Manuzon vs. Employees' Compensation Commission

A covered employee under Article 194(b) of Presidential Decree No. 626, as amended, includes a retired employee whose retirement was compelled by permanent total disability, and his primary beneficiaries are entitled to death benefits where death results from the same or a closely related work-oriented cause.

Consorcia F. Manuzon is the widow of a career government employee who served from 1957 at the Institute of National Language and from 1974 at Mindanao State University in Marawi City. Presidential Decree No. 626, as amended, establishes the Employees' Compensation system administered by the GSIS for the public sector and the Employees' Compensation Commission on appeal, providing income benefits for disability and death benefits to primary beneficiaries of covered employees and permanently totally disabled pensioners.

Petitioner's late husband began government service as a national language researcher in December 1957 at the Institute of National Language. He transferred to Mindanao State University in Marawi City as instructor in June 1974 and rose to assistant professor, the position he held when disaster struck in October 1982.

He was hospitalized at the Mindanao Sanitarium and Hospital for hemiparesis (R), found lying in bed unable to move his right side, with urinary incontinence and spasm of right upper and lower extremities. His attending physician, Dr. Levi H. Pagunzan, diagnosed cardio-vascular accident — hemorrhage. He thereafter underwent rehabilitation at the National Orthopedic Hospital, where Dr. Sylvia Velasco diagnosed his illness as hemiparesis (L) post CVA thrombosis. Because of the illness he retired from the service effective January 22, 1983. For hemiparesis, post cardio vascular attack, the System granted temporary total disability benefit from January 22, 1983 to February 24, 1983 and permanent total disability benefit from February 25, 1983 to December 1983, later continued to January 1984 and extended to January 1985.

On June 17, 1987, Mr. Manuzon died of acute myocardial infraction, four and one-half years after retirement. Petitioner, for herself and her four minor children, filed an income benefits claim for payment upon his death. On July 3, 1987, the System recommended payment of additional permanent total disability benefits from February 1985 up to the end of the guaranteed period on January 21, 1988, seven months after death, but disapproved the death claim on the ground that the contingency occurred after retirement where there was no longer an employer-employee relationship. The factual predicates relied upon below were that the fatal myocardial infraction occurred more than four years after retirement and was treated as a different illness from the cerebrovascular attack for which permanent total disability had been paid to the end of the guaranteed period.

• Work Connection and Continued Pension: Petitioner argued that continued pension was due because her husband died of a lingering illness found to be work-connected by the GSIS and became paralyzed while in service, with monthly pension having stopped in 1985 and additional pension paid only up to January 1988.
• Article 194(b) Interpretation: Petitioner maintained that a proper interpretation of Article 194(b) of Presidential Decree No. 626 entitles the primary beneficiaries of her deceased husband to death benefits.

• Occurrence After Retirement: Respondents countered that no additional benefit could be paid because death due to myocardial infraction occurred 4-1/2 years after retirement from the service, when there was no longer an employer-employee relationship, and was therefore evaluated as not compensable.
• Failure of Cardiovascular Compensability Conditions: Respondents argued that for a cardio vascular attack or myocardial infraction to be compensable, one of three stated conditions on acute exacerbation, severity and 24-hour onset, or symptoms during work must be satisfied, none of which was satisfied here.
• Different Illness and Full Payment: Respondents maintained that myocardial infraction was a different illness and could not be considered a complication of the cardio vascular attack for which the deceased had been properly and fully compensated with permanent total disability up to the guaranteed period from January 21, 1983 to January 21, 1988.

• Covered Employee Status: Whether a covered employee who was declared permanently and totally disabled, forced to retire, and died 4-1/2 years later is entitled to death benefits under Article 194(b) of Presidential Decree No. 626, as amended, despite no longer being in active service at death.
• Compensability of Death from Related Ailment: Whether death from myocardial infraction, claimed to be different from the compensated hemiparesis post cardio vascular attack, is compensable as work-connected and as the same or related cause.

• Covered Employee Status: Yes. A permanently totally disabled pensioner compelled to retire remains a covered employee under Article 194(b), the implementing rules expressly providing death benefits where income benefits for permanent total disability were being received at death.
• Compensability of Death from Related Ailment: Yes. Death was compensable because the fatal cardiovascular attack was closely related to the work-oriented thrombosis and paralysis that caused permanent total disability, the heart disease having developed during employment.

• Covered Employee Status: Although the term covered employee generally refers to one still in service at death, the Employees' Compensation Commission Rules provide otherwise for pensioners. Sec. 3(a), Rule XIII grants primary beneficiaries eighty percent monthly income benefit plus dependent's pension where the employee had been receiving permanent total disability benefits at death, while Sec. 3(b) preserves the balance of the five-year guaranteed period for secondary beneficiaries. Because a permanently and totally disabled employee cannot work and was compelled to retire by work-oriented disability, incapacity for gainful work expected to be permanent, inclusion within Article 194(b) was required, consistent with Article 194(d) contemplating funeral benefits for a permanently totally disabled pensioner. Any doubt was resolved in favor of the employee under liberal construction of social legislation.
• Compensability of Death from Related Ailment: The evidence showed stroke and cardio vascular accident from thrombosis or blockage of arteries during employment as professor, causing paralysis, compulsory retirement, and total permanent disability acknowledged as work-oriented. Death after retirement was likewise caused by cardio vascular attack or myocardial infraction. The retirement cause and death cause being closely related manifestations of heart disease that developed while working, the denial on the ground of a different, non-work-oriented cause was rejected. Death benefits must aid families of persons disabled by work-oriented causes, all the more where death follows from the same or related cause.

• Covered Employee Including Disabled Retiree — A covered employee under Article 194(b) of Presidential Decree No. 626, as amended, is not limited to one in active service at death; it includes an employee retired because of permanent total disability who was receiving income benefits at death, whose primary beneficiaries receive eighty percent of monthly income benefit plus dependent's pension, and whose secondary beneficiaries receive the remaining balance of the five-year guaranteed period. Applied to hold Mr. Manuzon, retired for paralysis from cardio vascular attack and receiving permanent total disability pension, still covered at his later death.
• Permanent Total Disability — Permanent total disability means an incapacity to perform gainful work which is expected to be permanent. Applied to explain why a pensioner cannot work and was compelled to retire, supporting continued coverage for death benefits.
• Liberal Construction of Social Legislation — Employees' compensation laws, as social legislation, are interpreted in favor of the employee, with doubts resolved in favor of protecting the employee's rights. Applied to construe Article 194(b) and its implementing rules to allow death and funeral benefits to the widow and minor children.

• "Permanent total disability means an incapacity to perform gainful work which is expected to be permanent." — Defines the controlling concept of permanent total disability to explain why a pensioner compelled to retire remains within the protection of Article 194(b).
• "We interpret this social legislation in favor of the employee. Any doubt as to its proper interpretation must be resolved in favor of the employee whose rights must be protected." — States the interpretive rule that justified resolving coverage and compensability in favor of the beneficiaries.
• "If the employee has been receiving income benefits for permanent total disability at the time of his death, the primary beneficiaries shall be paid the monthly income benefit equivalent to eighty percent plus the dependent's pension equivalent to 10 per cent thereof for every dependent child but not exceeding five counted from the youngest and without substitution." — Quotes the implementing rule establishing entitlement of primary beneficiaries despite retirement.

• Article 194(b), Presidential Decree No. 626, as Amended — Requires payment to primary beneficiaries upon death of a covered employee under permanent total disability of eighty percent of monthly income benefit plus dependent's pension, provided marriage validly subsisted at disability, with minimum death benefit of fifteen thousand pesos; applied as basis for granting death and dependent's pension to petitioner and minor children.
• Sec. 3(a), Rule XIII, Employees' Compensation Rules — Provides the eighty percent plus dependent's pension formula where the employee had been receiving permanent total disability income benefits at death; applied to show retired pensioners need not be in active service to generate death benefits.
• Sec. 3(b), Rule XIII, Employees' Compensation Rules — Provides secondary beneficiaries the monthly pension excluding dependent's pension for the remaining balance of the five-year guaranteed period where permanent total disability pension was being received at death; applied to distinguish guaranteed-period balance already paid from additional death benefits due.
• Article 194(d) and Article 194(cc), Presidential Decree No. 626 — Contemplate funeral benefits upon death of a covered employee or permanently totally disabled pensioner; applied to support coverage of retirees and to award P3,000.00 funeral benefits.
• Section 4(b), Presidential Decree No. 626, as Amended — Defines covered employee generally as an employee still covered by the GSIS at death; noted but held not to exclude retired permanently totally disabled pensioners under Article 194(b) and its rules.

Narvasa (Chairman), Cruz and Medialdea, JJ., concur. Griño-Aquino, J., is on leave.