IBARRA P. ORTEGA VS SOCIAL SECURITY COMMISSION and SOCIAL SECURITY SYSTEM

IBARRA P. ORTEGA

VS

SOCIAL SECURITY COMMISSION and SOCIAL SECURITY SYSTEM
555 SCRA 53 (2008)

Claims under the Labor Code for compensation and under the Social Security Law for benefits are not the same as to their nature and purpose.

Petitioner Ibarra Ortega, member of respondent Social Security System (SSS) filed claims for partial permanent disability benefits on account of his illness with SSS, which the latter granted for total of 23 months. After the expiration of his pension, Ortega then applied for total permanent disability benefits but such application was denied by SSS. SSS observed that Ibarra was already granted benefits under the same illness and his physical examination showed no progression of his illness. Accordingly, Ortega filed before Social Security Commission (SSC) a petition alleging that SSS ignored the fact that his attending physician diagnosed him of progressed illness. After exhausting administrative remedies, SSC took cognizance of the petition and after hearing on the merits, it denied Ortega’s claim for entitlement to total permanent disability.

On appeal, the Court of Appeals affirmed in toto the SSC order.

ISSUE:
Whether or not Ibarra can claim under Social Security Law for work connected disability claims insofar as it relates to a demonstration of disability to perform his trade and profession

HELD:
The conclusion that Ibarra is not entitled to total permanent disability benefits under the Social Security Law was reached after petitioner was examined not just by one but four SSS physicians, namely, Dr. Juanillo Descalzo III, Dr. Carlota A. Cruz-Tutaan, Dr. Jesus S. Tan and Dr. Rebecca Sison.

The initial physical examination and interview revealed that Ibarra had slight limitation of grasping movement for both hands. According to Dr. Descalzo, this finding was not enough to grant an extension of benefit since Ibarra had already received benefits equivalent to 30% of the body. Responding to the allegation that the April 2000 physical examination was performed in a short period of time, the doctor credibly explained that petitioner’s movements were already being monitored and evaluated from a distance as part of the examination of his extremities in order to minimize malingering and overacting. 45

Indeed, the evidence indicates that petitioner’s condition at the time material to the case does not fall under the enumeration in the above-quoted provisions of the Social Security Law. Moreover, as correctly held by the appellate court, the proviso of such provisions on the percentage degree of disability applies when there is a related deterioration of the illness previously considered as partial permanent disability. In this case, there is dearth of evidence on the proposition that petitioner’s array of illnesses is related to Generalized Arthritis and Partial Ankylosis of the specific body parts.

Ibarra’s reliance on jurisprudence on work-connected disability claims insofar as it relates to a demonstration of disability to perform his trade and profession is misplaced.
Claims under the Labor Code for compensation and under the Social Security Law for benefits are not the same as to their nature and purpose. On the one hand, the pertinent provisions of the Labor Code govern compensability of work-related disabilities or when there is loss of income due to work-connected or work-aggravated injury or illness. On the other hand, the benefits under the Social Security Law are intended to provide insurance or protection against the hazards or risks of disability, sickness, old age or death, inter alia, irrespective of whether they arose from or in the course of the employment. And unlike under the Social Security Law, a disability is total and permanent under the Labor Code if as a result of the injury or sickness the employee is unable to perform any gainful occupation for a continuous period exceeding 120 days regardless of whether he loses the use of any of his body parts.