CASE DIGEST: GSIS v. Besitan
G.R. No. 178901: November 23, 2011
GOVERNMENT SERVICE INSURANCE SYSTEM, Petitioner, v. MANUEL P. BESITAN, Respondent.
DEL CASTILLO, J.:
FACTS:
Petitioner GSIS is a social insurance institution charged with the management and administration of the trust fund of the Employees Compensation Commission (ECC) for government officials and employees.
Respondent Besitan was employed by the Central Bank of the Philippines on January 21, 1976 as a Bank Examiner. Subsequently, he was promoted as Bank Officer II and eventually as Bank Officer III.
In October 2005, Besitan was diagnosed with End Stage Renal Disease secondary to Chronic Glomerulonephritis and thus, had to undergo a kidney transplant at the National Kidney and Transplant Institute (NKTI), for which he incurred medical expenses amounting to P817,455.40.
Believing that his working condition increased his risk of contracting the disease, Besitan filed with the GSIS a claim for compensation benefits under Presidential Decree (PD) No. 626, as amended. The GSIS, however, denied the claim. The GSIS Decision was affirmed by the Employees Compensation Commission but reversed by the Court of Appeals.
GSIS contends that Besitans ailment is not an occupational disease; hence, it is incumbent upon him to prove that the risk of contracting the said disease was increased by his employment and working condition. And since he failed to show that there is a causal relationship between his employment and his ailment, he cannot claim compensation benefits under PD No. 626, as amended.
Besitan admits that his ailment is not listed as an occupational disease under PD No. 626, as amended. He, however, insists that he was able to prove by substantial evidence that the risk of contracting the disease was increased by his working condition. He maintains that in claiming compensation benefits, certainty is not required, only probability. He points out that he was in good health when he was employed by the Bangko Sentral ng Pilipinas in 1976 and that it was only in 2004 that he contracted his kidney ailment.
ISSUE:
I. Whether Besitan is entitled to compensation benefits under PD No. 626, as amended
HELD:
Section 1, Rule III of the Amended Rules on Employees Compensation provides that for the sickness or resulting disability or death to be compensable, the claimant must prove either (1) that the employee's sickness was the result of an occupational disease listed under Annex "A" of the Amended Rules on Employees Compensation, or (2) that the risk of contracting the disease was increased by his working conditions.
Under the increased risk theory, there must be a reasonable proof that the employees working condition increased his risk of contracting the disease, or that there is a connection between his work and the cause of the disease. Only a reasonable proof of work-connection, not direct causal relation, however, is required to establish compensability of a non-occupational disease. Probability, and not certainty, is the yardstick in compensation proceedings; thus, any doubt should be interpreted in favor of the employees for whom social legislations, like PD No. 626, were enacted.
Moreover, direct and clear evidence, is not necessary to prove a claim. Strict rules of evidence do not apply as PD No. 626 only requires substantial evidence or "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
In this case, since Besitans ailment, End Stage Renal Disease secondary to Chronic Glomerulonephritis is not among those listed under Annex "A," of the Amended Rules on Employees Compensation, he needs to show by substantial evidence that his risk of contracting the disease was increased by his working condition.
After a careful study of the instant case, we find that Besitan has sufficiently proved that his working condition increased his risk of contracting Glomerulonephritis, which according to GSIS may be caused by bacterial, viral, and parasitic infection (i.e. Typhoid fever, Syphilis, Leptospirosis, Toxoplasmosis, Varicella, Mumps, Measles, Schistosomiasis, Hepatitis B and C infection, etc.).
GOVERNMENT SERVICE INSURANCE SYSTEM, Petitioner, v. MANUEL P. BESITAN, Respondent.
DEL CASTILLO, J.:
FACTS:
Petitioner GSIS is a social insurance institution charged with the management and administration of the trust fund of the Employees Compensation Commission (ECC) for government officials and employees.
Respondent Besitan was employed by the Central Bank of the Philippines on January 21, 1976 as a Bank Examiner. Subsequently, he was promoted as Bank Officer II and eventually as Bank Officer III.
In October 2005, Besitan was diagnosed with End Stage Renal Disease secondary to Chronic Glomerulonephritis and thus, had to undergo a kidney transplant at the National Kidney and Transplant Institute (NKTI), for which he incurred medical expenses amounting to P817,455.40.
Believing that his working condition increased his risk of contracting the disease, Besitan filed with the GSIS a claim for compensation benefits under Presidential Decree (PD) No. 626, as amended. The GSIS, however, denied the claim. The GSIS Decision was affirmed by the Employees Compensation Commission but reversed by the Court of Appeals.
GSIS contends that Besitans ailment is not an occupational disease; hence, it is incumbent upon him to prove that the risk of contracting the said disease was increased by his employment and working condition. And since he failed to show that there is a causal relationship between his employment and his ailment, he cannot claim compensation benefits under PD No. 626, as amended.
Besitan admits that his ailment is not listed as an occupational disease under PD No. 626, as amended. He, however, insists that he was able to prove by substantial evidence that the risk of contracting the disease was increased by his working condition. He maintains that in claiming compensation benefits, certainty is not required, only probability. He points out that he was in good health when he was employed by the Bangko Sentral ng Pilipinas in 1976 and that it was only in 2004 that he contracted his kidney ailment.
ISSUE:
I. Whether Besitan is entitled to compensation benefits under PD No. 626, as amended
HELD:
Section 1, Rule III of the Amended Rules on Employees Compensation provides that for the sickness or resulting disability or death to be compensable, the claimant must prove either (1) that the employee's sickness was the result of an occupational disease listed under Annex "A" of the Amended Rules on Employees Compensation, or (2) that the risk of contracting the disease was increased by his working conditions.
Under the increased risk theory, there must be a reasonable proof that the employees working condition increased his risk of contracting the disease, or that there is a connection between his work and the cause of the disease. Only a reasonable proof of work-connection, not direct causal relation, however, is required to establish compensability of a non-occupational disease. Probability, and not certainty, is the yardstick in compensation proceedings; thus, any doubt should be interpreted in favor of the employees for whom social legislations, like PD No. 626, were enacted.
Moreover, direct and clear evidence, is not necessary to prove a claim. Strict rules of evidence do not apply as PD No. 626 only requires substantial evidence or "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
In this case, since Besitans ailment, End Stage Renal Disease secondary to Chronic Glomerulonephritis is not among those listed under Annex "A," of the Amended Rules on Employees Compensation, he needs to show by substantial evidence that his risk of contracting the disease was increased by his working condition.
After a careful study of the instant case, we find that Besitan has sufficiently proved that his working condition increased his risk of contracting Glomerulonephritis, which according to GSIS may be caused by bacterial, viral, and parasitic infection (i.e. Typhoid fever, Syphilis, Leptospirosis, Toxoplasmosis, Varicella, Mumps, Measles, Schistosomiasis, Hepatitis B and C infection, etc.).
