RAMON CORPORAL, PETITIONER, VS. EMPLOYEES’ COMPENSATION COMMISSION AND GOVERNMENT SERVICE INSURANCE SYSTEM, RESPONDENTS.

This is a petition
for certiorari questioning the decision of the Employees’ Compensation
Commission which denied petitioner’s claim for death benefits under
Presidential Decree No. 626, as amended.

I

Norma Peralta Corporal was employed as a public school teacher
with assignment in Juban, Sorsogon. On
November 28 to November 30, 1977, she
was confined at the Esteves Memorial Hospital for acute coronary insufficiency
and premature ventricular contractions.

On June 30, 1983, she was assigned to the Banadero Elementary
School in Daraga, Albay. Norma had to
walk three kilometers to and from said school as no transportation was
available to ferry her and other teachers from the national highway to the
school. During her fourth pregnancy,
Norma suffered a complete abortion and was hospitalized for two days at the
Albay Provincial Hospital. After her
maternity leave, Norma reported back to work.

In March of 1984, she again conceived. However, in September of the same year, she was transferred to
the Kilicao Elementary School, where she had to walk more than one kilometer of
rough road. On December 2, 1984, she
gave birth to a baby boy with the help of a “hilot.” An hour later,
she was rushed to the Immaculate Conception Hospital due to profuse vaginal
bleeding. She underwent a hysterectomy
but unfortunately, she died on the same day due to “shock, severe
hemorrhage” resulting from a “prolapse(d) uterus post partum.”
Norma was 40 years old when she died.

Her husband, Ramon Corporal, petitioner herein, filed a claim for
compensation benefit with the Government Service Insurance System (GSIS). The GSIS denied petitioner’s claim thus:

“Please be advised that on the basis of the proofs and
evidences (sic) submitted to the System, the cause of death of your wife, Shock
secondary to Severe Hemorrhage, Uterine PROLAPSE is not considered an
occupational disease as contemplated under the above-mentioned law (P.D. No.
626). Neither was there any showing
that her position as Teacher, MECS, Albay had increased the risk of contracting
her ailment” (Rollo, p. 23).

Petitioner filed several motions for the reconsideration of the
denial of his claim to no avail, because a re-evaluation of the claim by the
Medical Evaluation and Underwriting Group of the GSIS showed that there was
“no basis to alter its previous action of denial for the same reason x x x
that her cause of death is non-­work-connected as contemplated under the
law” and neither did her job as a teacher increase the risk of contracting
her ailment (Rollo, p. 25).

Petitioner appealed to the Employees’ Compensation Commission
(ECC). The ECC requested the GSIS to
re-evaluate petitioner’s claim and to finally determine compensability, with
instruction that in case the claim is denied once more by the System, the entire
record of the case be elevated to the ECC. The GSIS reiterated its denial of petitioner’s claim.

On September 7, 1988, the ECC rendered a decision also denying
petitioner’s claim. It said:

“Medical studies show that Prolapsed Uterus may occur in
infants and nulliparous women as well as multiparas. Defects in innervation and in the basic integrity of the
supporting structures account(s) for prolapse(d) in the first two and
childbirth trauma for the latter. The cervix
usually elongates because the weight of the nagging vaginal tissues pulls it
downward, whereas the attached but weak cardinal ligaments tend(s) to support
it. In third degree or complete
prolapse(d) both the cervix and the body of the uterus have passed through the
introitus and the entire vaginal canal is inverted. (Obstetrics and Gynecology, Wilson, Beecham, Carrington, 3rd
Edition, p. 585).

On the other hand Acute Coronary Insufficiency are terms often used
to describe a syndrome characterized by prolonged substernal pain, usually not
relieved by vasodilators of a short period of rest due to a more severe
inadequacy of coronary circulation. The
symptoms in this condition are more intense and prolonged than in angina
pectoris, but abnormal ECG and other laboratory findings associated with
myocardial infarction are absent. The
syndrome is covered by a temporary inability of one’s coronary arteries to
supply sufficient oxygenated blood to the heart muscle. (Merck, Manual of Diagnosis & Therapy,
pp. 100-101).

Based on the above medical discussion of the subject ailments, we
believe that the development of the fatal illness has no relation whatsoever
with the duties and working conditions of the late teacher. There is no showing that the nature of her
duties caused the development of prolapse of the uterus. The ailment was a complication of childbirth
causing profuse vaginal bleeding during the late stage. We also consider Acute Coronary
Insufficiency as non-work-connected illness for the reason that it is caused by
temporary inability of one coronary arteries (sic) to supply oxygenated blood
to the heart muscle. There is no damage
to heart muscle. In view thereof, we
have no recourse but to sustain respondent’s denial of the instant claim”
(Rollo, pp. 29-31).

Hence, petitioner filed
the instant petition, asserting compensability of the death of his wife.

II

Petitioner contends that
although prolapsed uterus is not one of occupational diseases listed by the
ECC, his claim should prosper under the increased risk theory. He anchors such claim on the fact that as
early as January 1984 or before Norma’s fifth pregnancy, he had noticed
a spherical tissue which appeared like a tomato protruding out of Norma’s
vagina and rectum. He avers that such
condition was attributable to Norma’s long walks to and from her place of
teaching – Banadero Elementary School, which is situated on the side of the
Mayon Volcano. Moreover, the roads
leading to the school are full of ruts and rocks, and, during the rainy season,
are flooded and slippery. Petitioner
asserts that inspite of these, Norma continued to discharge her duties as a
public servant, notwithstanding her pregnancy and her prolapsed uterus.

Petitioner also contends that the findings of the respondents
contravene the constitutional provision on social justice. He alleges that since the workmen’s
compensation law is a social legislation, its provisions should be interpreted
liberally in favor of the employees whose rights it intends to protect.

Under P.D. No. 626, as amended, for sickness and the resulting
death of an employee to be compensable, the claimant must show either: (a) that it is a result of an occupational
disease listed under Annex A of the Amended Rules on Employees’ Compensation
with the conditions set therein satisfied; or (b) that the risk of contracting
the disease is increased by the working conditions (Santos v. Employees’
Compensation Commission, 221 SCRA 182 [1993]; Quizon v. Employees’ Compensation
Commission, 203 SCRA 426 [1991]). Clearly, then, the principle of aggravation and presumption of compensability under the old Workmen’s Compensation Act
no longer applies (Latagan v. Employees’ Compensation Commission, 213 SCRA 715
[1992]).

Since petitioner admits that his wife died of an ailment which is
not listed as compensable by the ECC and he merely anchors his claim on the
second rule, he must positively show that the risk of contracting Norma’s
illness was increased by her working conditions. Petitioner failed to satisfactorily discharge the onus imposed by
law.

The fact that Norma had to walk six kilometers everyday and
thereafter, a shorter distance of more than one kilometer just to reach her
place of work, was not sufficient to establish that such condition caused her
to develop prolapse of the uterus. Petitioner did not even present medical findings on the veracity of his
claim that Norma had a tomato-like spherical tissue protruding from her vagina
and rectum.

Norma developed prolapse of the uterus because she was
multiparas, or one who had more than one child, and quite beyond the safe
child-bearing age when she gave birth to her fifth child – she was already
forty years old. Novak’s Textbook
on Gynecology describes prolapse of the uterus (descensus uteri)
as follows:

“An extremely common condition, being far more frequent in
elderly than in young patients. This is explained by the increasing laxity and atony of the muscular and
fascial structures in later life. The
effects of childbirth injuries may thus make themselves evident, in the form of
uterine prolapse, many years after the last pregnancy. Pregnancies in a
prolapsed uterus may lead to numerous complications, as noted by Piver and
Spezia.

The important factor in the mechanism of the prolapse is
undoubtedly injury or overstretching of the pelvic floor, and especially of the
cardinal ligaments (Mackenrodt) in the bases of the broad ligaments. Combined with this there is usually
extensive injury to the perineal structures, producing marked vaginal
relaxation and also frequent injury to the fascia or the anterior or posterior
vaginal walls, with the production of cystocele or rectocele. Usually, various combinations of these
conditions are seen, although at times little or no cystocele or rectocele is
associated with the prolapse. Occasional
cases are seen for that matter, in women who have never borne children, and in
these the prolapse apparently represents a hernia of the uterus through a
defect in the pelvic fascial floor” (Underscoring supplied).

The 1986 Current Medical Diagnosis &
Treatment also describes the condition as follows:

“Uterine prolapse most commonly occurs as a delayed result of
childbirth injury to the pelvic floor (particularly the transverse cervical and
uterosacral ligaments). Unrepaired
obstetric lacerations of the levator musculature and perineal body augment the weakness. Attenuation of the pelvic structures with
aging and congenital weakness can accelerate the development of prolapse.”

The determination of whether the prolapse of Norma’s uterus developed before or after her fifth pregnancy
is therefore immaterial since this illness is the result of the physiological
structure and changes in the body on pregnancy and childbirth.

With the evidence presented in support of the claim,
petitioner’s prayer cannot be granted. While as a rule labor and social welfare legislation should be liberally construed in favor of the
applicant, (Tria v. Employees’
Compensation Commission, 208 SCRA 834 [1992]), there is also the rule that such
liberal construction and interpretation of labor laws may not be applied where
the pertinent provisions of the Labor Code and P.D. No. 626, as amended, are
clear and leave no room for interpretation.

The Court commiserates with the petitioner and his children for
the loss of a loved one. We also
recognize the importance of the services rendered by public elementary school
teachers inspite of their meager salaries which are not proportionate to their
immense responsibility in molding the values and character of the youth in this
country (De Vera v. Employees’ Compensation Commission, 133 SCRA 685 [1984]).

But under the legal milieu of the case, we can only suggest, not
mandate, that respondents grant ex gratia some form of relief to
their members similarly situated as petitioner’s wife.

WHEREFORE, the petition is DENIED.

SO ORDERED.

Cruz, (Chairman), Davide, Jr., and
Kapunan, JJ., concur.

Bellosillo, J., on leave.