MEDICAL ASSESSMENT BY COMPANY PHYSICIAN IS NOT BINDING ON THE COURT AND MAY NOT PASS THE BURDEN TO THE SEAFARER TO PRODUCE SECOND OPINION

Medical assessment by company physician does not bind the court in determining whether the illness suffered by the seafarer while at work is work-related.

The Supreme Court ruled in the following case:

Dohle-Philman Manning Angency, Inc., et al. vs. Heirs of Andres Gazzingan represented by Lenie L. Gazzingan
G.R. No. 199568, June 17, 2015

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Facts:

DOHLE-Philman hired Gazzingan as a messman for a period of nine months on board the vessel M/V Gloria. Prior to his engagement, Gazzingan underwent a pre-employment medical examination (PEME) which yielded normal results except for a finding of left ventricular hypertrophy in his electrocardiogram test (ECG). Gazzingan was thus pronounced fit for sea duty and boarded the vessel M/V Gloria.

While M/V Gloria was docked at the port of Cartagena, Colombia, Gazzingan experienced chest pains. He was confined at the Cartagena de Indias Hospital due to chest pain, shortness of breath and back pain. The hospital’s cardiovascular and thoracic surgeon, Dr. Hernan Fernandez Cuartas, diagnosed him to have Acute Type-B Dissection. On August 3, 2006, Gazzingan was medically repatriated.

Upon arrival in Manila on August 5, 2006, Gazzingan was brought directly to Manila Doctors Hospital for further medical evaluation under the care of Dr. Justo Cammayo (Dr. Cammayo). DOHLE-PHILMAN, et al. received a letter from its company-designated physician, Dr. Raymond C. Banaga (Dr. Banaga), stating that Gazzingan is suffering from a non-work-related illness.

At the Manila Doctors Hospital, Gazzingan underwent numerous diagnostic tests and treatment. However, his confinement thereat was cut short as Gazzingan had no financial capacity to defray his hospital expenses since DOHLE-PHILMAN, et al. refused to further shoulder the same in view of Dr. Banaga’s declaration that his illness is not work-related. He was discharged from the hospital over the objection of his physician. In a medical certificate, Dr. Cammayo’s final diagnosis of Gazzingan’s illness was Dissecting Aneurysm.

Gzzingan filed a Complaint for non-payment or under payment of salaries/wages, sickness allowance, disability benefits and reimbursement of medical expenses and attorney’s fees.

LA Ruling:

The Labor Arbiter opined that although the cause of or the risk of contracting aortic dissection is uncertain, this uncertainty does not, however, eliminate the probability that such illness is work-connected. And since actual proof of causation is not necessary to justify compensability and it is enough that the nature of the seafarer’s work had contributed even in a small degree to the development of the disease, as in this case, the Labor Arbiter granted Gazzingan’s claims.

DOHLE-PHILMAN, et al. appealed to the NLRC. Pending appeal, Gazzingan died of hemorrhagic shock secondary to dissecting aortic aneurysm.

NLRC Ruling:

The NLRC gave weight to the opinion of the company-designated physician that Gazzingan’s illness is not work-related. It ruled that the Labor Arbiter’s Decision is not rooted on legal and factual basis. It explained that as Gazzingan did not seek and present a second opinion from another physician, he left the NLRC with no option but to consider the certification issued by Dr. Banaga as an accurate assessment of his medical condition.

The NLRC took note that Gazzingan is a smoker and has a prior surgery for the excision of lipoma, a hereditary disease. Thus, it concluded that his aortic dissection developed due to hereditary susceptibility, is not work-related and, consequently, not compensable.

Gazzingan’s counsel filed a motion for reconsideration which was denied for lack of merit in the NLRC Resolution.

CA Ruling:

The CA rendered a Decision granting the Petition, setting aside the NLRC ruling, and reinstating the Labor Arbiter’s Decision. It found no substantial evidence to prove that the illness of Gazzingan is congenital. It noted that Gazzingan, who had previously worked abroad for a similar job, had no record of having suffered from, or was treated for, dissecting aneurysm or any other heart ailment.

The CA thus concluded that his illness is presumed to have been acquired or aggravated by his strenuous job on board M/V Gloria. In view of the same, it upheld the Labor Arbiter’s awards of permanent disability benefits, sickness allowance and attorney’s fees in favor of respondents.

DOHLE-PHILMAN, et al. sought reconsideration of the CA Decision. They argued that Gazzingan’s smoking habits and history of a congenital condition of lipoma, as both revealed in his PEME, and the unchallenged expert opinion of Dr. Banaga constitute more than enough substantial evidence to conclude that his ailment is not work-related.

The CA denied DOHLE-PHILMAN, et al.’ Motion for Reconsideration. It noted that Gazzingan’s lipoma has no relation or causal connection to the ailment that caused his death. Anent Dr. Banaga’s assessment, the CA ruled that it cannot be relied upon because it was a mere opinion based solely on the PEME results. Dr. Banaga did not perform any prior assessment of Gazzingan’s health condition while he was confined at Manila Doctors Hospital or any exhaustive post-employment medical examination on him. The CA reiterated that the physical stress that Gazzingan suffered while he performed a strenuous job on board the vessel exposed him to injuries caused by dissecting aneurysm.

Issue/s:

Whether or not a PEME that clears the seafarer of medical issue who was later found ill is deemed to have acquired a work-related illness

Whether or not the company physician’s opinion on the condition of the seafarer after his repatriation due to medical issue based mainly on the PEME is sufficient to pass the burden to the seafarer to disprove said findings

Whether or not the Court is bound by the assessment of the company designated physician

SC Ruling:

The SC did not find merit in the petition.

“It is beyond cavil that it is the company-designated physician who is entrusted with the task of assessing the seaman’s disability.” It is the company-designated physician’s findings which should form the basis of any disability claim of the seafarer. Such assessment is arrived at after the seafarer submits himself to the company-designated physician for a post employment medical examination within three days from his repatriation.

It is significant to note, however, that courts are not bound by the assessment of the company-designated physician. While the company-designated physician must declare the nature of a seafarer’s disability, the former’s declaration is not conclusive and final upon the latter or the court. Its inherent merit will still be weighed and duly considered.

In Racelis vs. United Philippine Lines, Inc., the medical opinion presented by the employer stating that the seafarer’s ailment is congenital in origin was discarded by the Court because the opinion came from a physician who did not personally attend to the seafarer in the course of the latter’s medical treatment and for being unsubstantiated by any medical findings. The ailment which caused the seafarer’s death was held by the Court to be work-related for failure of the employer to overcome the statutory presumption of work-relatedness.

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Similarly, in Jebsens Maritime, Inc. vs. Babol, the Court did not give probative weight on the company doctor’s opinion that the seafarer’s condition is not work-related as the wordings used in the doctor’s report did not make a categorical statement confirming the total absence of work relation but only a mere probability. Again, the Court upheld the presumption of work-relation.

In Magsaysay Mitsui Osk Marine, Inc. vs. Bengson, the Court disregarded the company-designated physician’s categorical declaration that the seafarer’s illness is not work-related for being self-serving. As the facts of the case clearly showed the contributory factor of the seafarer’s daily working conditions to the illness suffered, even in the absence of a contrary opinion of other doctors, the Court sustained the illness’ work-connection.

Also, in Teekay Shipping Philippines, Inc. vs. Jarin, the Court ruled that it was unnecessary for the seafarer therein to consult and provide a contrary opinion from his own doctors since the causal connection between the illness and the work for which he had been contracted was clearly detailed and convincingly established by him.

The courts are not bound by the assessment of the company-designated physician. While the company-designated physician must declare the nature of a seafarer’s disability, the former’s declaration is not conclusive and final upon the latter or the court. Its inherent merit will still be weighed and duly considered.

Dr. Banaga’s opinion is not an accurate appraisal of the extent of Gazzingan’s disability. It was not based on the post-employment medical examination conducted on Gazzingan after his medical repatriation. In the absence of reasonable findings, diagnostic tests and procedures to support the assessment, the same cannot be simply taken at face value.

Moreover, Dr. Banaga hastily concluded that aortic dissection is hereditary without necessarily considering other varied factors that can contribute to the development of the disease. Consequently, his medical opinion cannot be given credence or serve as basis to deny Gazzingan’s disability claims.