Compensability of Illnesses in the Time of COVID-19

by Angel Grace D. Untalan, MAY 2021

Much like the setting of the alluded Gabriel García Márquez’ masterpiece, “Love in the Time of Cholera”, people all around the globe are currently faced with a generational outbreak that was once considered a faraway occurrence.

Workers regularly reporting to work, above all, endures a greater risk of contracting the novel coronavirus (“COVID-19”), especially now that the country is averaging an estimated 5,800+ new cases daily, within seven days.

Photo by Thirdman on Pexels.com

Normally, a work-related sickness, injury, or death is compensated under the Employees’ Compensation Program (“ECP”) which grants the following individuals benefits and services:

  • Private sector workers who are registered as compulsory members of the Social Security System (“SSS”) except self-employed;
  • Government sector employees who are registered members of the Government Service Insurance System (“GSIS”) including elective government officials who are receiving a regular salary;
  • Uniformed personnel of the AFP, the PNP, BFP, and the BJMP; and 
  • Overseas seafarers;

The compensability of an illness or injury is identified under two factors: one being an Occupational Disease and two, through the “increased risk theory”.

To establish compensability of a claim under the increased risk theory, the claimant must show proof of work connection, where the degree of proof required varies on a case-to-case basis.

On 6 April 2021, the Employees’ Compensation Commission (“ECC”), an attached agency of the Department of Labor and Employment’s (“DOLE”) issued Board Resolution No. 21-04-14 (“Board Resolution”) stating, among others, that COVID-19 acquired due to work or the working environment is compensable under the ECP, following the premise of the increased risk theory.

Photo by Thirdman on Pexels.com

The Board Resolution primarily resolved to include the following conditions for the compensability of COVID-19 in Annex A of P.D. No. 626as amended:

  1. There must be a direct connection between the offending agent or event and the worker based on epidemiologic criteria and occupational risk (e.g., healthcare workers, screening and contact tracing teams, etc.);
  2. The tasks assigned to the worker would require frequent face-to-face and proximity interactions with the public or with confirmed cases for healthcare workers;
  3. Transmission occurred in the workplace; or
  4. Transmission occurred while commuting to and from work.

However, the ECC highlighted that workers who avail themselves of work-from-home arrangements are not covered by the ECP, considering items 3 and 4 of the above-stated conditions set forth.

Certificate of employment from the employer indicating the last day of reporting to work; reverse transcriptase-polymerase chain reaction (RT-PCR) test showing positive COVID-19 result from any Department of Health (DOH)-accredited testing facility; medical records as appropriate; and application forms, are required to be submitted to claim the subject compensation.

Ahead of Labor Day, DOLE Secretary Silvestre Bello III noted on April 28 that the compensation for COVID-19 will be ₱30,000.00, regardless of the mildness or severity of the diagnosis.

There are now 33 illnesses in the List of Occupational and Work-related Diseases under the ECP, as reflected here: http://ecc.gov.ph/wp-content/uploads/2015/04/List_Compensable_Dis.pdf

To file an ECP claim, an employee must fill out and prepare all the prescribed forms and documentary requirements, for submission to any SSS and GSIS branch nationwide.

(A/N: As of writing, the ECC website stated that the subject Board Resolution, posted on 4 May 2021, is still for publication. It must be noted that the Board Resolution shall only take effect fifteen days after its publication in a newspaper of general circulation.)

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About the writer:

Angel Grace D. Untalan. A Legal Management graduate with an inclination to pursue the field of higher arts. She is moderately comfortable with social interaction, but can also relish her time off from the crowd. Her works are influenced by distinguished screenwriters such as Gene Roddenberry, George R.R. Martin, and Quentin Tarantino. She aspires to become a law practitioner at The Hague, who has published papers in a Scopus-indexed journal at some point in the future.

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