MANUEL BELARMINO, PETITIONER, VS. EMPLOYEES COMPENSATION COM­MISSION AND GOVERNMENT SERVICE INSURANCE SYSTEM, RESPONDENTS.

This seven-year-old case involves a claim for benefits for the
death of a lady school teacher which the public respondents disallowed on the
ground that the cause of death was not work-connected.

Before her death on February
19, 1982, petitioner’s wife, Oania Belarmino, was a classroom teacher of the Department of
Education, Culture and Sports assigned at the Buracan Elementary School
in Dimasalang, Masbate
(p. 13, Rollo). 
She had been a classroom teacher since October 18, 1971, or for eleven (11) years.  Her husband, the petitioner, is also a public
school teacher.

On January 14, 1982,
at nine o’clock in the morning, while
performing her duties as a classroom teacher, Mrs. Belarmino
who was in her 8th month of pregnancy, accidentally slipped and fell on the
classroom floor.  Moments later, she
complained of abdominal pain and stomach cramps.  For several days, she continued to suffer
from recurrent abdominal pain and a feeling of heaviness in her stomach, but,
heedless of the advice of her female co-teachers to take a leave of absence,
she continued to report to the school because there was much work to do.  On January
25, 1982, eleven (11) days after her accident, she went into labor
and prematurely delivered a baby girl at home (p. 8, Rollo).

Her abdominal pains persisted even after the delivery,
accompanied by high fever and headache. 
She was brought to the Alino
Hospital in Dimasalang,
Masbate on February 11, 1982.  Dr. Alfonso Alino
found that she was suffering from septicemia post partum due to infected
lacerations of the vagina.  She was
discharged from the hospital after five (5) days on February 16, 1982, apparently recovered, but she
died three (3) days later.  The cause of
death was septicemia post partum.  She
was 33 years old, survived by her husband and four (4) children, the oldest of
whom was 11 years old and the youngest, her new-born infant (p. 9, Rollo).

On April 21, 1983,
a claim for death benefits was filed by her husband.  On February
14, 1984, it was denied by the Government Service Insurance System
(GSIS) which held that “septicemia post partum, the cause of death, is not an
occupational disease, and neither was there any showing that aforesaid ailment
was contracted by reason of her employment. 
x x x.  The alleged accident mentioned could not have
precipitated the death of the wife but rather the result of the infection of
her lacerated wounds as a result of her delivery at home” (p. 14, Rollo).

On appeal to the Employees Compensation Commission, the latter
issued Resolution No. 3913 dated July
8, 1988 holding:

“We agree with the decision of the system, hence we dismiss this
appeal.  Post-partum septicemia is an
acute infectious disease of the puerperium resulting
from the entrance into the blood of bacteria usually streptococci and their toxins which cause dissolution of the
blood, degenerative changes in the organs and the symptoms of
intoxication.  The cause of this
condition in the instant case was the infected vaginal lacerations resulting
from the decedent’s delivery of her child which took place at home.  The alleged accident in school could not have
been the cause of septicemia, which in this case is clearly caused by factors
not inherent in employment or in the working conditions of the deceased.” (pp. 14-15, Rollo.)

Hence, this petition for review.

After a careful consideration of the petition and the annexes
thereof, as well as the comments of the public respondents, we are persuaded
that the public respondents’ peremptory denial of the petitioner’s claim
constitutes a grave abuse of discretion.

Rule III, Section 1 of the Amended Rules on Employees’
Compensation enumerates the grounds for compensability of injury resulting in
disability or death of an employee, as follows:

“SECTION 1.  Grounds – (a) For the injury and the resulting
disability or death to be compensable, the injury must be the result of an employment
accident satisfying all of the
following conditions:

“(1)         The employee must have been injured at the place where his
work requires him to be;

“(2)         The employee must
have been performing his official functions; and

“(3)         If the injury is
sustained elsewhere, the employee must have been executing an order for the employer.

“(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.

“(c)         Only injury or sickness that occurred on or after January 1, 1975 and the resulting
disability or death shall be compensable under these Rules.”

The illness, septicemia post partum, which resulted in the death
of Oania Belarmino, is
admittedly not listed as an occupational disease in her particular line of work
as a classroom teacher.  However, as
pointed out in the petition, her death from that ailment is compensable because
an employment accident and the conditions of her employment contributed to its
development.  The condition of the
classroom floor caused Mrs. Belarmino to slip and
fall and suffer injury as a result.  The
fall precipitated the onset of recurrent abdominal pains which culminated in
the premature termination of her pregnancy with tragic consequences to her.  Her fall on the classroom floor brought about
her premature delivery which caused the development of post partum septicemia
which resulted in death.  Her fall
therefore was the proximate or responsible cause that set in motion an unbroken
chain of events, leading to her demise.

“x x x what is
termed in American cases the proximate cause, not implying however, as might be
inferred from the word itself, the nearest in point of time or relation, but
rather, [is] the efficient cause, which may be the most remote of an operative
chain.  It must be that which sets the
others in motion and is to be distinguished from a mere preexisting condition upon which the effective cause operates, and
must have been adequate to produce the resultant damage without the
intervention of an independent cause.”
(Atlantic Gulf vs. Insular Government, 10
Phil. 166, 171.)

“The proximate legal cause is that acting first and producing the
injury, either immediately or by setting other events in motion, all
constituting a natural and continuous chain of events, each having a close
causal connection with its immediate predecessor, the final event in the chain
immediately effecting the injury as a natural and probable result of the cause which first acted, under such
circumstances that the person responsible for the first event should, as an
ordinarily prudent and intelligent person, have reasonable ground to expect at
the moment of his act or default that an injury to some person might probably
result therefrom.” (Bataclan
v. Medina, 102 Phil. 181.)

Thus in Enriquez v. WCC, 93 SCRA 366, 372, this Court ruled:

“x x x.  Verily,
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 sequels that flow from the primary injury are compensable.  (Ibid.)”

Mrs. Belarmino’s
fall was the primary injury that arose in the course of her employment as a
classroom teacher, hence, all the medical consequences flowing from it:  her recurrent abdominal pains, the premature
delivery of her baby, her septicemia post partum, and death, are compensable.

There is no merit in the public respondents’ argument that the
cause of the decedent’s post partum septicemia “was the infected vaginal
lacerations resulting from the decedent’s delivery of her child at home” for
the incident in school could not have caused septicemia post partum, x x x if the necessary precautions
to avoid infection during or after labor were (not) taken” (p. 29, Rollo).

The argument is unconvincing. 
It overlooks the fact that septicemia post partum is a disease of
childbirth, and premature childbirth would not have occurred if she did not
accidentally fall in the classroom.

It is true that if she had delivered her baby under sterile
conditions in a hospital operating room instead of in the unsterile
environment of her humble home, and if she had been attended by specially
trained doctors and nurses, she probably would not have suffered lacerations of
the vagina and she probably would not have contracted the fatal infection.  Furthermore, if she had remained longer than
five (5) days in the hospital to complete the treatment of the infection, she
probably would not have died.  But who is
to blame for her inability to afford a hospital delivery and the service of
trained doctors and nurses?  The court
may take judicial notice of the meager salaries that the Government pays its
public school teachers.  Forced to live
on the margin of poverty, they are unable to afford expensive
hospital care, nor the services of trained doctors and nurses when they or
members of their families are ill. 
Penury compelled the deceased to scrimp by delivering her baby at home
instead of in a hospital.

The Government is not entirely blameless for her death for it is
not entirely blameless for her poverty. 
Government has yet to perform its declared policy “to free the people
from poverty, provide adequate social services, extend to them a decent
standard of living, and improve the quality of life for all (Sec. 7, Art. II, 1973 Constitution and Sec. 9, Art. II, 1987
Constitution).  Social justice for the
lowly and underpaid public school teachers will only be an empty shibboleth
until Government adopts measures to ameliorate their economic condition and
provides them with adequate medical care or the means to afford it.  “Compassion for the poor is an imperative of
every humane society” (PLDT v. Bucay and NLRC, 164
SCRA 671, 673).  By their denial of the
petitioner’s claim for benefits arising from the death of his wife, the public
respondents ignored this imperative of Government, and thereby committed a
grave abuse of discretion.

WHEREFORE, the petition for certiorari is
granted.  The respondents Employees
Compensation Commission and the Government Service Insurance System are ordered
to pay death benefits to the petitioner and/or the dependents of the late Oania Belarmino, with legal rate
of interest from the filing of the claim until it is fully paid, plus
attorney’s fees equivalent to ten (10%) percent of the award, and costs of
suit.

SO ORDERED.

Narvasa, (Chairman), Cruz, and Medialdea, JJ., concur.

Gancayco, J., on leave.