DISPUTABLE PRESUMPTION IMPLIES THAT NON-INCLUSION IN THE POEA LIST OF COMPENSABLE ILLNESSES DOES NOT TRANSLATE TO AN ABSOLUTE EXCLUSION FROM DISABILITY BENEFITS HOWEVER, IT DOES NOT ALSO GRANT AUTOMATIC COMPENSATION

Disputable presumption implies “that the non-inclusion in the list of compensable diseases/illnesses does not translate to an absolute exclusion from disability benefits.”

Similarly, “the disputable presumption does not signify an automatic grant of compensation and/or benefits claim.”

There is still a need for the claimant to establish, through substantial evidence, that his illness is work-related.

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Thus, the SC held in this case:

Mario C. Madridejos vs. Nyk-Fil Ship Management, Inc.
G.R. No. 204262, June 7, 2017

Facts:

Petitioner Madridejos was a Filipino seafarer hired by respondent NYK-Fil Ship Management, Inc. (NYK-FIL), a registered local manning agency operating by virtue of Philippine laws for its foreign principal, International Cruise Services, Limited.

Madridejos signed an employment contract with NYK-FIL as a Demi Chef for the vessel “Crystal Symphony/Serenity.” The employment contract was effective for a period of 10 months. Two weeks after commencing work on board the vessel, Madridejos claimed that he suddenly slipped on a metal stairway and fell down, hitting his abdomen and chest on a metal pipe.

He was brought to the ship doctor and was diagnosed to have a “sebaceous cyst to the right of the umbilicus. Madridejos was treated at Spire Southampton Hospital in Hampshire, England. Under a local anesthesia, his cyst was removed, and the lesion was closed with three (3) stitches.

After two (2) months, or on July 5, 2010, NYK-FIL terminated Madridejos’ services through its foreign principal since he was merely probationary and the contract states that during the probationary period the employment can be terminated by either party without cause at any time upon fourteen (14) days prior written notice.

Madridejos was repatriated to the Philippines on July 6, 2010. Madridejos insisted that he did not finish his employment contract with NYK-FIL due to his unwanted health condition. Not being at fault for the pre-termination of his employment contract, he made demands upon NYK-FIL to pay his disability benefits.

The following day after repatriation, he allegedly reported to NYK-FIL “for a medical referral to the company doctor.” However, he did not get any referral letter since he was told that his illness was not work-related.

Due to persistent symptoms, he was purportedly constrained to undergo medical examinations by Physician-Surgeon Dr. Aylmer F. Espafio (Dr. Espafio) from Metropolitan Medical Center. He was also prescribed with medicines for his sebaceous cyst. Dr. Espafio found him entitled under P.O.E.A. Disability Grade 1 for Severe Residuals of Impairment of intra-abdominal organs which requires aid and attendance that will prevent worker from seeking any gainful employment.

Madridejos claimed that he also engaged the services of Dr. Eduardo Yu (Dr. Yu), an internist and specialist at Mary Chiles General Hospital. Dr. Yu found that due to his medical condition, he is permanently unfit for further sea service in any capacity. Such injury/illness are work-related since exposed to toxic and hazardous materials.

Madridejos argued that NYK-FIL ignored his repeated demands. He was then prompted to file a complaint “for disability benefits, payment of medical expenses, damages, and attorney’s fees” against NYK-FIL before the labor arbiter.

NYK-FIL denied that Madridejos was repatriated due to his sebaceous cyst.

LA Ruling:

The LA found that Madridejos’ illness “was incurred during the term of his employment contract,” making it “compensable.”

However, the LA held that since there was no evidence to prove the severity of Madridejos’ illness, he should only be given a Disability Grade of 7.

Both parties assailed the decision of Labor Arbiter Demaisip before the National Labor Relations Commission.

NLRC Ruling:

The National Labor Relations Commission, ruled in favor of NYK-FIL.

The National Labor Relations Commission found Madridejos’ story as “unnatural.” His allegation that he was advised to be repatriated for further treatment in the Philippines was not sufficiently proven. Based on Madridejos’ discharge letter from Hampshire, England, his operation merely required three (3) stitches. Hence, he could not have been advised to pursue further treatment in the Philippines since his operation was only a minor one.

The National Labor Relations Commission ruled further that Madridejos’ cyst was not work-related since it was “simply a slow-growing pea-sized sac growth under the skin” that grew as a consequence of infection and caused “‘clogging of sebaceous glands.” It can develop in any part of the body, and at times it just simply disappears.

The NLRC denied Madridejos’ Motion for Reconsideration. Hence, he filed a petition for certiorari.

CA Ruling:

The Court of Appeals dismissed Madridejos’ petition and ruled that the National Labor Relations Commission had judiciously denied Madridejos’ claim for disability benefits.

The CA held that all the doctors involved agreed that his severe stomach ache was due to a “Sebaceous Cyst to the right Umbilicus,” which was already removed on April 29, 2010. Hence, his repatriation in July 2010 was not due to his medical condition but due to the expiration of his contract as a probationary employee. Similarly, the Court of Appeals also confirmed National Labor Relations Commission’s finding that Madridejos’ cyst was not work-related.

The CA also denied his motion for reconsideration.

Issue/s:

Whether or not illness acquired during employment by seafarer though not included in POEA list is presumed work-related

Whether or not such presumed-work related illness is automatically compensable without proof

Whether or not PEME is conclusive proof of overall health condition of seafarer such that the fit-to-work status means that any illness thereafter is work-related

SC Ruling:

The SC did not find merit in the petition.

A work-related illness is “any sickness resulting to disability or death as a result of an occupational disease listed under Section 32-A with the conditions therein satisfied.

A sebaceous cyst is not included under Section 32 or 32-A of the 2000 Philippine Overseas Employment Agency Standard Employment Contract. However, the guidelines expressly provide that those illnesses not listed in Section 32 “are disputably presumed as work-related.”

Similarly, for an illness to be compensable, “it is not necessary that the nature of the employment be the sole and only reason for the illness suffered by the seafarer.” It is enough that there is “a reasonable linkage between the disease suffered by the employee and his work to lead a rational mind to conclude that his work may have contributed to the establishment or, at the very least, aggravation of any pre-existing condition he might have had.”

The disputable presumption implies “that the non-inclusion in the list of compensable diseases/illnesses does not translate to an absolute exclusion from disability benefits.” Similarly, “the disputable presumption does not signify an automatic grant of compensation and/or benefits claim.” There is still a need for the claimant to establish, through substantial evidence, that his illness is work-related.

Madridejos cannot solely rely on the disputable presumption. For his failure to substantiate his claim that his cyst was either work-related or work-aggravated, this Court cannot grant him relief. Accordingly, the disputable presumption “does not allow him to just sit down and wait for respondent company to present evidence to overcome the disputable presumption of work-relatedness of the illness.” Concomitantly, there is still a need for him to corroborate his claim for disability benefits.

Regrettably, Madridejos has failed to prove that the development of cyst was due to the nature of his job as a Demi Chef. For this reason, this Court cannot presuppose that it is work-related. Furthermore, it was already settled that Madridejos was not repatriated due to his alleged medical condition but due to the expiration of his contract as a probationary employee. For this reason, therefore, it becomes unnecessary for NYK-FIL to overcome the disputable presumption that n Madridejos’ illness was work-related.

A seafarer only needs to pass the mandatory [Pre-Employment Medical Examination] in order to be deployed on duty at sea.” A Pre-Employment Medical Examination cannot be relied upon to reflect a “seafarer’s true state of health” since it is not exploratory and may just disclose enough for employers to decide whether a “seafarer is fit for overseas employment.”

Due to the nature of a Pre-Employment Medical Examination, it is possible that Madridejos’ sebaceous cyst was not detected prior to his employment.

The Constitutional mandate in providing full protection to labor “is not meant to be a sword to oppress employers.