ILLNESS THAT IS NOT LISTED IN THE OCCUPATIONAL DISEASES MAY BE COMPENSABLE IF SUBSTANTIAL EVIDENCE PROVES THAT THE WORK CONDITIONS CAUSED OR, AT LEAST, INCREASED THE RISK OF CONTRACTING THE DISEASE

Illness, among other elements to be compensable, must have existed during the term of the seafarer’s employment contract.

Thus, the SC held in the following case:

Skippers United Pacific, Inc. and/or Ikarian Moon Shipping, Co., Ltd. vs. Estelito S. Lagne
G.R. No. 217036, August 20, 2018

Disability claim; Compensability; Presumption of work-relatedness; Colorectal cancer

Facts:

Estelito S. Lagne (Lagne) was hired by Skippers United Pacific, Inc. to serve as Oiler on board the vessel “Nicolaos M” which is owned and operated by its foreign principal, co-petitioner Ikarian Moon Shipping Co., Ltd. Lagne (collectively, Skippers, et al.) signed his employment contract which included the standard terms and conditions governing the employment of Filipino seafarers as prescribed by the Philippine Overseas Employment Administration (POEA).

Part of his pre-employment requirements, Lagne was subjected to a Pre-Employment Medical Examination (PEME) where he was declared “fit for sea duty. While on board however, Lagne started to feel pain on his anus whenever he carries heavy weights or performs laborious tasks. He also experienced chest pains and difficulty in breathing during his work which he tried to endure. However, his ailment persisted as he even experienced intolerable pain even during defecation. Later, Lagne felt that there was a protruding mass on his anus which he noticed to be increasing in size. Alarmed, he reported the matter to his supervisor.

Lagne was brought to the clinic at 51 Rue D’ansou 66600 Saint Nazaire, Montoir, France, where he was attended by a certain Dr. Bourgois. He was diagnosed to have a “rectal mass” and was recommended for medical repatriation after having been declared “unfit for duty.” Based on said findings, on May 17, 2010, Lagne was repatriated to the Philippines.

Upon his arrival, Lagne was referred for medical check-up at the General Med Health Services. After a series of laboratory tests, he was advised to undergo surgical evaluation and biopsy of the rectal mass.” Subsequently, Lagne was endorsed at the Metropolitan Medical Center, under the care of Dr. Esther G. Go (Dr. Go), the company-designated physician, who conducted colonoscopy and biopsy on Lagne. The results confirmed the presence of “anorectal mass.” Lagne was also subjected to CEA determination and CT scan of his whole abdomen and chest.

While his medical assessment was ongoing, Lagne filed a complaint before the arbitration branch of the NLRC claiming permanent total disability benefits, sick wages, damages and attorney’s fees against Skippers, et al..

Later, Dr. Go diagnosed   Lagne as suffering from “Moderately Differentiated Rectosigmoid Adenocarcinoma. ” Lagne was advised to undergo Abdominal Perineal Resection of the Rectosigmoid Tumor which includes the placement of permanent colostomy as management for his condition. Dr. Go, likewise, recommended transfusion of two (2) units of packed red blood cells in preparation for his surgery. Lagne, however, refused and manifested his desire to seek second opinion from his private doctor.

Lagne then sought the expertise of Dr. May S. Donato-Tan (Dr. Donato-Tan, a specialist in internal medicine and cardiology at the Philippine Heart Center, for the assessment and evaluation of his health condition. Subsequently, Dr. Donato-Tan found Lagne to have sustained a permanent disability due to “Moderately Differentiated Rectosigmoid Adenocarcinoma and Atherosclerotic Cardiovascular Disease” and declared him “UNFIT FOR DUTY in whatever capacity as seaman.

In his claim for disability compensation, Lagne asserted that his illness, rectosigmoid adenocarcinoma, was directly caused by his employment with Skippers, et al.. He alleged that the food regularly served in their assigned vessel involved mostly carbohydrates and meat, usually with saturated fat. He also averred that his duties as an oiler exposed him to manual and laborious tasks such as carrying heavy equipment and other materials which contributed to the worsening of his condition.

Skippers, et al. argued that Lagne is not entitled to any disability compensation since rectosigmoid adenocarcinoma is not listed as one of the occupational diseases under Section 32-A of the POEA Standard Employment Contract for Seafarers (POEA-SEC). They insisted that the same is not connected with his duties as an oiler and, therefore, is not compensable under the provisions of the POEA-SEC. They further claimed that even the medical conclusion of the company-designated physician confirmed that Lagne’s illness is not work-related.

LA Ruling:

The Labor Arbiter dismissed Lagne’s claim for total permanent disability benefits for his failure to substantiate his claim that his illness is work-related.

The LA ruled that the findings of Dr. Go should be upheld over the assessment of Dr. Donato-Tan because the former conducted an extensive and regular monitoring of Lagne’s condition as opposed to the latter who made her conclusion after a single consultation only. The Labor Arbiter, likewise, denied the prayer for sickness allowance, damages and attorney’s fees.

Aggrieved, Lagne appealed to the NLRC.

NLRC Ruling:

The NLRC reversed the decision of the Labor Arbiter and granted Lagne’s prayer for monetary awards.

The NLRC held that the food provisions on the ship consisting mostly of frozen meat and canned goods, as well as Lagne’s arduous job as an oiler, undoubtedly aggravated the latter’s rectal illness entitling him to recover permanent total disability benefits under the POEA-SEC.

Dissatisfied, Skippers, et al. sought reconsideration but the NLRC denied the same.

CA Ruling:

The Court of Appeals (CA) affirmed the Resolutions of the NLRC.

Skippers, et al. moved for reconsideration but it was denied by the CA. Thus, the instant petition for review on certiorari before the SC.

Issue/s:

Whether or not rectosigmoid adenocarcinoma being not a listed occupational disease under Section 32-A of the POEA Standard Employment Contract for Seafarers (POEA-SEC) is compensable

SC Ruling:

The SC denied the petition.

The SC held that for disability to be compensable under Section 20(B)( 4) of the POEA-SEC, two elements must concur: (1) the injury or illness must be work-related; and (2) the work-related injury or illness must have existed during the term of the seafarer’s employment contract.

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

The POEA-SEC defines a work-related injury as “injury(ies) resulting in disability or death arising out of and in the course of employment,” and a work-related illness 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.

For illnesses not mentioned under Section 32, the POEA-SEC creates a disputable presumption in favor of the seafarer that these illnesses are work-related. However, notwithstanding the presumption, on due process grounds, the claimant-seafarer must still prove by substantial evidence that his work conditions caused or, at least, increased the risk of contracting the disease. This is because awards of compensation cannot rest entirely on bare assertions and presumptions.

In order to establish compensability of a non-occupational disease, reasonable proof of work-connection is sufficient -direct causal relation is not required. Thus, probability, not the ultimate degree of certainty, is the test of proof in compensation proceedings.

In the instant case, Lagne was able to meet the required degree of proof that his illness is compensable as it is work-connected. Considering the manual and laborious job that Lagne does, the SC surmised that he was able to reasonably prove that his working conditions exposed him to factors that could have aggravated his medical condition.

The SC gave credence to Lagne’s positive assertion that he felt pain on his anus whenever he carries heavy weights, chest pains and difficulty in breathing during his work, and the increasing size of the protruding rectal mass. To note, Skippers, et al. have not refuted having assigned to Lagne such task of carrying heavy weights.

Moreover, the compensability of colorectal cancer has already been ruled upon in the case of Leonis Navigation Co., Inc., et al. v. Heirs of the late Catalino V Villamater, et al. Even Dr. Go, the company-designated doctor, while declaring that rectosigmoid adenocarcinoma is not work-related, she, however, admitted that rectosigmoid adenocarcinoma’s risk factors include age, diet rich in saturated fat, fatty acid and linoleic acid, and genetic predisposition.

Both the NLRC and the CA found Lagne’ s rectal illness to be compensable for permanent and total disability, because they found that his dietary provisions while at sea increased his risk of contracting colon cancer because he had no choice of what to eat on board. Suffice it to say, the strenuous nature of Lagne’s job, combined with his poor diet which consists of mostly carbohydrates and meat, usually with saturated fat, his advanced age as he was 55 at the time of hiring, we find it reasonable to conclude that Lagne acquired or developed his illness during the term of his contract. There is a probability that Lagne’ s work as an oiler caused o contributed even to a small degree to the development or aggravation of his rectal illness.

In determining the compensability of an illness, it is not required that the employment be the sole factor in the growth, development, or acceleration of a claimants’ illness to entitle him to the benefits provided for. It is enough that his employment contributed, even if only in a small degree, to the development of the disease.

The SC held further that even assuming that the ailment of the worker was contracted prior to his employment, this still would not deprive him of compensation benefits. For what matters is that his work had contributed, even in a small degree, to the development of the disease. Neither is it necessary, in order to recover compensation, that the employee must have been in perfect health at the time he contracted the disease. A worker brings with him possible infirmities in the course of his employment, and while the employer is not the insurer of the health of the employees, he takes them as he finds them and assumes the risk of liability.