The Supreme Court ruled that peptic ulcer, when caused or aggravated by work-related stress, can be a compensable illness under Philippine law. This means that employees suffering from peptic ulcer, whose jobs involve prolonged emotional or physical stress, may be entitled to receive income benefits if the condition leads to disability or death. This decision underscores the importance of considering the impact of work conditions on an employee’s health, reinforcing the state’s commitment to providing social justice and protection to the working class, especially in cases where work-related stress contributes to the development of a serious ailment.

From Engineer to Entitlement: Can Job Stress Trigger Compensation?

This case revolves around Jean Raoet’s claim for income benefits following the death of her husband, Francisco Raoet, an Engineer A at the National Irrigation Administration (NIA). Francisco’s death certificate indicated cardiac arrest, acute massive hemorrhage, and bleeding peptic ulcer disease as the causes of death. The Government Service Insurance System (GSIS) initially denied the claim, arguing that peptic ulcer was not explicitly listed as an occupational disease and that the respondent failed to prove the risk of contracting the disease was increased by the working conditions. The central legal question is whether Francisco’s peptic ulcer, allegedly caused or exacerbated by his stressful job, qualifies as a compensable illness under Presidential Decree No. 626 (P.D. 626), as amended.

The Supreme Court, in its analysis, first addressed the procedural issue of whether the GSIS was raising a question of fact or law. The Court clarified that while the actual cause of Francisco’s death might seem like a factual question, the core issue was whether sufficient evidence supported the claimed cause of death, making it a question of law suitable for review under Rule 45 of the Rules of Court. The Court emphasized that the CA decision hinged on the compensability of the cause of death, thus solidifying its jurisdiction to review the case.

Turning to the substantive issue, the Court referenced P.D. 626, as amended, which defines a compensable sickness as an occupational disease listed by the Employees’ Compensation Commission (ECC) or any illness caused by employment, subject to proof that the risk of contracting the same is increased by the working conditions. Section 1 (b), Rule III of the Amended Rules on Employees’ Compensation, further elaborates that compensability requires the sickness to be either an occupational disease listed in Annex “A” or one where the risk of contracting it is increased by the working conditions. This provision highlights the dual-track approach to determining compensability.

The Court acknowledged that the respondent submitted Francisco’s death certificate as proof of the cause of death. Citing Philippine American Life Insurance Company v. CA and People v. Datun, the Court reiterated that death certificates are prima facie evidence of the facts stated therein, including the immediate, antecedent, and underlying causes of death. The Court noted that neither the GSIS nor the ECC presented any evidence to refute the cause of death listed on the death certificate.

Discussing the CA decision, the Supreme Court noted that the CA had incorrectly focused on the immediate cause of death (cardiac arrest) while overlooking the underlying cause (peptic ulcer). However, the Supreme Court clarified that this error did not automatically disqualify the claim, as peptic ulcer itself can be a compensable illness under certain conditions. It is important to consider not only the immediate cause but also the underlying factors contributing to the health condition.

The Supreme Court then cited ECC Resolution No. 1676, which lists peptic ulcer as a compensable disease under Annex “A,” provided the claimant is in an occupation involving prolonged emotional or physical stress, such as professional people or transport workers. Given this framework, the critical question became whether Francisco’s occupation as an Engineer A at NIA involved prolonged emotional or physical stress. To determine this, the Supreme Court considered Francisco’s prior diagnosis of Hypertension, Severe, Stage III, Coronary Artery Disease, which the GSIS had previously recognized as work-connected, awarding him temporary total disability benefits.

Building on this principle, the Court noted that the underlying causes of these diseases are often linked to the stressful nature of an occupation. Furthermore, as Engineer A, Francisco supervised construction activities, reviewed structural plans, and shouldered significant responsibilities. These stresses did not cease after his temporary disability, and he continued in the same position until his death. The Court concluded that Francisco’s continuous exposure to prolonged emotional stress qualified his peptic ulcer as a compensable cause of death.

In arriving at its conclusion, the Court emphasized that it is not necessary for the employment to be the sole factor in the development of an illness to warrant compensation. It is sufficient that the employment contributed, even in a small degree, to the development of the disease. This aligns with the well-established principle that only a reasonable work-connection, not a direct causal relation, is required. The Court highlighted the GSIS v. Vicencio case, underscoring that probability, not certainty, is the touchstone in determining compensability. The Court stated:

It is well-settled that the degree of proof required under P.D. No. 626 is merely substantial evidence, which means, ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ What the law requires is a reasonable work-connection and not a direct causal relation. It is enough that the hypothesis on which the workman’s claim is based is probable. Medical opinion to the contrary can be disregarded especially where there is some basis in the facts for inferring a work-connection. Probability, not certainty, is the touchstone. It is not required that the employment be the sole factor in the growth, development or acceleration of a claimant’s illness to entitle him to the benefits provided for. It is enough that his employment contributed, even if to a small degree, to the development of the disease.

The Court acknowledged the potential concerns about the financial implications of granting compensation benefits, but it reiterated that P.D. 626 is a social legislation intended to protect the working class against the hazards of disability and illness. The Court emphasized that all doubts in the implementation and interpretation of the Labor Code should be resolved in favor of labor, in line with Article 4 of the Labor Code. In addition, it reminded the GSIS that the state guarantees the benefits prescribed under the law and accepts general responsibility for the solvency of the State Insurance Fund, as mandated by Article 184 of the Labor Code.

Article 184. Government guarantee. – The Republic of the Philippines guarantees the benefits prescribed under this Title, and accepts general responsibility for the solvency of the State Insurance Fund. In case of deficiency, the same shall be covered by supplemental appropriations from the national government.

Thus, concerns about the fund’s solvency cannot justify denying benefits to deserving claimants. Ultimately, the Supreme Court denied the GSIS petition, underscoring the state’s commitment to social justice and the protection of workers whose health is compromised by their employment.

FAQs

What was the key issue in this case?	The key issue was whether the death of an employee due to peptic ulcer, allegedly caused or aggravated by work-related stress, is compensable under P.D. 626, as amended. This hinged on whether the employee’s occupation involved prolonged emotional or physical stress.
What is P.D. 626?	P.D. 626, as amended, is the law governing employees’ compensation in the Philippines. It defines compensable sickness and injury and provides for income benefits to employees who suffer work-related disabilities or illnesses.
What does it mean for a disease to be “compensable”?	A compensable disease is one that entitles an employee to receive income benefits and other forms of assistance under the employees’ compensation law. This typically requires a showing that the disease is either an occupational disease or that the risk of contracting it was increased by the working conditions.
How does the Supreme Court define substantial evidence?	The Supreme Court defines substantial evidence as such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. It requires a reasonable work-connection, not a direct causal relation, between the employment and the disease.
What is the significance of a death certificate in compensation claims?	A death certificate is considered prima facie evidence of the facts stated therein, including the causes of death. Unless refuted by contrary evidence, the entries in the death certificate are presumed correct.
What is ECC Resolution No. 1676?	ECC Resolution No. 1676 lists peptic ulcer as a compensable disease when contracted under working conditions involving prolonged emotional or physical stress, as is common in professional occupations.
Does employment need to be the sole cause of the illness for it to be compensable?	No, employment does not need to be the sole cause. It is sufficient if the employment contributed, even to a small degree, to the development or aggravation of the disease.
What happens if the State Insurance Fund is insufficient to pay compensation claims?	The Republic of the Philippines guarantees the benefits and accepts general responsibility for the solvency of the State Insurance Fund. Any deficiency shall be covered by supplemental appropriations from the national government.

This case illustrates the importance of considering the totality of circumstances surrounding an employee’s health and working conditions when evaluating compensation claims. It reaffirms the principle that social justice and protection of labor are paramount concerns in Philippine law. The court’s decision highlights that even ailments not explicitly listed as occupational diseases can be compensable if a clear link exists between the work environment and the development or aggravation of the condition.

For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.

Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: GOVERNMENT SERVICE INSURANCE SYSTEM, VS. JEAN E. RAOET, G.R. No. 157038, December 23, 2009