When a compensable disease is not really compensable

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Persida Acosta

Dear PAO,
My father had been employed as a seaman for 20 years. He was diagnosed to have myocardial infarction four months after his last disembarkation and consequently died within the year. My mother tried to claim from the Social Security System since the cause of my father’s death was a listed compensable disease but she was denied for reasons that she allegedly failed to substantiate our claim and that my father contributed to his disease for being a smoker. Is this valid considering that the death of my father immediately came a few months after disembarkation?
Sincerely yours,
Aaron

Dear Aaron,
Fairly recent is the case of Cristina Barsolo v. Social Security System (G.R. No. 187950, January 11, 2017) penned by Associate Justice Marvic Leonen, who clearly discussed compensable diseases and myocardial infarction, that says.:

“The Amended Rules on Employee Compensation provide the guidelines before a beneficiary can claim from the state insurance fund. Rule III, Section l(b) states:

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.


The pertinent portions of Annex A of the Amended Rules on Employee Compensation read: 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.


“The following diseases are considered as occupational when contracted under working conditions involving the risks described herein:


18. CARDIO-V ASCULAR DISEASES. ** Any of the following conditions — a. If the heart disease was known to have been present during employment, there must be proof that an acute exacerbation was clearly precipitated by the unusual strain by reasons of the nature of his/her work. b. The strain of work that brings about an acute attack must be of sufficient severity and must be followed within 24 hours by the clinical signs of a cardiac assault to constitute causal relationship. c. If a person who was apparently asymptomatic before being subjected to strain at work showed signs and symptoms of cardiac injury during the performance of his work and such symptoms and signs persisted, it is reasonable to claim a causal relationship. (Emphasis supplied)

xxx        xxx        xxx
“In Ranises, we held that for myocardial infarction to be considered a compensable occupational disease, any of the three conditions must be proven by substantial evidence. […]”

Falling squarely with the situation of your father, if your mother was unable to prove the above-stated circumstances, the mere fact that your father died of myocardial infarction will not necessarily suffice to make his death compensable. Substantial evidence should be adduced that his illness was precipitated by the work he had and that his injury cannot be attributed to his own doing. If your father’s smoking habits, through the years, could have affected his health, the same may be used against him as a form of notorious neglect that will necessarily deny him of the benefit.

Again, we find it necessary to mention that this opinion is solely based on the facts you have narrated and our appreciation of the same. The opinion may vary when the facts are changed or elaborated.

We hope that we were able to enlighten you on the matter.

Editor’s note: Dear PAO is a daily column of the Public Attorney’s Office. Questions for Chief Acosta may be sent to dearpao@manilatimes.net

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