G.R. No.

L-64802 September 23, 1985

VENUSTO PANOTES, petitioner,
vs.
EMPLOYEES' COMPENSATION COMMISSION, GOVERNMENT SERVICE INSURANCE SYSTEM (Ministry of Education and
Culture), respondents.
R E S O L U T I O N

MAKASIAR, C.J .:
On March 29, 1984, WE rendered a decision in this case granting compensation benefits (pursuant to P.D. 626, as amended) to
petitioner Venusto Panotes for the death of his wife, Agustina Garfin Panotes. The fatal disease, colonic malignancy or cancer of the
colon, was considered by this Court as having been contracted due to or at least the risk of contracting the same had been increased
by the working conditions to which the deceased had been subjected as a public school teacher, and accordingly, 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 expenses, duly supported by proper receipts;
3) to pay the petitioner the sum of P1,200.00 as funeral expenses; and
4) 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 based on the following grounds:
1) reasonable work-connection is required by the law for an employees'compensation claims, the alleged fact of impossibility of proof
notwithstanding;
2) the legal requirement of work-connection should prevail upon the general liberality of the law;
3) award of attorney's fees is not within the contemplation of the law 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 the relation between the standard of reasonable work connection
established by this Court in compensation cases and the Court's statement in the case at bar that the cause of the fatal disease is
unknown (Emphasis supplied). Respondent's theory that, by granting petitioner's claim, the standard of reasonable work-connection for
compensation cases was rendered meaningless because this Court's findings in the present case that the cause of the fatal disease
cancer of the colon is still unknown, belies the finding that said fatal disease was caused by the nature of the work and/or the risk of
contracting the same was increased by the working conditions of the deceased. Respondent further submits the proposition that "if the
cause of the ailment is unknown, then it cannot also be said that the ailment is work-connected under the increased risk doctrine" (p.
73, rec., italics supplied). "To declare as compensable all ailments whose causes are unknown would be to place the claimants with
such types of ailments in a far better or superior position than those whose causes are known but cannot be proved as work-
connected", respondent adds (p. 71, rec.).
WE ruled in the case of Cristobal vs. Employees' Compensation Commission (L-49280, Feb. 26, 1981, 103 SCRA 329, 335336), thus:
The deceased died of rectal cancer on May 27, 1977. Concededly the exact cause or etiology of this disease is still
unknown. Even respondent ECC's own medical officer, Dr. Mercia C. Abrenica, certified that the cause of rectal
carcinoma as of any other malignancies is still unknown' (p. 9, ECC rec.). Its cause and development are insidious,
imperceptible to the naked eye, and defies expert analysis. Therefore, whether or not the disease rectal cancer was
caused or the risk of contracting the same was increased by the decedent's working conditions remains uncertain
This uncertainty, of course, cannot eliminate the probability that the ailment was work- connected as it had been
established that the deceased was exposed to unhygienic working conditions, various chemicals and intense heat
which are generally considered as predisposing factors of cancer. At this point, there is need to reiterate that when
the deceased started working in 1964, he was free from any kind of disease.
In ruling on this claim, this Court also applied the theory of increased risk under 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 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 (Emphasis supplied).
aside from the possibility that the disease might have been contracted prior 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 substantial evidence, which means 'such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion' (Ang Tibay vs. The Court of Industrial Relations
and National Labor Union, Inc., 69 Phil. 635) or clear and convincing evidence. In this connection, it must be pointed
out that the strict rules of evidence are not applicable in claims for compensation. ... (Emphasis supplied).
Under the employees' compensation law, there are two categories of occupational illness or disease deemed compensation; a) those
listed as occupational disease by the Commission, and b) any illness caused by the employment, subject to a showing by the employee
that the risk of contracting 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 not peculiar 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 a disease which is caused by, or especially
incident to, or the natural consequence of, the particular employment in which the workman is engaged, which results
from exposure therein to hazards greater or different than those involved in ordinary living, which generally develops
gradually over a considerable period of time in the employment, and which industry has not learned to fend against or
eliminate.
xxx xxx xxx
In determining the cause of disability, and whether the cause was an occupational disease within the provisions of the
statute, all factors must be taken into consideration; and whether a disease is compensable must be determined on
the basis of the particular facts involved in each case and the peculiar characteristics of each employment. Thus,
while an occupational disease is generally one which from common experience is recognized to be necessarily
incidental to the usual and ordinary course of the employment it has also been held that if the disease is one that
results from employment it is an occupational disease, even though the risk of disease was not generally known.
Accordingly, the disease need not be a natural and common result rather than an unexpected one.
While there is some authority to the effect that ordinary diseases of life are not compensable unless they follow as an
incident of an occupational disease, a disease, to be compensable as occupational, is generally not required to be an
extraordinary disease, and one to which the general public is not exposed, and it is not essential that the disabling
occupational disease should arise solely out of the occupation in which the employee is engaged, in order to make it
compensable. Moreover, the fact that an employee's disease may be of a class or nature which members of the
general public may acquire under ordinary and usual conditions and circumstances will not exclude it from the
benefits of the act if the disease was in fact occasioned as a result of being subjected to the risks afforded by the
unusual conditions of work in his employment (99 CJS Workmen's Compensation, S 169, pp. 566-569 [1958],
(Emphasis supplied).
Respondent GSIS further alleges that the evidences presented tended to prove a mere case of aggravation and not reasonable work-
connection, thus, the following allegations:
In the case at bar, this Honorable Court went on to describe in detail the physical, mental and emotional pressures
undergone by the deceased public school teacher who entered the service in perfect health was not confined in the
classroom but engaged in other school activities, was exposed to the elements, missed her meals because of
workloads, etc.all of which factors weakened her body resistance and made her susceptible to diseases.
These conditions are invariably present in different types of employment. In fact, even among teachers, these
conditions are unavoidably present but there has been no showing that many teachers have succumbed to cancer of
the colon. Thus, we humbly ask for clarification as to whether aggravating conditions unconnected to the ailment
contracted, are enough to establish reasonable work connection, though the doctrine of aggravation, as stated by this
Honorable Court, has already been removed under the present law (Ibaez vs. ECC, L-47008, March 8, 1978) [p. 73,
rec.].
Assuming arguendo that the evidences cited in the case at bar were mere aggravating conditions, this Court, in the case of Acosta vs.
ECC (109 SCRA 210) had occasion to discuss the matter as follows:
The GSIS itself was inclined to believe that the ailment of the deceased was aggravated by the nature of her work
when it stated in the comment that it has no relation at all to the work of the deceased as a public school teacher
except by way of aggravation.' if this is so, there would be no consistency in respondent denying the claim for
compensation on the ground that the risk of contracting the disease was not increased by her working conditions. It is
more in keeping with reason to hold that once a situation of aggravation arises, there exists a causal relation between
her work and her ailment which caused her death, as shown respondent GSIS has conceded the possibility of
aggravation being present. (Emphasis supplied).
It is apparent from respondent's arguments that what it seeks is a direct, actual proof of the causal connection between the fatal
disease and the working conditions of the deceased. WE, however, rule in this case as WE did in the other cases that actual proof of
causation is not necessary to justify compensability. The degree of proof required to establish proof of work-connection between
ailment and the deceased's employment is only substantial evidence or reasonable work connection (Cristobal vs. ECC, L-49280,
February 26, 1981, 103 SCRA 329; Neri vs. ECC 127, SCRA 672). Where cause of the employee's death is unknown, the right to
compensation subsists (Najera vs. ECC, 122 SCRA 697). Proof of causal connection between claimant's disease of tumor and his
employment as a condition of compensability, the causes of which disease cannot be explained, would render nugatory the
constitutional principles of social justice and protection to labor (Poral vs. ECC, 131 SCRA 602; Mercado Jr. vs. ECC 127 SCRA 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 justice guarantee secured by both the 1935 and 1973
Constitutions, respondents should adopt a more liberal attitude in deciding claims for compensation especially when
there is some basis in the facts for inferring a work- connection. This should not be confused with the presumption of
compensability and theory of aggravation under the Workmen's Compensation Act. While these doctrines may have
been abandoned under the new Labor Code (the constitutionality of such abrogation may still be challenged), it is
significant that the liberality of the law, in general, still subsists. All these factual and legal grounds were considered in
relation to each other constituting substantial evidence clearly convincing US to resolve that rectal cancer is
compensable.
Let it be pointed out too that the deceased's ailment was one of those falling under the borderline cases and in connection therewith,
this Court has ruled in the case of Sepulveda vs. ECC (84 SCRA 771) as cited in the case of San Valentin vs. ECC (118 SCRA 160),
that:
... (T)he respondent Commission under Resolution No. 223, dated March 16, 1977, adopted, as a policy, the
institution of a more compassionate interpretation of the restrictive provisions of P.D. 626, as amended, by its
administering agencies, the SSS and the GSIS, with respect to, among others, Myocardial Infarction and other
borderline cases. ... (Emphasis supplied).
Thus, the following diseases were deemed compensable: rheumatic heart 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), rectal cancer (Cristobal vs. ECC, L-
49280, February 26, 1981, 103 SCRA 29).
The very fact that the cause of a disease is unknown, creates the probability that the working conditions could have increased the risk
of contracting the disease, if not caused by it, thus, the increased risk doctrine 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
of labor. To warrant the arguments of respondent would render futile the provision of Article 4 of the New Labor Code, expressly
providing that:
All doubts in the implementation and interpretation of the provisions of this Code, its implementing rules and
regulations, shall be resolved in favor of labor (Emphasis supplied).
The preceding law is a direct implementation of the constitutional mandate on social justice and protection to labor as embodied in
Article 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 full employment and equality in employment, ensure equal
work opportunities regardless of sex, race, or creed, and regulate the relations between workers and employers. The
State shall assure the rights of workers to self-organization, collective bargaining, security of tenure, and just and
humane conditions of work. The State may provide for compulsory arbitration (Emphasis supplied).
Social justice in workmen's compensation cases is not equality but protection of the laborer as against the employer (De l os Santos vs.
WCC 120 SCRA 730).
Respondent GSIS refuses to appreciate the evidence substantiating the 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 equally
compelling factors. The deceased worked as an elementary school teacher from 1949 until she contracted the fatal disease in 1979.
She was in perfect health when she entered the government service. She was not only teaching and confined within the protection of
the classroom, but she was saddled as well with other outdoor activities. This Court takes judicial notice of the fact that public school
teachers are made to take up the burden of attending to various activities, both for the school and the community, aside from and in
addition to their duties as a teacher. This is a fact obvious and known to everyone familiar with our public school system and yet,
ironically, we close our eyes to it.
Finally, with respect to the award of attorney's fees, respondent argues that the award is not proper or should have been reduced to
only 5% of the compensation claim. The argument is devoid of merit. There is no prohibition against imposing attorney's fees on the
employer, 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:
xxx xxx xxx
A close examination of the aforequoted provision reveals that the intent of the law is to free the award from any
liability or charge so that the claimant may enjoy and use it to the fullest. It is the claimant who is exempt from liability
for attorney's fees. The defaulting employer or government agency remains liable for attorney's fees; because it
compelled the claimant to employ the services of counsel by unjustly refusing to recognize the validity of the claim of
petitioner. This actually is the rationale behind the prohibition. Nothing is wrong with the court's award of attorney's
fees which is separate and distinct from the other benefits awarded. Besides, in the instant case, the participation of
petitioner's counsel was not limited to the preparation or filing of the claim but in appealing petitioner's case before
this Court necessitating submission of pleadings to establish his cause of action and to rebut or refute the arguments
of herein respondents. Fairness dictates that the counsel should receive compensation for his services, otherwise, it
would be entirely difficult for claimants, majority of whom are not teamed in the intricacies of the law, to get good legal
service. To deny counsel compensation for his professional services, would amount to deprivation of property without
due process of law ( Emphasis supplied).
There is a clear difference, from the standpoint of legal policy, between attorney's fees to be paid by the laborer and fees awarded by
the court to be paid by the employer. The plain intent of the statute is that the compensation to be received by the inj ured workman
should not be reduced by more than 10% on account of lawyer's fees. This purpose is attained where the fees are to be paid by the
employer, since the compensation receivable by the workman is then in no way diminished. In the latter eventualit y, all that the law
requires is that the counsel's fees should be reasonable (NDC vs. WCC, L-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. The amount is actually discretionary upon the Court so long as it passes the test of reasonableness.
WHEREFORE, THE DECISION DATED MARCH 29, 1984 IS HEREBY AFFIRMED. THE MOTION FOR RECONSIDERATION IS
HEREBY DENIED FOR LACK OF MERIT, AND THIS DENIAL IS FINAL AND EXCUTORY LET ENTRY OF JUDGMENT BE MADE.
SO ORDERED.
Concepcion, Jr., Plana, Escolin, De la Fuente, Cuevas, Alampay and Patajo, JJ., concur.
Teehankee, Aquino and Abad Santos, JJ., took no part.
Melencio-Herrera, J., I join with Justice Gutierrez.
Relova, J., I join Justice Gutierrez in his dissent.
GUTIERREZ, JR., J ., dissenting:
I vote to grant the motion for reconsideration filed by the respondent GSIS. The risk of contracting cancer of the colon is common to all
mankind. Whether a person is employed or not makes no difference. The risk remains the same. There is nothing in the records of this
case which indicates in the least bit how the employment of the petitioner's wife could have contributed to the risk of contracting colonic
malignancy. As I have stated in earlier cases, employees' compensation benefits are not life insurance benefits. Death by itself does
not automatically entitle the heirs to employees' compensation. This Court is enacting its own employment compensation law, contrary
to the existing law passed by the proper lawmaking authority, when it rules that any and all causes of death or disability are valid
grounds for the payment of employees' compensation benefits.


























RUTH JIMENEZ, Petitioner, v. EMPLOYEES COMPENSATION COMMISSION and GOVERNMENT SERVICE INSURANCE
SYSTEM, Respondents.

Isidro Pasana for Petitioner.

The Solicitor General for Respondents.

SYLLABUS

1. LABOR AND SOCIAL LEGISLATION; LABOR CODE; EMPLOYEES COMPENSATION COMMISSION; COMPENSABILITY OF
ILLNESS; CANCER OF THE LUNGS, A BORDERLINE CASE REQUIRING STUDY OF CIRCUMSTANCES OF CASE. Admittedly,
cancer of the lungs (bronchogenic carcinoma) is one of those borderline cases where a study of the circumstances of the case is
mandated to fully appreciate whether the nature of the work of the deceased increased the possibility of contracting 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, the respondent has provided an opening through which petitioner can pursue and did
pursue the possibility that the deceaseds ailment could have been caused by the working conditions while employed with the Philippine
Constabulary. Respondents maintain that the deceased was a smoker and the logical conclusion is that the cause of the fatal l ung
cancer could only be smoking which cannot in any way be justified as work-connected. However, medical authorities support the
conclusion that up to now, the etiology or cause of cancer of the lungs is still largely unknown.

2. ID.; ID.; ID.; ID.; CONCLUSION OF COMMISSION NOT IN ACCORDANCE WITH MEDICAL AUTHORITIES AND FACTS ON
RECORD. The sweeping conclusion of the respondent Employees Compensation Commission to the effect that the cause of the
bronchogenic carcinoma of the 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 medical authorities nor with the facts on record. No certitude can arise from a position of uncertainty. WE are
dealing with possibilities and medical authorities have given credence to the stand of the petitioner that her husband developed
bronchogenic carcinoma while working as a soldier with the Philippine Constabulary. The records show that when the deceased
enlisted with the Philippine Constabulary in 1969, he was found to be physically and mentally healthy. A soldiers life is a hard one. As a
soldier assigned to field duty, exposure to the elements, dust and dirt, fatigue and lack of sleep and rest is a common occurrence.
Exposure to chemicals while handling ammunition and firearms cannot be discounted. WE take note also of the fact 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 to mention
psychological stress and other similar factors which influenced the evolution of his ailment.

3. ID.; ID.; ID.; ID.; THEORY OF INCREASED RISK. The theory of increased 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 establish compensability under the said theory, the claimant must
show proof of work-connection. Impliedly, the degree of proof required is merely substantial evidence, which means such relevant
evidence to support a decision (Ang Tibay v. The Court of Industrial Relations and National Labor Union, Inc., 69 Phil. 635) or clear
and convincing evidence. In this connection, it must be pointed out that the strict rules of evidence are not applicable in claims for
compensation. Respondents however insist on evidence which would establish direct causal relation between the disease rectal cancer
and the employment of the deceased. Such a strict requirement which even medical experts cannot support considering the uncertainty
of the nature of the disease would negate the principle of the liberality in the matter of evidence. Apparently, what the law merely
requires is a reasonable work-connection and not a direct causal relation. This kind of interpretation gives meaning and substance to
the liberal and compassionate spirit of the law as embodied in Article 4 of the new Labor Code which states that all doubts in the
implementation of the provisions of this Code, including its implementing rules and regulations shall be resolved in favor of labor."cralaw
virtua1aw library

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 "In compensation cases, strict rules on evidence are not
applicable. A reasonable work-connection is all that is required or that the risk of contracting the disease is increased by the working
condition." This is in line with the avowed policy of the State as mandated by the Constitution (Art. II, Sec. 9) and restated in the New
Labor Code (Art. 4) to give maximum aid and protection to labor.

D E C I S I O N

MAKASIAR, J .:

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

The undisputed facts are as follows:chanrob1es virtual 1aw library

Petitioner is the widow of the late Alfredo Jimenez, who joined the government service in June, 1969 as a constable in the Philippine
Constabulary (p. 2, rec.)

After rendering service for one year, he was promoted to the rank of constable second class. On December 16, 1974, he was again
promoted to the 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 was seated on the left side of the bus, fell down from the bus because of the sudden stop of the vehicle. As a result, he
was confined at the Cagayan Provincial Hospital for about one (1) week, and thereafter, released (comment of respondent ECC, pp.
25-36, rec.). He was again confined for further treatment from November 7, 1978 to May 16, 1979 at the AFP Medical Center in Quezon
City.

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

On November 7, 1978, the deceased was again confined at the Cagayan Provincial Hospital and then transferred to the AFP V. Luna
Medical Center at Quezon City for further treatment. He complained of off-and-on back pains, associated with occasional cough and
also the swelling of the right forearm. The doctors found a mass growth on his right forearm, which grew to the size of 3 by 2 inches,
hard and associated with pain, which the doctors 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
continue medication. He was then given light duty inside the barracks of their company.

Unfortunately, his ailment continued and became more serious.

On May 12, 1980, he died in his house at Anulung, Cagayan, at about 9:00 oclock 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 PC Regional 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 any provisions of the Articles of
War" (ECC rec., Proceedings of the PC Regional Board, June 6, 1980).

The Board recommended "that all benefits due to or become due subject EP be paid and settled to his legal heirs" (ECC rec.,
Proceedings of the PC Regional Board, June 6, 1980). Thus, as per records of the GSIS, petitioner was paid benefits due to her
deceased husband under Republic Act No. 610 (Comment of respondent ECC, p. 27, rec.)cralawnad

Nevertheless, petitioner filed a claim for death benefits under PD No. 626, as amended with the respondent GSIS. Said claim was
denied by the GSIS on the ground that her husbands death is not compensable "for the reason that the injury/sickness that caused his
death is not due to the circumstances of the employment or in the performance of the duties and responsibilities of said empl oyment"
(Letter of denial by the GSIS dated July 14, 1980, ECC rec.)

The said decision was affirmed by respondent Employees Compensation Commission in its decision dated August 21, 1981, stating
among others:chanrob1es virtual 1aw library
x x x


"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
properly applied by the respondent System. . . .

"Bronchogenic carcinoma, medical authorities disclose, is the most common form of malignancy in males reaching a peak between the
fifth and seventh decades and accounting for one in four male cancer deaths. The sex incidence is at least 5 to 1, male to female.
Extensive statistical analysis by medical authorities have confirmed the relationship between lung cancer and cigarette smoking. Other
factors that may have potential roles are exposure to ionizing radiation, exposure to chromates, metallic iron and iron oxides, arsenic,
nickel, beryllium and asbestos (Harrisons Principles of Internal Medicine by Wintrobe, Et Al., 7th Edition, p. 1322).

"Although Presidential Decree No. 626, as amended, was envisioned to give relief to workingmen, who sustain an injury or contract an
ailment in the course of employment and that to best attain its lofty objective, a liberal interpretation of the law should pervade in its
implementation, this precept, however, may not be invoked as not even a slight causal link between the development of the ail ment and
the decedents (sic) duties and working conditions as a PC sergeant could be deduced from the records of this case. The respondent
Systems ruling that appellants claim does not fall within the beneficiant provisions of Presidential Decree No. 626, as amended, and
therefore the same should be denied, is in full harmony with the law and the facts obtaining herein.

. . ." (Decision, pp. 10-12, rec.)

On September 28, 1981, Petitioner, assisted by counsel, filed the instant petition, the only pertinent issue being whether or not her
husbands death from bronchogenic carcinoma is compensable under the law.

The petitioner contends that her husbands death is compensable and that respondent Commission erred in not taking into
consideration the uncontroverted circumstance that when the deceased entered into the Philippine Constabulary, he was found to be
physically and mentally healthy. She farther contends that as a soldier, her husbands work has always 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 of citizens, he was subject to call at any time of day or night. Furthermore, he was even
assigned as security to one Emilio Cordero and always accompanied the latter wherever he went. Exposed to these circumstances for
several years, the deceaseds physical constitution began to deteriorate, which eventually resulted to his death from bronchogenic
carcinoma (Petition, pp. 2-9, rec.)

On the other hand, respondent Commission maintains that while the deceased soldier may have been exposed to elements of dust and
dirt and condition of lack of rest and continued fatigue by virtue of his duties to protect the life and property of the citi zens, such
conditions have no causal relation to his contraction of bronchogenic carcinoma. It is also the opinion of the respondent that since there
is evidence of the deceased to be a smoker, "the late Sgt. Jimenez may have indulged heavily in smoking and drinking, not merely
occasionally. And it has been demonstrated medically that the more cigarettes a person smokes, the greater the risk of developing
lung cancer" (Memorandum, p. 62, rec.). In short, the respondent alleges that the deceased was responsible to a large degree for his
having contracted bronchogenic carcinoma that led to his demise.cralawnad

WE find the petitioners claim meritorious.

Primary carcinoma of the lung is the most common fatal cancer and its frequency 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 is mandated to fully appreciate whether the nature of the work of the deceased increased the possibility of contracting such an
ailment. In the case of Laron v. Workmens Compensation Commission (73 SCRA 90), WE held, citing Schmidts Attorneys Dictionary
of Medicine, 165 Sup. 143; Beerman v. Public Service Coordinated Transport, 191 A 297, 299; Words and Phrases, 6 Permanent
Edition 61, "The English word cancer means crab, in the medical sense, it refers to a malignant, usually fatal, tumor or growth."
Findings of fact by the respondent points out that bronchogenic carcinoma is a malignant tumor of the lungs. 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, the respondent has provided an opening through which petitioner can pursue and did pursue the possibil ity that
the deceaseds ailment could have been caused by the working conditions while employed with the Philippine Constabulary.

Respondents maintain that the deceased was a smoker and the logical conclusion is that the cause of the fatal lung cancer could only
be smoking which cannot in any way be justified as work-connected. However, medical authorities support the conclusion that up to
now, the etiology or cause of cancer of the lungs is still largely unknown as provided for in the following:jgc:chanrobles.com.ph

"Although the etiology of cancer in humans cannot yet be explained at the molecular level, it is clear that genetic compositi on of the
host is important in cancer induction. Related immunologic factors may predispose the host to a putative carcinogen. There is some
evidence that viruses may play a role in the neoplastic process. In addition, both environmental and therapeutic agents have been
identified of carcinogens" (Harrison, Principles of Internal Medicine, 9th Edition, 1980, p. 1584).

"Considerable attention has been directed to the potential role of air pollution exposure to ionizing radiation and numerous occupational
hazards, including exposure to chromates, metallic iron and iron oxides, arsenic, nickel, beryllium and asbestos" (Harrison, Ibid, p.
1259).

"The lungs are the site of origin of primary benign and malignant tumors and receive metastases from many other organs and tissues.
Specific causes have not been established but a strong dose-related statistical association exists between cigarette smoking and
squamous cell and undifferentiated small (oat) cell bronchogenic carcinomas. There is suggestive evidence that prolonged exposure to
air pollution promotes lung neoplasms" (The Merck Manual, 13th Edition, p. 647).

"What emerges from such concepts is the belief that cancers in man do not appear suddenly out of the blue. . . . Moreover, there need
not be a single etiology or pathogenesis. Many influences may be at work during the evolution of the lesion and many pathways may be
involved. Indeed, the term cancer may embrace a multiplicity of diseases of diverse origins" (Robbins, Pathologic Basis of Disease, 2nd
Edition, 1979, p. 185, Emphasis supplied).

WE cannot deny the fact that the causes of the illness of the deceased are still unknown and may embrace such diverse origins which
even the medical sciences cannot tell with reasonable certainty. Indeed, scientists attending the World Genetic Congress in New Delhi,
India, have warned that about 25,000 chemicals used around the world could potentially cause cancer, and Lawrence Fishbein of the
U.S. National Center for Toxilogical Research pointed out that humans were daily exposed to literally hundreds of chemical agents via
air, food, medication, both in their industrial home and environments (Evening Post, December 16, 1983, p. 3, cols. 2-3).

The theory of increased risk is applicable in the instant case. WE had the occasion to interpret the theory of increased risk in the case
of Cristobal v. Employees Compensation Commission (103 SCRA, 336-337, L-49280, February 26, 1981):chanrobles.com.ph : virtual
law library

"To establish compensability under the said theory, the claimant must show proof of work-connection. Impliedly, the degree of proof
required is merely substantial evidence, which means such relevant evidence to support a decision (Ang Tibay v. The Court of
Industrial Relations and National Labor Union, Inc., 69 Phil. 635) or clear and convincing evidence. In this connection, it must be
pointed out that the strict rules of evidence are not applicable in claims for compensation. Respondents however insist on evidence
which would establish direct causal relation between the disease rectal cancer and the employment of the deceased. Such a strict
requirement which even medical experts cannot support considering the uncertainty of the nature of the disease would negate the
principle of the liberality in the matter of evidence, Apparently, what the law merely requires is a reasonable work-connection and not a
direct causal relation. This kind of interpretation gives meaning and substance to the liberal and compassionate spirit of the law as
embodied in Article 4 of the new Labor Code which states that all doubts in the implementation of the provisions of this Code, including
its implementing rules and regulations shall be resolved in favor of labor.

". . . As the agents charged by the law to implement the social justice guarantee secured by both 1935 and 1973 Constitutions,
respondents should adopt a more liberal attitude in deciding claims for compensation especially when there is some basis in the facts
inferring a work-connection. This should not be confused with the presumption of compensability and theory of aggravation under the
Workmens Compensation Act. While these doctrines may have been abandoned under the New Labor Code (the constitutionality of
such abrogation may still be challenged), it is significant that the liberality of the law, in general, still subsists. . . ." (Emphasis supplied)

The sweeping conclusion of the respondent Employees Compensation Commission to the effect that the cause of the bronchogenic
carcinoma of the 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 medical authorities nor with the facts on record. No certitude can arise from a position of uncertainty.

WE are dealing with possibilities and medical authorities have given credence to the stand of the petitioner that her husband developed
bronchogenic carcinoma while working as a soldier with the Philippine Constabulary. The records show that when the deceased
enlisted with the Philippine Constabulary in 1969, he was found to be physically and mentally healthy. A soldiers life is a hard one. As a
soldier assigned to field duty, exposure to the elements, dust and dirt, fatigue and lack of sleep and rest is a common occurrence.
Exposure to chemicals while handling ammunition and firearms cannot be discounted. WE take note also of the fact 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 to mention
psychological stress and other similar factors which influenced the evolution of his ailment.

WE held in the case of San Valentin v. Employees Compensation Commission (118 SCRA 160) that:jgc:chanrobles.com.ph

"x x x

"In compensation cases. strict rules of evidence are not applicable. A reasonable work-connection is all that is required or that the risk
of contracting the disease is increased by the working conditions."cralaw virtua1aw library

In the case of Dator v. Employees Compensation Commission

(L-57416, January 30, 1982), WE held the death of Wenifreda Dator, a librarian for 15 years, caused by bronchogenic carcinoma
compensable. Being a librarian, "she was exposed to duty books and other deleterious substances in the library under unsanitary
conditions" (Ibid., 632). WE do not see any reason to depart from the ruling in the said case, considering that a soldiers duties and
environment are more hazardous.

This is in line with the avowed policy of the State as mandated by the Constitution (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 AND THE 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 PETITIONERs MEDICAL AND HOSPITAL EXPENSES DULY SUPPORTED BY PROPER RECEIPTS; AND

3. TO PAY THE PETITIONER THE SUM OF ONE THOUSAND TWO HUNDRED (P1,200.00) PESOS FOR BURIAL EXPENSES.

SO ORDERED.

Concepcion, Jr., Guerrero, Abad Santos, De Castro and Escolin, JJ., concur.
Separate Opinions


AQUINO, J., dissenting:chanrob1es virtual 1aw library

I dissent. Bronchogenic carcinoma was not work-connected. The ECC did not err in denying death benefits.