(10) GOVERNMENT SERVICE INSURANCE SYSTEM (GSIS) v. THE HON.

COURT OF APPEALS and ROSA BALAIS

(Jan. 29, 1998)

FACTS: Private respondent started working as an emergency employee of the National Housing Authority (NHA) in 1952.
She then rose from the ranks until she was promoted to Chief Paying Cashier in 1984.

- Medical records disclose that on December 17, 1989, private respondent suddenly experienced chills, followed by loss
of consciousness. She was brought to the Capitol Medical Center where she was sedated but allowed to go home after
three hours.

- Later, on the same day, however, she vomited several times and suffered from parie-occipital pains. She was again
rushed to U.E.R.M. Medical Center where she underwent a thorough medical examination. She was diagnosed to be
suffering from Subarachnoid Hemorrhage Secondary to Ruptured Aneurysm. After undergoing craniotomy, she was
finally discharged from the hospital on January 20, 1990.

- Despite her operation, private respondent could not perform her duties as efficiently as she had done prior to her illness.
This forced her to retire early from the government service on March 1, 1990 at the age of 62. Thus, private respondent
filed a claim for disability benefits with the GSIS for the above-described ailment. Her illness was evaluated as
compensable by the GSIS Medical Evaluation and Underwriting Group. GSIS granted her temporary total disability (TTD)
benefits for the period starting and subsequently, permanent partial disability (PPD) benefits for nine months starting on
March 2, 1990.

- The private respondent requested the GSIS for the conversion of the classification of her disability benefits from
permanent partial disability (PPD) to permanent total disability (PTD). Such plea was denied by the GSIS on the ground
that the GSIS Medical Evaluation and Underwriting Department which evaluated her claim found no basis to alter its
findings. That the results of the physical examination did not satisfy the criteria for permanent total disability. Moreover,
she was told that the pension granted to her was the maximum benefit due her under the Rating Schedule established by
the ECC.

- The denial of her request then prompted private respondent to file a request for reconsideration of the earlier denial of
her application for the conversion of her disability benefits from permanent partial disability to permanent total disability,
explaining that since the time of her operation she continued to suffer from dizziness, headaches, loss of memory and
inability to properly sleep. Moreover, she contended that there were instances when she felt extremely weak and could
not walk without support. She further stated that she was required to take medication for life.

- The GSIS, however, denied reconsideration which denial was later affirmed on appeal by the ECC in its decision.

- CA: Promulgated a decision favorable to private respondent.

ISSUE: Whether or not private respondent is entitled to conversion of her benefits from permanent partial disability to
permanent total disability.

HELD: YES. While it is true that the degree of private respondent’s physical condition at the time of her retirement was
not considered as permanent total disability, yet, it cannot be denied that her condition subsequently worsened after her
head operation and consequent retirement. In fact, she suffered afterwards from some ailments like headaches,
dizziness, weakness, inability to properly sleep, inability to walk without support and failure to regain her memory. All
these circumstances ineluctably demonstrate the seriousness of her condition, contrary to the claim of petitioner. More
than that, it was also undisputed that private respondent was made to take her medication for life.

- A person’s disability may not manifest fully at one precise moment in time but rather over a period of time. It is possible
that an injury which at first was considered to be temporary may later on become permanent or one who suffers a partial
disability becomes totally and permanently disabled from the same cause.

- The Court has ruled that disability should not be understood more on its medical significance but on the loss of earning
capacity. Private respondent’s persistent illness indeed forced her to retire early which, in turn, resulted in her
unemployment, and loss of earning capacity.
- It has been a consistent pronouncement of this Court that permanent total disability means disablement of an
employee to earn wages in the same kind of work, or work of a similar nature that she was trained for or accustomed to
perform, or any kind of work which a person of her mentality and attainment could do.

- It is also important to note that private respondent was constrained to retire at the age of 62 years because of her
impaired physical condition. This, again, is another indication that her disability is permanent and total. As held by this
Court, the fact of an employee’s disability is placed beyond question with the approval of the employees optional
retirement, for such is authorized only when the employee is `physically incapable to render sound and efficient service.

- In the case at bar, the denial of the claim for permanent total disability benefit of private respondent who, for 38 long
years during her prime had rendered her best service with an unblemished record and who was compelled to retire on
account of her worsening condition, would indeed subvert the salutary intentions of the law in favor of the worker. The
Court, therefore, affirms the decision of the respondent Court of Appeals decreeing conversion of private respondent’s
disability from permanent partial disability to permanent total disability.

(11) GSIS v. CA (March 4, 1999)

FACTS: On June 10, 1964, private respondent Romeo S. Bella was employed by the Bureau of Animal Industry as a
livestock inspector. He retired from the service on August 16, 1986. On July 16, 1987, he was re-employed by the
Department of Agriculture as Agricultural Food Technologist and on March 1, 1994, promoted to the position of
Agriculturist II.

- As disclosed by his records of employment, private respondent was suspended without pay from September 1, 1993 to
March 1, 1994. A month after, or on April 1, 1994, to be precise, he was reinstated to his former position as Agriculturist II
at the Provincial Agricultural Office in Tacurong, Sultan Kudarat. On July 1, 1995, private respondent who was then
56years old, filed a terminal leave of absence due to physical disability.

- The medical records of private respondent reveal that he was suffering from Acute Myocardial Infraction and was
confined at the Notre Dame Hospital in Cotabato City from September 13, 1988 to September 19, 1988 and at the
Philippine Heart Center from September 6, 1994 to September 26, 1994.

- Thus, private respondent filed with the GSIS, Cotabato Branch, a claim for compensation benefits under P.D. 626, as
amended. Finding his application meritorious and his ailment compensable, the GSIS awarded him a Temporary Total
Disability income benefit during the periods of July 16 to July 21, 1994 and August 24 to August 29, 1994, as well as
reimbursement for medical expenses. Private respondent Romeo S. Bella was also granted a Permanent Partial Disability
income benefit equivalent to thirty-eight (38) months for his Ischemic Cardiomayopathy.

- Private respondent requested for the conversion of his benefits from Permanent Partial Disability to Permanent Total
Disability, reasoning out that his ailments of Ischemic Cardiomayopathyi[6] and Chronic Obstructure Pulmonary Disease
rendered him unable to engage in any gainful occupation for a continuous period exceeding 120 days, as certified to by
his attending physicians, Dr. Romulo Uy, Dr. Anne Marie Luat, Dr. Danilo Rustia, Dr. Juanito Lastimosa and Dr. Eldefonso
Maglasang.ii[8]

- GSIS denied his request for Permanent Total Disability on the ground that the degree of private respondents disability as
evaluated by petitioners medical officers, did not satisfy the criteria for Permanent Total Disability. His motion for
reconsideration was similarly denied.

- On appeal, the Employees Compensation Commission (ECC) affirmed the Decision of the GSIS, denying private
respondents request for conversion of his Permanent Partial Disability benefit to Permanent Total Disability benefit.

- CA: Came out with its decision reversing the Decision of the Employees Compensation Commission.

ISSUE: Whether or not the private respondent is entitled to permanent total disability benefits.

HELD: YES.

Permanent Total Disability Permanent Partial Disability

If as a result of the injury or sickness the employee is unable If as a result of the injury or sickness the employee
to perform any gainful occupation for a continuous period suffers a permanent partial loss of the use of any part of
exceeding 120 days except as otherwise provided for in his body.
Rule X of these Rules.

- Petitioner contends that the criteria for Permanent Total Disability, like permanent complete paralysis of two limbs have
not been met by private respondent’s ailment and physical condition. As aptly pointed out by the Solicitor General, total
disability does not mean a state of absolute helplessness, but disablement of an employee to earn wages in the same
kind of work or a work of similar nature, that he was trained or accustomed to perform, or any kind of work which a person
of his mentality and attachments could do.

- The fact that he was forced to retire at the early age of 56, due to a sickness disabling him from performing his job as
Agriculturist II, qualifies his disability as a Permanent Total Disability, though he lost no use of any particular anatomical
part of his body.

- Also, no less than five doctors certified that private respondents illness disabled him from performing any gainful
occupation for a continuous period exceeding 120 days. Well settled is the rule that a physicians report of sickness or
accident substantiates the disability claim.

- It is then beyond cavil that the sickness of the private respondent made him unable to perform any gainful occupation for
a continuous period exceeding 120 days, thus entitling him to permanent total disability benefits.

- Clearly, the position taken by the GSIS and the ECC runs counter to the avowed policy of the State to construe social
legislations liberally in favor of the beneficiaries. Section 18, Article II of the Constitution, provides:

Sec. 18. The State affirms labor as a primary social economic force. It shall protect the rights of workers and promote their
welfare.

- All things studiedly considered, we are of the ineluctable conclusion that the Court of Appeals erred not in granting
private respondents claim for Permanent Total Disability benefits.

(12) IJARES v. CA, ECC & GSIS

FACTS: Petitioner was employed by the government on March 16, 1955 as a Researcher in the Institute of National
Language of the Department of Education, Culture and Sports (DECS). In 1983, he was diagnosed by Dr. Merlin B.
Consing, a Phthisiologist, to have PTB Minimal and Emphysema. Since then, he has undergone medical treatment.

- From May 1 to 31, 1985, petitioner went on sick leave due to chronic emphysema. On June 1, 1985, he availed of early
retirement under Presidential Decree No. 1146 bringing to a close thirty (30) years of public service. He was sixty (60)
years old at the time of his retirement.

- Sometime in 1988, petitioner was confined at the Philippine General Hospital (PGH) due to Chronic Obstructive
Pulmonary Diseases, Emphysema, PTB class IV and S/P Pneumothorax, Right. He underwent a Pulmonary Function
Test which indicated Severe Obstructive Ventilatory Pattern unresponsive to Bronchodilator. Dr. Leon James Young of the
UP-PGH Medical Center found petitioner to be suffering from Permanent Total Disability.

- On January 5, 1989, petitioner filed with the Government Service Insurance System (GSIS) a claim for Permanent Total
Disability benefits under P. D. No. 626. After his ailment was evaluated medically compensable he was only granted
Permanent Partial Disability compensation, equivalent to a period of nineteen (19) months beginning June 1, 1985 to
December 31, 1986. His subsequent request for an award of his original claim was denied by the System on the ground
that the petitioner was already awarded the maximum benefits commensurate to the degree of his disability at the time of
retirement. The matter was elevated to the Employees Compensation Commission (ECC) which, in due, time affirmed the
finding of the GSIS, ratiocinating thus:

After going over the records of the case under consideration, we agree with the decision of the respondent
System in denying appellants claim for additional compensation. Under the ECC Schedule of Compensation,
appellant was already awarded the maximum benefits commensurate to the degree of his disability at the time of
his retirement from the service. The confinement of appellant at the Philippine General Hospital sometime in
January, 1988 due to PTB, minimal with Pulmonary Emphysema, Bilateral, could not be attributed to his
employment considering that he retired from the service on June 1, 1985, hence, the risk of his employment
aggravating his PTB was unlikely. For any progression of a retired employees condition after the date of his
 retirement is no longer within the compensatory coverage of P. D. 626, as amended, since severance of an
employee-employer relationship results to the release of the State Insurance Fund from any liability in the event of
sickness and resulting disability or death after such retirement or separation from the service. Thus, claim of
appellant for additional compensation benefits could not be given favorable consideration.

- Court of Appeals came out with the assailed decision affirming the disposition of the respondent Commission.

ISSUE: Whether or not Court of Appeals erred in not adjudging him entitled to his original income benefits claim for
Permanent Total Disability and not Permanent Partial Disability as found by the respondent Commission.

HELD: YES.

- Petitioner anchors his position on the fact that he was unable to perform any gainful occupation for a period exceeding
120 days by reason of his illness. It is his submission that his illness was acquired during his employment with the
government, the same illness which caused him to avail of an early retirement in 1985 and to be confined in 1988 at the
Philippine General Hospital. Further, petitioner theorizes that the diagnosis by his physician, Dr. Leon James Young,
declaring him to be permanently and totally disabled should have prodded the Commission to grant his original claim.

- On the other hand, the respondent Commission contended that the mere inability to perform gainful occupation for a
period exceeding 120 days due to his illness or injury does not entitle him (petitioner) to the benefits claimed. Respondent
Commission also seeks to deny further liability to the petitioner on account of the non-compensable nature of the illness of
the latter, alleging that the confinement of petitioner at the PGH sometime in 1988 due to the same ailment could not be
attributed to his employment considering that he retired from the service on June 1, 1985.

- It is abundantly clear that petitioner’s disability cannot be considered as anything less than permanent and total. As
attested to by the declaration of his physician and his medical history, it does not appear that petitioner comes within the
coverage of Rule X which should, in effect, only provide for entitlement to temporary total disability benefits. The early
retirement of an employee due to work-related ailment proves that indeed the employee was disabled totally to further
perform his assigned task, and to deny permanent total disability benefits when he was forced to retire would render
inutile and meaningless the social justice precept guaranteed by the Constitution.

- No amount of dodging by the respondent System will alter the undeniable fact that the illness of petitioner was
contracted while he was still in the service. This much is established as a result of the grant to him by the System of
permanent partial disability, after inevitably ruling on the compensable nature of said illness.

- The Court finds as devoid of any basis on record the conclusion of the Court of Appeals that modern medicine can easily
heal petitioner’s particular ailment if he is really taking all the care of a diligent patient. While it may be true that the law on
disability benefits does not preclude the possibility that one who receives benefits under a permanent total disability may
eventually be gainfully employed or recover from his permanent total disability, thus suspending the benefits, such
possibility however does not justify the denial of a claim for a permanent total disability which rightfully pertains to the
claimant. The petitioner is hereby declared entitled to benefits under Permanent Total Disability. No pronouncement as to
costs.