INJURY c. Acts of ministration.
The injury of the
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 caminero’s 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).
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 captain’s death
because his vessel sank in a marine disaster
arising out of employment is thus
compensable (Murillo vs. Mendoza, 66 Phil,
689).
A farm worker’s 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 employer’s
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
employer’s 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 workmen’s 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 workmen’s 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 employer’s 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
employee’s 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, Workmen’s
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 ІV, 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 employer’s
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 dependent’s 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 employee’s 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