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RUTH JIMENEZ v. ECC and GSIS

1. LABOR AND SOCIAL LEGISLATION; LABOR CODE; EMPLOYEESCOMPENSATION COMMISSION; COMPENSABILITY OF ILLNESS; CANCEROF THE LUNGS, A BORDERLINE CASE REQUIRING STUDY OFCIRCUMSTANCES OF CASE. — Admittedly, cancer of the lungs(bronchogenic carcinoma) is one of those borderline cases where a studyof the circumstances of the case is mandated to fully appreciate whetherthe nature of the work of the deceased increased the possibility ofcontracting such an ailment. WE have ruled in the case of Dator v.Employees Compensation Commission (111 SCRA 634, L-57416, January 30,

1982) that" (U)ntil now, the cause of cancer is not known." Indeed, therespondent has provided an opening through which petitioner can pursueand did pursue the possibility that the deceased’s ailment could have beencaused by the working conditions while employed with the PhilippineConstabulary. Respondents maintain that the deceased was a smoker andthe logical conclusion is that the cause of the fatal lung cancer could onlybe smoking which cannot in any way be justified as work-connected.However, medical authorities support the conclusion that up to now, theetiology or cause of cancer of the lungs is still largely unknown.

2. ID.; ID.; ID.; ID.; CONCLUSION OF COMMISSION NOT INACCORDANCE WITH MEDICAL AUTHORITIES AND FACTS ON RECORD. — The sweeping conclusion of the respondent Employees CompensationCommission to the effect that the cause of the bronchogenic carcinoma ofthe deceased was due to his being a smoker and not in any mannerconnected with his work as a soldier, is not in accordance with medical

authorities nor with the facts on record. No certitude can arise from aposition of uncertainty. WE are dealing with possibilities and medicalauthorities have given credence to the stand of the petitioner that herhusband developed bronchogenic carcinoma while working as a soldierwith the Philippine Constabulary. The records show that when thedeceased enlisted with the Philippine Constabulary in 1969, he was foundto be physically and mentally healthy. A soldier’s life is a hard one. As asoldier assigned to field duty, exposure to the elements, dust and dirt,fatigue and lack of sleep and rest is a common occurrence. Exposure tochemicals while handling ammunition and firearms cannot be discounted.WE take note also of the fact that he became the security of one Dr. EmilioCordero of Anulung, Cagayan, and he always accompanied the doctorwherever the latter went (p. 26, rec.). Such assignment invariably involvedirregular working hours, exposure to different working conditions, andbody fatigue, not to mention psychological stress and other similar factorswhich influenced the evolution of his ailment.

3. ID.; ID.; ID.; ID.; THEORY OF INCREASED RISK. — The theory ofincreased risk is applicable in the case at bar. In the case of Cristobal v. ECC(103 SCRA, 336-337) where the Court held that "to establishcompensability under the said theory, the claimant must show proof ofwork-connection. Impliedly, the degree of proof required is merelysubstantial evidence, which means ‘such relevant evidence to support adecision’ (Ang Tibay v. The Court of Industrial Relations and National LaborUnion, Inc., 69 Phil. 635) or clear and convincing evidence. In thisconnection, it must be pointed out that the strict rules of evidence are notapplicable in claims for compensation. Respondents however insist onevidence which would establish direct causal relation between the diseaserectal cancer and the employment of the deceased. Such a strictrequirement which even medical experts cannot support considering theuncertainty of the nature of the disease would negate the principle of the

liberality in the matter of evidence. Apparently, what the law merelyrequires is a reasonable work-connection and not a direct causal relation.This kind of interpretation gives meaning and substance to the liberal andcompassionate spirit of the law as embodied in Article 4 of the new LaborCode which states that ‘all doubts in the implementation of the provisionsof this Code, including its implementing rules and regulations shall beresolved in favor of labor."

4. ID.; ID.; ID.; STRICT RULES ON EVIDENCE NOT APPLICABLE;STATE POLICY OF LIBERALITY TOWARDS LABOR MUST BE MAINTAINED.— In San Valentin v. ECC (118 SCRA 160), the Court held that "Incompensation cases, strict rules on evidence are not applicable. Areasonable work-connection is all that is required or that the risk ofcontracting the disease is increased by the working condition."

This is in line with the avowed policy of the State as mandated by theConstitution (Art. II, Sec. 9) and restated in the New Labor Code (Art. 4) togive maximum aid and protection to labor.

This is a petition to review the decision of respondent EmployeesCompensation Commission (ECC) dated August 20, 1981 (Annex "A"Decision, pp. 10-12, rec.) in ECC Case No. 1587, which affirmed the decisionof respondent Government Service Insurance System (GSIS), denyingpetitioner’s claim for death benefits under Presidential Decree No. 626, asamended.

The undisputed facts are as follows: Petitioner is the widow of the lateAlfredo Jimenez, who joined the government service in June, 1969 as aconstable in the Philippine Constabulary (p. 2, rec.)

After rendering service for one year, he was promoted to the rank oconstable second class. On December 16, 1974, he was again promoted tothe rank of sergeant (p. 26, rec.)

Sometime in April, 1976, he and his wife boarded a bus from Tuguegarao,Cagayan, to Anulung, Cagayan. While on their way, Sgt. Jimenez, who wasseated on the left side of the bus, fell down from the bus because of thesudden stop of the vehicle. As a result, he was confined at the CagayanProvincial Hospital for about one (1) week, and thereafter, released(comment of respondent ECC, pp. 25-36, rec.). He was again confined forfurther treatment from November 7, 1978 to May 16, 1979 at the AFPMedical Center in Quezon City.

While on duty with the 111th PC Company, Tuguegarao, Cagayan, he wasassigned as security to one Dr. Emilio Cordero of Anulung, Cagayan (ECCrec., Proceedings of the PC Regional Board, June 6, 1980). In compliancewith his duty, he always accompanied the doctor wherever the latter wen(p. 26, rec.)

On November 7, 1978, the deceased was again confined at the CagayanProvincial Hospital and then transferred to the AFP V. Luna Medical Centeat Quezon City for further treatment. He complained of off-and-on backpains, associated with occasional cough and also the swelling of the righforearm. The doctors found a mass growth on his right forearm, whichgrew to the size of 3 by 2 inches, hard and associated with pain, which thedoctors diagnosed as "aortic aneurysm, medrastinal tumor" (p. 27, rec.)

His condition improved somewhat after treatment and he was released on

May 16, 1979. He was advised to have complete rest and to continuemedication. He was then given light duty inside the barracks of theircompany.

Unfortunately, his ailment continued and became more serious.

On May 12, 1980, he died in his house at Anulung, Cagayan, at about 9:00o’clock in the evening. He was barely 35 years old at the time of his death.

The cause of death, as found by the doctors, is "bronchogenic carcinoma"which is a malignant tumor of the lungs.

On June 6, 1980, an administrative hearing was conducted before the PCRegional Board. It was their official findings that the subject enlisted man"died in line of duty" ; that the deceased was a PC member of the 111th PC

Company at Tuguegarao, Cagayan; that he died due to "bronchogenic CA"; and that he "died not as a result of his misconduct and did not violate anyprovisions of the Articles of War" (ECC rec., Proceedings of the PCRegional Board, June 6, 1980).

The Board recommended "that all benefits due to or become due subjectEP be paid and settled to his legal heirs" (ECC rec., Proceedings of the PCRegional Board, June 6, 1980). Thus, as per records of the GSIS, petitionerwas paid benefits due to her deceased husband under Republic Act No610 (Comment of respondent ECC, p. 27, rec.)



Nevertheless, petitioner filed a claim for death benefits under PD No. 626,as amended with the respondent GSIS. Said claim was denied by the GSISon the ground that her husband’s death is not compensable "for thereason that the injury/sickness that caused his death is not due to thecircumstances of the employment or in the performance of the duties andresponsibilities of said employment" (Letter of denial by the GSIS datedJuly 14, 1980, ECC rec.)

The said decision was affirmed by respondent Employees CompensationCommission in its decision dated August 21, 1981, stating among others:"After an exhausted (sic) study of the evidences (sic) on record and the

applicable law on the case, we conclude that the law has been properlyapplied by the respondent System. . . .

"Bronchogenic carcinoma, medical authorities disclose, is the mostcommon form of malignancy in males reaching a peak between the fifthand seventh decades and accounting for one in four male cancer deaths.The sex incidence is at least 5 to 1, male to female. Extensive statisticalanalysis by medical authorities have confirmed the relationship betweenlung cancer and cigarette smoking. Other factors that may have potentialroles are exposure to ionizing radiation, exposure to chromates, metalliciron and iron oxides, arsenic, nickel, beryllium and asbestos (Harrison’sPrinciples of Internal Medicine by Wintrobe, Et Al., 7th Edition, p. 1322).

"Although Presidential Decree No. 626, as amended, was envisioned togive relief to workingmen, who sustain an injury or contract an ailment inthe course of employment and that to best attain its lofty objective, a

liberal interpretation of the law should pervade in its implementation, thisprecept, however, may not be invoked as not even a slight causal linkbetween the development of the ailment and the decedent’s (sic) dutiesand working conditions as a PC sergeant could be deduced from therecords of this case. The respondent System’s ruling that appellant’s claimdoes not fall within the beneficiant provisions of Presidential Decree No.626, as amended, and therefore the same should be denied, is in fullharmony with the law and the facts obtaining herein.. . ." (Decision, pp. 10-12, rec.)On September 28, 1981, Petitioner, assisted by counsel, filed the instantpetition, the only pertinent issue being whether or not her husband’sdeath from bronchogenic carcinoma is compensable under the law.

The petitioner contends that her husband’s death is compensable and thatrespondent Commission erred in not taking into consideration theuncontroverted circumstance that when the deceased entered into the

Philippine Constabulary, he was found to be physically and mentallyhealthy. She farther contends that as a soldier, her husband’s work hasalways been in the field where exposure to the elements, dust and dirt,fatigue and lack of sleep and rest was the rule rather than the exception.The nature of work of a soldier being to protect life and property ofcitizens, he was subject to call at any time of day or night. Furthermore, hewas even assigned as security to one Emilio Cordero and alwaysaccompanied the latter wherever he went. Exposed to thesecircumstances for several years, the deceased’s physical constitutionbegan to deteriorate, which eventually resulted to his death frombronchogenic carcinoma (Petition, pp. 2-9, rec.)

On the other hand, respondent Commission maintains that while thedeceased soldier may have been exposed to elements of dust and dirt andcondition of lack of rest and continued fatigue by virtue of his duties to

protect the life and property of the citizens, such conditions have nocausal relation to his contraction of bronchogenic carcinoma. It is also theopinion of the respondent that since there is evidence of the deceased tobe a smoker, "the late Sgt. Jimenez may have indulged heavily in smokingand drinking, not merely ‘occasionally’. And it has been demonstratedmedically that the more cigarettes a person smokes, the greater the risk ofdeveloping lung cancer" (Memorandum, p. 62, rec.). In short, therespondent alleges that the deceased was responsible to a large degreefor his having contracted bronchogenic carcinoma that led to his demise.

WE find the petitioner’s claim meritorious.

Primary carcinoma of the lung is the most common fatal cancer and itsfrequency is increasing (The Merck Manual, 13th Edition, p. 647).Admittedly, cancer of the lungs (bronchogenic carcinoma) is one of those

borderline cases where a study of the circumstances of the case ismandated to fully appreciate whether the nature of the work of thedeceased increased the possibility of contracting such an ailment. In thecase of Laron v. Workmen’s Compensation Commission (73 SCRA 90), WEheld, citing Schmidt’s Attorney’s Dictionary of Medicine, 165 Sup. 143Beerman v. Public Service Coordinated Transport, 191 A 297, 299; Wordsand Phrases, 6 Permanent Edition 61, "The English word ‘cancer’ means‘crab’, in the medical sense, it refers to a malignant, usually fatal, tumor ogrowth." Findings of fact by the respondent points out that bronchogeniccarcinoma is a malignant tumor of the lungs. WE have ruled in the case oDator v. Employees Compensation Commission (111 SCRA 634, L-57416

January 30, 1982) that" (U)ntil now, the cause of cancer is not known."Indeed, the respondent has provided an opening through which petitionecan pursue and did pursue the possibility that the deceased’s ailmentcould have been caused by the working conditions while employed withthe Philippine Constabulary.

Respondents maintain that the deceased was a smoker and the logicaconclusion is that the cause of the fatal lung cancer could only be smokingwhich cannot in any way be justified as work-connected. However, medicaauthorities support the conclusion that up to now, the etiology or cause ocancer of the lungs is still largely unknown as provided for in the following

"Although the etiology of cancer in humans cannot yet be explained at themolecular level, it is clear that genetic composition of the host is importanin cancer induction. Related immunologic factors may predispose the hostto a putative carcinogen. There is some evidence that viruses may play a

role in the neoplastic process. In addition, both environmental andtherapeutic agents have been identified of carcinogens" (HarrisonPrinciples of Internal Medicine, 9th Edition, 1980, p. 1584).

"Considerable attention has been directed to the potential role of airpollution exposure to ionizing radiation and numerous occupationahazards, including exposure to chromates, metallic iron and iron oxidesarsenic, nickel, beryllium and asbestos" (Harrison, Ibid, p. 1259).

"The lungs are the site of origin of primary benign and malignant tumorsand receive metastases from many other organs and tissues. Specificcauses have not been established but a strong dose-related statisticaassociation exists between cigarette smoking and squamous cell andundifferentiated small (oat) cell bronchogenic carcinomas. There issuggestive evidence that prolonged exposure to air pollution promoteslung neoplasms" (The Merck Manual, 13th Edition, p. 647).

"What emerges from such concepts is the belief that cancers in man donot appear suddenly ‘out of the blue’. . . . Moreover, there need not b e asingle etiology or pathogenesis. Many influences may be at work duringthe evolution of the lesion and many pathways may be involved. Indeedthe term cancer may embrace a multiplicity of diseases of diverse origins"(Robbins, Pathologic Basis of Disease, 2nd Edition, 1979, p. 185, Emphasissupplied).

WE cannot deny the fact that the causes of the illness of the deceased arestill unknown and may embrace such diverse origins which even themedical sciences cannot tell with reasonable certainty. Indeed, scientistsattending the World Genetic Congress in New Delhi, India, have warnedthat about 25,000 chemicals used around the world could potentiallycause cancer, and Lawrence Fishbein of the U.S. National Center fo

Toxilogical Research pointed out that humans were daily exposed toliterally hundreds of chemical agents via air, food, medication, both in theiindustrial home and environments (Evening Post, December 16, 1983, p. 3cols. 2-3).

The theory of increased risk is applicable in the instant case. WE had theoccasion to interpret the theory of increased risk in the case of Cristobal vEmployees Compensation Commission (103 SCRA, 336-337, L-49280February 26, 1981):"To establish compensability under the said theory, the claimant mustshow proof of work-connection. Impliedly, the degree of proof required ismerely substantial evidence, which means ‘such relevant evidence tosupport a decision’ (Ang Tibay v. The Court of Industrial Relations andNational Labor Union, Inc., 69 Phil. 635) or clear and convincing evidence.



In this connection, it must be pointed out that the strict rules of evidenceare not applicable in claims for compensation. Respondents however insiston evidence which would establish direct causal relation between thedisease rectal cancer and the employment of the deceased. Such a strictrequirement which even medical experts cannot support considering theuncertainty of the nature of the disease would negate the principle of theliberality in the matter of evidence, Apparently, what the law merelyrequires is a reasonable work-connection and not a direct causal relation.This kind of interpretation gives meaning and substance to the liberal andcompassionate spirit of the law as embodied in Article 4 of the new LaborCode which states that ‘all doubts in the implementation of the provisions

of this Code, including its implementing rules and regulations shall beresolved in favor of labor.’ ". . . As the agents charged by the law to implement the social justiceguarantee secured by both 1935 and 1973 Constitutions, respondentsshould adopt a more liberal attitude in deciding claims for compensationespecially when there is some basis in the facts inferring a work-connection. This should not be confused with the presumption ofcompensability and theory of aggravation under the Workmen’sCompensation Act. While these doctrines may have been abandonedunder the New Labor Code (the constitutionality of such abrogation maystill be challenged), it is significant that the liberality of the law, in general,still subsists. . . ." (Emphasis supplied)

The sweeping conclusion of the respondent Employees CompensationCommission to the effect that the cause of the bronchogenic carcinoma ofthe deceased was due to his being a smoker and not in any manner

connected with his work as a soldier, is not in accordance with medicalauthorities nor with the facts on record. No certitude can arise from aposition of uncertainty.

WE are dealing with possibilities and medical authorities have givencredence to the stand of the petitioner that her husband developedbronchogenic carcinoma while working as a soldier with the PhilippineConstabulary. The records show that when the deceased enlisted with thePhilippine Constabulary in 1969, he was found to be physically andmentally healthy. A soldier’s life is a hard one. As a soldier assigned to fieldduty, exposure to the elements, dust and dirt, fatigue and lack of sleepand rest is a common occurrence. Exposure to chemicals while handlingammunition and firearms cannot be discounted. WE take note also of thefact that he became the security of one Dr. Emilio Cordero of Anulung,Cagayan, and he always accompanied the doctor wherever the latter went(p. 26, rec.). Such assignment invariably involved irregular working hours,

exposure to different working conditions, and body fatigue, not tomention psychological stress and other similar factors which influencedthe evolution of his ailment.

WE held in the case of San Valentin v. Employees CompensationCommission (118 SCRA 160) that: "In compensation cases. strict rules ofevidence are not applicable. A reasonable work-connection is all that isrequired or that the risk of contracting the disease is increased by theworking conditions."

In the case of Dator v. Employees Compensation Commission:(L-57416, January 30, 1982), WE held the death of Wenifreda Dator, alibrarian for 15 years, caused by bronchogenic carcinoma compensable.Being a librarian, "she was exposed to duty books and other deleterioussubstances in the library under unsanitary conditions" (Ibid., 632). WE do

not see any reason to depart from the ruling in the said case, consideringthat a soldier’s duties and environment are more hazardous.

This is in line with the avowed policy of the State as mandated by theConstitution (Article II, Section 9) and restated in the new Labor Code(Article 4), to give maximum aid and protection to labor.

WHEREFORE, THE DECISION APPEALED FROM IS HEREBY SET ASIDE ANDTHE GOVERNMENT SERVICE INSURANCE SYSTEM IS HEREBY ORDERED.1. TO PAY THE PETITIONER THE SUM OF TWELVE THOUSAND(P12,000.00) PESOS AS DEATH BENEFITS;2. TO REIMBURSE THE PETITIONER’s MEDICAL AND HOSPITALEXPENSES DULY SUPPORTED BY PROPER RECEIPTS; AND3. TO PAY THE PETITIONER THE SUM OF ONE THOUSAND TWOHUNDRED (P1,200.00) PESOS FOR BURIAL EXPENSES.

VENUSTO PANOTES vs.ECC, GSIS

On March 29, 1984, WE rendered a decision in this case grantingcompensation benefits (pursuant to P.D. 626, as amended) to petitioneVenusto Panotes for the death of his wife, Agustina Garfin Panotes. Thefatal disease, colonic malignancy or cancer of the colon, was considered bythis Court as having been contracted due to or at least the risk ofcontracting the same had been increased by the working conditions towhich the deceased had been subjected as a public school teacher, andaccordingly, ordered respondent Government Service Insurance System:

1) to pay petitioner the sum of P12,000.00 as death benefits;2) to reimburse the petitioner's medical and hospital expensesduly supported by proper receipts;3) to pay the petitioner the sum of P1,200.00 as funeral expensesand4) to pay the petitioner the sum of P1,200.00 as attorney's fees.

On May 2, 1984, respondent GSIS filed a motion for reconsideration basedon the following grounds:

1) reasonable work-connection is required by the law for anemployees'compensation claims, the alleged fact of impossibility of proofnotwithstanding;2) the legal requirement of work-connection should prevail uponthe general liberality of the law;

3) award of attorney's fees is not within the contemplation of thelaw and which this Court had previously reduced to 5% (p. 82, rec.).

WE find the motion of respondent GSIS devoid of merit.

In this motion before US, respondent GSIS brings up the issue of therelation between the standard of reasonable work connection establishedby this Court in compensation cases and the Court's statement in the caseat bar that the cause of the fatal disease is unknown (Emphasis supplied)Respondent's theory that, by granting petitioner's claim, the standard oreasonable work-connection for compensation cases was renderedmeaningless because this Court's findings in the present case that thecause of the fatal disease cancer of the colon is still unknown, belies thefinding that said fatal disease was caused by the nature of the work and/othe risk of contracting the same was increased by the working conditionsof the deceased. Respondent further submits the proposition that "if the

cause of the ailment is unknown, then it cannot also be said that theailment is work-connected under the increased risk doctrine" (p. 73, rec.italics supplied). "To declare as compensable all ailments whose causes areunknown would be to place the claimants with such types of ailments in afar better or superior position than those whose causes are known butcannot be proved as work-connected", respondent adds (p. 71, rec.).

WE ruled in the case of Cristobal vs. Employees' CompensationCommission (L-49280, Feb. 26, 1981, 103 SCRA 329, 335336), thus:

The deceased died of rectal cancer on May 27, 1977. Concededly the exactcause or etiology of this disease is still unknown. Even respondent ECC'sown medical officer, Dr. Mercia C. Abrenica, certified that the cause orectal carcinoma as of any other malignancies is still unknown' (p. 9, ECCrec.). Its cause and development are insidious, imperceptible to the naked

eye, and defies expert analysis. Therefore, whether or not the diseaserectal cancer was caused or the risk of contracting the same was increasedby the decedent's working conditions remains uncertain This uncertaintyof course, cannot eliminate the probability that the ailment was workconnected as it had been established that the deceased was exposed tounhygienic working conditions, various chemicals and intense heat whichare generally considered as predisposing factors of cancer.At this point, there is need to reiterate that when the deceased startedworking in 1964, he was free from any kind of disease.



In ruling on this claim, this Court also applied the theory of increased riskunder Section 1 (b) Rule III of PD 626 which states that:

For the sickness and the resulting disability or death to be compensable,the sickness must be the result of an occupational disease listed underAnnex 'A' of these Rules with the conditions set therein satisfied;otherwise, proof must be shown that the risk of contracting the disease isincreased by the working conditions (Emphasis supplied).

aside from the possibility that the disease might have been contractedprior to the effectivity of the new Labor Code. To establish compensability

of the claim under the said theory, the claimant must show proof of work-connection. Impliedly, the degree of proof required is merely substantialevidence, which means 'such relevant evidence as a reasonable mindmight accept as adequate to support a conclusion' (Ang Tibay vs. TheCourt of Industrial Relations and National Labor Union, Inc., 69 Phil. 635)or clear and convincing evidence. In this connection, it must be pointedout that the strict rules of evidence are not applicable in claims forcompensation. ... (Emphasis supplied).

Under the employees' compensation law, there are two categories ofoccupational illness or disease deemed compensation; a) those listed asoccupational disease by the Commission, and b) any illness caused by theemployment, subject to a showing by the employee that the risk ofcontracting the same is increased by the working conditions (Jarillo vs.ECC, L52058, February 25, 1982). In defining the increased risk doctrine,Larson states: "the distinctiveness of the employment risk can be

contributed by the increased quantity of a risk that is qualitatively notpeculiar to the employment" (Larson's Workmen's Compensation Law,Vol. I, S 6.30, pp. 3- 4 [1978]).

An occupational disease is thus discussed further as follows:

An occupational disease generally providing compensation therefor, is adisease which is caused by, or especially incident to, or the naturalconsequence of, the particular employment in which the workman isengaged, which results from exposure therein to hazards greater ordifferent than those involved in ordinary living, which generally developsgradually over a considerable period of time in the employment, andwhich industry has not learned to fend against or eliminate.xxx xxx xxxIn determining the cause of disability, and whether the cause was anoccupational disease within the provisions of the statute, all factors must

be taken into consideration; and whether a disease is compensable mustbe determined on the basis of the particular facts involved in each caseand the peculiar characteristics of each employment. Thus, while anoccupational disease is generally one which from common experience isrecognized to be necessarily incidental to the usual and ordinary course ofthe employment it has also been held that if the disease is one that resultsfrom employment it is an occupational disease, even though the risk ofdisease was not generally known. Accordingly, the disease need not be anatural and common result rather than an unexpected one.

While there is some authority to the effect that ordinary diseases of lifeare not compensable unless they follow as an incident of an occupationaldisease, a disease, to be compensable as occupational, is generally notrequired to be an extraordinary disease, and one to which the generalpublic is not exposed, and it is not essential that the disabling occupational

disease should arise solely out of the occupation in which the employee isengaged, in order to make it compensable. Moreover, the fact that anemployee's disease may be of a class or nature which members of thegeneral public may acquire under ordinary and usual conditions andcircumstances will not exclude it from the benefits of the act if the diseasewas in fact occasioned as a result of being subjected to the risks affordedby the unusual conditions of work in his employment (99 CJS Workmen'sCompensation, S 169, pp. 566-569 [1958], (Emphasis supplied).

Respondent GSIS further alleges that the evidences presented tended toprove a mere case of aggravation and not reasonable work-connectionthus, the following allegations: In the case at bar, this Honorable Courtwent on to describe in detail the physical, mental and emotional pressuresundergone by the deceased public school teacher who entered the servicein perfect health was not confined in the classroom but engaged in otheschool activities, was exposed to the elements, missed her meals becauseof workloads, etc.—all of which factors weakened her body resistance andmade her susceptible to diseases.

These conditions are invariably present in different types of employment

In fact, even among teachers, these conditions are unavoidably presentbut there has been no showing that many teachers have succumbed tocancer of the colon. Thus, we humbly ask for clarification as to whetheraggravating conditions unconnected to the ailment contracted, areenough to establish reasonable work connection, though the doctrine oaggravation, as stated by this Honorable Court, has already been removedunder the present law (Ibañez vs. ECC, L-47008, March 8, 1978) [p. 73rec.].

Assuming arguendo that the evidences cited in the case at bar were mereaggravating conditions, this Court, in the case of Acosta vs. ECC (109 SCRA210) had occasion to discuss the matter as follows:

The GSIS itself was inclined to believe that the ailment of the deceasedwas aggravated by the nature of her work when it stated in the commentthat it has no relation at all to the work of the deceased as a public schoo

teacher except by way of aggravation.' if this is so, there would be noconsistency in respondent denying the claim for compensation on theground that the risk of contracting the disease was not increased by herworking conditions. It is more in keeping with reason to hold that once asituation of aggravation arises, there exists a causal relation between herwork and her ailment which caused her death, as shown respondent GSIShas conceded the possibility of aggravation being present. (Emphasissupplied).

It is apparent from respondent's arguments that what it seeks is a directactual proof of the causal connection between the fatal disease and theworking conditions of the deceased. WE, however, rule in this case as WEdid in the other cases that actual proof of causation is not necessary tojustify compensability. The degree of proof required to establish proof ofwork-connection between ailment and the deceased's employment is onlysubstantial evidence or reasonable work connection (Cristobal vs. ECC, L

49280, February 26, 1981, 103 SCRA 329; Neri vs. ECC 127, SCRA 672). Wherecause of the employee's death is unknown, the right to compensationsubsists (Najera vs. ECC, 122 SCRA 697). Proof of causal connectionbetween claimant's disease of tumor and his employment as a condition ofcompensability, the causes of which disease cannot be explained, wouldrender nugatory the constitutional principles of social justice andprotection to labor (Poral vs. ECC, 131 SCRA 602; Mercado Jr. vs. ECC 127SCRA 664).

In the case of Cristobal vs. ECC (Ibid.) cited earlier, this Court ruled:xxx xxx xxx... As the agents charged by the law to implement the social justiceguarantee secured by both the 1935 and 1973 Constitutions, respondentsshould adopt a more liberal attitude in deciding claims for compensationespecially when there is some basis in the facts for inferring a work

connection. This should not be confused with the presumption ocompensability and theory of aggravation under the Workmen'sCompensation Act. While these doctrines may have been abandonedunder the new Labor Code (the constitutionality of such abrogation maystill be challenged), it is significant that the liberality of the law, in general,still subsists. All these factual and legal grounds were considered inrelation to each other constituting substantial evidence clearly convincingUS to resolve that rectal cancer is compensable.



Let it be pointed out too that the deceased's ailment was one of thosefalling under the borderline cases and in connection therewith, thisCourt has ruled in the case of Sepulveda vs. ECC (84 SCRA 771) as citedin the case of San Valentin vs. ECC (118 SCRA 160), that:

... (T)he respondent Commission under Resolution No. 223, datedMarch 16, 1977, adopted, as a policy, the institution of a morecompassionate interpretation of the restrictive provisions of P.D. 626,as amended, by its administering agencies, the SSS and the GSIS, withrespect to, among others, Myocardial Infarction and other borderlinecases. ... (Emphasis supplied).

Thus, the following diseases were deemed compensable: rheumaticheart disease (Panangui vs. ECC 121 SCRA 65), lung cancer (Dator vs.ECC, G.R. No. 57416, January 30, 1982), senile cataract (Jarillo vs. ECC,L-52058, February 25, 1982), liver cancer (Abadiano vs. GSIS, L-52254,January 30, 1982), pancreatitis (Villavert vs. ECC 110 SCRA 274), rectalcancer (Cristobal vs. ECC, L-49280, February 26, 1981, 103 SCRA 29).

The very fact that the cause of a disease is unknown, creates theprobability that the working conditions could have increased the riskof contracting the disease, if not caused by it, thus, the increased riskdoctrine was applied in the present case.

The situation obtaining in the case at bar generates doubts, which by

principle and in keeping with the law, should be resolved in favor oflabor. To warrant the arguments of respondent would render futilethe provision of Article 4 of the New Labor Code, expressly providingthat:

All doubts in the implementation and interpretation of the provisionsof this Code, its implementing rules and regulations, shall be resolvedin favor of labor (Emphasis supplied).

The preceding law is a direct implementation of the constitutionalmandate on social justice and protection to labor as embodied inArticle II, Sections 6 and 9, herein quoted as follows:

Sec. 6. The State shall promote social justice to ensure ... the dignity,welfare, and security of all the people ... .

Sec. 9. The State shall afford protection to labor, promote fullemployment and equality in employment, ensure equal workopportunities regardless of sex, race, or creed, and regulate therelations between workers and employers. The State shall assure therights of workers to self-organization, collective bargaining, securityof tenure, and just and humane conditions of work. The State mayprovide for compulsory arbitration (Emphasis supplied).

Social justice in workmen's compensation cases is not equality butprotection of the laborer as against the employer (De los Santos vs.WCC 120 SCRA 730).

Respondent GSIS refuses to appreciate the evidence substantiatingthe claim of petitioner. It cited the evidences in the decision which

allegedly are, at most, aggravating conditions only. Respondent,however, failed to take these evidences in the light of other equallycompelling factors. The deceased worked as an elementary schoolteacher from 1949 until she contracted the fatal disease in 1979. Shewas in perfect health when she entered the government service. Shewas not only teaching and confined within the protection of theclassroom, but she was saddled as well with other outdoor activities.This Court takes judicial notice of the fact that public school teachersare made to take up the burden of attending to various activities, bothfor the school and the community, aside from and in addition to theirduties as a teacher. This is a fact obvious and known to everyonefamiliar with our public school system and yet, ironically, we close oureyes to it.

Finally, with respect to the award of attorney's fees, respondentargues that the award is not proper or should have been reduced toonly 5% of the compensation claim. The argument is devoid of meritThere is no prohibition against imposing attorney's fees on theemployer, for the benefit of the counsel for the claimant (Marte vs.ECC, L-46362, January 30,1982).In Cristobal vs. ECC (supra), this Court has ruled that:

A close examination of the aforequoted provision reveals that theintent of the law is to free the award from any liability or charge sothat the claimant may enjoy and use it to the fullest. It is the claimant

who is exempt from liability for attorney's fees. The defaultingemployer or government agency remains liable for attorney's feesbecause it compelled the claimant to employ the services of counseby unjustly refusing to recognize the validity of the claim of petitionerThis actually is the rationale behind the prohibition. Nothing is wrongwith the court's award of attorney's fees which is separate anddistinct from the other benefits awarded. Besides, in the instant casethe participation of petitioner's counsel was not limited to thepreparation or filing of the claim but in appealing petitioner's casebefore this Court necessitating submission of pleadings to establishhis cause of action and to rebut or refute the arguments of hereinrespondents. Fairness dictates that the counsel should receivecompensation for his services, otherwise, it would be entirely difficultfor claimants, majority of whom are not teamed in the intricacies of

the law, to get good legal service. To deny counsel compensation forhis professional services, would amount to deprivation of propertywithout due process of law ( Emphasis supplied).

There is a clear difference, from the standpoint of legal policybetween attorney's fees to be paid by the laborer and fees awardedby the court to be paid by the employer. The plain intent of thestatute is that the compensation to be received by the injuredworkman should not be reduced by more than 10% on account oflawyer's fees. This purpose is attained where the fees are to be paidby the employer, since the compensation receivable by the workmanis then in no way diminished. In the latter eventuality, all that the lawrequires is that the counsel's fees should be reasonable (NDC vs. WCCL-19863, April 29, 1964, 10 SCRA 696). Thus, the award of 10%attorney's fees is proper. There is no prohibition in the law as to such

an award nor as to the proper amount that should be awarded. Theamount is actually discretionary upon the Court so long as it passesthe test of reasonableness.

WHEREFORE, THE DECISION DATED MARCH 29, 1984 IS HEREBYAFFIRMED. THE MOTION FOR RECONSIDERATION IS HEREBY DENIEDFOR LACK OF MERIT, AND THIS DENIAL IS FINAL AND EXCUTORY LETENTRY OF JUDGMENT BE MADE

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