PERMANENT AND TOTAL DISABILITY EXISTS WHEN THE COMPANY-DESIGNATED FAILS TO MAKE DEFINITE AND COMPLETE MEDICAL ASSESSMENT WITHIN 120 DAYS FROM SEAFARER’S REPATRIATION

Permanent and total disability benefits should be awarded if the company-designated physician fails to issue an assessment within 120-days from the date of seafarer’s repatriation.

Thus, the SC held in the following case:

Phil-Man Marine Agency, Inc. and DOHLE (IOM) Limited vs. Aniano P. Dedace, Jr.
G.R. No. 199162, July 4, 2018

Medical assessment; Company-designated physician’s failure to make final and definitive assessment within 120 days from seafarer’s repatriation renders the disability permanent and total; Presumption of work-relatedness; Burden of proof; Compensability; Personal physician; Attorney’s fees; Attorney’s fees is not limited to unlawfully withheld wages

Facts:

Petitioner Phil-Man Marine Agency, Inc. (Phil-Man) engaged the services of respondent Aniano P. Dedace, Jr. (Dedace) to work on board the vessel MIV APL Shanghai for and on behalf of its principal, the petitioner Dohle (IOM) Limited (Dohle) [both Phil-Man, et al. are collectively referred to as Phil-Man, et al.]. Dedace boarded M/V APL Shanghai and performed his tasks thereon as an Able Seaman.

While on board, Dedace started feeling frequent intermittent pains on his lower right abdomen and left groin. He was admitted to the Gleneagles Maritime Medical Centre (GMMC) in Singapore where he was examined and attended to by Dr. Lee Choi Kheong (Dr. CK Lee) who found multiple (3) Right Liver Nodules –Suspected Haemangiomata, right Kidney Cyst (benign and need not be operated).

After undergoing further tests and Computed Tomography (CT) Scan, Dr. CK Lee diagnosed Dedace to be suffering from Disseminated Sepsis with Multiple Liver Abscesses. Dedace was repatriated to the Philippines on 1 March 2004, 11 and was referred to Dr. Nicomedes G. Cruz (Dr. Cruz). On 27 March 2004, the radiologist, Dr. Cesar S. Co, performed Magnetic Resonance Imaging (MRI) on Dedace, which revealed two lesions in the right lobe of the liver, unremarkable gallbladder, ducts, pancreas and spleen and lesion in the mid-portion of the right kidney.

It appeared that Phil-Man inquired from Dr. Cruz on whether Dedace’s illness was work-related. In his Reply, Dr. Cruz stated that their gastroenterologist was of the opinion that Dedace’s illness is not work-related.

Dr. Cruz stated that their gastroenterologist was asked if the illness of Mr. Dedace was work-related or not and the specific basis thereof. Dr. Cruz said that the answer was that Mr. Dedace has two benign nodules in the liver which were noted by CT scan and fine rieedle aspiration biopsy. The gastroenterologist opined that these lesions are not work-related. The diagnosis is that Dedace has disseminated sepsis with multiple liver abscess with live nodules, benign.

Thereafter, Phil-Man, through its President/General Manager, Captain Manolo T. Gacutan wrote a letter to Dedace informing him that his illness is not work-related and therefore not compensable. Dedace was further informed that all payments and treatment will be stopped and any further claims with regard to his condition shall likewise be denied.

This denial prompted Dedace to file his claims before the NLRC.

LA Ruling:

The LA ruled that Dedace’s illness was not work-related. It observed that Dedace failed to prove that his Disseminated Sepsis with Multiple Liver Abscesses is among the compensable occupational diseases listed under Section 32-A of the 2000 Philippine Overseas Employment Administration-Standard Employment Contract for Filipino Seafarers (PO EA-SEC). As such, there is neither factual nor legal basis for the claim of total and permanent disability benefits.

The Labor Code of the Philippines 2018 Edition (re-numbered and updated)

Nevertheless, the LA awarded Dedace sickness allowance equivalent to thirty (30) days of pay. Unsatisfied, Dedace appealed before the NLRC.

NLRC Ruling:

The NLRC affirmed the decision of the LA. It observed that while Dedace’s illness was disputably presumed to be work-related under Section 20(B), paragraph 4 of the POEA-SEC, such disputable was overcome when Dr. Cruz declared said illness was not work-related.

The NLRC further stated that Phil-Man’s payment of Dedace’ s sickness allowance and medical expenses did not amount to recognition that his illness was work-related.

Dedace moved for reconsideration, but the same was denied by the NLRC. Aggrieved, De dace filed a petition for certiorari before the CA.

CA Ruling:

The CA granted Dedace’s petition.

The CA opined that Phil-Man, et al. failed to overcome the disputable presumption that Dedace’s illness was work-related. It held that Dr. Cruz neither explained nor specified how he arrived at his conclusion that Dedace’s illness was not work-related. Thus, it held that the NLRC gravely abused its discretion when it grossly misapprehended the facts of the case.

Phil-Man, et al. moved for reconsideration, but the same was denied by the CA. Hence, this petition for review before the SC.

Issue/s:

Whether or not the medical finding that does not explain how the illness is not work-related can be considered full, complete and categorical assessment in compliance with the rules

Whether or not the seafarer needs to consult an independent physician if there is not definite medical assessment within 120 days from repatriation

Whether or not attorney’s fees can be awarded even if the claim does not involve unlawful withholding of wages

SC Ruling:

The SC did not find merit in the petition.

The SC held that for disability to be compensable under Section 20(B) of the 2000 POEA-SEC, it must be the result of a work-related injury or a work-related illness. The POEA-SEC defines work-related injury as “injuries resulting in disability or death arising out of and in the course of employment.” On the other hand, work-related illness has been defined as “any sickness resulting in disability or death as a result of an occupational disease listed under Section 32-A of the contract with the conditions set therein satisfied.”

However, the POEA-SEC’s definition of a work-related illness does not necessarily mean that only those illnesses listed under Section 32-A are compensable. Section 20(B)(4) of the POEA-SEC provides that illnesses not listed under Section 32 are disputably presumed as work-related. This disputable presumption operates in favor of the employee as the burden rests upon his employer to overcome the statutory presumption. Hence, unless contrary evidence is presented by the seafarer’s employer, this disputable presumption stands.

In this case, Phil-Man, et al. failed to overcome the presumption that Dedace’s illness is work-related. Dr. Cruz’s reply in response to Phil-Man’s query on whether Dedace’s illness is work-related, cannot be considered as an effective assessment for purposes of the POEA-SEC.

The POEA-SEC requires the company-designated physician to make an assessment on the medical condition of the seafarer within one hundred twenty (120) days from the seafarer’s repatriation. Otherwise, the seafarer shall be deemed totally and permanently disabled. Section 20(B)(3) of the POEA-SEC.

Even after undergoing several medical tests and consultations, Dedace was not issued a medical certificate to show Dr. Cruz’s final medical assessment on him. The records show only Dr. Cruz’s letter which was not even addressed to Dedace. Even assuming, for the sake of argument, that Dr. Cruz’s letter may be considered as his assessment on Dedace’s medical condition and fitness to work, the same would be inadequate to overthrow the disputable presumption in favor of Dedace for being incomplete and uncertain.

The SC held that it had already stressed the importance of making a full, complete, and categorical medical assessment. Citing Libang, Jr. vs. Indochina Ship Management, Inc, the company-designated physician stated in his medical certificate that the seafarer’s illness “could be pre-existing” and that “it was difficult to say whether his diabetes mellitus and small pontine infarct are pre-existing or not.” In ruling for the seafarer, the Court opined that the company-designated physician breached his obligation under Section 20(B)(3) of the POEA-SEC when he failed to give a definite assessment.

The SC had similar observation in this case. While the letter of Dr. Cruz stated that Dedace’s illness is not work-related, nothing would suggest that the same is a definite medical assessment. In the first place, the said statement was based merely on the opinion of another specialist, a gastroenterologist, who was not even named. Certainly, Dr. Cruz did not even offer his own opinion on the matter. Furthermore, the records do not show that Dedace was examined by or was placed under the care of any gastroenterologist. Thus, the unnamed gastroenterologist’s opinion on Dedace’ s illness is immaterial in this case.

Finally, neither Dr. Cruz nor the unnamed gastroenterologist gave an explanation for the statement that Dedace’s illness is not work-related. 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. For this reason, it is not enough that the company-designated physician merely state or claim that the illness is not work-related, or that the seafarer is fit for sea duties. He must justify said assessment using the medical findings he had gathered during his treatment of the patient-seafarer. Surely, the POEA-SEC requires a medical assessment, not a bare claim. An unsubstantiated assessment, even if made by the company-designated physician, is tantamount to a bare claim which must be rejected by the courts.

Considering that the company-designated physician effectively failed to make an assessment, Dedace is deemed totally and permanently disabled as of the date of the expiration of the 120-day period counted from his repatriation to .the Philippines. Consequently, there could no longer be any issue on whether his illness work-related or not.

In Magsaysay Maritime Corporation vs. NLRC, the case invoked by Phil-Man, et al., it was held that the claimant-seafarer has the burden of presenting substantial evidence, or such relevant evidence which a reasonable mind might accept as adequate to justify a conclusion that there is a causal connection between the nature of his employment and his illness, or that the risk of contracting the illness was increased by his working conditions.

The SC concluded that the pronouncements made in the Magsaysay case do not apply to the present case. The company-designated physician in the Magsaysay case was able to give a full, complete, and categorical medical assessment on the illness of the seafarer. The Court therein found that Dr. Ong-Salvador was able to sufficiently explain her basis in concluding that the seafarer’s illness was not work-related. She found the seafarer not to have been exposed to any carcinogenic fumes, or to any viral infection in his workplace.

The same could not be said in this case according to the SC. The statement that Dedace’s illness is not work-related was not sufficiently explained. The aforesaid statement was unsubstantial to support the position that Dedace’s illness is not compensable. All told, the SC found that Phil-Man, et al. failed to present sufficient controverting evidence to overthrow the disputable presumption that Dedace’s illness is work-related.

Dedace was under no obligation to consult with a physician of his choice under the given circumstances. It must be stressed that the duty of a seafarer to consult with his own physician arises only if the company-designated physician was able to issue an assessment within 120-days from the date of his repatriation. Thus, the SC held that the awards of permanent total disability benefits and sickness allowance are proper.

The award of attorney’s fees in labor cases, however, are not limited to those expressly covered by Article 111 of the Labor Code which states that attorney’s fees may be awarded in cases of unlawful withholding of wages. The Court has repeatedly held that the award of attorney’s fees is legally and morally Justifiable, not only in actions for recovery of wages, but also where an employee was forced to litigate and thus incur expenses to protect his rights and interest.

The propriety of the award of attorney’s fees in this case is clear. It could not be denied Dedace was forced to litigate and retain the services of his counsel thereby incurring expenses as a result of sPhil-Man, et al.’s refusal to pay the disability benefits rightfully due him. Dedace is therefore entitled to attorney’s fees equivalent to ten percent (10%) of his total monetary award.