MEDICAL ABANDONMENT DOES NOT ARISE WHEN IT IS DECLARED THAT THE SEAFARER HAS REACHED MAXIMUM MEDICAL IMPROVEMENT

Medical abandonment does not arise given that the company-designated physician, in the confidential medical report dated November 3, 2015, had already declared the former to have “already reached his maximum medical improvement,” thus, indicating his treatment through curative means to have already ended and that the subsequent check-ups were for the improvement of his physical appearance by means of fitting a scleral shell prosthesis. The said medical report also recommended a Grade 7 disability rating based on the specialist’s finding that Teodoro’s visual prognosis and recovery were poor due to “permanent loss of vision in one eye despite intravenous antibiotic and steroids as well as oral medications given,” thus rendering him “unfit for further sea duties.”

Facts:

On February 17, 2015, petitioner Jolly D. Teodoro (Teodoro) was hired as Chief Cook by respondent Teekay Shipping Philippines, Inc. (TSPI), for its principal, Teekay Shipping Limited (TSL), on board the vessel M.T. Al Marrouna for a period of eight (8) months, with such being covered by a Contract of Employment[5] and a Collective Bargaining Agreement (CBA) between TSPI, on behalf of TSL, and the Philippine Seafarers’ Union (PSU) – ALU TUCP.

After undergoing the required pre-employment medical examination, Teodoro was declared fit for duty by the company-designated physician notwithstanding the former’s declaration of Dyslipidemia and diabetes mellitus. For this reason, Teodoro was made to sign an Affidavit of Undertaking relative to his health condition before boarding the vessel.

On board, Teodoro claimed that aside from preparing meals for the officers and crew, he also assisted in hauling the food provisions from the upper deck of the ship to its reefer where the food items were frozen and stored at the meat and fish rooms, respectively. Because of the sudden extreme changes in temperature from the upper deck to the freezer during the hauling and storage process, Teodoro experienced a fever-like symptom with body pain and blindness in his left eye the following day.

Teodoro was brought to a hospital in India where he was diagnosed with “Left Eye Endophthalmitis with Orbital Cellulitis;” subsequently, he was repatriated on July 10, 2015 for further medical treatment.

Upon arrival in Manila, Teodoro was referred to a company­-designated physician at the Ship to Shore Medical Assist and his condition was confirmed. He was admitted at Medical City where testing and laboratory examinations were conducted regarding his eye ailment. He was found to have “Idiopathic Orbital Inflammatory Disease, Left Eye; Retinal Detachment, Left Eye; Panuveitis, Left Eye; Dacryoadenitis, Left Eye,” and thereafter, referred to the Marine Medical Services for further evaluation and treatment.

In a Medical Report dated November 3, 2015, the company­ designated physician explicated that Teodoro’s eye condition may have been triggered by his diabetes mellitus which, in addition to lack of sleep or inadequate rest, impaired his immune system, thus, making his body susceptible to infections. Hence, it was not work-related. Moreover, Teodoro’s visual prognosis and recovery were found to be poor due to the permanent loss of vision in one eye despite medications, and as such, he was declared to be unfit for further sea duties.

Teodoro was also advised to wear polycarbonate glasses to avoid further infection and was recommended to be fitted with scleral shell prosthesis to support his left eye, which, however was temporarily deferred. For this reason, the company-designated physician declared Teodoro to have already reached his maximum medical improvement and suggested a disability rating of Grade 7 or total loss of vision in one eye. Notwithstanding, Teodoro returned for re-evaluation on November 24 and 25, 2015, wherein no noticeable changes in his condition have been observed.

Considering that there was permanent loss of vision in his left eye resulting in his unfitness to work as declared by his attending specialist, and since he was no longer advised by TSPI to return for further consultations in view of the company’s alleged policy on a 130-day limit liability only, Teodoro demanded from TSPI the payment of disability benefits pursuant to the CBA, which the latter refused. This prompted Teodoro to raise his grievance before the Philippine Seafarers’ Union, which likewise resulted in a deadlock. Consequently, Teodoro filed a complaint for disability benefits against TSPI, its President Alex N. Verchez (Verchez), and its foreign principal, TSL, with the NCMB, DOLE.

In its defense, TSPI asserted that Teodoro did not suffer from a work-related illness, claiming that his eye condition was highly attributed to his pre-existing diabetes mellitus and that it was also aggravated by his own failure to take his prescribed medications. It denied that Teodoro’s illness was brought about by the working conditions on board the vessel, contending that the ship was seaworthy at all times and conducive to work, and that Teodoro was well aware of the safety items installed in his work area.

TSPI also argued that Teodoro breached his duties under the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) when he abandoned his treatment by not showing up for his scheduled re-evaluation on December 15, 2015 and effectively preventing the company-designated physician from arriving at a proper disability grading as required by law. Lastly, it denied the other monetary claims for lack of factual and legal bases.

PVA Ruling:

The Panel of Voluntary Arbitrators (PVA) ruled in favor of Teodoro, ordering TSPI, Yerchez, and TSL to jointly and severally pay him US$89,100.00 representing total and permanent disability benefits, as well

as ten percent (10%) attorney’s fees.

In so ruling, the PVA held that Teodoro’s eye condition was not caused by or associated with his diabetes mellitus, and that he did not abandon his treatment. On the contrary, the PVA held that TSPI was negligent in failing to provide a safe place to work and appropriate equipment to their workers to avoid all kinds of dangers and illnesses.

On this score, it was pointed out that TSPI’s personnel were exposed to extreme temperatures without the proper protective clothing, thus, creating a more dangerous work environment that resulted to Teodoro’s permanent blindness in the left eye and his incapacity to resume the same line of work. Consequently, even if Teodoro suffered blindness in only one eye, the CBA deems his disability as total and permanent, entitling him to US$89,100.00.

Aggrieved, TSPI moved for reconsideration, which the PVA denied. Hence, the matter was elevated to the CA via a petition for review pursuant to Rule 43 of the Rules of Court.

CA Ruling:

The Court of appeals (CA) partly granted TSPI’s petition declaring Teodoro entitled to partial and permanent disability benefits only, or Grade 7 disability as assessed by the company­-designated physician, and deleted the award of attorney’s fees.

While the CA sustained the finding that there was no medical abandonment given that no further medical treatment can be done to save Teodoro’s left eye except the improvement of his physical appearance, and that TSPI failed to disprove the presumption of work-relatedness of Teodoro’s illness, it nonetheless held that the loss of vision in one eye is equivalent to Grade 7 disability only under the POEA-SEC. The CA also found no basis in awarding Teodoro attorney’s fees, holding that there was no bad faith or malice on the part of TSPI.

Teodoro’s motion for reconsideration was denied; hence, the present petition with the Supreme Court (SC).

Issue/s:

Whether or not the seafarer who suffered blindness in one eye can be considered as a case of total and permanent disability

Whether or not the seafarer who did not submit for a scheduled medical checkup is deemed to have committed medical abandonment when the company-designated physician issued medical report stating that he had already already reached his maximum medical improvement

Whether or not the seafarerer committed medical abandonment where the company-designated physician declare that his treatment through curative means have already ended and that the subsequent check-ups were for the improvement of his physical appearance by means of fitting a scleral shell prosthesis

Whether or not for disability to be total and permanent it should result in total paralysis or complete helplessness

SC Ruling:

The Supreme Court (SC) granted the petition.

The SC held that Under Section 20 (A) of the 2010 POEA-SEC, the employer shall be liable for disability benefits only when the seafarer suffers from a work-related injury or illness during the term of his contract. A work-related illness is defined as “any sickness as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.”

Here, while Teodoro’s diagnosed condition is not among the listed occupational diseases under Section 32-A of the 2010 POEA-SEC, Section 20 (A) (4) nonetheless states that “[t]hose illnesses not listed in Section 32 of this Contract are disputably presumed as work-related.” Thus, the burden is on the employer to disprove the work-relatedness, failing which, the disputable presumption that a particular injury or illness that results in disability is work-related stands. Unfortunately, the said presumption was not overturned by TSPI. Moreover, the Grade 7 disability rating assessment by the company-designated physician negates any claim that the non-listed illness is not work-related.

Accordingly, having suffered a work-related illness in the course of his last employment contract, the 2010 POEA-SEC imposes upon the company-designated physician the responsibility to arrive at a definite assessment of the seafarer’s fitness to work or degree of disability within a period of 120 days from repatriation. During the said period, the seafarer shall be deemed on temporary total disability and shall receive his basic wage until he is declared fit to work or his temporary disability is acknowledged by the company to be permanent, either partially or totally, as his condition is defined under the POEA-SEC and by applicable Philippine laws.

However, if the 120-day period is exceeded and no definitive declaration is made because the seafarer requires further medical attention, then the temporary total disability period may be extended up to a maximum of 240 days, subject to the right of the employer to declare within this period that a permanent partial or total disability already exists. Failure of the company-designated physician to arrive at a definite assessment of the seafarer’s fitness to work or permanent disability within the prescribed periods, and if the seafarer’s medical condition remains unresolved, the law steps in to consider the latter’s disability as total and permanent.

In the case at bar, TSPI contended that Teodoro abandoned his medical treatment when he failed to return for his scheduled follow-up check-up on December 15, 2015 that effectively prevented the company-­designated physician from arriving at a definite assessment, which is in breach of his obligation under the POEA-SEC. However, as correctly pointed out by the CA, there was no medical abandonment on the part of Teodoro given that the company-designated physician, in the confidential medical report dated November 3, 2015, had already declared the former to have “already reached his maximum medical improvement,” thus, indicating his treatment through curative means to have already ended and that the subsequent check-ups were for the improvement of his physical appearance by means of fitting a scleral shell prosthesis. The said medical report also recommended a Grade 7 disability rating based on the specialist’s finding that Teodoro’s visual prognosis and recovery were poor due to “permanent loss of vision in one eye despite intravenous antibiotic and steroids as well as oral medications given,” thus rendering him “unfit for further sea duties.”

Considering that: (1) in the November 3, 2015 medical report, which was issued within the 120-day treatment period, the company-designated physician already gave Teodoro a partial and permanent disability rating of Grade 7, i.e., loss of vision or total blindness in one eye, and declared him to have already reached his maximum medical improvement, rendering him unfit for further sea duties; and (2)

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during Teodoro’s subsequent check-ups on November 24 and 25, 2015, respectively, the company-designated physician did not find any significant improvement in his condition, it is evident that there was no need for further medical treatment and he cannot be faulted for his failure to appear on his scheduled check-up session on December 15, 2015 nor can such be construed as abandonment. Besides, his attending specialist at Medical City likewise confirmed the permanent loss of vision in Teodoro’s left eye.

Notably, while the company-designated physician assessed Teodoro only a partial and permanent disability rating of Grade 7 in accordance with the POEA-SEC, the latter was nonetheless also found to be unfit for further sea duties. In Kestrel Shipping Co., Inc. v. Munar, the Court held that the POEA-SEC merely provides the minimum acceptable terms in a seafarer’s employment contract, and that in the assessment of whether a seafarer’s injury is partial and permanent, the same must be so characterized not only under the Schedule of Disabilities found in Section 32 of the POEA-SEC, but also under the relevant provisions of the Labor Code and the Amended Rules on Employee Compensation.

Indeed, under Section 32 of the POEA-SEC, only those injuries or disabilities that are classified as Grade 1 may be considered as total and permanent. However, if those injuries or disabilities with a disability grading from 2 to 14, hence, partial and permanent, would incapacitate a seafarer from performing his usual sea duties for a period of more than 120 or 240 days, depending on the need for further medical treatment, then he is, under legal contemplation, totally and permanently disabled.

In other words, an impediment should be characterized as partial and permanent not only under the Schedule of Disabilities found in Section 32 of the POEA-SEC but should be so under the relevant provisions of the Labor Code and the Amended Rules on Employee Compensation (AREC) implementing Title II, Book IV of the Labor Code. That while the seafarer is partially injured or disabled, he is not precluded from earning doing the same work he had before his injury or disability or that he is accustomed or trained to do. Otherwise, if his illness or injury prevents him from engaging in gainful employment for more than 120 or 240 days, as the case may be, he shall be deemed totally and permanently disabled.

From the foregoing, since Teodoro was declared by no less than his attending specialist to be unfit for further sea service due to permanent loss of vision in his left eye, the Court finds his resulting disability to be not only partial and permanent as ruled by the CA, but rather total and permanent as correctly found by the PVA. It is well to point out that in disability compensation, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairment of one’s earning capacity.

Total disability refers to an employee’s inability to perform his or her usual work. It does not require total paralysis or complete helplessness. Permanent disability, on the other hand, is a worker’s inability to perform his job for more than 120 days or 240 days, if the seafarer required further medical attention justifying the extension of the temporary total disability period, regardless of whether or not he loses the use of any part of his body.