LABOR Law

INJURY

Q. What an injury?

Answer. Injury is defined as any harmful changes in human organism from any
accident sustained at work while executing an order for the employer.

Q.

What are the conditions for compensability of injuries?

A. For injury and the resulting disability or death to be compensable, the injury
must be the result of an accident that satisfies all of the following conditions:

a. The employee must have been injured at the place where his work requires
him to be;
b. The employee must have been performing his official functions;
c. If the injury was sustained elsewhere, the employee must have been
executing an order for the employer (Sec. 1(a), Rule III, Amended Rules on
Employees Compensation).

Thus an injury or accident is said to arise in the course of employment when

it takes place within the period of employment, at a place where the employee
may be, and while he is fulfilling his duties or is engaged in doing something
incidental thereto. Note that in the course factor applies to time, place and
circumstances (PHHC vs. WCC, L 18246, 30 October 1964).

1. Distinguish arising out of and in the course of factors?

An injury or illness arise out of when it results from a risk or hazard which is
necessarily or ordinarily or reasonably inherent in or incident to the conduct of such
work or business. It refers to the origin or cause of the accident and are descriptive of its
character (PASUDECO; 16 SCRA 784).

In the course of takes place when an employee is doing the duty which he is
required to perform. It refers to time, place, and circumstances under which accident
takes place (Afable vs. Singer Machine Co.,58 Phil. 42).

2. What are the instances of compensable injuries?

The following are instances of compensable injuries:

a. Peculiar risks. A metro aide while at work on a public street was crushed to
death by an automobile. The injury caused by an accident was in pursuance
his employment, thus compensable.
b. Street perils. A camineros death or injury performing his work when hit by a
fast moving vehicle is held to be compensable (Balajadia vs. Province
Supra).
A street sweeper is exposed to the perils of the street thus any injury
arising there from is compensable (Balajadia vs. Province, G.R. No. L-41979,
15 October 1934).

c. Acts of ministration. The injury of the employee who heeded the call of
nature and sustained injuries in the performance of such act, is deemed
compensable. Likewise, acts necessary to the health and comfort of an
employee while at work such as satisfaction of thirst, hunger, etc. are
incidental to employment and injuries sustained there from are held to be
compensable. (Chua vs. Roman, L-14827, 31 October 1960).
d. Acts of God. A ships captains death because his vessel sank in a marine
disaster arising out of employment is thus compensable (Murillo vs.
Mendoza, 66 Phil, 689).
A farm workers death while administering insecticides to agricultural
plants in the open field, and lightning struck him, was held to be compensable.
 e. Assaults. A heated argument ensued between two workers over a work
assignment resulting in an assault by one to the other; the injury or death
arising there from has been held to be compensable (BLTC vs. Mandaguit, 70
Phil. 685).
However, assault occasional not attributable to employment such as when
it sprang from jealousy over a beautiful girl, as the two workers as rivals, was
held to be not compensable.

f. Recreational activities. The injury of the employee who was injured during a
company-sponsored recreational activity is deemed compensable. The test is
whether such activity is for the benefit or interest of the employer; otherwise it
is not compensable. (99 C.J.S. 737; RP vs. Amil, 10 SCRA 669).
An employee won a prize (around the world tour) for having been chosen as the
most outstanding employee of the year. In the course of such tour he met an
accident; the injury is deemed compensable.

g. Acts for the benefit of the employer. In an attempt to protect the properties
of the company, an employee was killed by the burglars. The resulting death
is compensable.
In his desire to retrieve the logs being carried away by strong current, the
employee, although a good swimmer, met his death by drowning as a
consequence. This is deemed compensable (Cuevo vs. Barrredo, No. L-
45699, 24 February 1938).

h. Acts during emergency. Whatever injuries are sustained in the course of a

rescue work during an emergency arising out of the employment are
compensable. Injury suffered by an employee in his attempt to rescue a co-
worker arising out of employment, is also a compensable (Estandarte vs.
Phil. Motor Alcohol Co., G.R. No. 39722, 1 November 1933).

3. Can injuries sustained off the premises be compensable?

 YES. An injury is compensable when it is sustained an employee anytime and
anywhere while executing an order for the employer. A well-known rule on the matter is
the coming and going rule. The following are compensable off-premise injuries:

a. The employee is on the way to or from work in a vehicle owned or supplied by

the employer. Example is the employers supplied bus (Talisay-silay Milling
Co. vs. WCC, 21 SCRA 366).
b. The employee is subject to call at all hours or at the moment of the injury.
Example: The employer summoned him, while on his way he was injured in
an accident.
c. The employee is traveling for the employer. Example: Traveling workers.
d. The employee is on his way to further work at time, even though on a fixed
salary. Example: The employer required employee to bring some papers at
home for overtime purposes; on his way he met an accident (Torbela vs.
ECC, G.R. No. L-42627, 21 February 1980).
e. The employee is required to bring the car to employers business place for
use therein (Iloilo Dock and engineering Co. vs. 26 SCRA 102, 105).
f. The employee is accidentally injured at a point reasonably proximate to the
place of work, such injury is deemed to have arisen out of and in the course
of his employment. Example: The school principal sustained an injury in a
vehicular accident while he was on his way to school and at the time of the
accident, he had in his possession official papers he worked on his residence
on the eve of his death (Vda. De Torbela vs. ECC, 96 SCRA 260).

4. What is the going and coming rule? Give the exceptions to the rule.

The general rule in workmens compensation law known as the going and
coming rule, is that 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 the
workmens compensation law. Thus, an injury or accident sustained by an employee
while using the public streets and highways in going to or returning from the place of
employment is not compensable. Such as injury is suffered as a consequence of risk
and hazard of employment. Furthermore, the employer is not an insurer against all
accidental injuries which might happen to an employee while in the course of
employment. (Iloilo Dock and Engineering Co. vs. WCC, 26 SCRA 102, 105)

This rule, however, admits of exceptions, to wit:

a. where the employee is proceeding to or from his work on the premises of his
employer;
b. where the employee is about to enter or about to leave the premises of his
employer by the way of the exclusive or customary means of ingress and
egress (proximity rule);
c. where the employee is charged, while on his way to of from his place of
employment or at his home, or during his employment with some duty or
special errand connected with his employment; and
d. where the employer as an incident of the employment provides the means of
transportation to and from the place of employment.
5. Explain and illustrate the proximity rule.

The proximity rule, an exception to the coming and going rule, provides that an
injury or accident sustained off the employers premise, but while in close proximity
thereto and while using a customary means of ingress and egress, is deemed
compensable.

Where the employee, while proceeding to work and running to avoid the rain,
slipped and fell into a ditch fronting the main gate of the employer's factory, and as a
result of which he died the next day, it was held that the accident occurred within the
zone of employment and therefore compensable.

6. What defenses may be interposed by the State Insurance Fund against a claim for
compensation made by a covered employee or his dependents?

The following defenses may be set up:

 a. The injury is not work-connected or the sickness is not occupational.
b. The disability or death was occasioned by the employees intoxication, willful
intention to injure or kill himself or another, or his notorious negligence.
c. No notice of sickness, injury or death was given to the employer.
d. The claim was filed beyond three (3) years from the time the cause of action
accrued.
7. Does intoxication bar compensation?

In order to prevent payment of compensation the following conditions must

concur:

a. there must be proof of actual intoxication;

b. the intoxication must be to such a degree that the employee is incapacitated
from substantially engaging in employment and performing his task;
c. the intoxication must be the proximate cause of the injury;
d. the intoxication must not only be the proximate cause (Schneider, Workmens
Compensation Laws, Vol. VI, 493-4; Balbija vs. Time Taxicab, 1219-R, 20
October 1955).
8. Does suicide bar compensation?

Since the employee committed the crime by himself, the resulting death is not
covered for compensation as in the following cases;

a. when It results from insanity resulting from compensable injury or disease;

b. when it occurs during a delirium resulting from compensable injury or disease;
and
c. when it flows from an uncontrollable impulse arising from compensable injury
or disease (Horovits, 41 Nebraska Law Journal, 36).

9. What is notorious negligence? Does it bar compensation?

 Notorious negligence is equivalent to gross negligence; it is something more than
mere carelessness or lack of foresight; it falls under the designation of evident and
manifest negligence and signifies a deliberate act of the employee to disregard his own
personal safety. However, mere disobedience to the rules, orders and/or prohibition
does not in itself constitute notorious negligence, if no intention can be attributed to the
injured to end his life.

Notorious negligence resulting in serious injury or death of the employee is not

compensable. However, no man in his senses would deliberately cause death. Thus,
the presumption is that the laborer by his instinct of self-preservation takes precaution to
avoid such danger unless a willful intention is attributed to him to end his life (Dela Cruz
vs. Cia. Maritima, G.R. No. 38236, 21 August 1933).

10. What is the liability of the State Insurance Fund?

Whenever other laws provide similar benefits for the same contingency, the
employee who qualifies for the benefits shall have the option to choose the law under
which the benefit will be paid to him. If the law chosen provides for benefits lesser than
those provided by the Labor Code, he shall be entitled only to the difference.

The employee cannot avail himself at the same time of similar benefits provided
by different laws, except the difference thereof. However, the employer may continue to
grant benefits already earned by the employees under any collective bargaining
agreement or any other arrangement (Sec. 2, Rule V, Amended Rules on Employees
Compensation).

11. What are the benefits excluded by the State Insurance Fund?

The following benefits are excluded by the State Insurance Fund:

a. Gratuity benefits under Section 699 of the Revised Administrative Code, as

amended by R.A. No. 1232;
b. Retirement, disability, sickness, and death benefits under the SSS Law ( R.A.
No. 1161, as amended);
 c. Life insurance, disability and retirement benefits under the GSIS Law (Com.
Act. No. 186, as amended);
d. Gratuities and pensions of every personnel for deaths and disabilities incurred
in line of duty in accordance with R.A. No. 610, as amended;
e. Medical benefits administered by the Philippine Medical Care Commission
provided in R.A. No. 4864, as amended; and
f. Other benefits granted by other laws and administered either by the GSIS or
SSS.

12. Is Article 173, now Art.179 of the Labor Code, as amended a bar to claim for
damages under the Civil Code?

NO. Article 179 of the Labor Code does not bar to claim for damages under Civil
Code arising from employers negligence, for liability under Article 17 is confined only to
illness or injury.

13. Is simultaneous recovery of benefits allowed?

YES. While it is true the SSS Law (R.A. No. 1161, as amended) is distinct and
different from the Labor Code, the provisions of Sections 15 of the SSS law and Article
179 of the Labor Code are in parimateria insofar as they both relate to payment of
compensation to covered employees, and insofar also as both provisions barred the
simultaneous recovery of benefits under both the SSS Law and the Labor Code, until
Article 173, now 179, wasthen amended by P.D No. 1921 in 1984. The amendment
introduced by P.D No. 1921 to Article 179 lifted the ban against the simultaneous
recovery of benefits under the Labor Code and the SSS law, and is deemed to have
repealed by necessary implication the provision of Section 15 of the SSS Law. Since
P.D. No. 1921 is the latest expression of the legislative will, it will prevail over Section 15
of the SSS Law. (Opinions of the Secretary of justice dated May 23, 1989 and January
12, 1990 addressed to the SSS).

Furthermore, benefits under the State Insurance Fund accrue due to the
employees concerned due to hazards involved and are made a burden on the
employment itself. On the other hand, social security benefits are paid to SSS
members by reason of their membership therein for which they contribute their money
to a general fund.

It must be noted that under the new Social Security Act (R.A. 8282), the
provision of Section 15 of the old SSS law which bars simultaneous recovery of
benefits, has already been deleted.

14. Can a claimant who has already recovered from the State Insurance Fund still
recover damages in a criminal or civil case in relation thereto?

NO. Unless otherwise provided, the liability of the State Insurance Fund under
this Title shall be exclusive and in place of all other liabilities of the employer to the
employee, his dependents or anyone otherwise entitled to receive damages on behalf of
the employee or his dependents.

15. G., who worked in the weaving department of a textile firm, was stabbed to death
by L., his fellow employee. L. was convicted of homicide and sentenced to pay
indemnity to the heirs of G. If the heirs have already recovered from the State
Insurance Fund, can they still hold the employer subsidiarily liable for the indemnity to
be paid by L., in the event the latter is unable to pay the same? Why?

NO, the heirs can no longer recover indemnity from the employer. The liability of
the State Insurance Fund is exclusive and in place of all other liabilities of the employer
to the employee and his dependents or beneficiaries. This includes the subsidiary
liability of the employer under the Revised Penal Code. (Generoso vs. Universal Textile
Mills, Inc.G.R. No. L-28586, January 22, 1980)

16. What are the liabilities of third parties?

In case the injury or death is caused by circumstances creating a legal liability

against a third party other than the employer, the injured employee or his dependents
may either claim compensation from the System under the Labor Code or sue for
damages in accordance with law. In case the benefit is paid by the system, the latter is
subrogated to the rights of the injured employee or his dependent in accordance with
the general law. Where the System recovers from such third party damages in excess
of those paid or allowed under Title II, Book IV, of the Labor Code, such excess shall be
delivered to the injured employee or another person entitled thereto, after deduction of
the expenses of the System and the cost of the proceedings.

It must be noted that injuries or death caused by a third person are compensable
provided the requisites of compensability are present. However, the injured employee
cannot claim payment twice for the same injuries, that is, from the third party and from
the SSS or GSIS (Alba vs. Bulaong, 101 Phil. 434).

17. S., a driver-mechanic, was killed when he tried to fight unidentified men who
carnapped the vehicle of his employers. As a consequence of his death, his heirs filed
an action for death compensation and damages before the RTC against his employers.
The latter, however, contended that the complaint should be dismissed as the
appropriate remedy is a claim under the Employees Compensation Program. Is the
contention of the employers correct? Explain.

NO. The employee or his heirs have the choice of cause of action and the
corresponding relief, i.e. either an ordinary action for damages based on Article 1171 of
the New Civil Code before the regular courts or a special claim for limited compensation
under the Employees Compensation Program. But the right of choice is qualified in that
the employee should be held to the particular remedy in which he stakes his fortune.
(Vda. de Severo vs. Go, G.R. No. L-44330, January 29, 1988)

18. Who are entitled to benefits under the employees compensation program?

The covered employee, his dependents, and in case of his death, his
beneficiaries.

19. Who are the dependents of the employee?

Dependents include the following:

a. the legitimate, legitimated or legally adopted child who is:

(1) unmarried,
(2) not gainfully employed, and
(3) not over eighteen years of age,
- or over eighteen but not over twenty-one years of age provided that he
is enrolled in school,
- or over twenty-one years of age provided that he is congenitally
incapacitated and incapable of self-support due to physical or mental
defect which is congenital or acquired during minority;
b. the legitimate spouse living with the employee; and
c. the legitimate parents of said employee wholly dependent upon him for
regular support.

20. What is the meaning of dependency?

Dependency is a relationship between two persons where the claimant-

beneficiary looks up to or relies for support upon another for the purpose of maintaining
himself consistent with the dependents station in life. Thus, a lawful dependent is one
who relies upon the deceased for the support with reasonable expectation that the
same shall continue. The support may take the form of sustenance, dwelling, clothing
and medical attendance. (Art. 290, New Civil Code)

21. Who are included under the term beneficiaries?

 Beneficiaries mean the dependent spouse until he remarries and dependent
children who are the primary beneficiaries. In their absence, the dependent parents
subject to the restrictions imposed on dependent children, the illegitimate children and
legitimate descendants, who are the secondary beneficiaries.

22. Who are the primary beneficiaries?

The following beneficiaries are considered primary:

a. The legitimate spouse living with the employee at the time of the employees
death until he remarries; and
b. Legitimate, legitimated or legally adopted or acknowledged natural children
who are unmarried, not gainfully employed, not over 21 years of age, or over
21 years of age provided that he is incapacitated and incapable of the self
support, due to physical or mental defect which is congenital or acquired
during minority: Provided further that the dependent acknowledged natural
chill shall be considered a primary beneficiary only when there are no other
dependent children who are qualified and eligible for monthly income benefit:
Provided, Finally, that if there are two or more acknowledged natural children,
they shall be counted from the youngest and without substitution, but not
exceeding five. (Sec. 1(b), Rule XV, Amended Rules on Employees
Compensation)

23. Who are the secondary beneficiaries?

The following beneficiaries are considered secondary:

a. The legitimate beneficiaries parents wholly dependent upon the employee for
support.
b. The legitimate descendants and illegitimate children who are unmarried, not
gainfully employed and not over 21 years of age, or over 21years of age
provided that he is incapacitated and incapable of self-support due to physical
 or mental defect which is congenital or acquired during minority. (Sec.1(c),
Rule XV, Amended Rules on Employees Compensation)

24. Who shall have priority?

Primary beneficiaries shall have priority claim to death benefit over secondary
beneficiaries. Whenever there are primary beneficiaries, no death benefit shall be paid
to secondary beneficiaries.

If the deceased employee has no primary beneficiaries at the time of his death
benefit shall be paid to his secondary beneficiaries.

If the deceased employee has no beneficiaries at the time of his death, the death
benefits shall accrue to the Employees Compensation Fund. (Sec.2, Rule XV, Amended
Rules on Employees Compensation)

25. Classify the benefits which may be enjoyed under the State Insurance Fund.

a. Medical Benefits
b. Disability Benefits
c. Death Benefits and
d. Funeral Benefits