ARTHRITIS

Philimare Inc. vs Benedicto Suganob, G.R. No. 168753 July 9,

2008: Apropos the appropriate disability benefits that respondent is
entitled to, we find that Suganob is entitled to Grade 1 disability
benefits which corresponds to total and permanent disability. As
correctly pointed out by the Court of Appeals, the medical certificate
issued by petitioners company physician do not conflict with that
issued by the physician chosen by Suganob. The medical certificate
issued on October 29, 2001 by petitioners company physician which
stated that Suganob was fit to return to work was conditional because
Suganob still has to maintain his medications. On the other hand, the
medical certificate of the physician chosen by Suganob which was
issued on April 5, 2002 indicated that Suganobs illness recurred and
continued which rendered him unfit to continue his work. In both
medical certificates, it is clear that Suganob was not considered as
totally cured and fit to return to work. Hence, there is no dispute that
Suganob is entitled to disability benefits.
Disability is intimately related to ones earning capacity. It should
be understood less on its medical significance but more on the loss of
earning capacity. To be entitled to Grade 1 disability benefits, the
employees disability must not only be total but also permanent.
Permanent disability is the inability of a worker to perform his
job for more than 120 days, regardless of whether or not he loses the
use of any part of his body. Clearly, Suganobs disability is permanent
since he was unable to work from the time he was medically
repatriated on September 17, 2001 up to the time the complaint was
filed on April 25, 2002, or more than 7 months. Moreover, if in fact
Suganob is clear and fit to work on October 29, 2001, he would have
been taken back by petitioners to continue his work as a Chief Cook,
but he was not. His disability is undoubtedly permanent.
Total disability, on the other hand, does not mean absolute
helplessness. In disability compensation, it is not the injury which is
compensated, but rather the incapacity to work resulting in the
impairment of ones earning capacity. Total disability does not require
that the employee be absolutely disabled, or totally paralyzed. What is
necessary is that the injury must be such that the employee cannot

pursue his usual work and earn therefrom. Both the companydesignated physician and Suganobs physician found that Suganob is
unfit to continue his duties as a Chief Cook since his illness prevented
him from continuing his duties as such. Due to his illness, he can no
longer perform work which is part of his daily routine as Chief Cook
like lifting heavy loads of frozen meat, fish, water, etc. when preparing
meals for the crew members. Hence, Suganobs disability is also total.
Lastly, petitioners allege that the Court of Appeals erred in
affirming the labor arbiters decision awarding 120-day sickness
allowance to Suganob. They point out that Suganob has in fact
received said illness allowance during the period that he was under
treatment by petitioners physicians.
Suganob, however, counters that he is entitled to said sickness
allowance because under the Philippine Overseas Employment
Administration (POEA) Standard Employment Contract, a seafarer
who is medically sick is entitled to sickness allowance for no less than
120 days.
We rule for Suganob. Section 20, par. B, sub-par. 3 of the
POEA Standard Employment Contract states,
3. Upon sign-off from the vessel for medical
treatment, the seafarer is entitled to sickness allowance
equivalent to his basic wage until he is declared fit to work
or the degree of permanent disability has been assessed
by the company-designated physician but in no case shall
this period exceed one hundred twenty (120) days.
Here, Suganob was unable to work for a period of more than
120 days. It is therefore correct that he be awarded his 120-day
sickness wages as required by the POEA Standard Employment
Contract.
No doubt Suganob became sick in the course of his
employment with petitioners because he was declared to be healthy
prior to his departure. This is corroborated by the fact that he was
2

subjected to thorough examination before boarding M/V Mekong Star.

Had he not been found fit to work prior to his departure, he would not
have been allowed to board said ship. Without a doubt, Suganob
acquired his illness in the course of his employment with petitioners.

CARDIOVASCULAR DISEASES
CORONARY ARTERY DISEASE AND OTHER HEART AILMENTS
Magsaysay vs Bengson, G.R. No. 198528 October 13,
2014: Cardiovascular disease, coronary artery disease and other
heart ailments are work-related and, thus, compensable.
Xxx
In many cases decided in the past, this Court has held that
cardiovascular disease, coronary artery disease, and other heart
ailments are compensable. Thus, in Fil-Pride Shipping
Company, Inc. v. Balasta, severe 3-vessel coronary artery
disease which the seaman contracted while serving as Able
Seaman was considered an occupational disease. In Villanueva,
Sr. v. Baliwag Navigation, Inc., it was held that the 2000 POEASEC considers heart disease as an occupational disease. In
Jebsens Maritime, Inc. v. Undag, the Court held that
hypertensive cardiovascular disease may be a compensable
illness, upon proof. In Oriental Shipmanagement Co., Inc. v.
Bastol and Heirs of the late Aniban v. National Labor Relations
Commission, it was held that myocardial infarction as a disease
or cause of death is compensable, such being occupational.
Iloreta v. Philippine Transmarine Carriers, Inc. held that
hypertensive cardiovascular disease/coronary artery disease
and chronic stable angina are compensable. Micronesia
Resources v. Cantomayor stated that a finding of coronary
artery disease entitles the claimant a seaman Third Officer to
disability compensation. In Remigio v. National Labor Relations
Commission, the Court held that the claimant a musician on
board an ocean-going vessel was entitled to recover for
suffering from coronary artery disease. In Sepulveda v.
3

Employees Compensation Commission, it was declared that the

employees illness, myocardial infarction, was directly brought
about by his employment as schoolteacher or was a result of the
nature
of
such
employment.
In the present case, petitioners flatly claim that Bengsons
hypertensive cardio-vascular disease is not compensable on the sole
basis of its company-designated physician Agbayanis declaration
that
such
illness
is
not
work-related.
However, the Court finds that Bengsons illness is work-related.
The undisputed facts indicate that respondent has been working for
petitioners since 1988; that per his service record, 37 he has been
serving as Third Mate for twelve (12) years; and that as Third Mate,
he was saddled with heavy responsibilities relative to navigation of
the vessel, ship safety and management of emergencies. It is
beyond doubt that respondent was subjected to physical and
mental stress and strain: as Third Mate, he is the ships fourth in
command, and he is the ships safety officer; these
responsibilities have been heavy burdens on respondents
shoulders all these years, and certainly contributed to the
development of his illness. Besides, [i]t is already recognized
that any kind of work or labor produces stress and strain
normally resulting in wear and tear of the human body.
Notably, it is a matter of judicial notice that an overseas worker,
having to ward off homesickness by reason of being physically
separated from his family for the entire duration of his contract,
bears a great degree of emotional strain while making an effort
to perform his work well. The strain is even greater in the case of
a seaman who is constantly subjected to the perils of the sea
while at work abroad and away from his family.

CENTRAL RETINAL VEIN OCCLUSION

Fil-Star Maritime Corporation vs Hanziel Rosete, G.R. No. 192686

November 23, 2011: In this case, respondent was diagnosed with
Central Retinal Vein Occlusion of his left eye. Central retinal vein
occlusion is medically defined as the blockage of the central retinal
vein by a thrombus. It causes painless vision loss which is usually
sudden, but it can also occur gradually over a period of days to
weeks.
This condition, despite numerous medical procedures
undertaken, eventually led to a total loss of sight of respondents left
eye. Loss of one bodily function falls within the definition of disability
which is essentially "loss or impairment of a physical or mental
function resulting from injury or sickness.
Although Central Retinal Vein Occlusion is not listed as one of
the occupational diseases under Section 32-A of the 2000 Amended
Terms of POEA-SEC, the resulting disability which is loss of sight of
one eye, is specifically mentioned in Section 32 thereof (Schedule of
Disability or Impediment for Injuries Suffered and Diseases Including
Occupational Diseases or Illness Contracted). More importantly,
Section 20 (B), paragraph (4) states that those illnesses not listed in
Section 32 of this Contract are disputably presumed as work-related.
The disputable presumption that a particular injury or illness
that results in disability, or in some cases death, is work-related
stands in the absence of contrary evidence. In the case at bench, the
said presumption was not overturned by the petitioners. Although, the
employer is not the insurer of the health of his employees, he takes
them as he finds them and assumes the risk of liability. Consequently,
the Court concurs with the finding of the courts below that
respondents disability is compensable.
Now, the Court shall determine whether respondent is entitled
to be awarded permanent total or permanent partial disability
benefits.
It should be noted that the company-designated physician
assessed the loss of respondents left eye as a permanent partial
disability while respondents own physician indicated his disability as
Grade 7.
5

The Court is more inclined to rule, however, that respondent is

suffering from a permanent total disability as he was unable to return to his
job that he was trained to do for more than one hundred twenty days
already.

COLON CANCER
Leonis Naviagation Co. vs Catalino Villamater, G.R. No. 179169
March 3, 2010: It is true that under Section 32-A of the POEA
Standard Contract, only two types of cancers are listed as
occupational diseases (1) Cancer of the epithelial lining of the bladder
(papilloma of the bladder); and (2) cancer, epithellematous or
ulceration of the skin or of the corneal surface of the eye due to tar,
pitch, bitumen, mineral oil or paraffin, or compound products or
residues of these substances. Section 20 of the same Contract also
states that those illnesses not listed under Section 32 are disputably
presumed as work-related. Section 20 should, however, be read
together with Section 32-A on the conditions to be satisfied for an
illness to be compensable, to wit:
For an occupational disease and the resulting
disability or death to be compensable, all the following
conditions must be established:
1.

The seafarers work must involve the risk described

herein;

2.

The disease was contracted as a result of the

seafarers exposure to the described risks;

3.

The disease was contracted within a period of

exposure and under such other factors necessary to
contract it;
6

4.

There was no notorious negligence on the part of

the seafarer.

Colon cancer, also known as colorectal cancer or large bowel

cancer, includes cancerous growths in the colon, rectum and
appendix. With 655,000 deaths worldwide per year, it is the fifth most
common form of cancer in the United States of America and the third
leading cause of cancer-related deaths in the Western World.
Colorectal cancers arise from adenomatous polyps in the colon.
These mushroom-shaped growths are usually benign, but some
develop into cancer over time. Localized colon cancer is usually
diagnosed through colonoscopy.
Tumors of the colon and rectum are growths arising from the
inner wall of the large intestine. Benign tumors of the large intestine
are called polyps. Malignant tumors of the large intestine are called
cancers. Benign polyps can be easily removed during colonoscopy
and are not life-threatening. If benign polyps are not removed from
the large intestine, they can become malignant (cancerous) over
time. Most of the cancers of the large intestine are believed to have
developed as polyps. Colorectal cancer can invade and damage
adjacent tissues and organs. Cancer cells can also break away and
spread to other parts of the body (such as liver and lung) where new
tumors form. The spread of colon cancer to distant organs is called
metastasis of the colon cancer. Once metastasis has occurred in
colorectal cancer, a complete cure of the cancer is unlikely.
Globally, colorectal cancer is the third leading cause of cancer
in males and the fourth leading cause of cancer in females. The
frequency of colorectal cancer varies around the world. It is common
in the Western world and is rare in Asia and in Africa. In countries
where the people have adopted western diets, the incidence of
colorectal cancer is increasing.
Factors that increase a persons risk of colorectal cancer include
high fat intake, a family history of colorectal cancer and polyps, the

presence of polyps in the large intestine, and chronic ulcerative

colitis.
Diets high in fat are believed to predispose humans to
colorectal cancer. In countries with high colorectal cancer rates, the
fat intake by the population is much higher than in countries with low
cancer rates. It is believed that the breakdown products of fat
metabolism lead to the formation of cancer-causing chemicals
(carcinogens). Diets high in vegetables and high-fiber foods may rid
the bowel of these carcinogens and help reduce the risk of cancer.
A persons genetic background is an important factor in colon
cancer risk. Among first-degree relatives of colon-cancer patients, the
lifetime risk of developing colon cancer is 18%. Even though family
history of colon cancer is an important risk factor, majority (80%) of
colon cancers occur sporadically in patients with no family history of
it. Approximately 20% of cancers are associated with a family history
of colon cancer. And 5% of colon cancers are due to hereditary colon
cancer syndromes. Hereditary colon cancer syndromes are disorders
where affected family members have inherited cancer-causing
genetic defects from one or both of the parents.
In the case of Villamater, it is manifest that the interplay of age,
hereditary, and dietary factors contributed to the development of
colon cancer. By the time he signed his employment contract on June
4, 2002, he was already 58 years old, having been born on October
5, 1943, an age at which the incidence of colon cancer is more likely.
He had a familial history of colon cancer, with a brother who
succumbed to death and an uncle who underwent surgery for the
same illness. Both the Labor Arbiter and the NLRC found his 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 except those provided on the vessels and these consisted
mainly of high-fat, high-cholesterol, and low-fiber foods.

CONGESTIVE HEART FAILURE/CARDIOMYOPATHY

Philippine Transmarine Carriers, Inc. vs National Labor
Relations Commission, Philippine Overseas Employment
Agency and Carlos Nietes, G.R. No. 123891 February 28, 2001:
Strict rules of evidence are not applicable in claims for compensation.
In NFD International Manning Agents, Inc. vs. NLRC, 269 SCRA 486,
494 (1997), we said:
Strict rules of evidence, it must be remembered, are not
applicable in claims for compensation and disability
benefits. Private respondent having substantially
established the causative circumstances leading to his
permanent total disability to have transpired during his
employment, we find the NLRC to have acted in the
exercise of its sound discretion in awarding permanent
total disability benefits to private respondent. Probability
and not the ultimate degree of certainty is the test of proof
in compensation proceedings.
Consistently the Court has ruled that disability should not be
understood more on its medical significance but on the loss of
earning capacity. Permanent total disability means disablement of an
employee to earn wages in the same kind of work, or work of similar
nature that [he] was trained for or accustomed to perform, or any kind
of work which a person of [his] mentality and attainment could do. It
does not mean absolute helplessness. In disability compensation, we
likewise held, it is not the injury which is compensated, but rather it is
the incapacity to work resulting in the impairment of ones earning
capacity.
CORONARY DISEASE
Micronesia Resources, etal vs Fabiolo Cantomayor, G.R. No.
156573 June 19, 2007: Not so. We have held that while it is the
company-designated physician who must declare that a seafarer9

claimant suffers a permanent disability, the former's declaration is not

conclusive upon the latter or the court. In the present case, there is
no indication that Cantomayor sought a second opinion. Nonetheless,
it is of record that the latter was rendered unfit to discharge his duties
as Third Officer for more than 120 days. It is of record that
Cantomayor was repatriated on March 23, 1999. Almost seven
months later or on October 8, 1999, Micronesia, et al.'s designated
physician issued the following medical findings on the condition of
Cantomayor:
x x x Post-operatively, he developed post-operative wound
infection on care. Post-operative Treadmill Exercise Test was
done last September 96, 1999 and the findings revealed signs
of ischemia at the inferolateral wall.
At present, the patient complains of on and off chest pain
and easy fatigability on long distance ambulation. He has
no shortness of breath and his blood pressure is controlled at
130/90.
Based on the clinical course and findings, I am recommending
a partial permanent disability. (Emphasis added)
Based on the foregoing medical record alone, it is clear that
Cantomayor had not been able to resume work as a Third Officer for
more than 120 days and that he continues to suffer chest pains and
fatigability on long distance ambulation. The partial disability
assessment of the company physician is therefore inconsistent with
said record. To quote from Remigio v. National Labor Relations
Commission once again:
A total disability does not require that the employee be
absolutely disabled, or totally paralyzed. What is necessary is
that the injury must be such that the employee cannot pursue
her usual work and earn therefrom. On the other hand, a total
disability is considered permanent if it lasts continuously for
more than 120 days. Thus, in the very recent case of Crystal
Shipping, Inc. v. Natividad, we held:

10

Permanent disability is inability of a worker to perform his

job for more than 120 days, regardless of whether or not
he loses the use of any part of his body x x x
Total disability, on the other hand, means the disablement
of an employee to earn wages in the same kind of work of
similar nature that he was trained for, or accustomed to
perform, or any kind of work which a person of his
mentality and attainments could do. It does not mean
absolute helplessness. 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.
Applying the foregoing standards, we find that petitioner
suffered from permanent total disability.
It is undisputed that petitioner started to suffer chest pains on
March 16, 1998 and was repatriated on April 23, 1998 after
having been found as "not fit for duty." The medical report dated
June 25, 1998 of the company-designated physician, Dr.
Abesamis, establishes the following facts, viz: a) petitioner
underwent a coronary bypass on April 2, 1998; b) petitioner was
"unfit" from April 27, 1998 (date of referral) to June 25, 1998
(date of medical report); c) petitioner may not return to sea duty
within 8-10 months after June 25, 1998; and d) petitioner may
return to sea duty as a piano or guitar player after 8-10 months
from June 25, 1998.
These facts clearly prove that petitioner was unfit to work
as drummer for at least 11-13 months -- from the onset of
his ailment on March 16, 1998 to 8-10 months after June
25, 1998. This, by itself, already constitutes permanent
total disability. What is more, private respondents were well
aware that petitioner was working for them as a drummer, as
proven by the communication of respondent principal to
respondent agency referring to petitioner as "drummer with our
enchanted isle quartet." Thus, the certification that petitioner
may go back specifically as a piano or guitar player means that

11

the likelihood of petitioner returning to his usual work as a

drummer was practically nil. From this, it is pristine clear that
petitioner's disability is total and permanent.
Private respondents' contention that it was not shown that it
was impossible for petitioner to play the drums during the 8-10
months that he was on land is specious. To our minds,
petitioner's unfitness to work attached to the nature of his job
rather than to its place of performance. Indeed, playing drums
per se requires physical exertion, speed and endurance. It
demands the performance of hitting strokes and repetitive
movements that petitioner, having undergone a triple coronary
bypass, has become incapacitated to do.
The possibility that petitioner could work as a drummer at sea
again does not negate the claim for permanent total disability
benefits. In the same case of Crystal Shipping, Inc., we held:
Petitioners tried to contest the above findings [of
permanent total disability] by showing that respondent
was able to work again as a chief mate in March 2001.
Nonetheless, this information does not alter the fact that
as a result of his illness, respondent was unable to work
as a chief mate for almost three years. The law does not
require that the illness should be incurable. What is
important is that he was unable to perform his
customary work for more than 120 days which
constitutes permanent total disability. (Emphasis
added; citations omitted)
Given that Cantomayor had not been able to resume the same work
or activity for more than 120 days, the CA cannot be faulted in
discarding the Grade 7 disability assessment of the company
physician and in declaring that Cantomayor suffers from Grade 1
disability.

12

DISC DESSICATION

Wallem Maritime Services, Inc. vs National Labor Relations

Commission and Tiburcio D. Dela Cruz, G.R. No. 163838
September 25, 2008: The more accurate view of Section 20-B(3) of the
POEA-SEC is that espoused by respondent. In his Comment and
Memorandum, respondent cited Remigio v. National Labor Relations
Commissionin which the Court referred to the definition of permanent
disability under the Labor Code to interpret Section 20-B(3), thus:

The standard employment contract for seafarers was

formulated by the POEA pursuant to its mandate under E.O.
No. 247 to "secure the best terms and conditions of
employment of Filipino contract workers and ensure
compliance therewith" and to "promote and protect the wellbeing of Filipino workers overseas." Section 29 of the 1996
POEA SEC itself provides that "[a]ll rights and obligations of
the parties to [the] Contract, including the annexes thereof,
shall be governed by the laws of the Republic of the
Philippines, international conventions, treaties and covenants
where the Philippines is a signatory." Even without this
provision, a contract of labor is so impressed with public
interest that the New Civil Code expressly subjects it to "the
special laws on labor unions, collective bargaining, strikes and
lockouts, closed shop, wages, working conditions, hours of
labor and similar subjects."
Thus, the Court has applied the Labor Code concept of
permanent total disability to the case of seafarers x x x.
There are three kinds of disability benefits under the
Labor Code, as amended by P.D. No. 626: (1) temporary total
disability, (2) permanent total disability, and (3) permanent
partial disability. Section 2, Rule VII of the Implementing Rules

13

of Book V of the Labor Code differentiates the disabilities as

follows:
Sec. 2. Disability.-- (a) A total disability is
temporary if as a result of the injury or
sickness the employee is unable to perform
any gainful occupation for a continuous
period not exceeding 120 days, except as
otherwise provided for in Rule X of these
Rules.
(b) A disability is total and permanent if
as a result of the injury or sickness the
employee is unable to perform any gainful
occupation for a continuous period exceeding
120 days, except as otherwise provided for in
Rule X of these Rules.
(c) A disability is partial and permanent if as
a result of the injury or sickness the employee
suffers a permanent partial loss of the use of any
part of his body. (Emphasis supplied)
Applying the foregoing definition of permanent disability, the Court therein
held that, notwithstanding the certification issued by the companydesignated physician that in 8-10 months the seafarer therein may already
work as a pianist, the fact remains that for the past 11 to 13 months, the
latter had not been able to perform his customary work as a drummer, and
this, by itself, already constitutes permanent total disability.

The foregoing concept of permanent disability has been consistently

employed by the Court in subsequent cases involving seafarers, such as in
Crystal Shipping, Inc. v. Natividad, in which it was reiterated that permanent
disability means the inability of a worker to perform his job for more than
120 days. Also in Philmare, Inc. v. Suganob, notwithstanding the opinion of
the company-designated physician that the seafarer therein was fit to work
provided he regularly took his medication, the Court held that the latter
14

suffered from permanent disability in view of evidence that he had been

unable to work as chief cook for more than 7 months. Similarly, in
Micronesia Resources v. Cantomayorand United Philippine Lines, Inc.
and/or Holland America Line, Inc. v. Beseril, the Court declared the
seafarers therein to have suffered from a permanent disability after taking
evidence into account that they had remained under treatment for more
than 120 days, and were unable to work for the same period.
Thus, it is not accurate to state -- as the CA and the NLRC did that
respondent is presumed permanently disabled just because, after 120 days
from his repatriation due to injury, he was not declared fit to resume sea
duty by Dr. Lim. Nor would it be correct for petitioners to claim that
respondent does not suffer from permanent disability just because at the
end of an 8-month period of evaluation and treatment, Dr. Lim had declared
him fit to work. Rather, the true test of whether respondent suffered from a
permanent disability is whether there is evidence that he was unable to
perform his customary work as messman for more than 120 days.
Under Section 20-B(3) of the POEA-SEC, it is a requirement sine
qua non to the filing of a claim for disability benefit that the claimant seafarer
be examined by a company-designated physician within three days from
his repatriation. But whatever medical report said company-designated
physician may issue will not be conclusive on the claimant, for the latter
may dispute said report by promptly consulting a physician of his own
choice. However, neither the medical report issued by the companydesignated physician nor the medical report issued by claimant's physician
of choice is binding on the labor tribunals and the courts, for both reports
will have to be evaluated based on their inherent merit.
In a number of cases, the Court disregarded the medical report issued by
the company-designated physician that the seafarer was fit to work in view
of evidence of record that the latter had in fact been unable to engage in his
regular work for more than 120 days
Indeed, the records of the present case are replete with evidence that
respondent was unable to resume work as messman for more than 120
days from his repatriation. The evidence consist of medical records that
from March 23 to 27, 2000, respondent underwent EMG-NCV of the
15

lumbar area and renal ultrasound but the results in both were negative.] On
April 10, 2000, respondent underwent EMG-NCV and Magnetic
Resonance Imaging of the lumbosacral spine, and the result showed that
he suffered from a mild disc dessication bulging L3-L4, L4-L5, for which he
was advised to continue physical therapy for another month. On May 26,
2000, respondent was admitted for laminectomy and discectomy, after
which he remained confined in the hospital where he was placed in a
chairback brace for immobilization and provided occupational and physical
therapy. It was only on June 7, 2000 that he was discharged. Over several
weeks, respondent regularly returned for check up with Dr. Lim who
advised him to continue rehabilitation. Upon check up on July 14, 2000,
respondent complained of lumbosacral pain, for which he was advised to
continue physical therapy. On that occasion, Dr. Lim expressly stated in his
medical report that [b]ased on his present medical condition, patient will not
be fit to resume sea duties in approximately 2-3 months time. On July 28,
2000, respondent complained of the same pain and was advised to
undergo re-evaluation and repeat EMG-NCV studies. Thus, on August 18,
2000, Dr. Lim again issued his finding that [based] on his present medical
condition, patient will not be fit to resume sea duties for the next two months
barring unforeseen events.

DISC
DESSICATION/DISC
COMPRESSION

HERNIATION/NERVE

ROOT

Al O. Eyanan vs Philippine Transmarine Carriers, G.R. No.

193468 January 28, 2015:
In this case, the following are
undisputed: (a) when Munar filed a complaint for total and permanent
disability benefits on April 17, 2007, 181 days had lapsed from the
time he signed-off from M/V Southern Unity on October 18, 2006; (b)
Dr. Chua issued a disability grading on May 3, 2007 or after the lapse
of 197 days; and (c) Munar secured the opinion of Dr. Chiu on May
21, 2007; (d) no third doctor was consulted by the parties; and (e)
Munar did not question the competence and skill of the companydesignated physicians and their familiarity with his medical condition.
It may be argued that these provide sufficient grounds for the
16

dismissal of Munars complaint. Considering that the 240-day period

had not yet lapsed when the NLRC was asked to intervene, Munars
complaint is premature and no cause of action for total and
permanent disability benefits had set in. While beyond the 120-day
period, Dr. Chuas medical report dated May 3, 2007 was issued
within the 240-day period. Moreover, Munar did not contest Dr.
Chuas findings using the procedure outlined under Section 20-B(3)
of the POEA-SEC. For being Munars attending physicians from the
time he was repatriated and given their specialization in spine
injuries, the findings of Dr. Periquet and Dr. Lim constitute sufficient
bases for Dr. Chuas disability grading. As Munar did not allege, much
less, prove the contrary, there exists no reason why Dr. Chius
assessment should be preferred over that of Dr. Chua.
It must be noted, however, that when Munar filed his complaint, Dr.
Chua had not yet determined the nature and extent of Munars
disability. Also, Munar was still undergoing physical therapy and his
spine injury had yet been fully addressed. Furthermore, when Munar
filed a claim for total and permanent disability benefits, more than 120
days had gone by and the prevailing rule then was that enunciated by
this Court in Crystal Shipping, Inc. v. Natividad that total and
permanent disability refers to the seafarers incapacity to perform his
customary
sea
duties
for
more
than
120
days.
Particularly:ChanRoblesVirtualawlibrary
Permanent disability is the inability of a worker to perform his
job for more than 120 days, regardless of whether or not he
loses the use of any part of his body. As gleaned from the records,
respondent was unable to work from August 18, 1998 to February 22,
1999, at the least, or more than 120 days, due to his medical
treatment. This clearly shows that his disability was permanent.
Total disability, on the other hand, means the disablement of an
employee to earn wages in the same kind of work of similar nature
that he was trained for, or accustomed to perform, or any kind of work
which a person of his mentality and attainments could do. It does not
mean absolute helplessness. In disability compensation, it is not the
injury which is compensated, but rather it is the incapacity to work
resulting in the impairment of ones earning capacity.
17

Petitioners tried to contest the above findings by showing that

respondent was able to work again as a chief mate in March 2001.
Nonetheless, this information does not alter the fact that as a result of
his illness, respondent was unable to work as a chief mate for almost
three years. It is of no consequence that respondent was cured
after a couple of years. The law does not require that the illness
should be incurable. What is important is that he was unable to
perform his customary work for more than 120 days which
constitutes permanent total disability. An award of a total and
permanent disability benefit would be germane to the purpose of the
benefit, which is to help the employee in making ends meet at the
time when he is unable to work.
Consequently, that after the expiration of the 120-day period, Dr.
Chua had not yet made any declaration as to Munars fitness to work
and Munar had not yet fully recovered and was still incapacitated to
work sufficed to entitle the latter to total and permanent disability
benefits.
In addition, that it was by operation of law that brought forth the
conclusive presumption that Munar is totally and permanently
disabled, there is no legal compulsion for him to observe the
procedure prescribed under Section 20-B(3) of the POEA-SEC. A
seafarers compliance with such procedure presupposes that the
company-designated physician came up with an assessment as to
his fitness or unfitness to work before the expiration of the 120-day or
240-day periods. Alternatively put, absent a certification from the
company-designated physician, the seafarer had nothing to contest
and the law steps in to conclusively characterize his disability as total
and
permanent.
This Courts pronouncements in Vergara presented a restraint against
the indiscriminate reliance on Crystal Shipping such that a seafarer is
immediately catapulted into filing a complaint for total and permanent
disability benefits after the expiration of 120 days from the time he
signed off from the vessel to which he was assigned. Particularly, a
18

seafarers inability to work and the failure of the company-designated

physician to determine fitness or unfitness to work despite the lapse
of 120 days will not automatically bring about a shift in the seafarers
state from total and temporary to total and permanent, considering
that the condition of total and temporary disability may be extended
up
to
a
maximum
of
240
days.
Nonetheless, Vergara was promulgated on October 6, 2008, or more
than two (2) years from the time Munar filed his complaint and
observance of the principle of prospectivity dictates that Vergara
should not operate to strip Munar of his cause of action for total and
permanent disability that had already accrued as a result of his
continued inability to perform his customary work and the failure of
the company-designated physician to issue a final assessment.38
(Citations omitted, emphases in the original and underscoring ours)
Similar to the circumstances obtained in Kestrel, the petitioner failed
to assail the competence of the company-designated physicians, and
seek the opinion of a third doctor mutually agreed upon by the
parties. In Kestrel and the instant petition too, the disability
assessment was made by the company-designated doctors after the
lapse of 120 days from the seafarers repatriation. Likewise, in both
cases, the complaints were filed by the seafarers before October 6,
2008, the date of the promulgation of Vergara v. Hammonia Maritime
Services,
Inc.,
et
al.39chanRoblesvirtualLawlibrary
Applying the doctrines enunciated in Kestrel, the Court finds that the
petitioner is entitled to total and permanent disability benefits under
the provisions of the POEA SEC. It bears stressing that the Court
need not even delve into the merits of the assessments made by Dr.
Alegre, on one hand, and Dr. Garduce, on the other. This proceeds
from an unalterable fact that Dr. Alegre had made the disability
assessment on January 20, 2007, or over five months from the
petitioners repatriation on August 17, 2006. Consequently, the rule
on the 120-day period, during which the disability assessment should
have been made in accordance with Crystal Shipping, Inc. v.
Natividad,40 the doctrine then prevailing before the promulgation of
Vergara on October 6, 2008, stands. Hence, due to the failure of Dr.
Alegre to issue a disability rating within the prescribed period, a
19

conclusive presumption that the petitioner is totally and permanently

disabled arose. As a result thereof, the petitioner is not legally
compelled to observe the procedure laid down in Section 20-B(3) of
the POEA SEC relative to the resort to a third doctor.

FOOT INJURY/TRAUMATIC ARTHRITIS

Seagull Maritime Corporation vs Jaycee Dee, G.R. No. 165156
April 2, 2007: Thus, the POEA Standard Employment Contract
recognizes the prerogative of the seafarer to request a second
opinion and, for this purpose, to consult a physician of his choice. In
case of disagreement between the assessments of the companydesignated physician and the seafarers doctor of choice, they may
agree to refer the seafarer to a third doctor. In such a case, the third
doctors assessment shall be final and binding on both the employer
and the seafarer.
It was therefore not erroneous at all for the NLRC and Court of
Appeals to base their decisions on the assessment of private
respondents chosen physicians, Dr. Meriales and Dr. Bundoc,
specially since their conclusion was arrived at only after a
consideration of the medical findings of Dr. Manalang, the companydesignated physician. We quote the medical certificate issued by Dr.
Manalang:
This is in reference to Seaman/AB Jaycee Dee who was repatriated
due to fractured left foot.
Patient was seen and re-evaluated by our Orthopedic Surgeon. He
was diagnosed to have Traumatic Arthritis Subtalar joint
(Talonavicular Talocalcaneal and Calcaneocuboid joint) left foot as a
result of previous traumatic injury (Talar and Calcaneal Fracture with
Alonavicular Dislocation).
Presently, patient has severe pain over the subtalar joint with
difficulty in weight bearing on the left foot while ambulating. The

20

proposed Triple Arthrodesis, which might eliminate, relieve and

stabilized left foot for functional weight bearing and ambulation
was rejected by the seaman.
Although there is no guarantee that he will be able to return to his
previous strenuous work, he might be able to walk for activity of
daily living with a less painful or more comfortable left foot.
Based [on] these findings, we are giving Disability Grade 11 for Mr.
Dee ($50,0000.00 x 14.93%) = $7465.00). (emphasis ours)
Significantly, Dr. Manalangs medical findings did not differ from those
of the other doctors consulted by private respondent. Essentially, he
shared their opinion that the "triple arthrodesis" operation could not
guarantee the restoration of private respondents former physical
condition. His pronouncement that
all that the operation might do is to enable private respondent to walk
for daily activities with a less painful or more comfortable left foot
insinuated that private respondents disability was permanent. His
medical opinion could be safely interpreted to mean that, as a result
of the injury, private respondent would no longer be able to perform
strenuous activities such as the rigorous duties of a seaman.
It is not surprising why Dr. Manalangs conclusion as to how much
private respondent should receive as disability benefit was at odds
with his own findings. The doctor, as the company-designated
physician, must have downplayed the compensation due to private
respondent; the company, after all, expected that of him. In this light,
it is thus not difficult to understand why the seafarer is given the
option by the POEA Standard Employment Contract to seek a second
opinion from his preferred physician.
Courts are called upon to be vigilant in their time-honored duty to
protect labor, especially in cases of disability or ailment. When
applied to Filipino seamen, the perilous nature of their work is
considered in determining the proper benefits to be awarded. These
benefits, at the very least, should approximate the risks they brave on
board the vessel every single day.
21

Accordingly, if serious doubt exists on the company-designated

physicians declaration of the nature of a seamans injury and its
corresponding impediment grade, resort to prognosis of other
competent medical professionals should be made. In doing so, a
seaman should be given the opportunity to assert his claim after
proving the nature of his injury. These evidences will in turn be used
to determine the benefits rightfully accruing to him.
Besides, we have consistently ruled that disability is intimately related
to ones earning capacity. The test to determine its gravity is the
impairment or loss of ones capacity to earn and not its mere medical
significance. Permanent total disability means disablement of an
employee to earn wages in the same kind of work or work of a similar
nature that he was trained for or accustomed to perform, or any kind
of work which a person of his mentality and attainment can do. It
does not mean state of absolute helplessness but inability to do
substantially all material acts necessary to the prosecution of a
gainful occupation without serious discomfort or pain and without
material injury or danger to life. In disability compensation, it is not the
injury per se which is compensated but the incapacity to work.
Although private respondents injury was undeniably confined to his
left foot only, we cannot close our eyes, as petitioners would like us
to, to the inescapable impact of private respondents injury on his
capacity to work as a seaman. In their desire to escape liability from
private respondents rightful claim, petitioners denigrated the fact that
even if private respondent insists on continuing to work as a seaman,
no profit-minded employer will hire him. His injury erased all these
possibilities.
It should not be assumed as well that the POEA standard
employment contract contains all the possible injuries that render a
seafarer unfit for further sea duties. This very case is in fact one of
those not specified in its schedule of disabilities. Petitioners are, at
this point, reminded that the POEA standard employment contract for
seamen was designed primarily for the protection and benefit of
Filipino seamen in the pursuit of their employment on board oceangoing vessels. Its provisions must be construed and applied fairly,

22

reasonably and liberally in their favor. Only then can its beneficent
provisions be fully carried into effect .
HYPERTENSION/CARDIOVASCULAR DISEASE/HYPERLIPIDIMIA

Rizaldy Quitoriano vs Jebsens Maritime Inc., G.R. No.

179868 January 21, 2010: In accordance with the avowed policy of
the State to give maximum aid and full protection to labor, the Court
has applied the Labor Code concept of permanent total disability to
Filipino seafarers, it holding that the notion of disability is intimately
related to the workers capacity to earn, what is compensated being
not his injury or illness but his inability to work resulting in the
impairment of his earning capacity; hence, disability should be
understood less on its medical significance but more on the loss of
earning capacity.
The standard employment contract for seafarers
was formulated by the POEA pursuant to its mandate
under E.O. No. 247 to secure the best terms and
conditions of employment of Filipino contract workers and
ensure compliance therewith and to promote and protect
the well-being of Filipino workers overseas.
Even
without this provision, a contract of labor is so impressed
with public interest that the New Civil Code expressly
subjects it to the special laws on labor unions, collective
bargaining, strikes and lockouts, closed shop, wages,
working conditions, hours of labor and similar subjects
(Art. 1700).
Thus, the Court has applied the Labor Code
concept of permanent total disability to the case of
seafarers. x x x.
xxxx

23

There are three kinds of disability benefits under the

Labor Code, as amended by P.D. No. 626: (1) temporary
total disability, (2) permanent total disability, and (3)
permanent partial disability. Section 2, Rule VII of the
Implementing Rules of Book V of the Labor Code
differentiates the disabilities as follows:
Sec. 2. Disability. (a) A total disability is
temporary if as a result of the injury or
sickness the employee is unable to perform
any gainful occupation for a continuous period
not exceeding 120 days, except as otherwise
provided for in Rule X of these Rules.
(b) A disability is total and permanent if
as a result of the injury or sickness the
employee is unable to perform any gainful
occupation for a continuous period exceeding
120 days, except as otherwise provided for in
Rule X of these Rules.
(c) A disability is partial and permanent
if as a result of the injury or sickness the
employee suffers a permanent partial loss of
the use of any part of his body.
In Vicente v. ECC (G.R. No. 85024, January 23,
1991, 193 SCRA 190, 195):
x x x the test of whether or not an
employee suffers from permanent total
disability is a showing of the capacity of the
employee to continue performing his work
notwithstanding the disability he incurred.
Thus, if by reason of the injury or sickness he
sustained, the employee is unable to perform
his customary job for more than 120 days
and he does not come within the coverage of
Rule X of the Amended Rules on Employees
24

Compensability (which, in more detailed

manner, describes what constitutes temporary
total disability), then the said employee
undoubtedly suffers from permanent total
disability regardless of whether or not he
loses the use of any part of his body.
A total disability does not require that the employee
be absolutely disabled or totally paralyzed. What is
necessary is that the injury must be such that the
employee cannot pursue his usual work and earn
therefrom (Austria v. Court of Appeals, G.R. No. 146636,
Aug. 12, 2002, 387 SCRA 216, 221). On the other hand,
a total disability is considered permanent if it lasts
continuously for more than 120 days. Thus, in the very
recent case of Crystal Shipping, Inc. v. Natividad (G.R.
No. 134028, December 17, 1999, 321 SCRA 268, 270271), we held:
Permanent disability is inability of a
worker to perform his job for more than 120
days, regardless of whether or not he loses
the use of any part of his body.
x x x.
Total disability, on the other hand,
means the disablement of an employee to
earn wages in the same kind of work of similar
nature that he was trained for, or accustomed
to perform, or any kind of work which a person
of his mentality and attainments could do. It
does not mean absolute helplessness. In
disability compensation, it is not the injury
which is compensated, but rather it is the
incapacity to work resulting in the impairment
of ones earning capacity. (Emphasis and
underscoring supplied)

25

Applying the standards reflected in the immediately quoted

ruling of the Court vis--vis the fact that it was only on November 16,
2001 that the fit to work certification was issued by Dr. Cruz or more
than five months from the time petitioner was medically repatriated on
May 30, 2001, petitioners disability is considered permanent and
total.
Significantly, it is gathered that petitioner remained unemployed
even after he filed on February 26, 2002 his complaint to recover
permanent total disability compensation and despite the August 31,
2005 Decision of the NLRC which was affirmed by the Court of
Appeals, ordering respondents to allow complainant to resume sea
duty.
That petitioner was not likely to fully recover from his disability
is mirrored by the Labor Arbiters finding that his illness would
possibly recur once he resumes his sea duties. Such finding could
account why petitioner was not re-deployed by respondents.

HYPERTHYROIDISM/GRAVES DISEASE
Magsaysay Maritime Services, Inc. and Princess Cruise Lines,
LTD. vs Earlwind Meinrad Antero F. Laurel, G.R. No. 195518
March 20, 2013: As borne by the records, Laurel was afflicted with
hyperthyroidism during the term of his employment contract that
caused his discharge for medical examination in Florida, U.S.A. on
April 3, 2005 and his subsequent repatriation to the Philippines.
Hyperthyroidism is the medical term to describe the signs and
symptoms associated with an overproduction of thyroid hormones. It
is a condition in which the thyroid gland makes too much thyroid
hormones affecting the tissues of the body. Although there are
several causes of hyperthyroidism, most of the symptoms patients
experience are the same regardless of the cause. Because the
body's metabolism is increased, patients often feel hotter than those
around them and can slowly lose weight even though they may be
26

eating more. The weight issue is confusing sometimes since some

patients actually gain weight because of an increase in their appetite.
Patients with hyperthyroidism usually experience fatigue at the end of
the day, but have trouble sleeping. Trembling of the hands and a hard
or irregular heartbeat (called palpitations) may develop. These
individuals may become irritable and easily upset. When
hyperthyroidism is severe, patients can suffer shortness of breath,
chest pain and muscle weakness.
The most common underlying cause of hyperthyroidism is Graves'
Disease. It is classified as an autoimmune disease, caused by the
patient's own immune system turning against the patient's own
thyroid gland. The hyperthyroidism of Graves' Disease, therefore, is
caused by antibodies that the patient's immune system makes. The
antibodies attach to specific activating sites on the thyroid gland and
those, in turn, cause the thyroid to make more hormones.
Stress is a factor that appears to trigger the onset of Graves'
Disease. Researchers have documented a definite connection
between major life stressors and the onset of Graves' disease. 29
Lifestyle factors are perhaps the biggest factor that lead to a
hyperthyroid condition. Two of the biggest lifestyle factors are chronic
stress and poor eating habits. There are other risk factors for the
disorder. Based on family and twin studies, genetic factors are
important. Postulated environmental and lifestyle risk factors include
cigarette smoking, stress and adverse life events, and high dietary
iodine intake. With regard to stress, while there is nothing that can be
done to entirely eliminate it in peoples lives, most can do a much
better job in handling it. Too much stress can create problems with
the adrenal glands, as while they are designed to handle acute stress
situations, they cannot adequately handle chronic, prolonged stress.
Problems with the adrenal glands will eventually affect other areas of
the body, including the thyroid gland. [Emphases supplied]
Laurel, in his Memorandum, aptly explained how stress can lead to a
thyroid condition, to quote:
Its important to understand that our bodies werent designed to
handle chronic stress.1wphi1 The adrenal glands were designed to

27

handle acute stress situations without much of a problem. But in

todays world most people are overwhelmed with stressful situations,
as they have stressful jobs, stressful relationships, financial issues,
and many issues that lead to chronic stress. Since the adrenal glands
werent designed to handle chronic stress situations, what happens is
that for a person who deals with a lot of stress AND does a poor job
of managing it, over a period of months and years their adrenal
glands will weaken, which can eventually lead to adrenal fatigue. But
even before these glands reach this point, this can create other
problems, including dysfunction of the thyroid gland. The way that
stressed out adrenals can cause thyroid malfunction is the following:
when the adrenal glands are stressed out, it puts the body in a state
of catabolism, which means that the body is breaking down. Because
of this, the body will slow down the thyroid gland as a protective
mechanism. The reason behind this is because the thyroid gland
controls the metabolism of the body, and so the body slows it down in
order to slow down the catabolic process. This is why many times the
thyroid gland wont respond to treatment until you address the
adrenal glands.
If the adrenal glands are not addressed, this can affect other bodily
systems. For example, someone with weak adrenal glands who has a
thyroid disorder can develop a compromised immune system. This
eventually can lead to an autoimmune thyroid disorder, such as
Graves Disease or Hashimotos Thyroiditis. [Emphasis and
underscoring in the original]
In sum, chronic stress can cause a lot of different problems, and if not
managed, it can ultimately lead to a thyroid condition. Of course, this
does not mean that all thyroid conditions are caused by stress, but
there is no question that stress is a culprit in many thyroid disorders.
Given the foregoing, although Graves Disease is attributed to genetic
influence, the Court finds a reasonable work connection between
Laurels condition at work as pastryman (cook) and the development
of his hyperthyroidism. His constant exposure to hazards such as
chemicals and the varying temperature, like the heat in the kitchen of
the vessel and the coldness outside, coupled by stressful tasks in his
employment caused, or at least aggravated, his illness. It is already
28

recognized that any kind of work or labor produces stress and strain
normally resulting in wear and tear of the human body. Thus, the
Court sustains the finding of the CA that:
Stressful conditions in the environment, in a word, can result in
hyperthyroidism, and the employment conditions of a seafarer on
board an ocean-going vessel are likely stress factors in the
development of hyperthyroidism irrespective of its origin. As
recounted by the respondent in his position paper, the work on board
the MV Star Princess was a strenuous one. It involved day-to-day
activities that brought him under pressure and strain and exposed
him to chemical and other irritants, and his being away from home
and family only aggravated these stresses.
Indeed, Laurel has shown a reasonable causation between his
working condition and his hyperthyroidism contracted during his
employment warranting the recovery of compensation. Settled is the
rule that for illness to be compensable, it is not necessary that the
nature of the employment be the sole and only reason for the illness
suffered by the seafarer. It is sufficient that there is a reasonable
linkage between the disease suffered by the employee and his work
to lead a rational mind to conclude that his work may have
contributed to the establishment or, at the very least, aggravation of
any pre-existing condition he might have had.
xxx
In the case at bench, a causal link between Laurels ailment and his
working condition was sufficiently established. Other than the specific
determination by the attending company doctor that "hyperthyroidism,
in which there is overactivity of the thyroid gland, usually secondary
to an immunologic reaction, is not work-related," no further
explanation was given to support the conclusion that the illness was
indeed not work-related. There was no declaration from the company
doctor as regards his fitness to return to work, while he was advised
by his own physician to refrain from undergoing strenuous activities.

29

Anent the issue as to who has the burden to prove entitlement to

disability benefits, the petitioners argue that the burden is placed
upon Laurel to prove his claim that his illness was work-related and
compensable. Their posture does not persuade the Court.
True, hyperthyroidism is not listed as an occupational disease under
Section 32-A of the 2000 POEA-SEC. Nonetheless, Section 20 (B),
paragraph (4) of the said POEA-SEC states that "those illnesses not
listed in Section 32 of this Contract are disputably presumed as workrelated." The said provision explicitly establishes a presumption of
compensability although disputable by substantial evidence. The
presumption operates in favor of Laurel as the burden rests upon the
employer to overcome the statutory presumption. Hence, unless
contrary evidence is presented by the seafarers employer/s, this
disputable presumption stands. In the case at bench, other than the
alleged declaration of the attending physician that Laurels illness was
not work-related, the petitioners failed to discharge their burden. In
fact, they even conceded that hyperthyroidism may be caused by
environmental factor.
As correctly concluded by the CA:
In the present case, it is reasonable to conclude with the NLRC that
the respondents employment has contributed to some degree to the
development of the disease. It is probable that the respondents
thyroid condition was the result of an aggravation due to exposure to
chemicals and stress that accompanied his work on an ocean-going
vessel. In this light, the POEA Standard Contract has created a
disputable presumption in favor of compensability saying that those
illnesses not listed in Section 32 are disputably presumed as workrelated. This means that even if the illness is not listed under the
POEA standard contract as an occupational diseases or illness, it will
still be presumed as work-related, and it becomes incumbent on the
employer to overcome the presumption. The petitioner has not
hurdled the bar, as the medical evidence that it submits even
concedes that hyperthyroidism may be caused by both environmental
and congenital factors. A mere aggravation of the illness by working
conditions will suffice to warrant entitlement to the benefits. The
presumption of compensability stands.
30

Although the employer is not the insurer of the health of his

employees, he takes them as he finds them and assumes the risk of
liability. The quantum of evidence required in labor cases to
determine the liability of an employer for the illness suffered by an
employee under the POEA-SEC is not proof beyond reasonable
doubt but mere substantial evidence or "such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion."
In this case, the Court finds that the decisions of both the NLRC and
the CA that Laurels illness was compensable were supported by
substantial evidence.
The compensability of Laurels hyperthyroidism having been
established, the opinion of the petitioners company-designated
doctor that the illness was not work-related no longer holds any
particular significance.
NASOPHARYNGEAL CARCINOMA
Jebsens Maritime Inc. vs Eleno A. Babol, G.R. No. 204076
December 4, 2013: Respondents cancer is by far, the most
common malignant tumor of the nasopharynx. Risk factors for this
cancer, as derived from the position paper field by the petitioners and
consistent with many medical literatyures on the matter, include (1)
salt-cured foods; (2) preserved meats, (3) Epstein-Barr virus, and (4)
family history. In every detail, it is clear that the dietary factor plays a
vital role in increasing the risk of acquiring the disease. For medical
purposes salt-cured fish and preserved meat can, thus, be
considered as high risk food that can contribute in the growth of this
type of cancer.
Respondent is of the theory that such high risk dietary factor
persisted on board the vessel, thus, increasing the probability that the
disease was aggravated by his working conditions:
On the food he took while on board, Complainant is exposed to the
risk of contracting his illness. The Supreme Court has taken judicial
notice of the fact that seamen are required to stay on board their
vessel by the very nature of their duties. It is also of common

31

knowledge that while on board, seamen have no choice but to eat the
food prepared by the kitchen staff of the vessel. They are also not at
liberty to prepared/cook their own food to suit their health needs.
Their day-to-day "diet" therefore depends on the kind of food served
on the vessel for the consumption of the entire crew. Thus, the long
voyage on the high seas, the vessels menu is limited to slat-cured
foods (such as salted fish, dried fish, anchovies, dreied meat, salted
eggs, etc.) frozen meat, processed meat, canned goods, and other
preserved risk of contracting nasopharyngeal cancer.
Complainant had no other alternative or option but to eat whatever is
served at the mess hall, and considering further that his "diet" or
sustenance while on board the vessel had presumably contributed to,
if not caused by, his present health condition, there is good reason to
conclude that his ailment or affliction is work related or, otherwise
stated, reasonably connected/aggravated by his work.
The above assertions of respondent do not constitute as substantial
evidence that a reasonable mind might accept as adequate to
support the conclusion that there is a causal relationship between his
illness and the working conditions on board the petitioners vessel.
Although the Court has recognized as sufficient that work conditions
are proven to have contributed even to a small degree, such must,
however, be reasonable, and anchored on credible information. The
claimant must thereore, prove a convincing proposition other that by
his mere allegations. This he failed to do.
The Court refuses to take judicial notice of said assertions on the
basis of an allegation of mere common knowledge. This is in light of
the changing global landscape affecting international maritime labor
practices. The Court notes the acceptance albeit steadily, of the
minimum standards governing food and catering on board oceangoing vessels as provided in the 2006 Maritime Labor Convention of
which the Philippines and MV Glasgows flag country Germanyhave
signed, to wit:
(a) food and drinking water supplies, having regard to the number of
seafarers on board, their religious requirements and cultural practices
as they pertain to food, and the duration and nature of the voyage,

32

shall be suitable in respect of quantity, nutritional value, quality

and variety;
(b) the organization and equipment of the catering department shall
be such as to permit the provision to the seafarers of adequate,
varied and nutritious meals prepared and served in hygienic
conditions; and
(c) catering staff shall be properly trained or instructed for their
positions.
Although not yet fully implemented, this International Labor
Organization (ILO) Convention merely underscores that food on
board an ocean-going vessel may not necessarily be limited as
alleged by respondent. In this respect, the petitions submitted
documents showing that fresh and varied provisions were provided
on board. Respondent, on the other hand, countered that even if
there were such provisions, salt0cured fish and diet such as bagoong
dilis, bagoong alamang, anchovies, etc. were still included as
victuals. The Court treats both submissions as equal in their respects
and, thus, cannot be the sole determinant of whether respondent is
entitled to his claims.

PULMONARY CONGESTION/SEPTICEMIA

Wallem Maritime Services, Inc. vs National Labor Relations

Commission and Elizabeth Inductivo, G.R. No. 130772
November 19, 1999 (LOSS OF LIFE): Indeed, there was never any
categorical or conclusive finding that Faustino Inductivo was afflicted
with cancer. Petitioners extensive discussion in support of their
"cancer theory" is nothing more than mere speculations cloaked in
medical gibberish.
Moreover, we agree with private respondent that opinions of
petitioners doctors to this effect should not be given evidentiary
weight as they are palpably self-serving and biased in favor of
33

petitioners, and certainly could not be considered independent. These

medical opinions cannot prevail over the entries in the Death
Certificate and Autopsy Report.
Furthermore, before Faustino Inductivo was made to sign the
employment contract with petitioners he was required to undergo, as
a matter of procedure, medical examinations and was declared fit to
work by no less than petitioners' doctors. Petitioners cannot now be
heard to claim that at the time Faustino Inductivo was employed by
them he was afflicted with a serious disease, and that the medical
examination conducted on the deceased seaman was not exploratory
in nature such that his disease was not detected in the first instance.
Being the employer, petitioners had all the opportunity to pre-qualify,
screen and choose their applicants and determine whether they were
medically, psychologically and mentally fit for the job upon
employment. The moment they have chosen an applicant they are
deemed to have subjected him to the required pre-qualification
standards.
But even assuming that the ailment of Faustino Inductivo was
contracted prior to his employment on board "MT Rowan," this is not
a drawback to the compensability of the disease. It is not required
that the employment be the sole factor in the growth, development or
acceleration of the illness to entitle the claimant to the benefits
provided therefor. It is enough that the employment had contributed,
even in a small degree, to the development of the disease and in
bringing about his death.
It is indeed safe to presume that, at the very least, the nature of
Faustino Inductivos employment had contributed to the aggravation
of his illness - if indeed it was pre-existing at the time of his
employment - and therefore it is but just that he be duly compensated
for it. It cannot be denied that there was at least a reasonable
connection between his job and his lung infection, which eventually
developed into septicemia and ultimately caused his death. As a
utilityman on board the vessel, he was exposed to harsh sea weather,
chemical irritants, dusts, etc., all of which invariably contributed to his
illness.

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Neither is it necessary, in order to recover compensation, that the

employee must have been in perfect condition or health at the time
he contracted the disease. Every workingman brings with him to his
employment certain infirmities, 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. If the disease is the proximate
cause of the employees death for which compensation is sought, the
previous physical condition of the employee is unimportant and
recovery may be had therefor independent of any pre-existing
disease.

PSORIASIS

Maersk Filipinas Crewing Inc. vs Nelson E. Mesina, G.R. No.

200837 June 5, 2013: Psoriasis comes from the Greek word
"psora" which means itch. It is a common disfiguring and stigmatising
skin disease associated with profound impaired quality of life. People
with psoriasis typically have sharply demarcated erythematous
plaques covered by silvery white scales, which most commonly
appear on the elbows, knees, scalp, umbilicus, and lumbar area.
Chronic plaque psoriasis (psoriasis vulgaris) is the most common
type of the disease which manifests thru plaques of varying degrees
of scaling, thickening and inflammation in the skin. The plaques are
typically oval-shaped, of variable size and clearly distinct from
adjacent normal skin.
As a result of the chronic, incurable nature of psoriasis, associated
morbidity is significant. Patients in primary care and hospital settings
have similar reductions in quality of life specifically in the functional,
psychological and social dimensions. Symptoms specifically related
to the skin (i.e., chronic itch, bleeding, scaling, nail involvement),
problems related to treatments (mess, odor, inconvenience, time),
arthritis, and the effect of living with a highly visible, disfiguring skin
disease (difficulties with relationships, difficulties with securing
employment, and poor self- esteem) all contribute to morbidity. About

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one in four patients experience major psychological distress, and the

extent to which they feel socially stigmatised and excluded is
significant.
Current available treatments for the disease are reasonably effective
as short-term therapy. Extended disease control is, however, difficult
to achieve as the safety profile of most therapeutic agents limit their
long-term use.
Until now, the exact cause of psoriasis remains a mystery. But
several family studies have provided compelling evidence of a
genetic predisposition to psoriasis, although the inheritance pattern is
still unclear. Other environmental factors such as climate changes,
physical trauma, infections of the upper respiratory tract, drugs, and
stress may also trigger its onset or development.
After a circumspect evaluation of the conflicting medical certifications
of Drs. Alegre and Fugoso, the Court finds that serious doubts
pervade in the former. While both doctors gave a brief description of
psoriasis, it was only Dr. Fugoso who categorically stated a factor that
triggered the activity of the respondents disease stress, drug or
alcohol intake, etc. Dr. Alegre immediately concluded that it is not
work-related on the basis merely of the absence of psoriasis in the
schedule of compensable diseases in Sections 32 and 32-A of the
POEA-SEC. Dr. Alegre failed to consider the varied factors the
respondent could have been exposed to while on board the vessel. At
best, his certification was merely concerned with the examination of
the respondent for purposes of diagnosis and treatment and not with
the determination of his fitness to resume his work as a seafarer in
stark contrast with the certification issued by Dr. Fugoso which
categorically declared the respondent as "disabled." The certification
of Dr. Alegre is, thus, inconclusive for purposes of determining the
compensability of psoriasis under the POEA-SEC. Moreover, Dr.
Alegres specialization is General Surgery while Dr. Fugoso is a
dermatologist, or one with specialized knowledge and expertise in
skin conditions and diseases like psoriasis. Based on these
observations, it is the Courts considered view that Dr. Fugosos
certification deserves greater weight.

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It remains undisputed that the respondent used strong detergent,

fabric conditioner, special soap and chemicals in performing his
duties as a steward. Stress and climate changes likewise permeate
his working environment as with that of any other seafarer. These
factors, taken together with Dr. Fugosos certification, confirm the
existence of a reasonable connection between the nature of
respondents work and the onset of his psoriasis.
At any rate, even in the absence of an official finding by the companydesignated physician or the respondents own physician, he is
deemed to have suffered permanent total disability pursuant to the
following guidelines in Fil-Star Maritime Corporation v. Rosete, thus:
Permanent disability is inability of a worker to perform his job for more
than 120 days, regardless of whether or not he loses the use of any
part of his body.
Total disability, on the other hand, means the disablement of an
employee to earn wages in the same kind of work of similar nature
that he was trained for, or accustomed to perform, or any kind of work
which a person of his mentality and attainments could do.
A total disability does not require that the employee be completely
disabled, or totally paralyzed. What is necessary is that the injury
must be such that the employee cannot pursue his or her usual work
and earn from it. A total disability is considered permanent if it lasts
continuously for more than 120 days. x x x. (Citations omitted)
It is undisputed that from the time the respondent was medically
repatriated on October 7, 2005 he was unable to work for more than
120 days. In fact, Dr. Alegres certification was issued only after 259
days with the respondent needing further medical treatments thus
rendering him unable to pursue his customary work. Despite the
declaration in the medical reports that psoriasis is not contagious, no
profit-minded employer will hire him considering the repulsive
physical manifestation of the disease, its chronic nature, lack of longterm cure and the vulnerability of the patient to cardiovascular
diseases and some cancers. Its inevitable impact to the respondents
chances of being hired and capacity to continue working as a seaman
cannot be ignored. His permanent disability thus effectively became
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total in nature entitling him to permanent total disability benefits as

correctly awarded by the LA and the CA.

SCHIZOPHRENIA

NFD International Manning Agents, Inc. vs National Labor

Relations Commission, G.R. No. 107131
March 13, 1997:
Petitioner mainly contends that private respondent's ailment was
acquired after the expiration of his contract, that is, after he was
declared fit to resume work by his attending physician. Respondent's
refutation of this argument is to the effect that the employment
contract did not expire; rather, the contract could no longer be
performed by private respondent because he was mauled within the
vessel, as a result of which he suffered contusion on the face and
lumbar region and became afflicted with epilepsy. Private
respondent's epilepsy worsened into schizophrenia, thereby
permanently preventing private respondent from performing his job
and earning a livelihood for himself and his family. Petitioner makes a
mountain out of the contention that private respondent was declared
fit to work after his repatriation. No mental examination of respondent,
however, was shown to have been conducted in the course of his
physical examination in February 1986. Thus, there is no medical
finding as to private respondent's mental fitness to resume work.
Furthermore, petitioner has not presented before the Labor Arbiter
and the NLRC sufficient medical evidence to the effect that
schizophrenia has definitively identified causes and that epilepsy is
and cannot be one of them. In other words, petitioner miserably failed
to negate the causal confluence of the mauling of private respondent
during his employment with petitioner, the contusions he suffered, the
epilepsy caused by the mauling and the schizophrenia which
subsequently developed, as the principal factor in the permanent total
disability of private respondent.
Strict rules of evidence, it must be remembered, are not applicable in
claims for compensation and disability benefits. Private respondent
38

having substantially established the causative circumstances leading

to his permanent total disability to have transpired during his
employment, we find the NLRC to have acted in the exercise of its
sound discretion in awarding permanent total disability benefits to
private respondent. Probability and not the ultimate degree of
certainty is the test of proof in compensation proceedings.
SLIPPED DISC
More Maritime Agencies, et.al. vs NLRC and Sergio F.
Homicillada, G.R. No. 124927 May 18, 1999: In the instant case,
the Court is more inclined to believe the findings of the POEA, which
are supported by substantial evidence:
The contention of respondent (herein petitioners)
that the sickness of the complainant (herein private
respondent) was pre-existing and was concealed
from the respondent is untenable. The fact is before
the complainant was made to sign the contract, he
was required to undergo medical examination and
declared fit to work otherwise the respondent would
not have accomodated him. The respondent cannot
avoid liability by saying that complainants sickness
was concealed from it. Being an employer,
respondent had all the opportunity to pre-qualify,
screen and choose their applicants and whether
they are medically, psychologically and mentally fit.
The moment it has chosen an applicant it is deemed
to have subjected its applicant to the required prequalification standard. Thus, the respondent cannot
now claim that complainants sickness was preexisting and concealed from it. Further, the defense
of the respondent that the disease of the
complainant is not connected or related to his work
does not deserve merit. The nature of the job of the
complainant, as an oiler, is to clean the engine.
Complainant was assigned to get in through the
manhole to clean the engine taking with him
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containers in which the mud and waste oil shall be

placed and carrying them out of the manhole for
disposal. This is the regular job of the complainant
resulting in Disc Herniation as diagnosed by the
physician. Moreover, even granting for the sake of
argument that the sickness is not work related, still
the complainant is entitled to disability benefits
provided the disease occurred during the effectivity
of the contract because the Standard Contract for
seamen approved by the POEA does not qualify
whether the sickness is work related or not.
In sum, the instant petition fails to show that the NLRC has committed
grave abuse of discretion to warrant the reversal of its decision of 21
February 1996 and its resolution of 19 April 1996. The injury
sustained by Homicillada is compensable the same having resulted
from the rigors of carrying heavy canisters in a crouching position
which logically strained his lower back that lead to his slipped-disc.
Migrant workers are the modern-day heroes of our time. Quite often
they find themselves laboring in the scorching heat and the freezing
cold in foreign lands. Their woes often remain unheard, their tears
unnoticed. It is time that the arms of justice reach out to them workers
and cradle them gently in her bosom.
SPINAL INJURY

Carlo F. Sunga vs Virjen Shipping Corporation, etal., G.R. No.

198640 April 23, 2014: While on its face, the facts seemed similar,
they are in fact different, thus leading us to decide the present case
differently. In Illescas, no unusual, fortuitous, unexpected or
unforeseen event took place or was reported. Illescas merely went
about his normal duties; he transported fire hydrant caps from the
deck to the engine workshop, then back to the deck to refit the caps.
The sudden snap Illescas felt on his back while carrying the fire
hydrant caps thus could not, by itself, qualify as an accident.

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In the present case, Sunga did not incur the injury while solely
performing his regular duties; an intervening event transpired which
brought upon the injury. To repeat, the two other oilers who were
supposed to help carry the weight of the 200-kilogram globe valve
lost their grasp of the globe valve. As a result, Sungas back snapped
when the entire weight of the item fell upon him. The sheer weight of
the item is designed not to be carried by just one person, but as was
observed, meant to be undertaken by several men and expectedly
greatly overwhelmed the physical limits of an average person.
Notably, this incident cannot be considered as foreseeable, nor can it
be reasonably anticipated. Sungas duty as a fitter involved changing
the valve, not to routinely carry a 200-kilogram globe valve
singlehandedly. The loss of his fellow workers group was also
unforeseen in so far as Sunga was concerned.
In Jarco Marketing Corporation, et al., v. Court of Appeals, we ruled
that an accident pertains to an unforeseen event in which no fault or
negligence attaches to the defendant. It is "a fortuitous circumstance,
event or happening; an event happening without any human agency,
or if happening wholly or partly through human agency, an event
which under the circumstances is unusual or unexpected by the
person to whom it happens."
Since Sunga encountered an accident on board MT Sunway, the CA
thus grossly misappreciated and misread the ruling of the NLRC,
leading the appellate court to find a grave abuse of discretion
sufficient for a reversal of the NLRC ruling. In other words, as the
NLRC found, Sunga's disability benefits should fall within the
coverage of the parties' CBA, which provides:
Article 28: Disability
28.1 A seafarer who sutlers permanent disabilitv as a result of an
accident whilst in the employment of the Company regardless of fault,
including accidents occurring while traveling to or from the ship, and
whose ability to work as a seafarer is reduced as a result thereof, but
excluding permanent disability due to willful acts, shall in addition to
sick pay, be entitled to compensation according to the provisions of
this Agreement. (emphasis ours)

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SPINAL INJURY: COMPRESSION FRACTURE VERTEBRAE

Camilo A. Esguerra vs United Philippines Lines, Inc.et.al., G.R.

No. 199932 July 3, 2013: The findings of the NLRC and the degree
of Petitioners disability are most in accord with the evidence on
record.
As ardently observed by the labor commission, the
orthopedic surgeon designated by the respondents, Dr. Chuasuan,
and the petitioners independent specialist, Dr. Sabado, were one in
declaring that petitioner is permanently unfit for sea duty. xxx. The
uncertain effect of further treatment intimates nothing more that the
injury sustained by the petitioner bars him from performing his
customary and strenous work as a seaferer/fitter. As such, he is
considered permanently and totally disabled.
Permanent and total disability means disablement of an employee to
earn wages in the same kind of work or work of similar nature that he
has trained for or accustomed to perform, or any kind of work which a
person of his mentality and attainment can do.
It is inconsequentional whether petitioner was actually recorded by
the respondents to be driving a motorcycle. It does not preclude an
award for disability because, in labor laws, disability need not render
the seafarer absolutely helpless or feeble to be compensable; it is
enough that it incapacitates to perform his customary work.
TOXIC GOITER
Career Philippines Shipmanagement, et.al., vs Salvador T.
Serna, G.R. No. 172086 December 3, 2012: The causal connection
the petitioners cite is a factual question that we cannot touch in Rule
45. The factual question is also irrelevant to the 1996 POEA-SEC. In
Remigio v National Labor Relations Commission, we expressly
declared that illnesses need not be shown to be work-related to be
compensable under the 1996 POEA-SEC, which covers all injuries or
42

illnesses occuring in the lifetime of the employment contract. We

contrast this with the 2000 POEA-SEC which lists the compensable
occupational diseases. Even granting that work-relatedness may be
considered in this case, we fail to see, too, how the idiopathic
character of toxic goiter and/or thyrotoxicosis excuses the petitioners,
since it does not negate the probability, indeed the possibility, that
Sernas toxic goiter was caused by the undisputed work conditions in
petitioners chemical tankers.

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