To be entitled to compensation and benefits under the governing POEA-SEC, it is not sufficient to establish that the seafarer’s illness or injury has rendered him permanently or partially disabled; It must also be shown that there is a causal connection between the seafarer’s illness or injury and the work for which he had been contracted.
Thus, the SC held in the following case:
Bright Maritime Corporation vs. Racela
G.R. No. 239390, June 3, 2019
Permanent and total disability; Work-relatedness; Compensability of illness; To be entitled to compensation and benefits under the governing POEA-SEC, it is not sufficient to establish that the seafarer’s illness or injury has rendered him permanently or partially disabled; It must also be shown that there is a causal connection between the seafarer’s illness or injury and the work for which he had been contracted
Respondent Jerry J. Racela (Racela) was hired by respondent Bright Maritime Corporation a local manning agency, to work as fitter on board the vessel owned by its foreign principal, Norbulk Shipping UK Limited (Collectively referred to as Bright Maritime, et al.).
Racela was also covered by a Collective Bargaining Agreement (CBA). Prior to hiring, Racela was subjected to medical examination and was declared “Fit for Sea Duty as Engine Rating.”
Thereafter, Racela complained of chest pains and difficulty in breathing. As a result, he was admitted at the Alisha Hospital in Israel for pulmonary edema and was diagnosed with “severe aortic regurgitation and aneurysm of the sinuses of valsava-aortic root.” He underwent open-heart surgery (aortic valve replacement), and was discharged and advised to consult his personal cardiologist in the Philippines. He was, likewise, prohibited from any physical exertion for six (6) months. On April 19, 2014, he was repatriated for medical reasons.
Upon arrival in the Philippines, Racela was immediately confined at the Chinese General Hospital after being referred to the company-designated physician at Alegre Medical Clinic for post-employment medical examination. He was discharged and was advised to continue his medical therapy.
After a follow-up checkup with the company-designated physician Racela’s condition was diagnosed as “aortic valve stenosis” and was referred to a cardiologist.
After subsequent re-evaluations by the company-designated physician, the latter rendered a medical opinion stating that since Racela’s aortic valve stenosis was pre-existing or hereditary, no disability grading was given pursuant to the POEA-SEC Contract, and that maximum medical cure had already been reached in this case.
A coronary angiography was conducted on Racela. In the medical report, the company-designated physician reiterated his assessment that no disability grade was given to Racela because his condition was deemed not work-related.
Racela consulted a private physician who issued a medical certificate stating that Racela was suffering from valvular heart disease, severe aortic regurgitation, aneurysm of sinus valsalva, S/P aortic valve replacement, normal coronary arteries and dilated left ventricle with systolic dysfunction. He was then given an impediment grade of VI (50%) and was declared unfit for sea duty.
Racela filed a disability complaint against Bright Maritime, et al. He claimed that he was not informed of any assessment by the company-designated physician as to his fitness for sea duty. He alleged that he had told Bright Maritime, et al. of the findings of his own private physician but Bright Maritime, et al. rejected or avoided his repeated requests for referral to a third doctor. Racela sought full disability benefits, among other claims.
Bright Maritime, et al. countered that Racela was informed of the assessment made by the company-designated physician. The causes and risk factors of his illness (aortic valve stenosis) having been explained to him, Racela seemed to have understood that his ailment was not work-related and that Bright Maritime, et al. shall continue to pay for his medical expenses until the 130th day or up to August 27, 2014, after which his treatment would be discontinued. Racela did not protest the assessment but only requested Bright Maritime, et al. to shoulder the cost of his coronary angiogram, which was granted.
About five (5) months later, Bright Maritime, et al. received a letter from Racela’s counsel stating that since Racela was not informed of the medical assessment by the company-designated physician, he obtained a second opinion from his chosen doctor, Dr. Vicaldo. Said doctor declared him “unfit to work as seaman in any capacity” with an impediment grade of 6 (50% disability). Racela thus demanded payment of US$60,000.00 as permanent total disability benefit.
After a conciliation-mediation conference before the NLRC-SENA Unit failed to settle the dispute, the proceeding was ordered closed and terminated. Thereafter, Bright Maritime, et al. again received a letter from Racela’s counsel requesting referral to a third doctor for a final evaluation of Racela’s disability.
Bright Maritime, et al. replied to the counsel of Racela, refuting the allegation of Racela that he was not informed of the medical assessment of the company-designated physician, and also manifested their willingness to refer Racela to a third doctor for a final determination of whether his condition was work-related. Afterwards, Racela’s counsel sent another letter denying Bright Maritime, et al.’s assertion that Racela was duly informed of the company-designated physician’s medical assessment. As per Racela’s account, he was merely told that he still had to undergo an angiogram and his medical treatment would stop after 120 days.
Bright Maritime, et al. further claimed that Racela’s counsel even personally conferred with their own counsel on the possible terms and conditions for the appointment of a third doctor, during which the former promised to send an e-mail containing their proposal. However, instead of such e-mail, Bright Maritime, et al. received a summons from the NLRC. Such actuations of Racela’s counsel indicate his lack of genuine intention to comply with the Third-Physician Rule under the POEA-SEC.
The LA found Racela to be entitled to total and permanent disability.
The LA held that while Racela failed to seek the opinion of the third doctor, the stipulations in the employment contract and CBA are merely permissive and not mandatory, hence the use of the word “may.” Moreover, with his disability still subsisting, Racela acted within his rights in instituting the complaint against Bright Maritime, et al.
On the issue of whether Racela’s heart ailment was work-related, the LA opined that their liability for compensation was impliedly admitted by Bright Maritime, et al. when they provided him with medical treatment and paid his sickness allowance. Such continued medical treatment and payment of sickness allowance was indicative of Bright Maritime, et al.’ assessment that Racela’s illness did, in fact, arise in the course of and/or was aggravated by the conditions of his employment.
The LA further ruled that Racela’s cardiovascular disease should be deemed accidental because not all fitters end up with such condition. This entitles Racela to the maximum amount provided in the CBA. The findings of the company-designated physician were not given credence for being ambiguous. Considering that there was no definite assessment of Racela’s fitness to work and his medical conditions remained unresolved, the LA concluded that he was already deemed totally and permanently disabled.
On appeal, the NLRC reversed the LA’s ruling.
The NLRC disagreed with the LA’s finding that Racela’s illness was work-related considering that he failed to present substantial evidence that would show the causal connection between his work as a fitter and his heart disease. Citing medical references, the NLRC noted that aortic valve stenosis could be caused by genetics, aging, and childhood rheumatic disease and may be aggravated by lifestyle choices.
These causes being natural, the illness could not have been accidental. As to Dr. Vicaldo’s findings, the NLRC pointed out that said physician did not perform any test on Racela. His recommendation was merely based on the medical examinations conducted by the company-designated physician.
Racela filed a motion for reconsideration but the NLRC denied the same. He then elevated the case to the CA in a petition for certiorari under Rule 65.
The CA reversed the NLRC, finding Racela’s illness to be work-related.
The CA held that the records of this case are bereft of any showing as to how Bright Maritime, et al.’s nature of work caused or contributed to the aggravation of his illness. Nevertheless, it found the illness to be work-related for two reasons. First, Bright Maritime, et al. did not exhibit any sign that he was sick when private Racelas employed him. Second, the Supreme Court took judicial notice in several cases that seafarers are exposed to harsh conditions of the sea, long hours of work and stress brought about by being away from their families.
The CA further held that the company-designated physician refused to give Bright Maritime, et al. a disability rating on the premise that his illness is not work-related. Further, private Racelas’ company-designated physician offered no explanation as with regard to Bright Maritime, et al.’s condition after undergoing coronary angiography. To dispel any confusion, private Racelas could have presented a copy of the results of the coronary angiography, itself, but did not. Due to such failure of the private Racelas, there arises a presumption that such evidence, if presented, would be prejudicial to it.
Bright Maritime, et al.’s motion for reconsideration was likewise denied.
Whether or not the seafarer, with respect to his work-related illness, is entitled to compensation and benefits on the mere fact that his illness or injury has rendered him permanently or partially disabled
The SC found the petition meritorious.
The SC held that the entitlement of overseas seafarers to disability benefits is a matter governed, not only by medical findings, but also by law and contract. The pertinent statutory provisions are Articles 191 to 193 under Chapter VI (Disability Benefits) of the Labor Code, in relation to Rule X of the Rules and Regulations Implementing Book IV of the Labor Code. The relevant contracts pertain to the POEA-SEC, as provided under Department Order No. 4, series of 2000 of the Department of Labor and Employment (DOLE), and the parties’ CBA.
Since Racela was hired in 2013, it is the 2010 POEA-SEC (Amended Standard Terms and Conditions Governing the Overseas Employment of Filipino Seafarers On-Board Ocean-Going Ships) under Philippine Overseas Employment Authority (POEA) Memorandum Circular No. 010-10 which is applicable in this case. Section 20(A) thereof governs the procedure for compensation and benefits for a work-related injury or illness suffered by a seafarer on board seagoing vessels during the term of his employment contract.
The SC held that the employer has liability when the seafarer suffers work-related injury or illness during the term of his contract which includes, among others, permanent total or partial disability of the seafarer caused by either injury or illness. The seafarer shall be compensated in accordance with the schedule of benefits enumerated in Section 32 of his Contract. Further, the disability shall be based solely on the disability gradings provided under Section 32 of this Contract, and shall not be measured or determined by the number of days a seafarer is under treatment or the number of days in which sickness allowance is paid.
According to the SC, two (2) elements must concur for an injury or illness to be compensable: first, that the injury or illness must be work-related; and second, that the work-related injury or illness must have existed during the term of the seafarer’s employment contract. To be entitled to compensation and benefits under the governing POEA-SEC, it is not sufficient to establish that the seafarer’s illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a causal connection between the seafarer’s illness or injury and the work for which he had been contracted.
The POEA-SEC defines a “work-related illness” as any sickness as a result of an occupational disease listed under Section 32-A with the satisfaction of conditions provided therein. Cardiovascular diseases, such as Racela’s aortic valve stenosis, is expressly included among those occupational diseases, which entitles the seafarer to compensation for the resulting disability if any of the specified conditions are met.
The SC held that based on the facts, it may be concluded that Racela’s heart disease has rendered him unfit for sea duty. The company designated-physician, however, refused to issue a disability grading for the reason that such illness is not work-related.
On July 21, 2014, the 93rd day from Racela’s signing-off and medical repatriation, the company-designated physician issued the medical assessment stating that the condition is pre-existing or hereditary. Based on the POEA Contract, no disability is given.
In Fil-Pride Shipping Company, Inc., et al. vs. Balasta, the Court ruled that the company-designated physician must arrive at a definite assessment of the seafarer’s fitness to work or permanent disability within a period of 120 or 240 days, pursuant to Article 192(c)(1) of the Labor Code and Rule X, Section 2 of the Amended Rules on Employee’s Compensation (AREC). If he fails to do so and the seafarer’s medical condition remains unresolved, the latter shall be deemed totally and permanently disabled.
Thus, even if it was shown that given the seafarer’s delicate post-operative condition, a definitive assessment by the company-designated physician would have been unnecessary as, for all intents and purposes, the seafarer was already unfit for sea duty. Still, with the said doctor’s failure to issue a definite assessment of the seafarer’s condition on the last day of the statutory 240-day period, the seafarer was deemed totally and permanently disabled pursuant to Article 192(c)(1) of the Labor Code and Rule X, Section 2 of the AREC. However, it must be pointed out that in the aforecited case, Racela sufficiently alleged the causal connection between his work duties/functions and his heart disease.
Clearly, the mere fact that a seafarer’s disability exceeded 120 days, by itself, is not a ground to entitle him to full disability benefits. Such should be read in relation to the provisions of the POEA Standard Employment Contract which, among others, provide that an illness should be work-related. Without a finding that an illness is work-related, any discussion on the period of disability is moot.
Cardiovascular disease is listed in Sec. 32-A as an occupational disease. However, for cardiovascular disease to constitute as an occupational disease for which the seafarer may claim compensation, it is incumbent upon the seafarer to show that he developed the same under any of the following conditions identified in Section 32-A(11 ).
Racela’s aortic valve stenosis cannot be considered to have developed under any of the first three instances precisely because of his failure to show that the nature of his work as fitter involved “unusual strain” as to bring about an acute attack or acute exacerbation of his heart disease that he supposedly contracted in the course of employment. There is no evidence that Racela has hypertension or diabetes; neither is there any allegation or proof that he was taking prescribed maintenance medicines or observing doctor-recommended lifestyle changes. While his blood pressure reading of 130/80mmHG is considered pre-hypertensive, there is no indication in his PEME that he was suffering from high blood pressure.
Indeed, Racela was unable to present substantial evidence to show that his work conditions caused, or at the least increased the risk of contracting his illness. Neither was he able to prove that his illness was pre-existing and that it was aggravated by the nature of his employment.
Consequently, although considered as an occupational disease, Racela’s heart ailment did not satisfy the conditions under Section 32-A (11) 2010 POEA-SEC to be considered occupational. His aortic valve stenosis not being work-related, the same is held/deemed not compensable.
As a final note, while the Court adheres to the principle of liberality in favor of the seafarer in construing the PO EA-SEC, it cannot allow claims for compensation based on surmises. Liberal construction is not a license to disregard the evidence on record or to misapply our laws.