OCCUPATIONAL DISEASE THAT IS LISTED AND A NON-LISTED ILLNESS AND THEIR RESULTING INJURY REQUIRE PROOF OF COMPENSABILITY

Occupational disease found in the 2000 POEA-SEC list and a non-listed illness and their resulting injury must sufficiently shown by substantial evidence to be compensable. Notably, the seafarer will, in all instances, have to prove compliance with the conditions for compensability, whether or not the work-relatedness of his illness is disputed by the employer.

Thus, the Supreme Court held in the August 9, 2017 case as follows:

Romana vs. Magsaysay Maritime Corporation
G.R. No. 192442, August 9, 2017

Facts:

Petitioner Benedict Romana (Romana) was employed by respondents Magsaysay Maritime Corporation, Eduardo Manese and/or Princess Cruise Lines, Ltd. (Magsaysay Maritime, et al.) as a Mechanical Fitter and boarded the vessel M/V Golden Princess.

He claimed that while he and fellow shipmates Alexander Mapa and Rogelio Acdal were walking along the ship alley, the metal ceiling fell and wounded his head. A few days thereafter, he experienced persisting headache and blurring of vision and consulted the ship’s doctor who prescribed him medicines.

As his condition did not improve, he was referred to a specialist in Barbados, West Indies, and was found to have a tumor (or hemangioblastoma) at the left side of his brain, for which he underwent left posterior fossa craniectomy.

He was repatriated on May 23, 2004 and the company-designated physician, in a medical report dated May 24, 2004, issued a finding that Romana’s illness is not work-related given that the same is an “abnormal growth of tissues in the brain’s blood vessels.”
He was later cleared and discharged. No further consultations were made. Thereafter, Romana consulted an independent physician, who on the other hand, declared his illness to be work-related and gave him a Grade 1 impediment after finding him unfit to resume work as a seaman and incapable of landing a gainful employment because of his medical background.

As a result, Romana filed a complaint, seeking payment of his disability benefits, illness allowance, reimbursement of medical expenses, damages, and attorney’s fees.

LA Ruling:

The Labor Arbiter (LA) dismissed the complaint, finding that Romana failed to establish that his illness is work-related.

In so ruling, the LA gave more credence to the findings of the company-designated physician that his employment did not increase the risk of contracting his illness, nor did his working conditions contribute to his illness.

Thus, Romana appealed the LA ruling.

NLRC Ruling:

The NLRC affirmed the LA ruling, holding that there was no evidence to support Romana’s claim that the nature of his work exposed him to risks of contracting a brain tumor.

Romana moved for reconsideration, but the same was denied. Hence, Romana elevated his case to the CA via a petition for certiorari.

CA Ruling:

The CA dismissed the certiorari petition, finding no grave abuse of discretion on the part of the NLRC.

The CA debunked Romana’s claims that he was hit on the head by a falling metal while on board the vessel, and that he was exposed to different chemicals that aggravated his condition, for lack of substantiation.

The CA likewise did not give credence to the independent physician’s finding that Romana’s illness is work-related, noting that said physician is a specialist in internal medicine and not in diseases of the brain.

Aggrieved, Romana filed a motion for reconsideration, which was, however, denied. Hence the petition before the SC.

Issue/s:

Whether or not the illness not listed in the 2000 POEA-SEC does not require proof of compensability

SC Ruling:

The SC denied the petition.

Under the 2000 POEA-SEC, “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” is deemed to be a “work-related illness.”

On the other hand, Section 20 (B) (4) of the 2000 POEA-SEC declares that “[t]hose illnesses not listed in Section 32 of this Contract are disputably presumed as work related.”

The legal presumption of work-relatedness was borne out from the fact that the said list cannot account for all known and unknown illnesses/diseases that may be associated with, caused or aggravated by such working conditions, and that the presumption is made in the law to signify that the non-inclusion in the list of occupational diseases does not translate to an absolute exclusion from disability benefits.

Given the legal presumption in favor of the seafarer, he may rely on and invoke such legal presumption to establish a fact in issue. “The effect of a presumption upon the burden of proof is to create the need of presenting evidence to overcome the prima facie case created, thereby which, if no contrary proof is offered, will prevail.”

Citing Racelis vs. United Philippine Lines, Inc. and David vs. OSG Shipmanagement Manila, Inc., the Court held that the legal presumption of work-relatedness of a non-listed illness should be overturned only when the employer’s refutation is found to be supported by substantial evidence, which, as traditionally defined, is “such relevant evidence as a reasonable mind might accept as sufficient to support a conclusion.

The presumption provided under Section 20 (B) (4) is only limited to the “work-relatedness” of an illness. It does not cover and extend to compensabilitv. In this sense, there exists a fine line between the work-relatedness of an illness and the matter of compensability.

As differentiated from the matter of work-relatedness, no legal presumption of compensability is accorded in favor of the seafarer. As such, he bears the burden of proving that these conditions are met. In view of that, the SC cited the case of Tagle vs. Anglo-Eastern Crew Management, Phils., lnc. that while work-relatedness is indeed presumed, “the legal presumption in Section 20 (B) ( 4) of the [2000] POEA-SEC should be read together with the requirements specified by Section 32-A of the same contract.

The seafarer/claimant is burdened to present substantial evidence that his work conditions caused or at least increased the risk of contracting the disease and only a reasonable proof of work-connection, not direct causal relation is required to establish its compensability.

The SC held that in Jebsen Maritime, Inc. vs. Ravena, there is a need to satisfactorily show the four (4) conditions under Section 32-A of the 2000 POEA-SEC in order for the disputably presumed disease resulting in disability to be compensable.

While Section 32-A of the 2000 POEA-SEC refers to conditions for compensability of an occupational disease and the resulting disability or death, the conditions stated therein should also apply to non-listed illnesses given that: (a) the legal presumption under Section 20 (B) (4) accorded to the latter is limited only to “work-relatedness”; and (b) for its compensability, a reasonable connection between the nature of work on board the vessel and the illness contracted or aggravated must be shown.

The SC held further that it would result in a preposterous situation where a seafarer, claiming an illness not listed under Section 32 of the [2000 PO EA-SEC] which is then disputably presumed as work-related and is ostensibly not of a serious or grave nature, need not satisfy the conditions mentioned in Section 32-A of the [2000 POEA-SEC]. In stark contrast, a seafarer suffering from an occupational disease would still have to satisfy four (4) conditions before his or her disease may be compensable.

For both listed occupational disease and a non-listed illness and their resulting injury to be compensable, the seafarer must sufficiently show by substantial evidence compliance with the conditions for compensability. Notably, the seafarer will, in all instances, have to prove compliance with the conditions for compensability, whether or not the work-relatedness of his illness is disputed by the employer.

In this regard, the seafarer, therefore, addresses the refutation of the employer against the work-relatedness of his illness and, at the same time, discharges his burden of proving compliance with certain conditions of compensability.

In this case, the company-designated physician, after due assessment of Romana’s condition, found that his illness was caused by an abnormal growth of tissue in the brain’s blood vessels (brain tumor) and therefore not work-related. To refute the same, Romana argued that he accidentally injured his head when a metal ceiling fell on his head that caused lesion and bleeding. The SC held that, as correctly pointed out by the CA, no evidence was presented to substantiate the said incident.

Romana asserted that the nature of his work may have contributed to his illness having been previously employed on board the same vessel under two (2) contracts, and that as a fitter, he was constantly exposed to inhalation of and direct contact to harmful chemicals, formaldehyde, hydrocarbons, fumes, and other deleterious emissions, changes of temperature of extreme hot and freezing colds at the engine room and deck areas and as the vessel crossed ocean boundaries. However, there is no showing that the foregoing work conditions increased the risk of contracting his illness.

Probability, not the ultimate degree of certainty, is the test of proof in disability compensation proceedings. Nevertheless, probability must be reasonable; hence it should, at least, be anchored on credible information. A mere possibility will not suffice, and a claim will fail if there is only a possibility that the employment caused the disease.

The Labor Code of the Philippines, 2018 Edition (re-numbered and updated) now available. Grab your copy now!