The case before the Court is an appeal via certiorari from the decision^[1]  of the Court of Appeals dismissing petitioner's appeal from the decision of the Employees' Compensation Commission^[2]  affirming the denial by the Social Security System of her claim for compensation benefits under P. D. No. 626, as amended.

The Employees' Compensation Commission denied petitioner's claim because there was no substantial evidence showing that her illness--atherosclerotic heart disease, atrial fabrillation and cardiac arrhythmia--was occupational or work-connected in her position for fourteen (14) years as overall custodian and officer in charge of the sewing department (of her employer Paul Geneve Entertainment Corporation), in constant exposure to physical stress and emotional and psychological pressure causing chest pains and bouts of cardiac arrhythmia.

The facts, as found by the Court of Appeals, are as follows:

"Sometime in 1982, the Petitioner was employed as sewer by the Paul Geneve Entertainment Corporation, a corporation engaged in the business of sewing costumes, gowns and casual and formal dresses. She was later promoted as the officer-in-charge and the over-all custodian in the Sewing Department, more particularly the procurement of all the materials needed by the Sewing Department as well as insuring the quality of the products from the sewing department.

"Sometime in the early part of 1996, Petitioner started to feel chest pains. In April, 1996, she filed a leave of absence from work as the chest pains became unbearable. Per results of Petitioner's Medical examination conducted by Dr. Claudio Saratan, Jr., Medical Specialist I, holding clinic at the Manila Sanitarium in Pasay City, and in St. Claire's Hospital at Dian Street corner Boyle, Manila, Petitioner was found suffering from Atherosclerotic heart disease, Atrial Fibrillation, Cardiac Arrhythmia (Annex "D", Petition). Upon recommendation of her doctor, Petitioner resigned from her work hoping that with a much-needed complete rest, she will be cured.

"Petitioner later filed a disability claim with the SSS from the Employees' Compensation Fund, under Presidential Decree No. 626, as amended. The SSS denied Petitioner's claim. The Petitioner filed on August 27, 1998, a "Motion for Reconsideration" with the SSS but the latter denied Petitioner's motion. Dissatisfied, the Petitioner appealed from the said Decision to the Public Respondent. On January 15, 1999, the Public Respondent rendered a Decision denying her appeal, the decretal portion of which reads:

"WHEREFORE, the decision of the respondent System appealed from is hereby AFFIRMED, and this case DISMISSED for want of merit." (at p. 28, Rollo)

"Petitioner filed on March 9, 1999, a "PETITION FOR REVIEW" under Rule 43 of the 1997 Civil Procedure with a "MOTION TO LITIGATE AS PAUPER LITIGANT". On March 18, 1999, this Court granted the Petitioner's "Motion to Litigate as Pauper" and ordered the Public Respondent to file its Comment on the Petition. The Public Respondent did file its Comment on the Petition.

"The Petitioner insists in her Petition at bench that the nature of her employment and the working conditions in her place of employment exacerbated the risks of contracting Atherosclerotic Heart disease, Atrial Fibrillation, Cardiac arrhythmia. Hence, the Public Respondent committed a reversible error in finding and declaring that Petitioner did not contract the disease that bedeviled her due to her work and working conditions and that Petitioner's nature of employment did not predispose her to contract the disease and, hence, the Petitioner was not entitled to her claim."^[3]

On October 25, 1998, the Court of Appeals promulgated its decision dismissing the petition, ruling that petitioner's illness was not compensable because petitioner failed to adduce substantial evidence proving any of the conditions of compensability.^[4]

Hence, this appeal.^[5]

The issues in this appeal are whether petitioner's illness is compensable, as work-related, and whether there was sufficient evidence of compensability.

We reverse the appealed decision. Petitioner's illness is compensable.

"Under the Labor Code, as amended, the law applicable to the case at bar, 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 from either (a) any illness definitely accepted as an occupational disease listed by the Commission, or (b) any illness caused by employment, subject to proof that the risk of contracting the same is increased by working conditions."^[6]  In other words, "for a sickness and the resulting disability or death to be compensable, the said sickness must be an occupational disease listed under Annex "A" of said Rules,^[7]  otherwise, the claimant or employee concerned must prove that the risk of contracting the disease is increased by the working condition."^[8]

The Court of Appeals ruled that "atherosclerotic heart disease, atrial fibrillation, cardiac arrhythmia" from which petitioner suffered falls under the classification "cardiovascular diseases" and under Resolution No. 432, dated July 20, 1977 of the Employees' Compensation Commission, cardiovascular disease is listed as compensable occupational disease provided that substantial evidence is adduced to prove any of the following conditions:

"a)	If the heart disease was known to have been present during employment there must be proof that an acute exacerbation clearly precipitated by the unusual strain by reason of the nature of his work.
"b)	The strain of work that brings about an acute attack must be of sufficient severity and must be followed within twenty four (24) hours by the clinical signs of a cardiac insult to constitute causal relationship.
"c)	If a person who was apparently asymptomatic before subjecting himself to strain of work showed signs and symptoms of cardiac injury during the performance of his work and such symptoms and signs persisted, it is reasonable to claim a causal relationship."[9]

In this case, petitioner has shown by uncontroverted evidence that in the course of her employment, due to work related stress, she suffered from severe chest pains which caused her to take a rest, per physician's advice, and ultimately to resign from her employment. She was diagnosed as suffering from "atherosclerotic heart disease, atrial fibrillation, cardiac arrhythmia" which, as heretofore stated, is included within the term cardiovascular diseases.^[10]

Indisputably, cardiovascular diseases, which, as herein above-stated include atherosclerotic heart disease, atrial fibrillation, cardiac arrhythmia, are listed as compensable occupational diseases in the Rules of the Employees' Compensation Commission, hence, no further proof of casual relation between the disease and claimant's work is necessary.^[11]

Consequently, the Court of Appeals erred in ruling that there was no substantial evidence supporting the finding that petitioner's illness was an occupational disease compensable under P. D. No. 626, as amended.

The degree of proof required under P. D. No. 626, is merely substantial evidence, which means, "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."^[12]  The claimant must show, at least, by substantial evidence that the development of the disease is brought largely by the conditions present in the nature of the job. What the law requires is a reasonable work-connection and not a direct causal relation. It is enough that the hypothesis on which the workmen's claim is based is probable. Medical opinion to the contrary can be disregarded especially where there is some basis in the facts for inferring a work-connection. Probability, not certainty, is the touchtone.^[13]

WHEREFORE, the Court hereby GRANTS the petition for review on certiorari and REVERSES the decision of the Court of Appeals in CA-G.R. SP No. 52027 dismissing the appeal from the denial of petitioner's claim by the Employees Compensation Commission.

In lieu thereof, the Court SETS ASIDE the decision of the Employees' Compensation Commission and orders the Social Security System to pay petitioner full disability benefits as provided for under P. D. No. 626, as amended.

No costs.

SO ORDERED.

Puno, Kapunan, and Ynares-Santiago, JJ., concur.
Davide, Jr., C.J., (Chairman), respectfully dissent. Voted to affrim.

---

^[1]  Petition, Annex "E", Rollo, pp. 55-66.

^[2]  Petition, Annex "B"(Annex "E"), Rollo, pp. 36-41.

^[3]  Decision, CA-G.R. SP No. 52027, Callejo, Sr., ponente, Abad Santos, Jr. and Umali, JJ., concurring. Petition, Annex "E", Rollo, pp. 55-66.

^[4]  Ibid., Rollo, at p. 63.

^[5]  Filed on March 30, 2000, Rollo, pp. 3-17.

^[6]  Millora vs. ECC, 227 Phil. 139, 144 [1986] ; Quizon vs. Employees' Compensation Commission, 203 SCRA 426, 433 [1991] .

^[7]  Amended Rules on Employees' Compensation.

^[8]  Bravo v. ECC, 227 Phil. 93, 97 [1986].

^[9]  CA Decision, Rollo, at pp. 61-62.

^[10]  CA Decision, supra, at p. 62, citing Dorland's Medical Dictionary, 27th Edition [1988], p. 275.

^[11]  Quizon vs. Employees' Compensation Commission, supra, Note 6, citing Rodriguez vs. Employees' Compensation Commission, 178 SCRA 30 [1989] ; Abellara vs. Secretary of Labor, 164 SCRA 711 [1985].

^[12]  Sarmiento vs. Employees' Compensation Commission, 228 Phil. 400, 405 [1986] , citing Cristobal vs. Employees' Compensation Commission, 103 SCRA 329 [1981]; Acosta vs. Employees' Compensation Commission, 109 SCRA 209 [1981]; Ang Tibay vs. Court of Industrial Relations, 69 Phil. 635 [1940]; Saliba vs. Employees' Compensation Commission, 128 SCRA 723 [1984]; Neri vs. Employees' Compensation Commission, 127 SCRA 672 [1984]; Juala vs. Employees' Compensation Commission, 127 SCRA 462 [1984] ; De Vera vs. Employees' Compensation Commission, 133 SCRA 685 [1984] ; Delegente vs. Employees' Compensation Commission, 118 SCRA 67 [1982] ; San Valentin vs. Employees' Compensation Commission, 118 SCRA 160 [1982].

^[13]  Sarmiento vs. Employees' Compensation Commission, supra, at p. 405.