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RepublicofthePhilippines
SUPREMECOURT
Manila

FIRSTDIVISION

G.R.No.146360May20,2004

AZUCENAO.SALALIMA,petitioner,
vs.
EMPLOYEESCOMPENSATIONCOMMISSIONandSOCIALSECURITYSYSTEM,respondents.

DECISION

YNARESSANTIAGO,J.:

BeforeusisapetitionforreviewoncertiorarioftheDecision1oftheCourtofAppealsdatedApril12,2000aswell
asitsResolutiondatedDecember6,2000,whichaffirmedtheEmployeesCompensationCommissionsdenialof
petitioners claim for compensation benefits resulting from the death of her husband, Juancho Salalima, under
PresidentialDecreeNo.626,asamended.

Petitioners husband, Juancho S. Salalima, was employed for twentynine years as a route helper and
subsequently as route salesman for the Meycauayan Plant of CocaCola Bottlers Phils., Incorporated. In 1989,
duringanannualcompanymedicalexamination,Juanchowasdiagnosedwithminimalpulmonarytuberculosis.2
HisillnessremainedstationaryuntilOctober1994whenJuanchowasconfinedattheManilaDoctorsHospitalto
undergo section biopsy. His biopsy revealed that he had "Adenocarcinoma, poorly differentiated, metastatic".3
Consequently,heunderwentchemotherapyattheMakatiMedicalCenter.OnFebruary1,1995,hewasfoundto
besufferingfrompneumonia.4OnFebruary14,1995,hewasconfinedattheMakatiMedicalCenter.Hediedtwo
days later on February 16, 1995 due to "Adenocarcinoma of the Lungs with widespread metastasis to Neck,
Brain, Peritoneal Cavity, Paracaval Lymph Nodes, Abscen Acute Renal Failure Septicemia Upper
GastrointestinalBleeding".5

AclaimforcompensationbenefitsunderP.D.626asamendedwasfiledbyhissurvivingwife,Azucena,petitioner
herein,withtheSocialSecuritySystem(SSS).InareportdatedNovember12,1998,SSSBranchManagerElnora
Montenegro and Senior Physicians Corazon Bondoc and Annabelle Bonifacio recommended the denial of
petitioners claim on the ground that Adenocarcinoma of the Lungs (Cancer of the Lungs) had no causal
relationshipwithJuanchosjobasaroutesalesman.6Petitionersmotionforreconsiderationwasdenied.Hence,
petitionerbroughtthecasetotheEmployeesCompensationCommission(ECC),whichaffirmedthedecisionof
the SSS. In its Decision7 dated October 7, 1999, the ECC relied upon the Quality Assurance Medical Report
preparedbyDr.Ma.VictoriaM.AbesamisfortheSSSstatingthatJuanchosexposuretosmoganddustisnot
associatedwiththedevelopmentoflungcancer.8

PetitionerelevatedthecasetotheCourtofAppealsarguingthatJuanchosrouteasasalesmanexposedhimto
allkindsofpollutants,nottomentionthedailyhazardsandfatiguethatcamewithhistasks.Shepointedoutthat
the SSS and the ECC disregarded Juanchos medical history and the fact that the risk of contracting Juanchos
ailment was increased by the nature of his work.9 In its Comment, ECC averred that the presumption of
compensability and the theory of aggravation prevalent under the Workmens Compensation Act have been
abandoned.UndertheimplementingrulesofP.D.626,asamended,forthesicknessandtheresultingdisabilityor
deathtobecompensable,thesicknessmustbetheresultofanoccupationaldiseaselistedunderAnnexAofthe
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 ECC argued that neither condition is present in Juanchos
case since lung cancer is not an occupational disease nor is the risk of contracting lung cancer increased by
Juanchos working conditions.10 The SSS joined the arguments of the ECC and added that petitioner was not
able to present substantial evidence to overcome the conclusion reached by the SSS that Juanchos cause of
deathwasnotworkconnected.11
InherReply,petitionercitedtheraisondtreforthepassageofRepublicActNo.8749,otherwiseknownasthe
Clean Air Act. Petitioner stated that the Act provides for a comprehensive pollution control policy that mainly
concentratesontheprohibitionofleadedgasolineduetoitsscientificallyprovendeleteriouseffectonthehealth
ofindividuals.12PetitionerlikewiseattachedaclippingfromthenewspaperManilaStandard13containingareport
statingthatifthepresentlevelofdieselexhaustcontinues,thepollutioncouldbeexpectedtocausemorethan
125,000casesoflungcancerin70years.

OnApril12,2000,theCourtofAppealsaffirmedthedecisionoftheECC,statingthatthefactualfindingsofquasi
judicialagencies,suchastheECC,ifsupportedbysubstantialevidence,areentitledtogreatrespectinviewof
their expertise in their respective fields.14 Petitioners Motion for Reconsideration15 was denied for lack of
merit.16

Hence,thispetitionforreviewoncertiorari,raisingtheloneissue:

WHETHER OR NOT THE DECISION OF THE HONORABLE COURT OF APPEALS DENYING PETITIONERS
CLAIM UNDER P.D. 626, AS AMENDED, IS IN ACCORDANCE WITH THE RULES ON EMPLOYEES
COMPENSATIONANDEXISTINGJURISPRUDENCE.

PetitionerclaimsthatthejudgmentoftheCourtofAppealswaspremiseduponamisapprehensionoftherelevant
factsofthecaseatbar.SheanchorsherpetitiononthefactthatwhilethecauseofherhusbandJuanchosdeath
was Adenocarcinoma of the lungs, he nonetheless suffered from two listed occupational diseases, namely
pulmonarytuberculosisandpneumonia,priortohisuntimelydemise,whichsheinsistsjustifiesherclaimfordeath
benefits.

Wefindmeritinthepetition.

P.D.No.62617amendedTitleIIofBookIVontheECCandStateInsuranceFundoftheLaborCode.Underthe
provisions of the law as amended, for the sickness and resulting disability or death to be compensable, the
claimantmustprovethat:(a)thesicknessmustbetheresultofanoccupationaldiseaselistedunderAnnex"A"of
theRulesonEmployeesCompensation,or(b)theriskofcontractingthediseasewasincreasedbytheclaimants
working conditions.18 This means that if the illness or disease that caused the death of the member is not
includedinthesaidAnnex"A,"thenhisheirsareentitledtocompensationonlyifitcanbeproventhattheriskof
contractingtheillnessordiseasewasincreasedbythemembersworkingconditions.

Under the present law, Adenocarcinoma of the lungs (cancer of the lungs) which was the immediate cause of
Juanchos death as stated in his death certificate, while listed as an occupational disease, is compensable only
amongvinylchlorideworkersandplasticworkers.19This,however,wouldnotautomaticallybarpetitionersclaim
foraslongasshecouldprovethatJuanchosriskofcontractingthediseasewasincreasedbythelattersworking
conditions.20

Inthecaseatbar,therearetwoconflictingmedicalreportsonthecorrelationbetweenJuanchosworkasaroute
salesmanandtheillnesshesufferedwhichwastheimmediatecauseofhisdemise.Dr.PabloS.Santos,Coca
Colas Head of Medical Services, stated in his report that while Juanchos job does not expose him to any
chemical material used within the plant, consideration must be given to smog and dust as factors in the
developmentofhislungcancer.21Ontheotherhand,Dr.Ma.VictoriaM.AbesamisoftheSocialSecuritySystem
declaredinherreportthatJuanchosexposuretosmoganddustisnotassociatedwiththedevelopmentoflung
cancer.22

According to medical experts, Adenocarcinoma of the lungs is one of the four major histologic varieties of
bronchogenic carcinoma, the characterization being based upon the cell types that compose the carcinoma.
Bronchogeniccarcinoma,morecommonlyknownaslungcancer,isthetermusedtodesignatenearlyalltypesof
malignantlungtumors.Medicalbookslisttheetiologyoflungcancersasfollows:cigarettesmoking,occupational
exposure,airpollution,andotherfactorssuchaspreexistinglungdamageandgeneticinfluences.23

We agree with petitioner that the respondent government agencies failed to take into consideration Juanchos
medical history in their assessment of the claim for benefits filed by petitioner. For a considerable stretch of
JuanchosstayatCocaCola,hewasfoundtobesufferingfrompulmonarytuberculosis.Severalmonthsbefore
his demise, he was diagnosed with Adenocarcinoma of the lungs. A little over two weeks before his death,
Juancho was afflicted with pneumonia. The obvious deduction is that Juancho, from the time he acquired
pulmonarytuberculosisuntilhispassingaway,waspredisposedtovariedlungdiseases.

It is worth noting that tuberculosis is most commonly confused with carcinoma of the lung because the highest
incidence of both diseases is in the upper lobe of the lungs and in older men. The symptoms of both diseases
include loss of weight, chronic cough, bloodstreaked sputum and mild fever.24 Likewise, numerous studies
indicate that scars within the lungs and diffuse pulmonary fibrosis are associated with a slightly increased
incidenceoflungcancer.25Tuberculosisisadiseasecharacterizedbylesionsinthelungsaswellastuberculous
scars.26Thus,inlightofJuanchoscontinuedexposuretodetrimentalworkenvironmentandconstantfatigue,the
possibility that Juanchos Adenocarcinoma of the lungs developed from the worsening of his pulmonary
tuberculosisisnotremote.

The degree of proof required under P.D. No. 626 is merely substantial evidence, which means, "such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion." What the law requires is a
reasonable workconnection and not a direct causal relation. It is enough that the hypothesis on which the
workmen'sclaimisbasedisprobable.Medicalopiniontothecontrarycanbedisregardedespeciallywherethere
is some basis in the facts for inferring a workconnection. Probability, not certainty, is the touchstone.27 In
Juanchoscase,webelievethatthisprobabilityexists.Juanchosjobrequiredlonghoursonthestreetsaswellas
hiscarryingofcasesofsoftdrinksduringsalescalls.Thecombinationoffatigueandthepollutantsthataboundin
hisworkenvironmentverilycontributedtotheworseningofhisalreadyweakrespiratorysystem.Hiscontinuous
exposuretothesefactorsmayhaveledtothedevelopmentofhiscancerofthelungs.

It escapes reason as well as ones sense of equity that Juanchos heirs should now be denied compensation
(death)benefitsforthesolereasonthathisillnessimmediatelybeforehediedwasnotcompensableinhislineof
work.ThepicturebecomesmoreabsurdwhenweconsiderthathadJuanchodiedafewyearsearlier,whenthe
diagnosis on him revealed only pulmonary tuberculosis, his heirs would not perhaps be going through this
arduous path to claim their benefits. Denying petitioners claim is tantamount to punishing them for Juanchos
deathofagraverillness.

P.D. 626, as amended, is said to have abandoned the presumption of compensability and the theory of
aggravation prevalent under the Workmens Compensation Act. Despite such abandonment, however, the
presentlawhasnotceasedtobeanemployeescompensationlaworasociallegislationhence,theliberalityof
thelawinfavoroftheworkingmanandwomanstillprevails,andtheofficialagencychargedbylawtoimplement
the constitutional guarantee of social justice should adopt a liberal attitude in favor of the employee in deciding
claims for compensability, especially in light of the compassionate policy towards labor which the 1987
Constitutionvivifiesandenhances.28

WHEREFORE, in view of the foregoing, the petition for review on certiorari is GRANTED. The Decision of the
Court of Appeals in CAG.R. SP No. 56174 dated April 12, 2000 is REVERSED and SET ASIDE. The Social
Security System is ordered to pay petitioner Azucena Salalimas claim for death benefits under the Employees
CompensationAct.

SOORDERED.

Panganiban,(ActingChairman),Carpio,andAzcuna,JJ.,concur.
Davide,Jr.,C.J.,(Chairman),onofficialleave.

Footnotes
1PennedbyAssociateJusticeRomeoJ.Callejo,Sr.asconcurredinbyAssociateJusticesCancioC.
GarciaandMartinS.Villarama,Jr.
2RoentgenologicalReportdated16December1989,CourtofAppealsRollo,p.12.

3SSSPhysiciansMedicalReportdated12November1998,Rollo,p.58.

4RoentgenologicalReportdated1February1995,Rollop.47.

5Supra,note3.

6Id.

7Rollo,p.60.

8CourtofAppealsRollo,p.40.

9PetitionforReviewfiledwiththeCourtofAppeals,Rollo,pp.2432.

10CommentoftheECC,Rollo,pp.6671.
 11CommentoftheSSS,Rollo,pp.7279.

12Reply,Rollo,pp.8084.

13Rollo,p.85.

14CourtofAppealsDecision,Rollo,pp.8793.

15Rollo,p.94.

16Rollo,p.122.

17Promulgatedon27December1974.

18AmendedRulesonEmployeesCompensation,RuleIII,Section1(b).

19AmendedRulesonEmployeesCompensationAnnexA(17).

20Limbov.EmployeesCompensationCommissionandSocialSecuritySystem,G.R.No.146891,30July
2002,385SCRA466.

21CourtofAppealsRollo,p.39.

22Supra,note5.

23AllenR.Myers,Medicine,1986,pp.7778.

24HarrisonsPrinciplesofInternalMedicine,1970,6thed.,p.872.

25Supra,note23.

26Supra,note24,pp.870871.

27Salmonev.Employees'CompensationCommissionandSocialSecuritySystem,G.R.No.142392,26
September2000,341SCRA150.
28EmployeesCompensationCommissionandGovernmentServiceInsuranceSystemv.CourtofAppeals,
G.R.No.121545,14November1996,264SCRA248.

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