DISABILITY BENEFITS CLAIMS MUST BE ESTABLISHED BY SUBSTANTIAL EVIDENCE AND CANNOT REST ON MERE SPECULATIONS, PRESUMPTIONS OR CONJECTURES

Disability benefits require proof and the seafarer has the onus probandi. As such, it cannot rest on mere speculations, presumptions or conjectures

 Maunlad Trans Inc., Carnival Cruise Lines vs. Isidro
G.R. No. 222699, July 24, 2017

Facts:

Petitioner Maunlad Trans Inc., (MTI), for and in behalf of its foreign principal, Carnival Cruise Lines, hired Respondent Gabriel Isidro (Isidro) as bartender for a period of six (6) months. Isidro boarded the vessel “M/S Miracle”

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Sometime in November 2009, Isidro figured in an accident while lifting heavy food provisions. When his right knee became swollen and he experienced pain, Isidro reported his situation to the ship’s physician for medical examination.

Subsequently, Isidro’s condition was diagnosed as “Right Knee Synovitis, Meniscal, Chondromalacia”. He was given medication and was advised by the physician that he can continue working. He was then referred for further medication. However, the medication administered to him proved ineffective.

Isidro underwent a series of examinations and treatment. After his treatment, he went back to work. However, he began experiencing skin rashes on his right leg which later on spread to his left lower extremity, and to both his upper extremity and trunk. These skin eruptions were diagnosed by the ship’s physician as ”psoriasis”. He was given medications and was advised to get dermatologic consultation upon completion of his contract.

Consequently, on February 12, 2010, he was ordered repatriated to the Philippines. Isidro arrived on February 16, 2010. Three days after his repatriation Isidro was admitted was attended to by the company-designated doctor (Dr. Cruz-Balbon).

On his initial evaluation on February 22, 2010, Isidro’s knee synovitis was not mentioned in his past medical history. Isidro was instead referred to a dermatologist who opined that Isidro has ”psoriaris vulgaris” based on clinical history and physical examination. As such, Isidro was given medications and was advised to come back for re-evaluation.

During his follow-up examination, Isidro’s psoriatic lesions on both lower extremities were noted to still be erythematous. He was advised to continue his medications and to come back. Still, there was no mention that Isidro complained of a knee injury.

Later, Isidro was referred to a cardiologist for evaluation of his blood pressure elevations. The test results, however, showed to be normal. Isidro was again seen by a dermatologist who reviewed the histopath result of his skin biopsy. Because the characteristic change in the psoriaris cannot be appreciated, the dermatologist recommended a temporary discontinuation of his medication and a repeat of his biopsy.

In any of a series of subsequent medical examinations, there was no mention that Isidro complained of his knee injury. He was reported to have been cleared cardiac-wise and the psoriatic lesions on both legs have decreased in size and redness. He was advised to continue applying topical cream on his legs.

In a follow-up report on July 20, 2010, or 121 days from his initial examination, legs erythema was noted on Isidro’s psoriatic lesions on his right leg.

Thereafter, Isidro sought the opinion of a private doctor. Dr. Jacinto assessed him to be suffering from ”psoriasis, chondromalacia (medial femoral candy/tibial plateaus) right, grade II injury medial collateral ligament right knee, sprain, medial head of gastrocnemus with hemarthrosus.”

Isidro was advised to undergo Magnetic Resonance Imaging (MRI) and surgery. Dr. Jacinto also found Isidro unfit to go back to work. For these reasons, Isidro filed a complaint before the Labor Arbiter for full disability benefits.

Later, 226 days after the initial referral to the company-designated doctor, the attending dermatologist, Dr. Mary Belly Gan-Chao, issued a disability grading of “Grade 12 for slight residual or disorder.”

LA Ruling:

The Labor Arbiter (LA) issued his Decision finding Isidro to be entitled to compensation equivalent to Grade 12 disability grading, or in the amount of US$5,225 and 10% attorney’s fees.

Consequently, Isidro appealed to the NLRC.

NLRC Ruling:

The NLRC granted the appeal and modified the LA’s award by granting full disability compensation benefits.

Upon denial of Maunlad’s motion for reconsideration, the case was elevated to the CA on certiorari. Maunlad argued that the alleged knee injury suffered by Isidro was neither the cause of his repatriation nor was it examined by the company-designated physician. Maunlad contended that Isidro never complained of said knee injury prior to the filing of his labor complaint.

In any case, Maunlad argued that Isidro is only entitled to compensation equivalent to Grade 12 disability grading as certified to by the company-designated physician.

CA Ruling:

The CA denied the petition for certiorari. Contrary to Maunlad’s assertions, the CA held that Isidro’s knee injury was made known to Maunlad, as Isidro was in fact treated for such ailment while on board the vessel.

The CA further noted that the company-designated physician, Dr. Cruz-Balbon, was cognizant of Isidro’s knee injury since the latter noted the existing skin rashes on his right leg that spread to his lower and upper extremities and on his trunk.

Maunlad’s motion for reconsideration was similarly denied by the CA. Hence, it resorted to the instant petition.

Issue/s:

Whether or not the disability claim based on illness not complained of will prosper

SC Ruling:

In a case of claims for disability benefits, the onus probandi falls on the seafarer as claimant to establish his claim with the right quantum of evidence; and as such, it cannot rest on mere speculations, presumptions or conjectures.

Awards of compensation depend on the presentation of evidence to prove a positive proposition. The quantum of proof required is substantial evidence.

Given this standard, Maunlad cannot be held liable for the alleged knee injury suffered by Isidro. While the facts, as found by the CA and the NLRC, point to the existence of a knee injury which Isidro suffered during the term of his employment contract and while on board the vessel, such knee injury was not the ailment complained of by Isidro upon repatriation to the Philippines and is, likewise, not the illness for which he was given medical treatment.

That Isidro did not complain of, and was not treated for, the alleged knee injury is evident from the medical reports submitted by the company-designated physician detailing the progress of Isidro’s skin condition.