Social Legislation and Agrarian Reform Law
Revised Governemnt Service Insurance
Act of 1997 RA 8291
Government Service Insurance System Act of 1997 is
the present law.
Commonwealth Act 186 – first created GSIS. The
membership was made compulsory for all regular
and permanently appointed employees of the
Commonwealth, and optional for all regular and
permanent employees of the National Assembly.
Compulsory coverage were considered automatically
insured on life
Concept of Pension
Pension is a periodic allowance of money granted by
the government in consideration or recognition of
meritorious past services, or of loss or injury
sustained in the public service. It is not a gift or
gratuity.
Retirement pension is different from retirement
pay
Retirement pension is in the nature of pay withheld to
induce continued faithful service and amounts to
compensate for services previously rendered.
Design: to induce competent persons to enter and
remain in public service and encourage retirement to
those who have become incapacitated from
performing the duties as well as they may be
performed by younger or more vigorous persons.
Government Employees with Separate Retirement
Schemes
1. justices and judges
2. Armed Forces of the Philippines
3. PNP
Salient Provisions under Revised GSIS Act
(c) Employer- The national government, its political
subdivisions, branches, agencies or instrumentalities,
including government-owned or controlled
corporations, and financial institutions with original
charters, the constitutional commissions and the
judiciary;
Coverage of GSIS System
1. National government, its political subdivisions,
2. Government-owned or controlled corporations
3. Government financial institutions with original
charters; and
4. the judiciary
"(d) Employee or Member- Any person receiving
compensation while in the service of an employer as
defined herein, whether by election or appointment,
irrespective of status of appointment, including
barangay and Sanggunian officials;
"(e) Active Member- A member who is not separated
from the service;
"(f) Dependents- Dependents shall be the following:
(a) the legitimate spouse dependent for
support upon the member or pensioner;
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GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
(b) the legitimate, legitimated, legally
b;adopted child, including the illegitimate
child, who is unmarried, not gainfully
employed, not over the age of majority, or is
over the age of majority but incapacitated
and incapable of self-support due to a mental
or physical defect acquired prior to age of
majority; and
(c) the parents dependent upon the member
for support;
Who are the beneficiaries?
"(g) Primary beneficiaries- The legal dependent
spouse until he/she remarries and the dependent
children;
"(h) Secondary beneficiaries- The dependent
parents and, subject to the restrictions on dependent
children, the legitimate descendants;
(i) Compensation- The basic pay or salary
received by an employee, pursuant to his
election/appointment, excluding per diems, bonuses,
overtime pay, honoraria, allowances and any other
emoluments received in addition to the basic pay
which are not integrated into the basic pay under
existing laws;
"(p) Gainful Occupation- Any productive activity that
provided the member with income at least equal to
the minimum compensation of government
employees;
"(q) Disability- Any loss or impairment of the normal
functions of the physical and/or mental faculty of a
member which reduces or eliminates his/her capacity
to continue with his/her current gainful occupation or
engage in any other gainful occupation;
"(r) Total Disability- Complete incapacity to
continue with his present employment or engage
in any gainful occupation due to the loss or
impairment of the normal functions of the physical
and/or mental faculties of the member;
"(s) Permanent Total Disability- Accrues or arises
when recovery from the impairment mentioned in
Section 2 (Q) is medically remote;
"(t) Temporary Total Disability- Accrues or arises
when the impaired physical and/or mental faculties
can be rehabilitated and/or restored to their normal
functions;
"(u) Permanent Partial Disability- Accrues or arises
upon the irrevocable loss or impairment of certain
portion/s of the physical faculties, despite which the
member is able to pursue a gainful occupation.
"B. MEMBERSHIP IN THE GSIS
VIP
"SEC. 3. Compulsory Membership. - Membership
in the GSIS shall be compulsory for all employees
receiving compensation who have not reached the
compulsory retirement age, irrespective of
employment status, except members of the Armed
Forces of the Philippines and the Philippine National
Police, subject to the condition that they must settle
 Social Legislation and Agrarian Reform Law 2
 
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
first their financial obligation with the GSIS, and by law to remit regular monthly contributions for
contractuals who have no employer and employee life insurance policies to GSIS in order to
relationship with the agencies they serve. answer for life insurance benefits.

*members of the judiciary are special GSIS

"Except for the members of the judiciary and Members
constitutional commissions who shall have life
insurance only, all members of the GSIS shall have b) Active of Inactive
life insurance, retirement, and all other social security Active – presently employed in the government or
protections such as disability, survivorship, still in the government service and are required to
separation, and unemployment benefits. pay contributions

Inactive – no longer employed or separated from

IRR:
service either by resignation, retirement, disability,
Who are subject to Who are NOT subject to dismissal from service, retrenchment, or who is
compulsory coverage compulsory coverage deemed retired from the service under Act.
1. All Government 1. Uniformed personnel
employees who are of the AFP, PNP, BFP, "SEC. 4. Effect of Separation from the Service. - A
receiving fixed and BJMP; member separated from the service shall continue
monthly to be a member, and shall be entitled to whatever
compensation and 2.Barangay and benefits he has qualified to in the event of any
not reached the Sangguniang official contingency compensable under this Act.
mandatory who are not receiving
retirement agre of fixed monthly
Once a member shall always be member despite
65 years, whether compensation
separation from service
elective or
- the member separated from service continues to be
appointive; 3.Contractual
a member, therefore, entitled to whatever benefits he
2. Elective officials employees who are not
has qualified to in the event of any contingency.
who will be more receiving fixed
than 65 years old at compensation;
It shall be mandatory and compulsory for all
the end of his term
employers to include the payment of
(including the period 4. Employees who do
contributions in their annual appropriations the
of his re-election not have monthly
heads of offices and agencies shall be criminally
without interruption); regular hours of work or
liable if they fail. They may also be held
3. Officials appointed not receiving fixed
administratively liable for non-remittance /
by the President of monthly compensation
delayed remittance of premium contributions to
the Republic of the
the GSIS.
Philippines who *members of judiciary
remain in office after shall have life insurance
GSIS Benefits
reaching the age of only
Members of the GSIS are entitled to the following
65;
benefits:
4. Contractual or
1. Separation Benefits
Casual employees
- members who resign or are
ho received fixed
separated from service after
monthly
rendering for at least 3 years but less
compensation and
than 15 years etc… p 372
render number of
2. Unemployment or involuntary separation
working hours for
benefits
the month
"SEC. 12. Unemployment or Involuntary Separation Benefits. -
Unemployment benefits in the form of monthly cash payments
equivalent to fifty percent (50%) of the average monthly
*Class Notes (CN): Who are subject to compulsory compensation shall be paid to a permanent employee who is
involuntarily separated from the service due to the abolition of his
coverage? office or position usually resulting from reorganization: Provided,
That he has been paying integrated contributions for at least one
Difference of SSS and GSIS as to Casual (1) year prior to separation. Unemployment benefits shall be paid
Employment: in accordance with the following schedules:
Casual employment – there is absolute exclusion
in SSS while in GSIS they are covered provided "Contributions Made Benefit Duration
there is EE-ER relationship, working hours and
1 year but less than 3 years 2 months
they receive fixed monthly compensation. 3 or more years but less than 6 years 3 months

Classes of GSIS membership:
a) Regular or Special
Regular Members – regular employees the
Republic of the Philippines, national or local,
legislative bodies, GOCC with original charters,
GFI, except the uniformed personnel of AFP,
PNP, BFP and BJMP
Special Members– officers of the constitutional
commission, members of the judiciary,
including those with equivalent who are required
6 or more years but less than 9 years 4 months
9 or more years but less than 11 years 5 months
11 or more years but less than 15 years 6 months
"The first payment shall be equivalent to two (2) monthly benefits.
A seven-day (7) waiting period shall be imposed on succeeding
monthly payments.
"All accumulated unemployment benefits paid to the employee
during his entire membership with the GSIS shall be deducted from
voluntary separation benefits.
 Social Legislation and Agrarian Reform Law
"The GSIS shall prescribe the detailed guidelines in the
operationalization of this section in the rules and regulations
implementing this Act.
-available to permanent employees
involuntary separation from the
service due to the abolition of office
or reorganization
VIP
Conditions to be entitled to the
unemployment benefit:
1. he was a permanent employee at the time
of separation
2. his separation was involuntary
3. due to the abolition of his office or position
due to reorganization
4. he has been paying the required premium
contributions for at least 1 year prior to
separation
3. Disability benefit
- Permanent Partial
- Permanent Total
disability caused by injury or disease resulting in
complete, irreversible and permanent incapacity
to work or to engage in any gainful occupation.
a) complete loss of sight for both eyes
b) loss of two limbs at or above the ankle or
wrist
c) permanent complete paralysis of two limbs
d) brain injury resulting in incurable imbecility
or insanity
Conditions for entitlement of Partial Disability
benefit :
1. if he was in the service at the time of
disability or
2. if separated from service, he has paid at
least 36 months contribution within the 5-year
period immediately preceding his disability or
has paid a total of at least 180 months
contributions prior to the disability. Provided
that the following conditions are met:
1. he is gainfully employed prior to
the commencement of disability
resulting in loss of income as
evidenced by any incontrovertible
proof
2. he is not a registered member of
any social insurance institution
3. he is not receiving any other
pension either from GSIS or another
local or foreign institution
* A member is not entitled to the benefit if the
permanent partial disability was caused by his
grave misconduct, notorious negligence, habitual
intoxication or wilful intervention to kill himself or
another
Suspension of disability benefit
Unless the member reached the minimum
retirement age, disability benefits shall be
suspended when he:
a) is reemployed
b) recovers from the disability as determined
by GSIS
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GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
c) fails to present himself for medical
examination when required by GSIS
Forfeiture of disability benefits
The disability benefits will be automatically forfeited if
the GSIS member refuses or fails:
a) to have himself medically treated by a
physician when required by the GSIS
b) take prescribed medications
c) have himself confined in a hospital, when such
confinement is required by GSIS
d) avail himself of rehabilitation facilities as may
be duly recommended by the GSIS
e) observe such precautionary or preventive
measure us prescribed by a physician to prevent
the aggravation or continuance of his disability
4. Temporary total disability benefit
5. Retirement benefit
"SEC. 13. Retirement Benefits. - (a) Retirement benefits shall be:
"(1) the lump sum payment as defined in this Act payable at the
time of retirement plus an old-age pension benefit equal to the
basic monthly pension payable monthly for life, starting upon
expiration of the five-year (5) guaranteed period covered by the
lump sum; or
"(2) cash payment equivalent to eighteen (18) months of his basic
monthly pension plus monthly pension for life payable immediately
with no five-year (5) guarantee.
"(b) Unless the service is extended by appropriate authorities,
retirement shall be compulsory for an employee of sixty-five (65)
years of age with at least fifteen (15) years of service: Provided,
That if he has less than fifteen (15) years of service, he may be
allowed to continue in the service in accordance with existing civil
service rules and regulations.
"SEC. 13-A. Conditions for Entitlement. - A member who retires
from the service shall be entitled to the retirement benefits
enumerated in paragraph (a) of Section 13 hereof: Provided, That:
(1) he has rendered at least fifteen years of service;
(2) he is at least sixty (60) years of age at the time of retirement;
and
(3) he is not receiving a monthly pension benefit from permanent
total disability.
To be entitled to the retirement benefits, the GSIS
member must meet the following conditions:
1. He has rendered at least 15 years of
service
2. he is atleast 60 years of age at the time of
retirement
3. He is not receiving a monthly pension
benefit from permanent total disability
Benefits that cannot be enjoyed by the member:
6. Survivorship benefit
If the GSIS member dies, the primary beneficiary are
entitled to the following survivorship benefits
whichever is applicable:
-deceased was in the service at the time of
his death or if separated from service:
- has at least 3 years of service at
the time of his death and has paide
36 monthly contributions
- if there are no primary beneficiary the
Survivor benefit will go to the secondary
beneficiaries
 Social Legislation and Agrarian Reform Law
7. Funeral benefit – intended to defray the
expenses incident to the burial and funderal
of the deceased member, pensioner or
retiree. It is payable to any qualified
individual, in accordance with the following
order of priority:
1. legitimate spouse
2. Legitimate child who spend for
funeral expenses
3. any other person showing
incontrovertible proof that he
shouldered the funeral expenses of
the deceased
8. Life Insurance Benefit – is compulsory and
available to all employees, except for
Members of the Armed Forces of the
Philippines and the Philippine National
Police.
Prescriptive period for filing claims
"SEC. 28. Prescription. - Claims for benefits under
this Act except for life and retirement shall prescribe
after four (4) years from the date of contingency.
- Claims for GSIS benefits except for life insurance
and retirement must be filed within 4 years from the
date of contingency.
-Claims filed after 4 years will be barred by
prescription
GSIS is a quasi-legislative body any claim shall be
filed in the GSIS such as the qualification of
claimants etc
-Decisions are appealable to the Court of Appeals
CASES UNDER GSIS
Reason for Compulsory Retirement
The reason for compulsory retirement is founded on
public policty which aims by it to maintain efficiency in
the government service and at the same time give to
the retiring public servants the opportunity to enjoy
during the remainder of their lives.
Whether or not per diem is considered as
compensation under Revised GSIS Act?
- What would be controlling is the nature of the
remuneration not the label attached to it
GR: allowance for expenses incident to the discharge
of an office is not salary, but if the renumeration
received does not constitute a mere “allowance for
expenses” but appears to be his actual base pay,
then no amount of categorizing the salary as a per
diem would take the allowance received from the
term “service with compensation” for purpose of
computing the number of years of service in the
government.
Extension of Service is it allowed?
* The head of the government agency concerned is
vested with discretionary authority to allow or disallow
extension of service of an official or employee who
has reached sixty five years of age and completing
15 years of government service, this discretion is
nevertheless to be exercised conformably with
existing regulations (Rabor vs CSC)
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GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
- Section 11 (b) of PD No 146 must be read together
with Memorandum order 27.
Is pension gratuitous?
Pension is not gratuity but rather a form of deferred
compensation for services performed and his right to
it commences to vest upon his entry into the retirment
system and becomes an enforceable obligation in
court upon fulfilment of all conditions under which it is
to be paid.
Retirement laws are to be liberally interpreted in favor
of the retiree because their intention is to provide for
his sustenance and hopefully even comfort, when he
is no longer has the stamina to continue earning his
livelihood.
Who has a superior authority?
Supreme Court decided to uphold the superior
authority of the board over the general manager.
- General Manager’s approval is not beyond review
and reprobation by the Board of Trustees.
Who has jurisdiction?
The GSIS has original and exclusive jurisdiction to
determine whether a member is qualified or not to
avail of the old age pension benefit based on its
computation of a member’s years of service of the
government.
Computation:
- The computation of members services with
compensation included not only full time but also part
time and other services with compensation as may
be included under the rules and regulations
prescribed by the system.
Whether or not Sec 18 is unconstitutional for
prohibiting a spouse from receiving survivors
pension if the dependent spouse married the
pensioner within 3 years before the pensioner
qualified for pension?
Yes it is unconstitutional and violates due process ,
discriminatory and denies equal protection clause
- Denial of due process – the proviso is unduly
oppressive and outrightly denying a dependent
spouse claim for survivorship pension.
- the outright confiscation of benefits due the
surviving spouse without giving the surviving spouse
opportunity to be heard.
- proviso undermines purpose of PD 1146 which is to
assure comprehensive and integrated social security
and insurance benefits to government employees
and their dependents in the event of sickness,
disability, death and retirement of the government
employees.
Violation of Equal protection clause- the provisio
discriminates the surviving spouse
- there is no reasonable connection between the
means employed and the purpose intended.
Life insurance and retirement benefit are distinct from
each other. The member must designate his
beneficiary in both claims or else it will accrue to the
estate and will be given to his legal heirs in
accordance with the law.
 Social Legislation and Agrarian Reform Law 5
 
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
Life insurance benefit – any person, belongs to the
estate of the insured.

Unemployment or Involuntary Separation Benefits

payable to permanent employee

Appointment differs from designation

However, the term appointment under EO 966 is
used in general sense to include the term
designation.

Hence, petitioner is entitled to additional

compensation even though he was merely
designated which, following the letter and spirit of the
law, should be included in his highest basic salary
rate for purposes of computing his retirement
benefits.
mployer’s Compensation
 Social Legislation and Agrarian Reform Law
Commission (ECC)
Workmen’s Compensation legistlation has arisen
out of conditions produced by modern industrial
development. Under the compensation acts, the
theory of negligence as the basis of liability is
discarded, and in general, a right to compensation is
given for all injuries incident to the employment, with
certain exemptions, the amount of which is limited
and determined in accordance with a definite
schedule in a summary and informal method of
procedure, although the elements of compensability
are not uniform in all jurisdiction.
The primary purpose of a workmen’s compensation
act is to provide compensation for disability or death
resulting from occupational injuries or diseases or
accidental injury to, or death of, employees.
The statute is remedial one enacted primarily for the
benefit of the man who works in the pursuits subjects
to its provisions, it is for the benefit of injured
employees and not injured employers.
Purpose:
1. Provide compensation for disability arising from
occupational disease
2. Accidental disease
ECC- is not a charity but recognition of a moral duty
and the erection of it into a legal obligation of the
public, not mere employer, to compensate
reasonably those who are injured while in the
employment of others, as part of the natural,
necessary cost of production.
Employees Compensation Act covers the
following:
1. All employees not over 60 years of age
2. All employees over 60 years of age but has paid
contributions prior to reaching the age of 60
3. All employers
4. All members of the SSS and GSIS
Concept of worker’s compensation…When it all
started?
– Industrial unrest. When workers were compelled to
face hazardous conditions of employment: mines,
steel mills, cotton mills, coal mills etc.
Before: The burden of proof is on the employee that
the employer is not providing safety gears in the work
place before the employer is required to pay worker’s
compensation
Present: such need was dispensed with. The
employee and employer became partners
However, the injury, sickness, death must be
connected with employment. If there is no
connection, compensation is not granted.
- only the connection of employment is required, no
need to prove the negligence on the part of employer.
General purposes of Workermen’s compensation
legislation:
1. Improve the economic status of the workers
2. Obviate the uncertainties, delay, expense, and
hardship attendant upon the enforcement of court
remedies
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GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
3. Transfer from the worker to the industry in which
he is employed, and ultimately to the consuming
public, a greater proportion of the economic loss due
to industrial accidents and injuries
4. Improve the relations between employers and
employees bu avoiding or reducing the friction
incident to litigation
5. Provide not only for employees a remedy which is
both expeditious and independent of proof of fault,
but also for employers a liability which is limited and
determinate.
*not precluded to include similar benefits such as the
ECC , such remedy is treated as separate from ECC
Source of Compensation
1. Direct Payment
- payment of compensation by the employer
directly to the employer
2. Insurance Statutes
- requires the employer to take out insurance
either with an insurance bureau operated by
the state (GSIS, SSS) or with a private
company (*maxicare), or to contribute to a
compensation fund, and if an employee is
injured the compensation is paid by the
insurer or from the compensation fund.
Bodies that administer the ECC:
SSS – private sector
GSIS – government sector
Labor Code – adopts the compensation fund type.
- all covered employers are required to remit
to a common fund a monthly contribution
equivalent to one percent of the monthly
salary credit of every covered employee.
- employee pays no contribution to the fund
(any agreement to collect contributuon from
the employee is prohibited)
- employer’s contribution makes up the State
Insurance fund from which comes the
compensation to be paid to claimant
employee or the employee’s dependents in
case the employee suffers from work-
connected injury or disease.
*employer cannot deduct. It is the
sole obligation of the employer to
pay, but with respect to SSS the
employee is required to contribute
Process
A compensation claim starts with a work-related
injury or disease that befalls an employee. Within 5
days, he must notify his employer who, in turn, must
enter the notice in a logbook (in some cases, notice
to the employer is not required). Within 5 days after
making the entry, the employer reports to the SSS or
the GSIS the sickness, injury, or death that he deems
work-connected. In effect, the employer decides
initially whether the injury or sickness is work related
or not.
The claim goes to the System which decides on the
claim. The two systems serve as administering
agencies of the Employees’ Compensation
Commission which is the policy-making body.
Appeals
The ECC is also the appeal body – w/n 30 days
 Social Legislation and Agrarian Reform Law
What the System denies may be appealed before the
ECC. What the ECC denies is appealable to the CA
or if it is favourable to the worker, it is final and
executory.
Effectivity
PD 626 applies only prospectively because it took
effect on January 1, 1975, it applies to illnesses
contracted on or after that date. For those contracted
before that date, the applicable law is the previous
Workmen’s compensation.
Workmen’s Compensation act distinguished from
Employee’s Compensation Law
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GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
1. the employee must have been injured at
the place where his work requires him to be
2. the employee must have been performing
his official functions
3. if injury is sustained elsewhere, the
employee must have been executing an
order from an employer
“Arising out of” or “in the course of employment”
- there is no particular formula can be laid down
which will automatically solve the case, since the
sphere of the employment is variable in extent
depending upon the nature of the particular work and
aslo upon the nature

Workemen’s Employee’s Arising out of – occuring at the time of employment

Compensation Compensation Law while performing some duties. Ensues from a risk
There was presumption Abolished presumption reasonably incident to the employment and if some
of compensability of compensability and sense due to the employment.
If the ailment of the rule on aggravation
employee was of illness caused by the In the course of employment – employee expose to
aggravate due to work nature of employment. danger though the danger is not inherent to the
the employer is liable for employment
compensation Rationale: restore
sensible equilibrium Generaly held: it is not necessary that in order for an
between employees injury to be regarded as having arisen out of or in the
right to receive course of employment, should have occurred during
reparation for work hours of active labor, or on premises within the
connected disabilityxxx control of the employer
and because the
employee’s claim is Proximity rule
directed to the SIF, the - employment includes not only the actual doing of
employer does not have the work, but also a reasonable margin of time and
to controvert the claim space necessary to be used in passing to and
Employer should SIF from the place where the work is to be done,
controvert or dispute the where the latter is expressly or impliedly included in
claim for compensation the terms of employment.
with 14 days from the
date of disability or Proximate Cause
within 10 days from -does not imply neares in point of time or relation but
knowledge, if he fails, rather, is the sufficient cause, which may be the most
deemed as waiver remote of an operative chain. It must be which sets
the others in motion.
Requisites under the present law PD 442, Art 173 to - It is to be extinguished from a mere preexisting
be entitled to sickness or death benefits, the sickness condition upon which the effective cause operates,
or death resulting therefrom must be, or have and must have been adequate to produce the
resulted from either resultant damage without intervention of an
independent cause.
a) any illness definitely accepted as an
occupational disease listed by the -The proximate legal cause is that acting first and
Commission producing the injury, either immediately or by setting
b) any illness caused by employment subject other events in motion. They constitute a natural and
to proof that the risk of contracting the same continuous chain of events, each having a close
is increased by working conditions causal connection with its immediate predecessor.
law PD 626 requirements for a death to become
compensable: Class Discussions of Atty. Panes:
1. death which is caused by the employment
2. disease which is aggravated by his line of work Employment is not limited to work, but also covers
3. death by reason of the nature or his employment personal acts. We are only humans – for efficient
discharge of function we do some relief, taking rest,
Compensable Work-related Injury attending union meetings – are connected to
What gives rise to a compensation claim is either employment
injury or disease. But what is compensated is not the
injury or disease itself but the attendant loss or Chua Yeng vs Roma
impaired earning capacity. -nature of work requires extertion of effort. Natural
tendency of body to rehydrate. It was encumbent
Rule III Sec 1(a): For injury and resulting disability or upon the employer to provide water. Employee had to
death to be compensable, the injury must be the go to employers kitchen. - compensable
result of an employment accident satisfying all of the
following grounds: Luzon Stevedoring Co. vs WCC
 Social Legislation and Agrarian Reform Law
- taking a bath not only habitual but necessary to the
human body. Not only clean himself but find
enjoyment due to monotonous work-compensable
Examples:
Routes/bus drivers
> When there is deviation of work such as routes,
injury is not compensable – he deviated from usual
work.
> Compensable if after the deviation of work,
he resumed his travel to work. The deviation
ended, resumed to work – it is compensable
Seminars/Business meetings/ coventions etc.
> The purpose of travel was intermingled with
personal purpose – Employee was requested to go to
Boracay to meet a client of the employer, employee’s
mind -> a chance to relax, to employer’s mind ->
purpose is to work
Dual purpose: Compensable, regardless of
employees purpose as long as primary purpose is for
business or employment
>Not compensable if the employee made
some detours and was injured during the
detour.
Example: meeting at the hotel, the
employee tried cliff diving
somewhere else and he was injured.
Employer sponsored activities / vacation / retreat
- it is compensable – if you happen to fall and
was injured
- encourage efficiency of emplouyees
recharge and be more efficient with work
-in cases of accidents rule is it is
compensable
Employer gave the employee a bonus, trip to Korea
> Employee suffered injury while in Korea – it is
compensable
> Injury sustained in a Social Club and its
membership is encouraged by the employer –
compensable
> Sports events sponsored by the employer, intrams,
sportsfest, compete each and injury was sustained –
compensable
Acts of God, Force majeure
> Caught in typhoon or natural catastrophe
- when required to be in a particular place at
that time – compensable
> Worker is struck by lightning while working –
compensable
> Ship employee drowned along with ship, it is
compensable
> killed or injured in a typhoon or storm required to be
in a particular place – compensable
> Employee assaulted by fellow employee death
resulted – compensable if attack arose from work
dispute, resentment originating from work assaulted
by subordinate
8
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
> Death or injury on occasion of employment –
compensable
> Increased risk jobs
- compensable jobs guarding the property
- keeping or carrying of money increased
temptation -> robbery
> Employer assigned you in slum areas where there
are addicts – due to nature of the job increased
bodily harm -> compensable
> Bus drivers, taxi drivers – increased risk of being
killed or harmed – take passengers who are
sometimes criminals
> Member of PNP, AFP exposed to rebels, NPA and
other insurgency
Injury or death due to violation of company rules
> Yes compensable if violation itself is not the cause
of accident
-serious doubt where employee understood
the rule, the doubt is construed in favor of the
employee. He could not understand it –
compensable
> Violation was not intentional but curious –
compensable
>Negligence does not preclude compensability as
long as it is not notoriously negligent
Limit to compensability
> 1.cause by employees intoxication
2. wilful intention to kill or injure oneself or another
3. notorious negligence
Disability – does not refer to bodily injury. Refers to
earning capacity
You are receiving Disability benefits but you have
recovered
- you can no longer claim for disability benefit, since
income has restored
Disability is partial not permanent (does not lose
your earning capacity)
- despite to partial permanent disability does not
prohibit discharge of partial benefits even if you are
earning.
Dependents:
Does not mean absolute dependency not literal
dependency
- dependent who can fend for himself can still be
considered as dependent
Requirement of Spouse
1) lawfully married even if spouse is gainfully
employed
Separated spouse (Separation de facto)
- as long as he/she is an innocent spouse he/she is
entitled to warrant such benefits
Period to file claims under the ECC
Art 201 – 3 years from the time the cause of action
accrues
 Social Legislation and Agrarian Reform Law
- 3 years lapse can still claim Art 1144 of the Civil
Code provides 10 years for obligations created by
law
Mode of filing – Mere filing of notice of the injury or
disease effectively suspend the running of the
prescriptive period.
ECC Cases | Doctrines
Personal needs | Necessary to the human body
Yeng vs Roma
- acts are reasonably necessary to the health and
comfort of an employee while at work, such as
satisfaction of his thirst, hunger or other physical
demands, or protecting himself from excessive cold,
are nevertheless incidental to employment, and
injuries sustained in the performance of such act are
generally held to be compensable as arising out of
and in the course of the employment
Compensation can be granted even if the injury
occurred while the order was not performing acts
strictly in the course of his duties, but engaged in an
activity
- either related or incidental to his duties
- doing an act in the interest of his
employer
Luzon Stevedoring Co vs Workmen’s
Compensation Commission
- he was undertaking something that is necessary to
his personal need and comfort since taking of bath is
not only habitual in a sailor but necessary to the
human body.
- No clear evidence that his death was due to
notorious negligence and not to a cause which he
could have reasonably avoided
Iloilo Dock and Engineering Co. vs WCC
Going and Coming Rule under the Workmen’s
Compensation Commission
General Rule: In the absence of special
circumstances, an employee injured in, going to or
coming from his place of work is excluded from the
benefits of Workemen’s compensation acts.
Exception to the general rule:
Four recognized exceptions to the going and
coming rule:
1. Where the employee is proceeding to or
from his work on the premises of his
employer;
2. Where the employee is about to enter or
about to leave the premises of his employer
by way of the exclusive or customary means
of ingress or egress;
3. Where the employee is charged, while on
his way to or from his place of employment or
at his home, or during his employment, with
some duty or special errand connected with
his employment
4. Where the employer, as an incident of the
employment, provides the means of
transportation to and from the place of
employment.
9
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
> Workmen’s compensation act covers occupational
injuries, which, as such, must have causative
connection with something not merely in common
with the public, but peculiar to the employment.
In the course of employment deals mainly with the
element of time and space or time, place and
circumstances. Thus, if the injury occurred fifteen
minutes before working and within 100 feet of the
employer’s premises on sidewalks or public roads,
the question “in the course of” is flatly raised.
Proximity Rule Exception
Exception to the general going and coming rule is
that:
An employee is generally considered to be in the
course of his employment while coming to or going
from his work, when, though off the actual premises
of his employer, he is still in close proximity
thereto, is proceeding diligently at an appropriate
time, by reasonable means, over the natural,
practical, customary, convenient and recognized
way of ingress, or egress either on land under the
control of the employer, or an adjacent property with
the express or implied consent of the employer.
Proximate Cause
Belarmino vs ECC
- her fall was the proximate cause or responsible
cause that set in motion an unbroken chain of events,
leading to her demise.
- Where the primary injury is shown to have arisen in
the course of employment, every natural
consequence that flows from the injury likewise
arises out of the employment, unless it is the result of
an independent intervening cause attributable to
complainants own negligence or misconduct.
- Her fall was the primary injury that arose in the
course of her employment as a teacher, hence, all
medical consequences flowing from it are
compensable
> it Is not the intention of the legislature to make
employer an insurer against all accidental injuries
which might happen to the employee
- but only for such injuries arising from or
growing out of the risks peculiar to the nature of the
work in the scope of the workman’s employment or
incidental to such employment, and accidents in
which it is possible to trace the injury to some risk or
hazard to which the employee is exposed in a special
degree by reason of such employment
>Soldiers | PNP
Hinoguin vs ECC
- a soldier should be presumed to be on official duty
unless he is shown to have clearly and unequivocally
put aside that status or condition temporarily by e.g.,
going on an approved vacation leave. Even vacation
leave may, be preterminated by superior orders.
- A solider in the AFT must accept certain risk that he
will be fired by forces hostile to the State of the
Government.
- must also assume the risk of being accidentally fired
upon by his fellow soldiers.
- Accidental discharge of the M-16 arose out of an in
the course of his employment as soldier on active
duty
 Social Legislation and Agrarian Reform Law 10
Alano vs ECC (Principal)
- There was nothing private or personal about the
school principal’s being at the place of the accident.
She was there because her employment required her
to be there.
- The claim is compensable when an employee is
accidentally injured at a point reasonably proximate
to the place at work, while he is going to and from his
work, such injury is deemed to have arisen out and in
the course of his employment
Lazo vs ECC (Security Guard)
- met an accident on his way home
- compensable - the accident may be said to have
arisen out of or in the course of employment, for
which reason his death is compensable
> The new law discarded the concepts of
“presumption of compensability” and “aggravation” to
restore what the law believes is a sensible
equilibrium between the employer’s obligation to pay
workmen’s compensation and the employees’ rights
to receive reparation for work-connected death or
disability
> Applying the new law, it must be proved that her
working conditions increased the risk of her
contracting the fatal illness
Occupational Disease
> Contracted in direct connection with work, came
during industrial revolution, massive industrialization
Disease caused agents
Pottery – silica dust harmful to the lungs
Factory of plastic products – lead, harmful toxins
Matches – phosphorus – expense at the health of
workers
Mines and coal mines – steam industry – coal
particles caused black lung disease and other known
disease
> discovered that diseases were specific among the
industries
Asbestos – cause of asbestosis, fatal conditons
Radiation – hospital workes
> Considered as occupational disease – disease
which appeared after several years which is
attributed where the patient worked before
> Exposure to disease causing
agents inhaled, contact, can be ingested by
workers
Occupational disease
-one which results from the nature of the
employment, and by nature is meant conditions to
which all employees of a class are subject and which
produce the disease as a natural incident of a
particular occupation, and attach to that occupation a
hazard which distinguishes it from the usual run of
occupations and is in excess of the hazard attending
the employment in general
Menez vs ECC
- compensable. Exposed to dirty surroundings, poor
diet.
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
- disease afflicting the teacher was aggravate due to
the conditions of work
Theory of increased risk
- because of the conditions of work, compensability is
construed in favor of the employee because the
conditions of work increased the risk of the disease
Degree of proof required
- The degree of proof required in PD 626 is merely
substantial evidence, which means relevant
evidence as a reasonable mind might accept as
adequate to support a conclusion
*Aggravation of a disease can be applied if the
employee started to work before the enactment of the
new law (?) (not sure)
> when there are two or more possible explanations
regarding an issue of compensability that which
favors the claimant must be chosen
Personal insight: In order for an illness to be
appreciated before the ECC(or favorable response
before the court) that the illness is aggravated by
employment, it is necessary to show:
- Substantial proof
- claimant must show reasonable work connection
> to establish compensability under the increased
risk theory, the claimant must show proof of
reasonable work-connection, not necessarily direct
casual relation. The degree of proof required is
substantial evidence
Dabatian vs GSIS
-peptic ulcer is not accepted as an occupational
disease
- Dabatian died when old comopensation law had
already been abrogated. No competent evidence
whatsoever was submitted to prove that Dabatian’s
ailment was contracted prior to January 1, 1975 in
order to bring it under the protective mantle of the old
compensation law.
> aggravation of illness no longer present in
the current law
Under the new law, in order for the employee to be
entitled to sickness or death benefits, the sickness or
death resulting therefrom must be, or must have
resulted either:
a) any illness definitely accepted as an
occupational disease listed by the
Commission
b) any illness caused by employment subject
to proof that the risk contracting the same is
increased by working conditions
- since peptic ulcer is not included in the list,
petitioner has the burden of proving that the nature of
her husband’s work increased the risk of contracting
the disease
Lupo vs GSIS (vaginal bleeding, incomplete
abortion, lifting heavy tax books)
- the opinion of the ECC medical officer that there
was no causal connection between the ailment and
work conditions of the wife of the petitioner cannot
 Social Legislation and Agrarian Reform Law 11
overcome the substantial evidence submitted by
petitioner’
- Additionally, medical opinion to the contrary can be
disregarded especially when there is some basis in
the fact for inferring a work connec tion.
ECC Discussions
Article 166. Compulsory coverage. — Coverage in
the State Insurance Fund shall be compulsory upon
all employers and their employees not over sixty
years of age: Provided, That an employee who is
over sixty years of age and paying contributions to
qualify for the retirement or life insurance benefit
administered by the System shall be subject to
compulsory coverage: Provided, further, That in case
of an employee who is both covered by the SSS and
GSIS, only his employment under the GSIS shall be
considered for purposes of his coverage.
>>Employees Compensation Act covers the
following:
1. All employees not over 60 years of age
2. All employees over 60 years of age but has paid
contributions prior to reaching the age of 60
3. All employers
4. All members of the SSS and GSIS
Article 168. Effective date of coverage. —
Compulsory coverage of the employer during the
effectivity of this Title shall take effect on the first day
of his operation, and that of the employee on the date
of his employment.
Art 172.
Article 170. Limitation of liability. — The State
Insurance Fund shall be liable for compensation to
the employee or his dependents, except when the
disability or death was occasioned by the employee's
intoxication, willful intention to injure or kill himself or
another, notorious negligence, or otherwise provided
under this Title.
Exceptions:
1. Employee’s intoxication
2. wilful intention to injure or kill
himself or another
3. notorious negligence
Class Discussion:
>> As a general rule, suicide is not compensable.
Except when the employee jumped and in the
Collective Bargaining Agreement, the employer shall
pay for the lost of life
- CBA is a contract and being a conrtract
cannot hinder the employee and emloyer
from entering a contract
- Art 172 only limits the State Insurance Fund
but it does not limit the agreement of the
Employee and Employer.
>> Negligence does not limit compensability. It is
notorious negligence that limits compensability
- Soldier testing a dynamite in an open sea is not
notorious negligence – it is in connection of work.
Mabuhay Shipping Services vs NLRC
- wilful act to harm others, challenged and assaulted
an employee
-was in a state of intoxication
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
Interorient Maritime Enterprises vs Pineda
-60 days obligation of the employer after the contract
ends
- State Insurance Fund is liable
- not a wilful act of the seamen, he was mentally ill
- Employer has an obligation to safely deliver
employee to the point of hire.
Article 173. Exclusiveness of liability. — 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. The payment of compensation under
this Title shall bar the recovery of benefits as
provided for in Section 699 of the Revised
Administrative Code, Republic Act Numbered eleven
hundred sixty-one, as amended, Commonwealth Act
numbered one hundred eighty-six, as amended,
Republic Act numbered sixty-one hundred eleven, as
amended, Republic Act numbered six hundred ten,
as amended, Republic Act numbered forty-eight
hundred sixty-four, as amended, and other laws
whose benefits are administered by the System,
during the period of such payment for the same
disability or death, and conversely.
Ysmael Maritime Corporation vs Avelino
- employee or his heirs are no longer free to opt for
the other remedy. In other words, the employee
cannot pursue both actions simultaneously.
As thus applied to the case at bar, respondent Lim
spouses cannot be allowed to maintain their present
action to recover additional damages against
petitioner under the Civil Code. In open court,
respondent Consorcia Geveia admitted that they had
previously filed a claim for death benefits with the
WCC and had received the compensation payable to
them under the WCA
It is therefore clear that respondents had not only
opted to recover under the Act but they had also
been duly paid. At the very least, a sense of fair play
would demand that if a person entitled to a choice of
remedies made a first election and accepted the
benefits thereof, he should no longer be allowed to
exercise the second option. "Having staked his
fortunes on a particular remedy, [he] is precluded
from pursuing the alternate course, at least until the
prior claim is rejected by the Compensation
Commission.
 Social Legislation and Agrarian Reform Law 12
 
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***
• Government Sector Employed
• Private sector employed
National Health Insurance Act b) Indigents
c) Individually paying
Dependents: - The legal dependents of a member • Self-employed
are: • OFWs
1. the legitimate spouse who is not a member • Employers and employees of international
2. the unmarried and unemployed legitimate, organizations and foreign governments
legitimated, illegitimate, acknowledged children as based in the Philippines
appearing in the birth certificate, legally adopted or • Privately Sponsored
stepchildren below 21 years of age • Others including the following:
3. Children who are twenty one years old or above o Individuals who are separated from
nut suffering from congenital disability, either physical employment and who intend to
or mental, or any disability acquired that renders continue membership
them totally dependent on the member for support o Parents who are not qualified as
4. the parents who are sixty years old or above legal dependents, indigents or
whose income is below an amount to be determined retirees/pensioners
by the Corporation in accordance with the guiding o Children who are not qualified as
principles set forth in Article I of this Act legal dependents
o Unemployed persons who are not
qualified as indigents
Health care benefits are accessed through accredited o Citizens of the Philippines residing in
healthcare provides. Health Care Providers refers to: other countries
1. Health care institution d) Non- Paying
2. Health care professionals
3. Health maintenance organization Guiding principles
4. Community-based health care
organization Compulsory Coverage as provided under RA
7875
Sec.10 Benefit Package (see provision) - All citizens of the Philippines shall be required to
enrol in the National Health Insurance Program in
Sec 11. Excluded Personal Health Services order to avoid adverse selection and social inequity

Sec 12 Entitlement of Benefits

- at least 3 months have been paid within the
6 months prior to the first day of his or his
dependent’s availment. Provided, that the
member can show contributions thereto with
sufficient regularity.

The following need not to pay the monthly

contributions:
1. Retirees and pensioners of the SSS and
GSIS prior to the effectivity of this act
2. Members who reach the age of retirement
as provided for by law and have paid at least
120 monthly contributions
3. Enrolled indigents

Sec 17. Quasi-Judicial Powers

a) conduct investigation for the determination
of question, controversy, complaint, or
unresolved grievance brought to its attention,
and render decisions and determine the case
even in the absence of any party
b) summon parties to a controversy
c) suspend temporarily, revoke permanently,
or restore the accreditation of a health care
provider or the right benefits of a member
and/or impose fines after due notice and
hearing.

*suspension of benefits of members not more

than 6 months

IRR Section 6. Nature and Scope – The NHIP shall

cover the following members and their dependents:

a) Employed
 Social Legislation and Agrarian Reform Law 13  
GSIS | PHILHEALTH | PAGIBIG | ECC
Kimberly Benazir May R. Codilla Notes
***Caveat: Use this material at your own risk***

Home Development Mutual Fund PD 1752

Law: Mandatory Coverage – Membership in the

fund shall be mandatory upon all employees covered
by the SSS and GSIS and their respective
employers; Provided however that coverage of the
employees whose monthly compensation is less that
4,000 shall be voluntary, provided further, that upon
membership with the fund, their employees shall
contribute an amount in accordance with section 1 of
Rule VI hereof

Discussion ni sir: Mandatory upon the following

1. Private and government sector
2. Uniformed Members
3. Bureau of Management
4. Foreign Employers
5. Spouses who devote full time at home
*self-employed subject to mandatory coverage

Termination of Membership
1. Membership Term Maturity (20 years or 240
monthly contributions)
2. Death
3. Retirement
4. Permanent Total Disability or Insanity
5. Deoarture from the Country permanently
6. Termination from the service by reason of health
7. Occurrences other than the above shall not
constitute termination of membership as may
otherwise be provided by the Board of Trustees (such
as Resignation – does not terminate membership)\

Effectivity – ER: 1st day of business operation |

EE- 1st day of Employment

>> Suspension or Layoff – membership is not

terminated, payment is only suspended

>> No retroactive effect

>>Nature of Obligation of the Employer

- Fiduciary obligation – he is a trustee of the
contributions of the employee

Parallel program – apply for integration