Published — April 27, 2018
The following post does not create a lawyer-client relationship between Alburo Alburo and Associates Law Offices (or any of its lawyers) and the reader. It is still best for you to engage the services of your own lawyer to address your legal concerns, if any.
Also, the matters contained in the following were written in accordance with the law, rules, and jurisprudence prevailing at the time of writing and posting, and do not include any future developments on the subject matter under discussion.
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As Wilke Collins once said, “accidents will happen sometimes, no matter how careful a man may be.” This is the very reason why insurance businesses thrive, and why being insured plays a huge role in managing risks and contingencies. Acknowledging this necessity, social legislation recognizes the need to insure workers against work-connected hazards, and created a system for compensating such workers from an established fund in case accidents indeed happen.
With this, the government developed an Employees’ Compensation Program whereby employees and their dependents may promptly secure adequate income, medical or related benefits from the State Insurance Fund in the event of work-connected illness, disability or death [See: Art. 172, Labor Code]. More importantly, the liability of the State Insurance Fund shall be exclusive, and takes the place of the employer’s liability to its employees, making it imperative for every employer to faithfully ensure that both the establishment and their workers are covered by the program, and the corresponding contributions are religiously paid [See: Art. 179].
Compulsory coverage and contributions
Coverage in the State Insurance Fund, which is being administered by the Employee’s Compensation Commission, through the Social Security System (“SSS”), shall be compulsory upon all employers and their employees not over 60 years of age. However, employees over 60 years old shall still be subject to compulsory coverage provided that said employee is paying contributions to qualify for retirement or life insurance benefit being administered by the SSS [See: Art. 174]. Such coverage shall take effect on the employer’s first day of operation, and on the employee’s date of employment [See: Art. 176].
Contributions to the State Insurance Fund shall be paid entirely by the employer. Any contract or agreement for the deduction of any portion of such contribution payments from the salaries of the employees shall be null and void [See: Art. 189(b)].
Compensable diseases and injuries
For the sickness and the resulting disability or death to be compensable, the sickness must be the result of an occupational disease listed under the Rules on Employees Compensation (view full list here), and the conditions set therein must be satisfied. Otherwise, proof must be shown that the risk of contracting the disease is increased by the working conditions [See: Rule III, Sec. 1(b), Amended Rules on Employees Compensation]. For the injury and the resulting disability or death to be compensable, the injury must be the result of accident arising out of and in the course of the employment [See: Rule III, Sec. 1(a)].
Theory of “increased risk”
To establish compensability, the claimant must show substantial proof of work-connection, but what is required is merely a reasonable work-connection and not a direct causal relation [See: G.R. No. L-58176]. Proof of actual ailment is not necessary. The test of evidence of the relation of the disease with the employment is probability and not certainty [See: G.R. No. L-64802].
Thus, where an employee working in a printing department who handled various chemicals for printing was exposed to intense heat and often neglected personal necessity due to inadequate facilities in his place of work, it was ruled that his death due to rectal cancer is compensable. It is so because, although rectal cancer is not listed as an occupational disease, there was ample proof that the risk of contracting the same was increased, if not caused, by the working conditions prevailing in the employer’s premises [See: G.R. No. L-49280].
On the other hand, the disability of a clerk in due to brain tumor, and the death of a driver due to amyotrophic lateral sclerosis, have been held not to be compensable, as the claimants failed to submit such proof as would constitute a reasonable basis for concluding either that the conditions of employment of the claimants caused the ailment or that such working conditions had aggravated the risk of contracting those ailments [See: G.R. No. 58445]. Same is true regarding a school teacher who died of liver cirrhosis, where such death was held not to be compensable considering that the work of a teacher does not increase the hazards which naturally cause liver illness [See: G.R. No. 58879].
The “going and coming rule”
In the absence of special circumstances, an employee injured while going to or coming from his place of work is excluded from the benefits of workmen’s compensation [Alcantara, citing 8 Schneider, Workmen’s Compensation, p. 7-8].
This rule, however, admits of exceptions, to wit:
- Where the employee is going to or from his work on the premises of his employer;
- Where the employee is about to enter or about to leave the premises of his employer through the customary entrance or exit;
- Where the employee is charged, while on his way to or from his place of work, with some duty or errand connected with his employment; and
- Where the employer, as an incident of employment, provides for the means of transportation to and from his place of work [See: G.R. No. L-35745].
Thus, where a school teacher was on her way home from school and would continue to perform other school works in connection with her employment as school teacher, her fatal vehicular accident can be treated as a necessary incident to her school work. Her death was therefore held to be compensable [Ibid].
Limit on the liability of the State Insurance Fund
Generally, the liability of the State Insurance Fund shall be exclusive and takes the place of all other liabilities of the employer to the employee or his dependents [See: Art. 179, Labor Code]. However, the State Insurance Fund shall not be liable for compensation to the employee or his dependents where the disablity or death was occassioned by the claimant’s intoxication, willful intention to injure or kill himself or another, or notorious negligence [See: Art. 178].
Though we try to avoid accidents the best that we could, it is still good to know for both employers and employees that there is a Fund that will answer for possible work-connected illnesses, injuries or death. The Fund is even further strengthened upon the government’s guarantee on the State Insurance Fund’s solvency [See: Art. 190]. All of this simply shows that the contributions being collected through the SSS for workmen’s compensation is useful not only for purposes of compensating wounded employees, but also in shielding the law-abiding employers from possible liability.
Alburo Alburo and Associates Law Offices specializes in business law and labor law consulting. For inquiries regarding social security and other employee welfare benefits, you may reach us at info@alburolaw.com, or dial us at (02)7745-4391/0917-5772207.
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