Itogon-Suyoc Mines, Inc. vs. Dulay

Tuberculosis aggravated by the nature of employment is compensable, and pre-employment clearance plus more than two years of continuous work supports aggravation where disabling far advanced disease later appears. The employer's obligation for medical care under Section 13 subsists during the period of disability even after separation from service and is not confined to the 208-week or monetary limits applicable to compensation.

Itogon-Suyoc Mines, Inc. was the mining employer and Fruto Dulay its underground mucker. Section 2 of the Workmen's Compensation Act (Act No. 3428, as amended) requires compensation where an employee contracts tuberculosis directly caused by employment or either aggravated by or the result of the nature of such employment, while Section 13 governs medical services and Section 14 governs compensation amounts.

Previous to employment with Itogon-Suyoc Mines, Inc., Fruto Dulay applied to Antamok Mining Company on October 10, 1950 but was refused admission after being found afflicted with a lung ailment. On September 22, 1951, he was again refused after X-ray examination disclosed far advanced pulmonary tuberculosis, fibro-caseous with traction of the heart to the right and beginning infiltrations in the left upper lung. Seven months later, on April 30, 1952, Itogon-Suyoc allowed him to work after he passed the employment physical examination conducted by Dr. Ramon Pellicer, a company physician, which did not include a chest X-ray.

As mucker, Dulay bored five-feet-deep holes by means of a stop machine weighing 200 pounds more or less and blasted them with dynamite, and lifted timber of varied sizes including round posts that could hardly be carried by two persons. His underground workplace was hot with no electric fan for adequate ventilation, and he worked either the night shift from 4:00 to 12:00 p.m. or the day shift from 7:00 a.m. to 3:00 p.m. On April 28, 1954, he was automatically separated for exceeding vacation leave without permission, but after requesting the General Superintendent, he was readmitted on May 14, 1954.

On July 7, 1954, Dr. Hugo A. Rosa, the company physician who succeeded Dr. Pellicer, X-rayed Dulay and found fibro-caseous lesions all over the right lung and fibroid lesions on the left with markedly retracted mediastinum to the right, remarked as far advanced chronic pulmonary tuberculosis. On July 16, 1954, Dulay stopped working at the instance of the company physician and received medication from the respondent until September 12, 1955. From August 2 to 3, 1954, inclusive, he paid Dr. Jose Villamil P1.00 daily for streptomycin injections, and a November 3, 1954 X-ray revealed no apparent radiographic change. When he sought employment with Philippine Engineers' Syndicate on December 18, 1954, he was rejected for affliction described as right lung fibro-caseous lesion all over with retracted mediastinum. At the time he was told to stop working, he was earning P24.00.

The Commission found that Dulay admitted far advanced pulmonary tuberculosis on September 22, 1951, but that the illness must have improved during more than seven months of complete rest, was arrested and inactive when he passed the April 1952 physical examination and worked for more than two years, then was reactivated and progressed to a more disabling far advanced stage by strenuous mining and nighttime underground duties, necessitating separation.

• Absence of Arrest and Aggravation: Petitioner argued that there was absolutely no evidence Dulay was under medical treatment after the September 22, 1951 finding of far advanced pulmonary tuberculosis to warrant the conclusion that the illness had been arrested at hiring on April 30, 1952 and then aggravated and reactivated by work.
• Nondisclosure and Bad Faith: Petitioner maintained that Dulay was guilty of bad faith in allegedly not disclosing his illness when he submitted to the required company physical examination.
• Termination of Medical Liability: Petitioner assailed the order to provide continuous medical and hospital services until cure or arrest, arguing that Dulay was no longer in its employ and that liability for medical care could not extend beyond 208 weeks.
• Meaning of Contracted Sickness: Petitioner argued that Dulay could not be said to have contracted sickness under Section 13 on the assumption that his lung ailment was merely aggravated by work.

• Aggravation and Compensability: Whether pulmonary tuberculosis, pre-existing at hiring, was aggravated by the nature of underground mucking work so as to be compensable.
• Fitness Clearance and Disclosure: Whether passing the company physician's pre-employment physical examination and working for more than two years negates bad faith and supports work-connected aggravation.
• Duration of Medical Liability: Whether the employer's duty to provide continuous medical and hospital services under Section 13 persists after separation from employment and beyond 208 weeks.
• Contracted Sickness: Whether tuberculosis aggravated by employment constitutes contracted sickness within Section 13 for purposes of medical attendance.

• Aggravation and Compensability: Yes. Aggravation by the nature of employment renders tuberculosis compensable under Section 2, the strenuous duties and hot underground conditions having reactivated the disease to a disabling stage.
• Fitness Clearance and Disclosure: Yes. Clearance by the employer's own physician and retention for more than two years indicated fitness at hiring, with no bad faith in nondisclosure where found fit to work.
• Duration of Medical Liability: Yes. Medical liability under Section 13 lasts during the period of disability while the employee is sick, without requiring a subsisting employer-employee relationship and without the 208-week and P4,000 compensation limits.
• Contracted Sickness: Yes. Tuberculosis either aggravated by or the result of the nature of employment under Section 2 is contracted sickness entitling the employee to medical attendance under Section 13.

• Aggravation and Compensability: Section 2 compensates tuberculosis directly caused by employment or either aggravated by or the result of its nature. Although Dulay admitted far advanced disease in September 1951, more than seven months of rest preceded April 1952 hiring, and admission after the company physician's examination strongly indicated the illness was arrested and inactive. Boring with a 200-pound machine, lifting timber hardly carriable by two persons, and hot, unventilated underground night work reactivated the ailment to a more disabling far advanced stage necessitating separation. Both the hearing officer and the Commission en banc so found, and long-standing precedent sustains affirmance where evidence supports the Commission's finding.
• Fitness Clearance and Disclosure: Pre-employment examination resulting in admission to work, followed by more than two years of allowed work until the company physician ordered stoppage, established fitness as determined by the employer's own physician. Later discovery of tuberculosis was thus attributed to the nature of the heavy work under aggravating conditions. No bad faith attended the alleged nondisclosure where the required examination found Dulay fit to work.
• Duration of Medical Liability: Section 13 imposes medical liability as long as the illness was contracted during employment, with no employer-employee relationship required as a condition. The obligation lasts for as long as the employee is sick, during the period of disability. The 208-week limit, like the P4,000 limit in Sections 12, 14, 16, and 18, refers to liability for compensation and has no reference to medical care.
• Contracted Sickness: Because Section 2 expressly includes tuberculosis either aggravated by or the result of the nature of employment, aggravation shown on the facts satisfies contracted sickness under Section 13. Medical attendance was therefore correctly provided.

• Aggravation as compensability under the Workmen's Compensation Act — Tuberculosis need not be originally caused by employment; aggravation by or as a result of the nature of employment suffices for compensation under Section 2. Applied here, reactivation from an arrested, inactive state to far advanced disabling disease by heavy mucking in hot underground conditions made the claim compensable.
• Effect of pre-employment fitness finding — Admission after the employer's own physician's physical examination, followed by years of continuous work until ordered to stop by the company physician, indicates fitness at hiring and attributes later disabling disease to work conditions, negating bad faith for alleged nondisclosure. Applied here, clearance by Dr. Pellicer and more than two years of service supported aggravation rather than concealed unfitness.
• Continuing medical liability during disability — The employer's duty under Section 13 to furnish medical, surgical, and hospital services lasts during the period of disability for as long as the employee is sick from an employment-contracted or aggravated illness, even after separation, and is not capped by the 208-week or monetary limits governing compensation under Sections 12, 14, 16, and 18. Applied here, continuous care until cure or arrest was sustained despite termination of employment, following La Mallorca-Pambusco vs. Isip.
• Substantial evidence deference to the Workmen's Compensation Commission — Findings of the hearing officer and the Commission en banc on aggravation are sustained where supported by evidence, in line with a long array of decisions. Applied here, concurring findings of aggravation from heavy work were affirmed.

• "When an employee suffers personal injury from any accident arising out of and in the course of his employment, or contracts tuberculosis or other illness directly caused by such employment, or either aggravated by or the result of the nature of such employment, his employer shall pay compensation in the sums and to the person hereinafter specified...." — States the controlling Section 2 standard making aggravated tuberculosis compensable and anchoring the affirmance.
• "Moreover, the fact that he was admitted into the service, and allowed to work for more than two years after having passed the physical examination made by Dr. Ramon Pellicer sometime in April, 1952, is a strong indication that said illness was arrested and therefore inactive." — Articulates the inference from pre-employment clearance and continued service that the prior disease had become inactive before work-related reactivation.
• "Section 13 does not require employer-employee relationship as a condition for the employer's liability. As long as the illness was contracted during the employee's employment, the employer's obligation subsists." — Defines the scope of continuing medical liability after separation from service.
• "The limit of 208 weeks, like the limit of P4,000, refers to the liability of the employer for compensation (Secs. 12, 14, 16, 18, Act No. 3428, as amended) and has no reference at all to the employer's liability for medical care (See. 13) which lasts during the 'period of disability'." — Distinguishes compensation ceilings from open-ended medical care during disability.

• La Mallorca-Pambusco vs. Isip, et al., G.R. No. L-16495, Oct. 19, 1961 — Followed as authority that the 208-week and monetary limits govern compensation liability, while medical care under Section 13 lasts during the period of disability.

• Section 2, Workmen's Compensation Act (Act No. 3428, as amended) — Provides compensation for tuberculosis directly caused by employment or either aggravated by or the result of its nature; applied to hold Dulay's reactivated far advanced disease compensable.
• Section 13, Workmen's Compensation Act — Requires the employer to provide medical, surgical, and hospital services during disability; applied to sustain continuous care until cure or arrest despite separation and beyond 208 weeks.
• Section 14, Workmen's Compensation Act, as amended — Basis cited by the Commissioner for the P2,995.20 compensation award.
• Sections 12, 14, 16, 18, Workmen's Compensation Act — Cited to show the 208-week and P4,000 limits pertain to compensation, not to Section 13 medical care.
• Section 45, Workmen's Compensation Act — Cited by the Commissioner as the basis for waiver for failure to submit the employer's report on time.
• Section 55, Workmen's Compensation Act, as amended — Basis cited for the P35.00 costs assessed against the employer.

Bengzon, C.J., Padilla, Barrera, Paredes, Dizon and Makalintal, JJ., concur.