DISABILITY COMPLAINT FILED PRIOR TO ISSUANCE OF MEDICAL ASSESSMENT IS NOT PREMATURE IF DELAY IS CAUSED BY THE COMPANY

Disability benefits entitlement rules provide that:

(a) the 120 days provided under Section 20-B (3) of the POEA-SEC is the period given to the employer to determine fitness to work and when the seafarer is deemed to be in a state of total and temporary disability;

(b) the 120 days of total and temporary disability may be extended up to a maximum of 240 days should the seafarer require further medical treatment; and

(c) a total and temporary disability becomes permanent when so declared by the company-designated physician within 120 or 240 days, as the case may be, or upon the expiration of the said periods without a declaration of either fitness to work or permanent disability and the seafarer is still unable to resume his regular seafaring duties.

Thus, the SC held in the following case:

Paringit vs. Global Gateway Crewing Services, Inc., Mid-South Ship and Crew Management

G.R. No. 217123, February 6, 2019

Disability benefits; Compensability; Nature of employment is not the only determinant of seafarer’s illness; Reasonable connection; 120-day rule; 240-day rule; Filing of complaint prior to issuance of medical assessment; Effect of filing if the cause of delay of assessment is the company

Facts:

Petitioner Oscar M. Paringit (Paringit) entered into a six (6)-month employment contract with Mid-South Ship and Crew Management, Inc., representing Seaworld Marine Services, S.A. He was employed as Chief Mate of the Panaman vessel Tsavliris Hellas.

Prior to his deployment, Paringit underwent a pre-employment medical examination, where he disclosed that he had high blood pressure. Still, he was declared fit for duty. A few months later, Paringit began to feel constantly fatigued and stressed. He also noticed blood in his feces.

When the vessel was docked at the port of Las Palmas, Spain, Paringit was rushed to the intensive care unit of Clinica Perpetuo Socorro, where he underwent blood transfusion. Paringit was later on discharged from the intensive care unit with a diagnosis of: “Decompensated cardiac insufficiency. Severe anemia. Renal dysfunction.” He was transferred to a regular room for further treatment and monitoring and was discharged from the hospital.

He was soon medically repatriated and arrived in Manila on February 9, 2012.

Paringit was admitted to the YGEIA Medical Center for evaluation and management. He again underwent blood transfusion and was placed on medication. Paringit was discharged from the hospital with a working diagnosis of: “Congestive Heart Failure; Hypertensive Cardiovascular Disease; Valvular Heart Disease; Anemia Secondary to Upper GI Bleeding Secondary to Bleeding Peptic Ulcer Disease.” Dr. Maria Lourdes A. Quetulio (Dr. Quetulio), the company-designated physician, prescribed Paringit’s medication and advised him to return to the hospital for his check-up.

After his check-up, Dr. Quetulio advised Paringit to continue his prescribed medication and referred him to a valvular heart specialist for further management. She also advised him to return for his follow-up check-up.

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On March 2, 2012, Paringit consulted a valvular heart specialist at the Philippine Heart Center who advised him to have a repeat 2D echocardiogram and coronary angiography. Dr. Quetulio noted that Paringit was a candidate for open-heart surgery. She also advised him to continue his medication while waiting for his employer’s go signal on his recommended procedures.

Paringit underwent repeat 2D echocardiogram, which showed that he had a severe valvular problem. The cardiologist who examined him recommended that he undergo open-heart surgery for valve replacement or repair, with possible coronary bypass graft.

Paringit underwent a coronary angiography. While the procedure revealed that he had no blocked coronary vessels, the attending cardiologist opined that he still had to undergo open heart surgery for valve replacement or repair. Dr. Quetulio again advised him to continue his medication while awaiting his employer’s approval of the recommended open-heart surgery.

By April 30, 2012, Paringit was still waiting for his employer’s decision on his open-heart surgery. On May 18, 2012, Dr. Quetulio noted that Paringit hesitated to undergo the recommended open-heart surgery and wanted to undergo a herbal treatment instead. On June 4, 2012, Paringit consulted Dr. May S. Donato-Tan (Dr. Donato-Tan), a cardiologist at the Philippine Heart Center. After evaluating Paringit and reviewing the results of his laboratory examinations, Dr. Donato-Tan concluded that with his heart condition, he would need regular medication, further laboratory procedures, and periodic check-ups with a cardiologist to prevent any aggravation of his illness. She declared him to be permanently disabled and unfit for duty as a seaman.

Paringit filed a Complaint for medical expenses and other money claims against Global Gateway Crewing Services, Inc. (Global Gateway), Mid-South Ship & Crew Management, Inc., Seaworld Marine Services, S.A., and Captain Simeon Flores (Captain Flores), president of Global Gateway. On June 13, 2012, Paringit executed a quitclaim, where he acknowledged receiving US$6,636.70 from St. Tsavliris Hellas as his sickness allowance from February 8, 2012 to June 8, 2012.

Dr. Quetulio informed Global Gateway that Paringit seemed hesitant to undergo the recommended operation and instead opted for herbal treatment. She also stated that Paringit’s heart condition was pre-existing, not work-related.

LA Ruling:

The LA granted Paringit’s Complaint.

She found that his various illnesses were work-related or work-aggravated, brought about by the type of food served and the stressful nature of his job aboard the ship. Further, Labor Arbiter Savari found that since Dr. Donato-Tan declared Paringit’s unfitness to work as a seafarer, his disability was total and permanent.

Global Gateway and Captain Flores appealed Labor Arbiter Savari’ s Decision before the National Labor Relations Commission.

NLRC Ruling:

The National Labor Relations Commission dismissed the Appeal and affirmed Labor Arbiter Savari’ s Decision.

The National Labor Relations Commission upheld Labor Arbiter Savari’s ruling that Paringit was entitled to permanent total disability benefits, his illness being work-related and acquired during the term of his employment contract.

Global Gateway and Captain Flores moved for reconsideration, but their Motion was denied.

They then filed a Petition for Certiorari before the Court of Appeals.

CA Ruling:

The Court of Appeals granted their Petition.

The Court of Appeals faulted Paringit for choosing an alternative treatment, then demanding permanent and total disability benefits based on his doctor’s assessment on his unfitness for sea duty, rather than consulting a third physician as required by law.

Further, the Court of Appeals noted that Paringit filed his Complaint 124 days after his medical repatriation, which was still well within the 240-day medical treatment period granted to his employer. Thus, the Complaint was premature since he had no cause of action for his claim of total and permanent disability benefits.

Paringit moved for reconsideration, but the Court of Appeals denied his Motion.

Issue/s:

Whether or not compensability shall be determined solely by the nature of work

Whether or not the filing of the complaint prior to issuance of disability assessment is premature when the company refused to respond to seafarer’s request for open-heart surgery as recommended by the physician

SC Ruling:

The Philippine Overseas Employment Administration Standard Employment Contract (POEA Standard Employment Contract) defines a work-related illness as “any sickness as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.”

Paringit took medication to normalize his high blood pressure, but the working conditions and mandatory diet aboard the vessel made it difficult and nearly impossible for him to maintain a healthy lifestyle. He stressed that he and the other seafarers were served mostly high-fat, high-cholesterol, and low-fiber food aboard the vessel. Furthermore, his work as Chief Mate carried considerable stress and required him to stay up for long stretches of time, up to the early hours of the morning.

The SC likewise adhered to the factual finding of the LA that the Paringit, despite being hypertensive, was declared fit to work in his pre-employment medical examination. Moreover, the poor food choices in his workplace led or contributed to his heart disease: Paringit was declared fit to work prior to embarkation, hence, there is no other conclusion than that he developed or his illnesses were triggered or aggravated on board and his working conditions precipitated his unknown illnesses. Hence, his diseases which are congestive heart failure, hypertensive cardiovascular disease, valvular heart disease are work-related or aggravated because the fats and chemicals in frozen and preserved meats congested his arteries. His stress caused peptic ulcer to him. Clearly, his illnesses are work-related/aggravated.

Citing Magsaysay Maritime Services, et al. vs. Laurel the SC emphasized that in determining the compensability of an illness, it is not necessary that the nature of the employment be the sole reason for the seafarer’s illness. A reasonable connection between the disease and work undertaken already suffices.

The case of Vergara v. Hammonia Maritime Services, Inc., et al. explained the relevant rules and period for reckoning a seafarer’s permanent disability for entitlement to disability benefits. Kestrel Shipping Co., Inc., et al. vs. Munar then summarized the rules for entitlement to disability benefits discussed in Vergara.

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The records show that Dr. Quetulio recommended Paringit to undergo open-heart surgery, but Global Gateway failed or refused to act on this. Dr. Quetulio first broached the possibility of open-heart surgery on March 5, 2012, about a month after Paringit’s medical repatriation. The succeeding weeks led to her formally advising Global Gateway of Paringit’s need for open-heart surgery, yet the company failed or refused to respond to her request, despite repeated follow-ups.

The Court of Appeals faulted Paringit for filing a Complaint before Dr. Quetulio could issue a disability assessment, and declared that she had 240 days to do so since Paringit needed additional treatment and evaluation. However, with Global Gateway’s deafening silence over the requested operation, stretching beyond the mandated 120 days within which Dr. Quetulio could give her assessment, it cannot be said that she needed / additional time to assess Paringit’s condition.

The facts show that Paringit had to undergo an open-heart surgery before Dr. Quetulio could properly assess his condition and issue a disability assessment. Unfortunately, Dr. Quetulio had reached an impasse with her management of Paringit’s case. Global Gateway’s silence meant that she could neither issue the required disability assessment within the 120-day period nor extend the period to 240 days to further evaluate and treat Paringit.

Dr. Quetulio’s failure to timely issue a disability assessment was due to Global Gateway, not because Paringit impliedly refused treatment due to his supposed inclination toward an alternative treatment, as the Court of Appeals held. Thus, the labor tribunals did not err in giving credence to the findings of the private physician.

The POEA Standard Employment Contract spells out the conditions for compensability. Here, the compensability of Paringit’s condition is clear; however, instead of fulfilling its responsibilities, Global Gateway delayed his treatment and raised technical procedural barriers that were clearly unwarranted.