SATURNINO T. BISENIO, SR., PETITIONER, VS. EMPLOYEES’ COMPENSATION COMMISSION (ECC) AND SOCIAL SECURITY SYSTEM (SSS), RESPONDENTS.
BUESER, J.:
“WHEREFORE, the appealed decision is MODIFIED and the System is ordered to pay the corresponding EC disability benefits to the appellant for his Hearing Loss, in accordance with the results of the physical examination to be conducted by the System, plus reimbursement of medical expenses incurred for his medical consultations due to the said ailment subject to the expense limitations prescribed by the Commission. However, the appellant’s claim for EC disability benefits for his Pneumonitis; Coronary Artery Disease; Degenerative Osteoarthritis; Sciatica and Dyslipidemia is hereby DENIED due to absence of substantial evidence showing causal relationship between the said ailments and the working conditions of the appellant.
SO ORDERED.”
The Facts
The pertinent facts and antecedent proceedings, as borne by the records, are as follows:
Petitioner was a miner employed by Philex Mining Corporation (“Philex”) from January 1972 to August 1979. He then worked for CDCP Mining Corporation (“CDCP”) from September 1979 to September 1983. Afterwards, petitioner returned to work for Philex from April 1987 to 1 December 2010. An SSS member, petitioner was assigned with SSS No. 01-0160648-4.
As a miner, petitioner is tasked to perform proper maintenance of all production blocks, access drifts and dumping points and the installation of underground supports.
In particular, petitioner’s duties and responsibilities were as follows: (1) to extract ore at drawpoints/trenches in accordance with draw control specification; (2) to perform high packing activities and blasting of high packs, hang-ups and pack-up draw points/LTR; (3) to check the operating condition of equipment tools, materials and safety paraphernalias; (4) to initiate immediate secondary blasting at all work areas as the need arises; (5) to pull out ore from LTR; (6) to operate conventional rock drill machines; (7) to install/maintain steel sets and timbers underground supports along pressured crosscuts, drifts and draw points; (8) to inform supervisors and notify workers and guards all approaches in all blasting activities; (9) to adhere and enforce good housekeeping and loss control practices; (10) to comply with Mine Safety Rules, Regulations, Standard Operating Procedures, Company Policies and Collective Bargaining Agreement; (11) to attend and participate actively in safety meetings and seminars as required; (12) to perform rescue and recovery operations if qualified, as the need arises; (13) to suggest and recommend improvements in the work-area; and (14) to familiarize himself on the different escape routes underground.
Petitioner’s records reveal that he received SSS sickness and permanent partial disability (PPD) benefits effective 17 December 1996 for his fracture due to a blasting incident in the mining area.
Petitioner also underwent an Audiogram examination on 20 August 2010, which revealed that he had mild to moderate hearing loss, bilateral. On 28 September 2010, petitioner went for a consultation at the Notre Dame de Chartres Hospital in Baguio City due to hearing loss, chest pain associated with easy fatigability and multiple joint pains in his nape, lumbo-sacral area and knees. He was diagnosed with hearing loss, interstitial pneumonitis, sciatica right leg, degenerative osteoarthritis, coronary artery disease and dyslipidemia. On 10 December 2012, petitioner retired from his work.
Consequently, petitioner filed a claim for disability benefits with the SSS Baguio City Branch (SSS Baguio) on 16 February 2011, which was allegedly returned to him by one of the medical officers of the branch. Petitioner then sent a letter to the ECC Secretariat on 1 April 2011 to inform the latter of his claim. Acting on petitioner’s claim, the ECC Secretariat endorsed the letter to the SSS-Medical Operations Department (SSS-MOD) for appropriate action.
On 5 May 2011, SSS Baguio wrote a letter requiring petitioner to submit his medical and employment records and directing him to report to the branch for physical examination and interview. Petitioner then submitted his laboratory examination results, in which he was diagnosed with interstitial pneumonitis, bilateral and degenerative osteoarthritis.[2]
On 2 August 2011, the SSS-MOD denied petitioner’s claim for failure to show proof that he had filed a claim for disability benefits for hearing loss as a result of the alleged air blast accidents in 1987 and 1996. The denial was also anchored on its findings that there is no causal connection between petitioner’s job as a miner and his other illnesses, i.e., interstitial pneumonitis, sciatica right leg, osteoarthritis, coronary artery disease and dyslipidemia.
On 9 September 2011, the present claim was submitted to the Technical Review Committee for initial deliberation. Consequently, the Committee recommended the grant of EC disability benefits but only for petitioner’s hearing loss. It was recommended that the claim for disability benefits due to his other diseases be denied.
During the deliberations, petitioner was directed by the Committee to submit chest x-ray films showing interstitial pneumonitis or pneumoconiosis, if any. Allegedly, petitioner submitted his chest x-ray results to the SSS Baguio. However, upon verification, it was revealed that there is no record that petitioner submitted said x-ray results to the branch.
On 4 February 2012, the ECC Secretariat received an email message from a Pulmonologist requesting the submission of petitioner’s lung function test results. Since the laboratory examinations cannot be done in Baguio, petitioner refused the Secretariat’s offer to facilitate the examination.
On 24 April 2012, the case was re-submitted to the Committee. After deliberations, the Committee maintained its previous recommendation to grant EC benefits to petitioner but only for his hearing loss. Petitioner’s other claims were denied on the ground that there is no causal relationship between the alleged diseases and his working conditions.
In the now assailed Decision dated 23 May 2012, the ECC, in the manner as afore-quoted, granted petitioner’s claim for disability benefits but only in so far as his hearing loss is concerned. Petitioner’s claim pertaining to his other diseases was denied on the ground that the same were not the direct result of his employment as a miner. In fine, the ECC opined that the petitioner failed to present substantial evidence to establish causal connection between the claimed ailments and his previous working conditions.
Aggrieved, petitioner filed the present legal recourse.
The Issue
The main issue to be resolved in this petition is whether petitioner’s interstitial pneumonitis, sciatica right leg, degenerative osteoarthritis, coronary artery disease and dyslipidemia are work-related and thus compensable.
The Court’s Ruling
We find the present petition partly meritorious.
Questioning the factual and legal findings of the ECC, petitioner asserts that his other illnesses, i.e., pneumonitis, sciatica right leg, degenerative osteoarthritis, coronary artery disease and dyslipidemia, were caused by factors inherent in his nature of work and working conditions as an underground production miners for more than three (3) decades. On this note, petitioner highlights the proffered medical findings and recommendations on record made by his examining physicians. He contends that said medical records have established the compensability of his illnesses under the Increased Risk Theory considering that he had shown substantial evidence of work-connection.
Time and again, appellate courts have put great weight to the factual findings of administrative agencies and quasi-judicial bodies, namely the SSS and the ECC, as they have acquired expertise in all matters relating to employee compensation and disability benefits.[3]
The foregoing legal precept notwithstanding, the evidence on record leads this Court to dissent and modify the assailed ECC Decision. The ECC, in granting petitioner’s prayer for disability benefits but only as it pertains to his hearing loss, has committed reversible error when it disregarded the attending circumstances as they find relevance in the applicable laws and jurisprudence.
Verily, Section 1 of Rule III of the Amended Rules on Employees’ Compensation provides:
“SECTION 1. Grounds –
(a) For the injury and the resulting disability or death to be compensable, the injury must be the result of accident arising out of and in the course of the employment. (ECC Resolution No. 2799, July 25, 1984).
(b) For the sickness and the resulting disability or death to be compensable, the sickness must be the result of an occupational disease listed under Annex “A” of these Rules with the conditions set therein satisfied, otherwise, proof must be shown that the risk of contracting the disease is increased by the working conditions. x x x x”
Guided by the foregoing, for the sickness or resulting disability or death to be compensable, the claimant must prove either (1) that the employee’s sickness was the result of an occupational disease listed under Annex “A” of the Amended Rules on Employees’ Compensation, or (2) that the risk of contracting the disease was increased by his working conditions.[4]
Anent the “increased risk theory” as prescribed under the second instance, there must be a reasonable proof that the employee’s working condition increased his risk of contracting the disease, or that there is a connection between his work and the cause of the disease.[5] Only a reasonable proof of work-connection, not direct causal relation, however, is required to establish compensability of a non-occupational disease.[6]
In the case at bench, petitioner’s diseases, save for his osteoarthritis, are not included as among the occupational and compensable diseases listed in Annex “A” of the Amended Rules on Employees’ Compensation. Thus, to favor the present entreaty for disability benefits respecting said diseases, petitioner has the burden to establish that the risk of contracting the same was increased by his working conditions as an underground miner.
As aptly observed by the ECC, petitioner has failed to overcome his onus to prove that his duties as a miner caused or increased his risk of contracting pneumonitis, coronary artery disease and dyslipidemia. There is no substantial evidence to prove that being an underground miner exposes workers to contract said diseases. Neither is there reasonable proof that petitioner’s working conditions caused or increased his risk of contracting said diseases. To favor petitioner sans reasonable proof of work-connection borders on unfounded conjecture and guesswork, which this Court cannot, and will absolutely not, sanction.
Specifically, the cause of petitioner’s pneumonitis, which is dust exposure, has not been established by substantial evidence. While it may be said that petitioner is expectedly exposed to dust considering the nature of his job as an underground miner, there is no proof on record that the dust to which he had been exposed to in the mine is the specific dust that causes pneumonitis.
What is more, there is no reasonable work-connection between petitioner’s coronary artery disease and dyslipidemia on one hand and his duties as a miner on the other. There are various factors that contribute to these diseases such as age, environment, diet and lifestyle. Truth be told, petitioner’s coronary artery disease and dyslipidemia were primarily caused by atherosclerosis as enhanced by his elevated level of bad cholesterol. There is no showing that said affliction is work-related.
Nonetheless, as can be gleaned from the records, petitioner has established the compensability not only of his hearing loss but also of his osteoarthritis and sciatica. Aside from the fact that osteoarthritis is listed as an occupational and compensable disease,[7] petitioner’s osteoarthritis was undeniably advanced by his heavy and strenuous physical labor as an underground miner for more than thirty years. Considering that the ECC itself found that petitioner’s sciatica is a complication of his osteoarthritis, said ailment is likewise compensable.[8]
True, it can be said that being degenerative, petitioner’s osteoarthritis is age-related. Still, petitioner admittedly performed hard labor and he operated rock drilling machines for more than three decades. Osteoarthritis is deemed compensable if the claimant’s occupation involved carrying heavy loads or unduly heavy physical labor and use of vibratory tools, which is the case here. This serves as reasonable proof that the petitioner’s working conditions increased his risk of contracting said disease and that as an underground miner, there is a connection between his work and the cause of said diseases.
All told, there is cogent reason to warrant the modification of the ECC Decision in so far as it should include the grant of petitioner’s claim for disability benefits for his osteoarthritis and sciatica. The nature of petitioner’s job as a miner as particularly enumerated above justifies the finding that said diseases are work-connected. It bears to stress that the primordial purpose of PD No. 626 is to provide meaningful protection to the workers against the hazards of disability or illness; hence, a liberal attitude in favor of the employee and his beneficiaries in deciding claims for compensation should be adopted.[9]
WHEREFORE, the foregoing considered, the present petition is hereby PARTLY GRANTED. The assailed ECC Decision dated 23 May 2012 is hereby MODIFIED in so far as the Social Security System (SSS) is ordered to pay the corresponding EC disability benefits to petitioner for his Osteoarthritis and Sciatica, plus reimbursement of medical expenses incurred for his medical consultations due to said diseases subject to the expense limitations prescribed by the ECC. No costs.
SO ORDERED.
De Guia-Salvador (Chairman) and Garcia, JJ., concur.
[1] Rollo, pp. 22-31.
[2] Id. at p. 78.
[3] Gatus vs. Social Security System, G.R. No. 174725, 26 January 2011.
[4] Government Service Insurance System vs. Besitan, G.R. No. 178901, 23 November 2011.
[5] Castor-Garupa vs. Employees’ Compensation Commission, G.R. No. 158268, 12 April 2006.
[6] Government Service Insurance System vs. Cordero, G.R. Nos. 171378 & 171388, 17 March 2009.
[7] Number 24 of Annex “A” of the Amended Rules on Employees’ Compensation: “OSTEOARTHRITIS. a) Any occupation involving: aa) joint strain from carrying heavy loads, or unduly heavy physical labor, as among laborers and mechanics; bb) minor or major injuries to the joint; cc) excessive use or constant strenuous usage of a particular joint, as among sportsmen, particularly those who have engaged in the more active sports activities; dd) extreme temperature changes (humidity, heat, and cold exposures); and ee) faulty work posture or use of vibratory tools.”
[8] Page 8 of the ECC Decision.
[9] Government Service Insurance System v. Villareal, G.R. No. 170743, 12 April 2007.