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COMPENSABILITY

SEC.1, RULE III, PD No. 626


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

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.
ANNEX A

For an occupational disease and the resulting disability or death to be
compensable, all of the following conditions must be satisfied:

1. The employee's work must involve the risks described herein;
2. The disease was contracted as a result of the employee's exposure to
the described risks;
3. The disease was contracted within a period of exposure and under
such other factors necessary to contract it;
4. There was no notorious negligence on the part of the employee.
GSIS V. GABRIEL
(GR No.130379, June 21, 1999)
Prosecutor Rosendo Gabriel Jr. was at the time of his
death on January 11, 1995 a Prosecutor II of Quezon City
Record showed that he had more than 30 years of service
in the government.
He was found to be suffering:
- Mild restrictive & obstructive pulmonary defect and lower
esophageal obstruction probably malignant (1993)
- Esophageal cancer, hypertensive atherosclerotic heart
disease (1994)
- Acute myocardial infraction as the chief complaint was
chest pains (1994)
- Esophageal cancer, metastasis with pleural effusion
(1995)
- Died of cardiac arrest secondary to esophageal cancer.

GSIS V. GABRIEL
(GR No.130379, June 21, 1999)

GSIS: denied the claim because
a. esophageal cancer is not listed as an
occupational disease under Annex A of PD
No. 626
b. there is no showing that claimants duties
involve risk of contracting the above illness.
ECC: denied the motion
CA: reversed the decision of ECC
GSIS V. GABRIEL
(GR No.130379, June 21, 1999)
ISSUE: Whether the resulting death of prosecutor from his
last illness is compensable under PD No. 626, as
amended.
SC: The cardiac arrest causing sudden death was caused
primarily by myocardial infraction rather than by
esophageal cancer.
even if esophageal cancer is not compensable, there can
be no question that coronary artery disease or atherosclerotic
heart disease is compensable.

the incidence of a listed occupational disease whether or not
associated with a non-listed ailment is enough basis for
requiring compensation (GSIS v. CA)






VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
Celerino Valeriano was employed as a fire truck driver
assigned at the San Juan Fire Station
On July 3, 1985, petitioner met a friend by the name
of Alexander Agawin. They decided to proceed to
Bonanza Restaurant in EDSA, for dinner.
Owner-type jeepney they were riding in figured in a
head-on collision with another vehicle at the
intersection of N. Domingo and Broadway streets in
Q.C.
Petitioner was thrown out of the vehicle and was
severely injured. He was brought to the hospital for
several treatments.
On Sept. 16, 1985, he filed a claim for income
benefits under PD 626 with GSIS.

VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
GSIS: Opposed on the ground that the injuries he
sustained did not directly arise or result from the
nature of his work.
ECC: Under the present compensation law, injury
and the resulting disability or death is compensable
if the injury resulted from an accident arising out of
and in the course of employment.
- This condition is found wanting in the case. The
accident the appellant met occurred outside of his
time and place of work. Neither was appellant
performing his official duties as a fireman at the time
of the accident.
VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
CA: Agreed with the finding of the ECC that petitioners
injuries and disability were not compensable,
emphasizing that they were not work-connected
Petitioners Contention:
- Invoke 24 hours duty doctrine (Hinoguin vs. ECC)
claiming that his position is akin to that of a military
man, and that the exigency of his job as a fireman
requires a constant observance of his duties, as such
he can be considered to have been on call when he
met the accident.
ISSUES:
- Whether petitioners injuries are work- connected
- Whether petitioner fireman, like soldiers, can be
presumed to be on 24- hour duty

VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
SC:
For the injury and the resulting disability to be
compensable, they must have necessarily resulted from an
accident arising out of and in the course of employment.
For injury to be compensable , the standard of work-
connection must be substantially satisfied. The injury and
the resulting disability sustained by reason of employment are
compensable regardless of the place where the injured
occurred, if it can be proven that at the time of the injury, the
employee was acting within the purview of his employment
and performing an act reasonably necessary or incidental
thereto.
- Petitioner sustained the injuries after pursuing a purely
personal and social function. His injuries and consequent
disability were not work- connected and thus not
compensable.
VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
SC: In Hinoguin and Nitura , the Court granted death
compensation benefits to theirs heirs, as both members of the
Phil. Army.
- The concept of workplace cannot always literally applied
to a soldier on active duty status who, to all intents and
purposes, is on a 24-hour official duty status, subject to
military discipline and at the law and at the call of his
superior officers at all times, except on vacation leaves.
- In ECC v. CA, Court reviewed Hinoguin, Nitura and ECC
and noted that in each case death benefits were granted,
not just because of the principle that soldiers or policemen
were virtually working round the clock, but of the
reasonable nexus between the absence of the
deceased from his assigned place of work and the
incident causing his death.

VALERIANO V. ECC
(GR No. 136200,June 8, 2000)
SC:
Taking together jurisprudence and pertinent guidelines
of ECC with respect to claims for death benefits:
1. That the employee must be at the place where his
work requires him to be
2. That the employee must have been performing his
official functions
3. That if the injury is sustained elsewhere, the employee
must have been executing an order for the employer.

24 hour duty doctrine cannot be applied to petitioners case.
- He was neither at assigned work place nor in pursuit of
orders of his superiors when he met an accident.
- He was not doing an act within his duty and authority as a
fire truck driver at the time he sustained his injuries.
GSIS V. CUANANG
(GR No. 158846, June 3, 2004)
Carmen Cuanang was formerly employed as a teacher in the
Division of City Schools, Manila. She was first appointed as
Elementary Grade Teacher, then promoted to Teacher I and
later on to Teacher II.
Carmen served as Teacher II until she applied for early
optional retirement after completing almost 26 years of
government service.
Sept. 14-18, 1997 she was confined for Bronchial Ashma &
Pneumonia, RHD and Mitral Stenosis. She filed sickness
benefits with GSIS under PD 626. GSIS awarded her
Temporary Total Disability benefits from Nov. 14-25, 1998.
He was also granted Permanent Partial Disability benefits
for 9 months.
She died at the age of 65 with the immediate cause of death
was determined to be Cardio Pulmonary Arrest with Acute
Myocardial Infarction as the antecent cause, and Bronchial
Asthma and Hypertension as underlying cause.
GSIS V. CUANANG
(GR No. 158846, June 3, 2004)
Respondent filed with petitioner GSIS a claim for death
benefits under PD 626.
GSIS: death was due to Myocardial Infarction is not
compensable under PD 626 since it occurred after retirement
and beyond PPD period.
ECC: affirmed the GSIS denial of respondents claim.
The ailment Acute Myocardial Infarction cannot be
considered work- connected since it is complication of RHD
which is a result of her Rheumatic Fever acquired during
childhood
Bronchial Asthma cannot be given due course since it took
beyond PPD period
Hypertension was developed after Cuanangs retirement
negates compensability since it could be due to factors other
than her work.

GSIS V. CUANANG
(GR No. 158846, June 3, 2004)
CA: set aside ECCs decision
The degree of proof required under PD 626 is merely
substantial evidence. The claimant must show, at least, by
substantial evidence that the development of the disease is
brought largely by a conditions present in the nature of the job.

What the law requires is a reasonable work connection and
not direct causal connection.

ISSUE: Whether the resulting death of Carmen Cuanang is
compensable under PD 626.
SC: The wife of the respondent died a year after her
retirement . Clearly, the period between her retirement and
demise was less than 1 year. A claim for benefit for such death
cannot be defeated by the mere fact of separation from
service.
GSIS V. CUANANG
(GR No. 158846, June 3, 2004)
There was a substantial evidence to support respondents
claim.
- The requisite substantial evidence came from the expert
opinion of Dr. Arsenio Estreras who issued the Death
Certificate
- Expert opinion is fully supported by the facts leading to
Carmen Cuanangs deteriorating health condition and
ultimately, her death. When she joined the government
service on Oct. 1, 1972, she was in perfect health, but
condition while still in service started to worsen.
- Myocardial Infarction or known as coronary is a life
threatening condition. Predisposing factors include stress.
The collective effect of all the factors involved during her
service contributed to the deterioration of her already
precarious health.
- The respondents claim is GRANTED.