the disabled
employee may remain to be the main support of his family.  Denial to him of further hospital, medical or
surgical services would be aggravating the economic distress his family is
suffering.

“Because society does not
seem to accept him (like a cured
leper) his feeling of depression may drive him to commit suicide or may infect
the other members of the family who may, in desperation, commit anti-social
acts, which would engender a
more serious tragedy for the family.

“Then again, to abandon one who is permanently disabled after
the first medical treatment, is virtually to consign
him to the scrap heap or to the garbage dump of human derelicts, no longer
entitled to the concern and solicitude of the State.  Nothing
would be more inhuman, repugnant to the central core of our democratic welfare
state as envisioned by our Constitution and shocking to a compassionate society.  As heretofore emphasized, the Government
should be the last to give up hope on the recovery and rehabilitation of those
who are now considered permanently disabled. 
Laboratories all over the world are continuously testing and searching
for the panacea for all ailments that plague humanity.  There is greater possibility that such a cure
may be discovered in our time.  The right
to life rank second to none in the hierarchy of human rights.  The entire world is witness to the amazing survival
of Karen Quinlan for the last two years (over 4 years now) after the
life-giving apparatus was disconnected from her body.

“It is likewise possible that from our own flora and fauna may
be dis­covered the remedy for many an ailment or injury.  Many of
our plants, fruits and vegetables have been found to cure, prevent or
minimize serious cardiac ailments, hypertension, arthritis,
afflictions of the kidney and bladder, as well as deep wounds.  Some of our vegetables are likewise natural
disinfectants.  Lately the lowly chichirica and dioscorea
have been found to be a cure for cancer (BT or DE, May 13, 1978).

“God in His infinite wisdom, has
provided the remedies for human diseases, injuries and afflictions.  The genius of resourceful man will discover
these cures somehow, sometime — sooner than expected.

“As the Florida Supreme Court pragmatically opined in the 1950
case of Di
Giorgio Fruit Corp. vs. Pittman, ‘Medicine is not an exact science x x x.  Moreover, in this modern era of extensive
scientific research, it is not possible to say with certainty today that any
disease is incurable for no one knows but
that tomorrow will herald a new miracle drug’ (49 So. 2d 600, 603).

“A Filipino eye specialist gave the information that blindness
due to glaucoma may in time be a thing of the past.

“Specialists have provided relief to those afflicted with
cardiac and kidney diseases through transplanting healthy hearts and kidneys
for diseased   or impaired ones.

“Social legislations which constrict the rights of labor,
should yield to the social justice guarantee of the new Consti­tution which
stresses that:

‘Sec. 6. 
The State shall promote social justice to ensure the dignity, welfare
and security of all the people.  Towards
this end, the State shall regulate the acquisition, ownership, use,
enjoyment and disposition of private
property, and equitably diffuse property ownership and
profits’ (Art. II, 1973 Consti­tution, underscoring supplied).

“To underscore this obligation of the State, Section 9 of
Article II likewise directs that:

‘The State shall afford protection to labor, promote full employment and equality in employment,
ensure equal work opportunities regardless of sex, race, or creed, and regulate
the relations between workers and employers.  The State shall assure the rights of
workers to self-organization, Collective bargaining, security of tenure, and just and humane
conditions of work.  The State may
provide for compulsory arbitration’ (1973 Constitutions underscoring supplied).

“The conservative view limiting the right of the injured or
ailing employee to only one surgical or medical service prevailing in some
States of the American Union should not find adherence in our jurisdiction;
because such States seem to be still
dominated by the capitalistic philosophy as they do not provide in their
respective constitutions any guarantee of social justice in favor of
their citizens.  If, on the other hand,
the humanitarian view which sustains the right of the ailing or injured
employee to continuous medical and surgical services until he has been fully
rehabilitated, is espoused by the progressive states of the United States of
America despite the absence of any social justice guarantee in their respective
constitutions; a fortiori such compassionate approach should be
followed in our jurisdiction, where our Constitution expressly guarantees
social justice ‘to ensure the dignity, welfare and security of all the people’
(Sec. 6, Art. II, 1973 Constitution), while commanding the State to ‘afford
protection to labor’ and ‘assure the right of workers to x x
x just and humane conditions of work’ (Section 6,
Art. II, 1973 Constitution).

“The fear that this humane, liberal and progressive view will
swamp the Government with claims for continuing medical, hospital and surgical
services and as a consequence unduly drain the National Treasury, is no
argument against it; because the Republic of the Philippines as a welfare
State, in providing for the social justice guarantee in our Constitution,
assumes such risk.  This assumption of
such a noble responsibility is, as heretofore stated, only just and equitable
since the employees to be benefitted thereby
precisely became permanently injured or sick while invariably devoting the
greater portion of their lives to the service of our country and people.  Human beings constitute the most valuable
natural resources, of the nation and therefore should merit the highest
solicitude and the greatest protection from the State to relieve them from
unbearable agony.  They have a right to
entertain the hope that during the few remaining years of their life some
dedicated institution or gifted indi­vidual may produce a remedy or cure to
relieve them from the painful or crippling or debilitating or humiliating
effects of their injury or ailment, to fully and completely rehabilitate them
and develop their ‘mental, vocational and social potentials°, so that they will
remain useful and productive citizens.

“Finally, the New Labor Code itself commands that ‘all doubts in the implementation and
interpretation of this Code, including its implementing rules and regulations,
shall be resolved in favor of labor’ (Section 4, Presidential Decree No. 442,
as amended).  This echoes Article 1702 of
the Civil Code of the Philippines,
which provides that:

‘in case of doubt, all labor legislations
and all labor contracts shall be construed in favor of safety and decent living for the laborer’.

“The school of thought
that resists the expansion of the social rights of employees and workers is
essentially capitalistic, conservative, reactionary and selfish.  The invocation of the due process clause to
challenge the validity of social and labor legislation as violative
of the freedom of contract and an undue deprivation of property had long been
discarded in America since the 1937
case of West Coast Hotel vs. Parrish (300 U.S. 379) affirming the validity of
minimum wage laws.  In our country, such
a view was repudiated after the 1924 case of People vs. Pomar (46 Phil. 440). 
Thereafter, other social legislations followed and survived the
constitutional test such as our own minimum wage law, the 8 hour labor law, and
various amendments to the workmen’s compensation law, and employer’s liability
act, law on maternity leave with pay, and laws for the protection of women and
minors employed in dangerous industries and occupations.  Such statutes were held not to trench upon the
Constitution, even in the states of the American Union whose constitutions do
not expressly guarantee social justice specifically in favor of the working
class, as heretofore stated.

“Then again, the fear that con­tinued hospitalization and
medical treatment of employees who are permanently disabled would constitute an
intolerable burden on the employer, whether government or private, is more
fancied than real.  Firstly, no
statistics have been cited to show that there are many
permanently disabled and needing continued medical treatment or
hospitali­zation for a long period. 
Secondly, the employer can always secure or purchase insurance against
such possible liability.

“In the instant case, the govern­ment is the employer against
whom such liability for continued hospitalization, medical services and medical
supplies, is being raised.  The government can always appropriate the
necessary funds for the purpose.

“The government has been losing revenues, either through graft
and corruption or failure to honestly and fully collect such revenues.  These amounts of which the
government has been mulcted by dishonest public officers, private contractors,
or suppliers or which the government failed to collect by reason of the
criminal neglect or dishonesty of its collecting agencies, may aggregate
hundreds of millions, if not billions, of pesos yearly.  The financial
exposure of the government to provide medical and hospital services for its
unfortunate employees rendered permanently disabled but still suffering pain or
humiliation or degradation by reason of such permanent disability is
practically minimal, or not substantial, compared to the millions of pesos that
the country is losing all these years through graft and corruption.  The government has failed not only to
prosecute many big-time tax dodgers, grafters and corruptors but also to
recover even a portion of the unpaid revenues or the amounts embezzled or
stolen from its coffers.  Until the
guilty parties are brought before the courts, the tribunals cannot do
anything.”

In this case of
petitioner who served the govern­ment as municipal judge from
1947 to 1969, risking his health and life, and who prays for a second
reimbursement of his medical expenses, “x x x this Court has the singular opportunity to afford him
relief from his misery and not let him deteriorate until his body is finally and totally decomposed and dissolved into dust.  Any gratuity that he might have received,
aside from the first compensation for wage loss and the first refund for
hospitalization and medical treatment, would not even be sufficient to maintain
his family for the remaining few years of his life.  With his retirement gratuity and disability
compensation already exhausted by now (after eleven years from 1969), he and
his family are exposed to complete misery. 
The government or the court that does not lift a hand to rescue the
ailing employee and his family from such abject penury cannot rightly claim to
be an agency of social justice, much less pretend to be compassionate.”

2.  And the Court En Banc
by way of emphasizing ITS role as a potent social justice arm of the State
concluded optimistically in the aforesaid Biscarra
case that —

“WE may yet escape the judgment of history that the Supreme
Tribunal was once found wanting in ‘moral vision’ and abdicated ITS role as an
active implementing instrument of reform.’ “

3.  It appears that
petitioners claim for medical reimbursement as stated in his letter to the Workmens Compensation Unit was for the amount of P20,588.85
(p. 242, WCC rec.).  However, the
receipts submitted by his counsel totalled only P19,880.00, as follows:

WHEREFORE, THE DECISION OF THE RESPONDENT COMMISSION IS
HEREBY REVERSED AND SET ASIDE AND THE RESPONDENT DEPARTMENT (NOW MINISTRY) OF
JUSTICE IS HEREBY ORDERED TO PAY PETITIONER THE SUM OF NINETEEN THOUSAND EIGHT
HUNDRED EIGHTY (P19,880.00) PESOS AS REIMBURSEMENT FOR MEDICAL EXPENSES.

Fernandez, Guerrero, and
De Castro, JJ., concur.

Teehankee, J., (Chairman), concurs in the result in a separate opinion.

Melencio-Herrera, J., see dissent.