MEDICAL FINDINGS OF COMPANY DESIGNATED PHYSICAN WHO CONDUCTED EXTENSIVE EXAMINATION PREVAILS OVER THAT OF PRIVATE PHYSICIAN’S WHO DID NOT ORDER MEDICAL TESTS

Medical findings made by the company-designated physicians who conducted an extensive examination on the seafarer prevail over that of private physician’s who saw him on only one occasion and did not even order that medical tests be done.

Perea vs. Elburg Shipmanagement Philippines, Inc., et al.
G.R. No. 206178, August 9, 2017

Facts:

Pedro Perea entered into a Contract of Employment with Elburg Shipmanagement Philippines, Inc. (Elburg) under its principal Augustea Atlantica SRL/Italy. Perea was hired as a fitter and was deployed to work aboard MV Lemno.

While on board, Perea had difficulty breathing while repairing a pipe. The following day, he had chest pains with palpitations. He was seen by a doctor that same afternoon and was advised to take medication and to rest for three (3) consecutive days. However, he did not feel any better even after resting and taking medications; thus, he asked to be repatriated.

Now available: Labor Code of the Philippines 2018 Edition with Notes and Comments by Atty. Villanueva

A few days later, Perea was welding when the oxygen and acetylene torch he was holding exploded. He hit his left shoulder and twisted his fingers in trying to avoid the explosion. He took a pain reliever to ease the pain but three (3) days later, he found that two (2) of his fingers had grown numb.

Perea was sent to a medical facility in Tuzla, Turkey because of continued chest pains. He was pronounced to have soft tissue trauma and was told to rest, avoid exertion, and avoid using his right arm. He was transferred to SEMA Hospital where he was declared to be suffering from “[C]ubital [T]unnel Syndrome (mainly due to swelling and bleeding), soft tissue injury of the right elbow.” The treatment proposed was to put his right arm in a sling and to rest for recovery for 10 days. He was soon repatriated to the Philippines.

On June 3, 2010, after conducting laboratory examinations and other medical procedures on Perea, company-designated physicians Dr. Karen Hao-Quan (Dr. Hao-Quan) and Dr. Robert D. Lim (Dr. Lim) gave an initial impression, “To Consider Cubital Tunnel Syndrome, Right; Hypertension; Rule Out Ischemic Heart Disease” and recommended that a Dipyridamole Thallium Scan be conducted.

On July 31, 2010, in a letter to El burg, Dr. stated that the cause of hypertension was not work-related and opined that Perea’s estimated length of treatment would be approximately three (3) to four (4) months.

Perea filed a complaint for underpayment of his sick leave pay, permanent disability benefit, compensatory, moral and exemplary damages, and attorney’s fees.

On October 21, 2010, Perea consulted Dr. Antonio C. Pascual (Dr. Pascual), an internist, cardiologist, echocardiographer, who diagnosed him with “Uncontrolled Hypertension [and] Coronary Artery Dr. Pascual found Perea to be medically unfit to work as a seafarer.

After a series of examinations, Dr. Hao Quan and Dr. Lim certified that Perea was cleared of the injuries that caused his repatriation. The parties met for mediation proceedings and a possible compromise agreement but were unsuccessful. They were then directed to submit their respective position papers, together with their supporting evidence.

LA Ruling:

The LA dismissed Perea’s complaint for lack of merit.

The Labor Arbiter ruled that while Section 32-A of the POEA Contract provided that hypertension may be compensable, this was applicable only if it caused “impairment of function[s] of body organs like kidneys, heart and brain, resulting in permanent disability.”

The Labor Arbiter held that Perea’s hypertension did not impair the functions of his organs, as evidenced by Dr. Hao-Quan and Dr. Lim’s medical reports. Between the findings of Dr. Hao-Quan and Dr. Lim and those of Dr. Pascual, the Labor Arbiter gave more weight to the findings of the company-designated physicians who concluded that Perea was not suffering from coronary disease based on the results of a coronary angiogram.

Perea appealed the Labor Arbiter Decision.

NLRC Ruling:

The NLRC dismissed Perea’s appeal and affirmed the Labor Arbiter’s Decision in toto.

The National Labor Relations Commission likewise upheld Dr. Hao-Quan and Dr. Lim’s assessment on Perea’s physical fitness, finding it to be more credible than Dr. Pascual’s.

The National Labor Relations Commission denied Perea’s Motion for Reconsideration. Perea filed a Petition for Review with the Court of Appeals but it was dismissed in the Court of Appeals Resolution.

CA Ruling:

the Court of Appeals stated that hypertension may be compensable under Section 32-A of the POEA Contract only if it caused the dysfunction of body organs, which must be substantiated with (a) chest x-ray report, (b) ECG report, (c) blood chemistry report, (d) funduscopy report, and (e) [CT] scan.

The Court of Appeals declared that while Dr. Pascual certified that Perea was suffering from uncontrolled hypertension, his certification was not supported by the required procedures and laboratory exams. Thus, his medical opinion, which was rendered after a single consultation, could not be considered over   that of the company-designated physicians, who monitored Perea’s progress and subjected him to extensive examination.

The Court of Appeals denied Perea’s Motion for Reconsideration. Thus, Perea filed this Petition for Review.

Issue/s:

Whether or not the medical findings of company-designated physician who conducted extensive examination prevail over private physician who examined the seafarer only once and did not order medical tests.

SC Ruling:

For an illness or injury to be compensable under the POEA Contract, it must have been work-related and acquired during the term of the seafarer’s contract. Work-related illness is defined as “any sickness resulting to disability or death as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.”

Thus, Hypertension classified as primary or essential, is considered compensable if it causes impairment of function[s] of body organs like kidneys, heart, eyes and brain, resulting in permanent disability; Provided, that, the following documents substantiate it: (a) chest x-ray report, (b) ECG report, (c) blood chemistry report, ( d) funduscopy report, and ( f) C-T scan.

It is not disputed that petitioner was treated for injuries and hypertension during the term of his contract. Soon after his repatriation, petitioner was seen by the company-designated physicians, who gave the initial impression, “To Consider Cubital Tunnel Syndrome, Right; Hypertension; Rule Out Ischemic Heart Disease.

As between the findings made by the company-designated physicians who conducted an extensive examination on the petitioner and Dr. Pascual who saw petitioner on only one (1) occasion and did not even order that medical tests be done to support his declaration that petitioner is unfit to work as [a] seaman, the company-designated physicians’ findings that petitioner has been cleared for work should prevail.

The SC held that the said position finds support in Philman Marine vs. Cabanban, which also gave more credence to the findings of the company-designated physician over those of the private physician

The SC further held that the doctor who have had a personal knowledge of the actual medical condition, having closely, meticulously and regularly monitored and actually treated the seafarer’s illness, is more qualified to assess the seafarer’s disability.