SEAFARER HAS THE DUTY TO INFORM EMPLOYER OF CONTRARY MEDICAL FINDINGS FOR THE THIRD-DOCTOR RULE TO OPERATE

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Seafarer shall submit himself to a post-employment medical examination by a company-designated physician within three working days upon his return. If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the employer and the seafarer. The third doctor’s decision shall be final and binding on both parties.

The seafarer has the duty to inform the employer of the contrary findings failing which the findings of the company-designated physician prevail. Thus, the SC held in the following case:

Ranoa vs. Anglo-Eastern Crew Management Phils., Inc.
G.R. No. 225756, November 28, 2019

Material concealment; Where there is no proof that the seafarer deliberately concealed his illness for a malicious purpose there can be no material concealment; Third Doctor; Referral to a third doctor is a mandatory requirement when there is conflict between the medical findings of the company-designated physician and seafarer’s independent doctor; The initiative for referral should come from the employee; The seafarer must issue notification to the employer that he disagrees with the company doctor’s assessment based on the duly and fully disclosed contrary assessment from his own doctor; Disability benefits;

Facts:

Respondent Anglo-Eastern Crew Management Phils. Inc., for and in behalf of its principal, Anglo-Easter Crew Management (Asia) Ltd., hired petitioner, Vitorino G. Ranoa, as Master of its vessel, Genco Bay for six months, collectively Anglo-Eastern, et al.

Prior to his deployment, Ranoa underwent routinary Pre-Employment Medical Examination (PEME). In the process, he was asked whether he was aware of, diagnosed with, or treated for hypertension and heart disease, among others. He answered in the negative. Based on the results of his examination, he was declared fit for sea duty and got deployed.

Barely two months on board, Ranoa suffered dizziness, vomiting, chest pain, shortness of breath, and coldsweat. He was brought to a doctor in London who noted his elevated blood pressure. Consequently, he got repatriated. As soon as he arrived in the country, he was referred to company-designated doctors Karen Frances Hao-Quan and Marianne C. Sy.

The doctors’ finding was he had hypertensive cardiovascular disease. He was issued Grade 12 disability rating. Dissatisfied, Ranoa sought the opinion of a private doctor, Dr. Antonio C. Pascual of the Philippine Heart Center. Dr. Pascual found him to be suffering from Stage 2 hypertension and coronary artery disease and advised him to continue with his medication and treatment. Dr. Pascual opined that he was unfit for sea duties.

Ranoa averred that despite this finding, Anglo-Eastern, et al. refused to award him total and permanent disability benefits. Hence, he got constrained to file the complaint for permanent total disability benefits.

Anglo-Eastern, et al. argued that Ranoa willfully concealed the fact that he was previously diagnosed with coronary artery disease and had undergone coronary angiogram. Assuming that he was entitled to disability benefits, he was only entitled to Grade 12 disability benefits, as opined by the company-designated doctors.

LA Ruling:

The Labor Arbiter (LA) granted Ranoa’s claim for total and permanent disability benefits.

The LA found the charge of concealment of material fact to be unsubstantiated. Ranoa was deemed fit for sea duties. If he already had a heart condition prior to boarding, then the same would have been reflected in his PEME, but it was not. He was, therefore, deemed fit prior to assuming his duties.

Anglo-Eastern, et al. appealed to the National Labor Relations Commission (NLRC.

NLRC Ruling:

The NLRC affirmed with modification the LA Decision.

The NLRC held that Ranoa was not guilty of concealment or misrepresentation when he did not disclosed that he had previously undergone an angiogram. It said that an angiogram was neither an illness nor an operation, it was simply a “procedure preparatory to an operation.”

Since nothing serious came out of its, Ranoa did not conceal anything when he did not indicate it in his PEME. In any case, he was found fit for sea duties. More, cardiovascular disease was one of the occupational diseases listed under Section 32-A of the POEA-SEC.

The NLRC found the award of damages unnecessary. Anglo-Eastern, et al. filed a motion for reconsideration. It was denied by the NLRC. Thus, they went to the Court of Appeals (CA).

CA Ruling:

The CA reversed the NLRC Decision.

The CA held that while Ranoa was indeed diagnose with hypertensive cardiovascular disease and minor coronary artery disease, he failed to prove the existence of the circumstances to make the disease compensable under the POEA-SEC. He did not show that he was indeed exposed to a certain degree of strain in work that would contribute to the deterioration of his health.

Anglo-Eastern, et al.’s doctors, on the other hand, were consistent in finding that even prior to boarding, Ranoa already had cardiovascular disease. These two company-designated physicians from different hospitals swore that Ranoa told them he had previously been diagnosed with hypertension and took medicines therefor for a year. Ranoa did not refute this. Notably too, there was no iota of evidence showing that he was complying with his prescribed medications for such illness.

Ranoa cannot deny his existing illness, albeit he was found fit to work after his PEME. Jurisprudence had consistently held that a PEME is generally not explanatory in nature, nor a thorough examination of an applicant’s medical condition. Lastly, the CA held that Ranoa did not even ask to be referred to a third doctor after his chosen physician came out with a finding contrary to those of the company-designated doctors. The POEA-SEC commands such referral and so does jurisprudence.

Ranoa filed the petition before the Supreme Court (SC).

Issue/s:

Whether or not there is material concealment despite the fact that no substantial evidence was presented to prove this fact by the employer

Whether or not notification of contrary medical conclusion is required of seafarer prior to referral to a third doctor

Whether or not the initiative for referral to a third doctor should come from employee

SC Ruling:

The SC partly granted the petition.

The SC held that there was no material concealment on the part of Ranoa. Citing 2010 PEOA-SEC, the SC held that an illness shall be considered as pre-existing if prior to the processing of the POEA contract, any of the following conditions is present: (a) the advice of a medical doctor on treatment given for such continuing illness or condition; or (b) the seafarer had been diagnosed and has knowledge of such illness or condition but failed to disclose the same during the PEME, and such cannot be diagnosed during the PEME.

Fraudulent misrepresentation is not only to say that a person failed to disclose the truth but that he or she deliberately concealed it for a malicious purpose. To equate with fraudulent misrepresentation, the falsity must be coupled with intent to deceive and to profit from that deception.

Here, none of these conditions obtains according to the SC. Ranoa denied that he committed fraudulent misrepresentation. Anglo-Eastern, et al. had not adduced evidence to prove that indeed, he was already suffering from hypertension and coronary artery disease as far back as 2010. Thus, without anything to substantiate Ranoa’s so-called previous diagnosis, there was nothing he could have concealed from Anglo-Eastern, et al.

Further, Ranoa passed the PEME prior to his boarding. He was declared fit to work by the company-designated doctors. Had he been already suffering from hypertension and coronary artery disease, this would have been reflected in his physical examination. Thus, he cannot be said to have had any pre-existing illness prior to boarding. Finally, the SC held that assuming he was indeed previously diagnosed with hypertension and coronary artery disease, he still could not be guilty of material concealment. There was no proof that he “deliberately concealed” his illness for a malicious purpose. It was not shown that he had the intent to deceive and to profit from that deception. Consequently, he cannot be considered guilty of concealment as to disqualify him from claiming disability benefits.

In resolving the issue on the referral to a third doctor, the SC cited the POEA-SEC, as amended by POEA Memorandum Circular No. 10, Series of 2010, governing the law at the time Ranoa was employed in 2013. It states that the seafarer shall submit himself to a post-employment medical examination by a company-designated physician within three working days upon his return. If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the employer and the seafarer. The third doctor’s decision shall be final and binding on both parties.

As mandated, upon repatriation, the seafarer concerned shall be examined and treated by the company-designated physician. If the seafarer disagrees with the final assessment of the company-designated physician, the former may procure a second opinion from a physician of his or her choice. In case of a conflicting assessment, the parties may resort to a third doctor.

In this case, there is no dispute that Ranoa was not referred to a third doctor. He insisted that Anglo-Eastern, et al. had the duty to refer him to a third doctor. He claimed that they did not, as they even ignored him. Anglo-Eastern, et al., on the other hand, maintained they were never informed that Ranoa consulted another doctor, much less, the findings of that doctor. Believing they had complied with their obligations to Ranoa, they were surprised to have received a notice of the case from the labor arbiter’s office.

The SC pointed out that Ranoa cannot demand that Anglo-Eastern, et al. initiate the referral to a third doctor. How could they make referral themselves when in the first place, Ranoa had not even informed them or shown proof of such contrary assessment? Citing Marlow Navigation Philippines, Inc. vs. Osias, the SC held that upon notification, that the seafarer disagrees with the company doctor’s assessment based on the duly and fully disclosed contrary assessment from his own doctor, the seafarer shall then signify his intention to resolve the conflict by the referral to a third doctor whose ruling shall be final and binding on the parties. Upon notification, the company carries the burden of initiating the process for the referral to a third doctor.

The SC observed that there was nothing on recording showing that Ranoa had furnished Anglo-Eastern, et al. with a copy of Dr. Pascual’s (Note: Ranoa’s independent doctor) findings and conclusions. Nor was there anything to show that he informed them of such contrary medical conclusion. Clearly, he did not fully disclose the contrary assessment to Anglo-Eastern, et al. as mandated under the POEA-SEC and jurisprudence.

If Rano truly wanted to be referred to a thid doctor, then he should have fully informed Anglo-Eastern, et al. of Dr. Pascual’s contrary findings and demanded that he be referre to a third doctor. Only after upon such full disclosure and demand to be referred to a third doctor does the employer’s duty to activate the third doctor provision arises.

Citing Generato M. Hernandez vs. Magsaysay Maritime Corporation, the SC held that the initiative for referral to a third doctor should come from the employee. He must actively or expressly request for it. The CA correctly ruled that referral to a third doctor is mandatory, but it erred in dismissing Ranoa’s claim for disability benefits.

Considering that Ranoa was asymptomatic prior to boarding and that his symptoms persisted, it is reasonable to claim a causal relationship between his illness and his work. Anglo-Eastern, et al. have not disputed the claim of Ranoa that he was constantly exposed to strenuous work. Such activities could have led to or at least aggravated his heart ailment, thus making it a compensable work-related illness.

Ranoa, however, is not entitled to permanent and total disability benefits but only to Grade 12 disability benefits as found by the company-designated doctors. This is because he inexplicably failed to comply with the POEA-SEC’s mandated procedure for referral to third doctor. As between the company-designated physicians who have all the medical records of Ranoa for the duration of his treatment and as against the latter’s chosen physician who merely examined him for a day as an outpatient, the former’s finding must prevail.