I. What is
Occupational Disease?
Occupational
diseases in the Philippines are so common that common workers no longer know
the difference between work-related diseases and hereditary or pre-existing
illnesses. This awareness shortcoming results to the deprivation of rights
which are all supported by Philippine law, and specifically, the labor code and
Presidential Decree 626.
The term occupational
disease refers to any ailment
caused, developed or resulted from work and by the work environment itself. The
disease may originate directly from the nature of work, the risks encompassing
the job, the environment that comes with the work or any factor brought about
by the duties.
Manual laborers
almost always experience muscle sprains due to their job description. Encoders
are always at high risk of developing Carpal tunnel syndrome (CTS) due to the
repetitive positioning of the hands on keyboard. Chemical engineers who
frequently rove chemical plantations are always exposed to toxic chemicals that
may cause lifetime respiratory and organ problems. Street sweepers whose duty
is practically to work with dirt, garbage and pollutions may develop diseases
associated with their job description, like leptospirosis
during rainy season and skin cancer from prolonged exposure to the sun and
pollutants during hot dry season.
Occupational
diseases are not to be confused with occupational injuries. The former
term results to long-term health conditions that may interfere with the performance
of responsibilities, if not totally impede one from working, while the latter
is used to describe short-term injuries obtained from work-related factors that
may minimally, if not totally, affect the performance of tasks and responsibilities
of the worker.
Unlike injuries,
occupational diseases are grounds for claiming early retirement benefits in the
form of disability compensation arising from the need for long-term or
permanent medical support, or temporary or permanent disability of the
claimant. With all the medical reasons entitled to corresponding compensation
into consideration, the fact remains that occupational injuries are still
plausible to aggravation, leading to occupational diseases in the long run.
Common and rare
diseases, whether medically classified as hereditary, genetic, environmental,
incidental, etc., can be considered as work-related. Thus, all occupational
diseases fall under other medical categories as well.
Primary ailments
are not always occupational in nature and occupational diseases are not always
primary ailments. Howbeit, complications of non-work-related sicknesses forming
new ailments due to work-related factors can be declared occupational diseases
as well. Such cases are still subject to contest by and large, principally and
legally speaking.
All compensations
for work-related ailments, injuries and deaths in the Philippines are upheld by
the Employee’s Compensation Commission (ECC). Appeal on the body’s decision is
still possible through regular litigation process in the courts.
II. Identifying the List
Among the health
conditions considered as work-related sicknesses, either as direct effect or as
complication arising from occupational risks, respiratory conditions are the
most prone to aggravation that may develop to more serious ailments.
The following
are the recognized occupational and compensable diseases as universally
accepted.
- Cancer
of the epithelial lining of the bladder
- Cancer,
epithellomatous or ulceration of the skin or of the corneal surface of the
eye
- Cataract
- Deafness
- Decompression
sickness
- Dermatitis
- Infections
- Ionizing
radiation disease, inflammation, ulceration or malignant disease of skin
or subcutaneous tissues of the bones or leukemia, or anemia of the
aplastic type
- Poisoning
- Pneumoconiosis
- Diseases
caused by abnormalities in temperature and humidity
- Vascular
disturbance in the upper extremities
- Viral
Hepatitis
- Poisoning
by cadmium
- Leukemia
and lymphoma
- Cancer
of stomach and other lymphatic and blood forming vessels; nasal cavity and
sinuses
- Cancer
of the lungs, liver and brain
- Cardio-Vascular
Diseases
- Cerebro–Vascular
Accidents
- Malaria
and Schistosomiasis
- Pneumonia
- Hernia
- Bronchial
Asthma
- Osteoarthritis
- Viral
Encephalitis
- Peptic
ulcer
- Pulmonary
Tuberculosis
- Essential
Hypertension
- Asbestosis
The given
occupational diseases can still lead to other complications, which may or may
not be recognized as work-related. This issue is subject to investigation and
hearing as pleased by the appealing party.
III. Occupational Disease in International
Perspective
The
international community, especially the United States of America, doesn’t see
the issue as a laughing matter. In fact, specializing research and regulating
bodies have been established to cater to the cause and adhere to international
standardizing guidelines in relation to occupational safety and health. These
bodies commit to the improvement and more efficient management of Environment,
Health and Safety within public and private organizations in a global scale.
A complaint of
an ailing worker in the US against a company unwilling to render disability
compensations and benefits can easily lead to a half-million law suit, and
similar cases are not unusual in their justice system. The information
dissemination on the rights of US citizens regarding occupational safety and
health is incredibly high as there is an active propagation of labor laws as
initiated both by the government and private sectors. Such issues also catch
significant media attention which proves that safety and health matters at work
are growing interests in their culture.
Do Filipinos act
the same with such violation of their right?
IV. Knowing the Rights and Benefits
Stated in
Chapter VI of the Labor Code are the declarations a patient can file, which are
classified according to the status of the illness – temporary total disability,
permanent total disability and permanent partial disability. Compensation
benefits cover all disability categories under the Workmen’s Compensation Law
(PD 626).
All Filipinos
proven to be suffering from the backlash of working under hazardous and risky
conditions are entitled to disability benefits unless disqualified under
legally exempted circumstances.
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Disability
benefit refers to the compensation package granted to an employee from private
or public sector, including the dependents, to make up for the provider’s lost
opportunity to continue working, temporarily or permanently, due to
work-related injury, sickness or death. The disability benefit is given by the
Social Security System (SSS) in the form of Disability Compensation or the Government
Service Insurance System (GSIS) in the form of Employees Compensation (EC),
whichever organization covers the employee’s membership. Depending on the
claim’s category, an employee can avail either of the following mandatory
benefits:
- cash
income for disability or death
- medical
assistance and related services for sickness or injury
- rehabilitation
services in addition to monetary benefit for permanent disability
The enumerated privileges
(as only members can avail) all fall under mandatory benefits as stipulated by
the Philippine Constitution. However, another set of benefits or monetary
compensation can be availed directly from the employer (right to a safe working
environment) if it can be proven that there is negligence on occupational
safety and health on the employer’s part. Conscious negligence or not, the
employer is still accountable to the employee.
Whether
privilege or right, a claimant can file only one claim, or all at the same time,
if applicable.
V. Employment: Links and Probabilities
In the last
couple of years, there is a significant increase in incidents of work-related
illnesses in the country which prompted the Occupational Safety and Health
Center (OSHC), a branch of the Department of Labor and Employment (DOLE) tasked
to do continuous research and information dissemination on occupational safety
and health, to recommend new entrees in the existing list of accepted
occupational diseases. Occupational cancers such as lung cancer, bladder
cancer, leukemia, liver cancer and three more related diseases lead the newly identified
health cases to which qualified employees are protected against.
Chronic renal
failure is also seen climbing the charts. In fact, it appeared in SSS’ record
as the most frequent basis of disability claims, albeit not necessarily
reflecting work environment origin.
The increased
number of occupational health risks remains bothering, but the opposite in
number is seen among successful compensation benefits awarded to availing
employees.
According to the
preliminary results of the January 2012 Current Labor Statistics (CLS) released
by the Bureau of Labor and Employment Statistics (BLES), the Philippine labor
force is still largely comprised of employment from the services sector which
sums to almost 20 million people. This translates to more Filipinos with
employers to back-up the upheld labor right mandated by the Amended Rules on
Employees’ Compensation. However, this is only on legal basis and not on
actuality.
The service
sectors are teeming with minimum wage employees, and they are the most
vulnerable to environmental, health and safety hazards. They are also the less
benefited in pre- and post-employment periods.
The Philippines
has more underemployed workers at 19.3% of the entirety than those employed who
commensurate to their educational attainment. They both seemingly fail to
maximize their rights to compensation for occupational diseases and injuries. In
a country where majority in the underemployment statistics belongs to manual
laborers, with only 41.2% reaching at least high school level, the concept of
such right is widely unknown. As the agricultural sector predominantly represents
the labor force at 43.4% in the underemployed category alone, while only 40.7%
belongs to the services sector, it is deduced that most marginalized Filipinos
do not even have employers to seek for when it comes to occupational diseases
and the compensations and benefits that come with it.
Certainly, there
is lack of awareness among workers whenever a violation of their right to avail
compensation and benefits for acquired illnesses as possibly caused and
developed by environmental and occupational factors is committed. But tracing the
lack of knowledge on such cases, the lack of awareness has possibly arisen from
the unidentified acceptable occupational diseases.
VI. Diseases: Occupational or Pre-existing?
In a report
compiled by the National Statistical Coordination Board (NSCB) in 2009 and
published in Philippine Industry Yearbook of Labor Statistics, work-related
musculoskeletal diseases topped the list of occupational diseases in the
Philippines. These are the lesser serious cases with include back and
neck-shoulder pain, shoulder tendinitis and the infamous carpal tunnel syndrome,
which is often developed from repetitive wrong posture of the hands while doing
work in front of the computer.
Peptic ulcer and
essential hypertensions follow next but may also be contested by employers as
primary ailments or pre-existing conditions – illnesses that are either
hereditary or possibly developed at an earlier time prior to employment.
However, the
most widely accepted diseases in the row are occupational dermatitis and bronchial
asthma. Occupational dermatitis is a type of contact dermatitis where the
allergens are acquired from the work environment. For some workers exposed to similar
risk, this may seem a normal skin reaction caused by a hard day’s work due to
the lack of understanding of the chemicals and irritants regularly used in the
workplace. Manual laborers from the construction, manufacturing and agricultural
industries often experience such condition, but they stay unprotected most
often than not, physically and legally.
Many victims consider
the condition less dreadful that does not require exacting legal process for
compensation. This is, of course, notwithstanding the cause.
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Bronchial
asthma, a commonly reported occupational respiratory disease, is also often
seen among Filipino workers, whether toiling on a menial job or office setting.
Many studies relate it to environmental risks, most of them found in workplaces.
Unfortunately, as it is the most prominent pre-existing condition as well (even
medical insurance companies classify it as pre-existing), direct connection is
not readily acceptable. Patients with bronchial asthma, whether authentically
connected with past jobs or not, will have hard time proving the claim to the
authorities.
VII. Occupational Disease vis-à-vis
Economic Standing
Another fatal
occupational disease worthy of attention is tuberculosis (TB), also the sixth
leading cause of mortality among Filipinos. Surveys show that it frequently
appears on retired factory workers, especially the ones from industries
utilizing chemical in production and wood works. However, its most prominent
link is to cigarette smoking, both active and passive. On this ground, proving
origin from the workplace is highly contestable.
Despite the
obscurity on the basis of identifying TB as common occupational disease in the
Philippines, international data on the top causes of mortality collected by the
World Health Organization (WHO) show it as a prevalent reason for death only
among low- and medium- income countries. It does not appear in high-income
countries. According to The World Bank, the Philippines is classified as a lower-middle-income
country.
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TB is the
seventh top killer disease among low-income countries. It is sixth in the Philippines,
also a low-income economy. This shows that there is consistency among
classified countries.
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As the income
level of the countries moves up, the record of TB-related deaths also goes
down.
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Among the
high-income countries or first world countries, TB is not a top killer disease.
These countries include the following:
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It is worth
adding that the countries with less recorded TB-related deaths also have more
teeth when it comes to Environment, Health and Safety (EHS) standardization as
compared to the Philippines.
The economic
standing of countries according to salary does not necessarily correlate with
the type of disease, occupational or not. It is noticeable, though, that the
countries having generally higher cases of TB mortality are the ones with more menial
jobs on industries employing manual laborers.
In the
Philippines alone, where many TB patients link their disease to work
environment, there is an apparent trend in the social category of victims, significant
majority belonging to wage earners.
On the other
hand, the first world countries have fewer incidents, insufficient to place it
on the top list. It can be deduced without finality that the type of work
environment and nature of work in these countries affect the end result of
their mortality rate in accordance to cause. Likewise, these richer countries
have unquestionably better facilities, working conditions and better practices
and standards of Occupational Safety and Health (OSH). Their guidelines are
more likely seen as applied rules than theoretical, having more research and
stricter guidelines on OSH regulation as mandated by laws.
VIII. Occupational Safety and Health (OSH)
Standardization
There is an
ongoing initiative by the World Health Organization (WHO) and the International
Labour Organization (ILO) – two leading agencies advocating occupational safety
and health standardization and monitoring at an international scale – to assist
developing nations on OSH matters through projects like “Healthy Cities” (a
project that aims to “establish healthy public policy at the local level
through health promotion).
Based on the
2007 Factsheet released by the European Agency for Safety and Health at Work, the
reference for this global action, developing countries allot lower budgets for
OSH but spends relatively higher percentage of their GDPs on work-related
illnesses – as much as 10% of the total GDPs while European nations under the strict
mandate of the aforementioned agency only spends around 2.6% to 3.8%.
The agency sets
the same standard for all member countries, making the advanced development,
promotion and productivity in each member state at par with each other; thus,
at par with international standards.
Using the data,
it can be interpreted for European countries alone that the lower the OSH
budget and policy regulation is, the higher the spending on avoidable
circumstances like occupational diseases will be.
In the United
States of America (USA), the Occupational Safety and Health Administration
(OSHA) enforces all regulations and requirements as mandated by the federal
law. It is the governing agency of the US Department of Labor in charge of certifying
and inspecting companies. Unlike its counterpart in the Philippines (OSHC), the
requirements set by OSHA are all for compliance to keep the operation going.
The OSHC requirements, on the other hand, are for accreditation purposes only and
not do not serve as prerequisites for permits.
The world’s most
recognized certification for occupational health and safety management systems
(OHSMS) is the OHSAS 18000 (Occupational Health and Safety Advisory Services),
a British Standard pioneered by BSI Group (British Standard Institution). It is
renowned as an equivalent to ISO 9001:2000 and ISO 14001:2004 – the highest
certifying body for private or public organizations worldwide. These standards
are prevalently used in Europe and North America to help with occupational
health and safety performance and develop policy making methods.
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Passing one of
the three aforementioned certifications is complicated enough. In spite of the
difficulties in achieving these high standards, many international organizations
still aim to implement all three to get the corresponding accreditations.
Despite global
recognition and widespread application from western countries and first-world
Asian countries (even including Malaysia), Philippine companies do not widely use
these standards and in fact, do not allot budget as much as their foreign
counterparts do.
The AFNOR Groupe
of France and Standards Australia are the counterparts of the Occupational
Safety and Health Center in the Philippines. Both agencies have the same strict
regulations as that of the International Organizations for Standardization
(ISO).
The countries
with less numbers of deaths as a direct result, if not associated, of
occupational diseases belong to the group with stricter and more regulated
standards in OSH. More studies are also conducted by their designated agencies to
conform and adopt improved policies and guidelines on occupational health and
safety management.
IX. Disability Benefit Claims, Refusal and
Dismissal
Like in any
other claims, an investigation is imperative as stated in government and
company policies. Oftentimes, the investigation reaches litigation through
court hearing. This is the most difficult part – proving the claim and the
liability of the employee and employer, respectively. Inauspiciously, it is
safe to state that claimants who reach this stage are somehow luckier to have
known such right exists. Hence, many Filipinos do not know the concept of
company liabilities.
An employee who
plans to file for compensation benefits due to the declaration of disability to
the SSS or GSIS needs to prove the veracity of medical condition to qualify as
occupational disease and be declared compensable. Contests from concerned
companies are anticipated, but concomitant complaints can be redirected to the
Employee’s Compensation Commission (ECC), which is the governing body in
regulating employee benefits as part of the Liability Rule under the Handbook
on Employee’s Compensation and State Insurance Fund, should the complaints be
dismissed. Court proceedings come next if another dismissal happens at the
level of the governing body.
Diseases,
whether recognized as environmental/occupational or not, do not receive
approval without much scrutiny to protect the rights of employers against
extortion and abuse of employees seeking compensation. Certain qualifications
and due process have been identified towards the resolve of cases to keep both
parties equally treated. But why does the law allow refusal of claims and
dismissal of subsequent cases?
Many listed
occupational diseases have relatively high number of cases even outside the
environmental and occupational setting. Carpal tunnel syndrome (CTS) is an
example of an occupational disease that is very popular among office workers
who spend hours in front of the computer. However, it cannot be associated with
work right away as there are many ways of acquiring it even inside the home.
Students are also susceptible to the disease.
For a disease to
be quantified as work-related, it should be proven to have first existed on or
after employment period. Pre-existing condition can be dismissed right away,
especially if the condition has far association with the company industry or
the nature of the job has low chance of producing such health problem.
It should not
also be categorized as secondary ailment resulting from a pre-existing primary
ailment. Secondary ailments, or practically quantified as complications, should
be proven to have been exacerbated by the occupational disease per se to have
merit. Unfortunately, a complication said to have started from a pre-existing
primary ailment has weaker, but not essentially impossible, substance on the
claim.
A good example
of a workman’s compensation filed as claim to GSIS and subsequently, as an
appeal to ECC and case to the Court of Appeals (CA), is the case GSIS vs. Valenciano. Valenciano was a
Clerk II and eventually, a Senior Terminal Operations Officer at the Philippine
Ports Authority (PPA). He filed a claim for compensation benefits with the GSIS
after being diagnosed with coronary artery disease in 1984. Two years later,
Diabetes Mellitus was discovered rendering him to be insulin resistant leading
to increased arterial pressure. This condition gave him the risk of developing
hypertension in 1988. A decade has passed and he was diagnosed with Pulmonary
Tuberculosis II.
By 2002, he was
suffering from diabetes mellitus, pneumonia, hypertension, pulmonary
tuberculosis and cerebro-vascular disease (CVD).
The claim was
denied by GSIS while the appeal was also dismissed by ECC on the ground that
Valenciano’s primary ailment was not occupational disease; “neither was there
any showing that his duties have increased the risk of contracting said
ailments.” The ECC concluded that his “hypertension, pneumonia and pulmonary
tuberculosis were mere complications of his primary ailment of diabetes
mellitus, which is not an occupational disease; hence, not compensable.” CVD,
albeit possibly an occupational disease, was likewise dismissed after the
claimant “failed to show compliance with all the conditions for its
compensability.”
However, the Court
of Appeals (CA) reversed the decision, ruling that while hypertension,
pneumonia and pulmonary tuberculosis were caused by diabetes mellitus, the
development of the diseases didn’t occur without environmental and occupational
factors, as deemed associated with Valenciano’s employment history.
Valenciano began
smoking frequently at the age of 20 which has a strong association with the
contracted diseases. His primary ailment is undisputedly conterminous to the
presented complications. But whatever it is that the cause of the diseases are
inclined to, occupational factors undoubtedly affected the end result of his
health which became CA’s basis for the subsequent standing. Nonetheless, grey
areas and point for disputes are available for the case.
For similar
cases, modern scientific findings are leaning towards conclusions that certain
types of sicknesses may evolve into something else due to external factors
other than what originally caused the primary ailments. The inclusion of these scientifically
plausible factors on the epidemiology and mutation of recognized occupational
disease may improve the overall regulation of benefits for employees and add
credibility to the existing list of considerable and recognized occupational
diseases.
The traditional
way of looking at health conditions and their causes are still prevalently
applied in the Philippines, which make consideration for possible work-disease link
narrower; hence, it is more inefficient.
X. Rights to Benefits: Ignorance or
Oversight?
Among the most
common occupational diseases, work-related musculoskeletal diseases
consistently grab the top spot since 2003. It is noticeable that the number of
occupational diseases also increased by 34.29% from the 2007 data – 47,235 to
71894 cases. Environmental factors,
although not necessarily occupational factors, affect the continual rise in
cases, but other external factors, such as lifestyle and genetic, are to be
considered. Nonetheless, the data signifies clearly that there is heightened
problem in occupational diseases in general that demands full attention from
the concerned government agencies, employers and employees.
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In the
most-recent survey conducted by the Bureau of Labor and Employment Statistics
(BLES) under DOLE, the most common occupational injuries in non-agricultural
establishments are superficial injuries and open wounds with an average
incidence rate of 50.8%. It took more than half of the cases of occupational
injuries recorded in the Philippines, a significantly wide gap ahead of the
second most common case which is dislocations, sprains and strains,
collectively, at a lower percentage of 12.7%.
As the term
implies, these superficial injuries tend to be overlooked by employees due to
relatively non-serious effects to the health, also tendered with minimal to no
medical attention at all. Thus, there is absolutely high chance of overlooking
rights against these work-related injuries.
Condoned right is
a condoned action and solution by the employer and employee alike. Big or
small, serious or superficial, every case of occupational injury should be
handled appropriately and in accordance to existing laws protecting the labor
force. It can be deduced that non-serious injuries do not elicit much attention
from concerned workers, enough to command legal benefits as identified by the
ECC.
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Notwithstanding
the obvious decrease in number of work-related injuries since 2003, the
significantly high number of cases still infers lack of impressive occupational
health and safety management systems in the country.
Many employers may
have been doing their homework towards improvement of recorded incidence, but
do employees actively do their part in bringing these cases to the attention of
the authorities?
XI. Issues to Address
The main issues
to be addressed on this employee welfare matter revolve around the fulfillment
of the rights bestowed upon employees with work-related injuries and diseases
and their encompassing backdrop in the Philippines, including clearly
delineating the liability of both the employer and employee.
- What
are the issues of work-related diseases and injuries at large in the
Philippine set-up?
- What is
the stand of the government on occupational diseases?
- Does the
government give enough and efficient service on this matter?
- To what
extent are occupational diseases covered by employers’ liability?
- Do
employers act on claims in accordance to governing mandates and laws?
- Are
employees with occupational diseases given sufficient attention, benefits
and consideration?
- Do
employees with occupational diseases know the appropriate actions, or at
the least, their rights on their cases?
