JESUS E. VERGARA v. HAMMONIA MARITIME SERVICES, INC. and ATLANTIC MARINE LTD. (G.R. No.

172933,
October 6, 2008)

Facts:
 Jesus Vergara was a seafarer hired by Hammonia to work on board a vessel British Valour for nine months as
pumpman.
 In August 2000, while attending to a defective hydraulic valve, he felt he was losing his vision. He complained
to the Ship Captain that he was seeing black dots and hairy figures floating in front of his right eye. His condition
developed into a gradual visual loss. The ships medical log entered his condition as internal bleeding in the eye
or glaucoma.
 He was sent home on September 5, 2000 for medical treatment. The company-designated physician, Dr. Robert
D. Lim of the Marine Medical Services of the Metropolitan Hospital, confirmed the correctness of the diagnosis
at Port Galveston, Texas. Dr. Lim then referred the petitioner to an ophthalmologist at the Chinese General
Hospital who subjected the petitioners eye to focal laser treatment on November 13, 2000; vitrectomy with fluid
gas exchange on December 7, 2000; and a second session of focal laser treatment on January 13, 2001.
 On January 31, 2001, the ophthalmologist pronounced the petitioner fit to resume his seafaring duties per the
report of Dr. Robert D. Lim, Medical Coordinator.
 Vergara then executed a certificate of fitness for work in the presence of Dr. Lim.
 Claiming that he continued to experience gradual visual loss despite the treatment, he sought a second opinion
from another ophthalmologist, Dr. Patrick Rey R. Echiverri, who was not a company-designated physician. Dr.
Echiverri gave the opinion that the petitioner was not fit to work as a pumpman because the job could precipitate
the resurgence of his former condition.
 On March 20, 2001, the petitioner submitted himself to another examination, this time by Dr. Efren R. Vicaldo,
a physician who was not also designated by the company. Dr. Vicaldo opined that although the petitioner was
fit to work, he had a Grade X (20.15%) disability which he considered as permanent partial disability.
 On the basis of the diagnoses of the two doctors, Vergara demanded from his employer payment of disability
and sickness benefits, pursuant to the Philippine Overseas Employment Administration Standard Employment
Contract Governing the Employment of all Filipino Seamen on Board Ocean-going Vessels (POEA Standard
Employment Contract), and the existing CBA in the company.
 The company denied his demand.
 Hence, Vergara filed a complaint for disability benefits, sickness allowance, damages and attorney's fees before
the Labor Arbiter.
 LABOR ARBITER: granted the complaint of Vergara.
 NLRC: REVERSED the LA and DISMISSED the complaint on the ground that Vergara had been declared fit to
resume sea duty and was not entitled to any disability benefit.

Issue:
 Whether or not Vergara is entitled to disability benefit. - NO.

Held:

SC DENIED THE PETITION OF VERGARA.

Entitlement to disability benefits by seamen on overseas work is a matter governed, not only by medical findings but,
by law and by contract. The material statutory provisions are Articles 191 to 193 under Chapter VI (Disability Benefits)
of the Labor Code, in relation with Rule X of the Rules and Regulations Implementing Book IV of the Labor Code. By
contract, Department Order No. 4, series of 2000 of the Department of Labor and Employment (the POEA Standard
Employment Contract) and the parties CBA bind the seaman and his employer to each other.

In this respect and in the context of the present case, Article 192(c)(1) of the Labor Code provides that:

x x x The following disabilities shall be deemed total and permanent:

(1) Temporary total disability lasting continuously for more than one hundred twenty days, except as otherwise
provided in the Rules;

xxx

The rule referred to - Rule X, Section 2 of the Rules and Regulations implementing Book IV of the Labor Code
- states:

Period of entitlement. (a) The income benefit shall be paid beginning on the first day of such disability.
If caused by an injury or sickness it shall not be paid longer than 120 consecutive days except where
such injury or sickness still requires medical attendance beyond 120 days but not to exceed 240 days
 from onset of disability in which case benefit for temporary total disability shall be paid. However, the
System may declare the total and permanent status at anytime after 120 days of continuous temporary
total disability as may be warranted by the degree of actual loss or impairment of physical or mental
functions as determined by the System. [Underscoring ours]

These provisions are to be read hand in hand with the POEA Standard Employment Contract whose Section
20 (3) states:

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.

As these provisions operate, the seafarer, upon sign-off from his vessel, must report to the company-designated
physician within three (3) days from arrival for diagnosis and treatment. For the duration of the treatment but in no case
to exceed 120 days, the seaman is on temporary total disability as he is totally unable to work. He receives his basic
wage during this period 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 Standard Employment Contract and by
applicable Philippine laws.

If the 120 days initial period is exceeded and no such 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.

A temporary total disability only becomes permanent when so declared by the company physician within the periods he
is allowed to do so, or upon the expiration of the maximum 240-day medical treatment period without a declaration of
either fitness to work or the existence of a permanent disability.

In the present case, while the initial 120-day treatment or temporary total disability period was exceeded, the company-
designated doctor duly made a declaration well within the extended 240-day period that the petitioner was fit to work.

Viewed from this perspective, both the NLRC and CA were legally correct when they refused to recognize any disability
because the petitioner had already been declared fit to resume his duties. In the absence of any disability after his
temporary total disability was addressed, any further discussion of permanent partial and total disability, their existence,
distinctions and consequences, becomes a surplusage that serves no useful purpose.

A twist that directly led to the filing of this case is the issue of whose medical pronouncement should be followed given
that the company-designated physician had declared the petitioner fit for work with a certification of fitness duly executed
by the latter, while the petitioners physicians gave qualified opinions on his medical situation.

The POEA Standard Employment Contract and the CBA clearly provide that when a seafarer sustains a work-
related illness or injury while on board the vessel, his fitness or unfitness for work shall be determined by the
company-designated physician.

If the physician appointed by the seafarer disagrees with the company-designated physicians assessment, the
opinion of a third doctor may be agreed jointly between the employer and the seafarer to be the decision final
and binding on them.

Thus, while petitioner had the right to seek a second and even a third opinion, the final determination of whose decision
must prevail must be done in accordance with an agreed procedure. Unfortunately, the petitioner did not avail of this
procedure; hence, we have no option but to declare that the company-designated doctors certification is the final
determination that must prevail.

As a last point, the petitioner has repeatedly invoked our ruling in Crystal Shipping, Inc. v. Natividad, apparently for its
statement that the respondent in the case was unable to perform his customary work for more than 120 days which
constitutes permanent total disability. This declaration of a permanent total disability after the initial 120 days of
temporary total disability cannot, however, be simply lifted and applied as a general rule for all cases in all contexts. The
specific context of the application should be considered, as we must do in the application of all rulings and even of the
law and of the implementing regulations.

Crystal Shipping was a case where the seafarer was completely unable to work for three years and was undisputably
unfit for sea duty due to respondents need for regular medical check-up and treatment which would not be available if
he were at sea.

While the case was not clear on how the initial 120-day and subsequent temporary total disability period operated, what
appears clear is that the disability went beyond 240 days without any declaration that the seafarer was fit to resume
work. Under the circumstances, a ruling of permanent and total disability was called for, fully in accordance with the
operation of the period for entitlement that we described above. Viewed from this perspective, the petitioner cannot cite
the Crystal Shipping ruling as basis for his claim for permanent total disability.
CRYSTAL SHIPPING, INC. v. DEO P. NATIVIDAD (G.R. No. 154798, October 20, 2005)

Facts:

 A/S Stein Line Bergen, through its local manning agent, petitioner Crystal Shipping, Inc., employed respondent
Deo P. Natividad as Chief Mate of M/V Steinfighter for a period of ten months.
 Within the contract period, respondent complained of coughing and hoarseness and was brought to shore for
examination. He was diagnosed with swelling neck and lymphatic glands right side in neck, declared unfit for
duty, and advised to see an ear-nose-throat specialist.
 He was repatriated to Manila on August 18, 1998.
 Shortly after his arrival, respondent was referred to ClinicoMed Inc., the company-designated clinic, for check-
up and later thoroughly examined at the Manila Doctors Hospital. He was diagnosed with papillary carcinoma,
metastatic to lymphoid tissue consistent with thyroid primary and reactive hyperplasis, lymph node. His
attending physician diagnosed him permanently disabled with a grade 9 impediment, with grade 1 as the most
serious.
 A second opinion by Marine Medical Services and Metropolitan Hospital attending physician, Dr. Robert D. Lim,
likewise concurred that respondent was disabled with a grade 9 impediment.
 While his treatment with Dr. Lim was ongoing, respondent sought the opinion of Dr. Efren R. Vicaldo, who
opined that he was totally and permanently disabled for labor with a grade 1 impediment.
 The attending physician, Dr. Wilson D. Lim, confirmed the earlier assessments of disability with a grade 9
impediment.
 All expenses incurred in respondents examination and treatments were shouldered by the petitioners.
Respondent was also paid the allowable illness allowances, commensurate to a grade 9 impediment.
 Crystal Shipping offered US$13,060 as disability benefits which Natividad rejected. He claimed that he deserves
to be paid US$60,000 for a grade 1 impediment.
 Natividad filed with the Regional Arbitration Branch a complaint for disability benefits.
 LABOR ARBITER: ruled for Natividad and ordered Crystal Shipping to pay him US$60,000 as disability benefits,
P100,000 as moral damages, and ten percent of the total monetary award as attorneys fees.
 NLRC: AFFIRMED the ruling of LA.

Issue:

Whether or not Natividad is entitled to disability benefits. - YES

Held:

SC DENIED THE PETITION FILED BY CRYSTAL SHIPPING.

In resolving the merits of the case, we find pertinent Section 30 of the POEA Memorandum Circular No. 55,
Series of 1996, which provides the schedule of disability or impediment for injuries suffered and illness contracted. The
particular illness of the respondent is not within those enumerated. But, the same provision supplies us with the guideline
that any item in the schedule classified under grade 1 constitutes total and permanent disability.

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.

Although the company-designated doctors and respondents physician differ in their assessments of the degree of
respondents disability, both found that respondent was unfit for sea-duty due to respondents need for regular medical
check-ups and treatment which would not be available if he were at sea. There is no question in our mind that
respondents disability was total.
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.
MARIANO MASANGCAY v. TRANS-GLOBAL MARITIME AGENCY, INC. AND VENTNOR NAVIGATION, INC. (G.R.
No. 172800, October 17, 2008)

Facts:
 Masangcay was hired by Ventnor, through its manning agent, Trans-Global as an oiler on M/T Eastern Jewel,
an oil tanker.
 While on board, Masangcay notice a reddish discoloration of his urine upon urination. This happened several
times and later became associated with bouts of left lower abdominal pain radiating to the loin area.
 He was brought to nearest hospital on the nearest port because of abdominal pain and left loin pain of 10 days
with difficulty in urinating.
 The attending physician at said hospital diagnosed him to be suffering from renal failure due to multiple renal
stones on the left kidney with bilateral hydronephrosis with dilation of ureters and pelvicalyceal system. [L]eft
nephrostomy or better removal of the right pelvi-ureteric calculus was the recommended treatment but
Masangcay refused surgical intervention and insisted on being repatriated back to the Philippines instead.
 Upon his arrival in Manila, Masangcay was immediately referred to Trans-Global designated physician, Dr.
Barrientos. His blood test results showed elevated BUN and Creatinine levels and his urinalysis revealed an
active infection.
 During one of Masangcays subsequent follow-ups, his attending physician, requested a CT scan of his upper
abdomen to asses the status of his (Masangcay) right kidney, even though the urinalysis showed no more trace
of blood. The result of the scan revealed an obstructing urethrolithiasis on the right kidney with secondary
hydronephrosis, i.e., a poorly functioning right kidney where the flow of urine is obstructed by the presence of
kidney stones. Due to the aforementioned result, the removal of the non-functioning right kidney was advised
but Masangcay refused.
 Masangcay was then referred to Dr. Reynaldo C. de la Cruz of the National Kidney and Transplant Institute
(NKTI) for a second opinion. Thereat, due to right ureterolithiasis, said physician confirmed the need for another
operation; thus, on the 17th until the 23rd of December 2002, Masangcay was admitted and confined at the
NKTI.
 On 29 January 2003, upon follow-up, Dr. dela Cruz pronounced Masangcay fit to resume work as all his
laboratory examinations showed normal results. Accordingly, on 30 January 2003, Trans-Globals designated
physician, Dr. Barrientos of the Associated Medical & Clinical Services, Inc., declared Masangcay fit to go back
to work after a regular medical examination and pegged the disability period of the latter to be from 3 October
2002 until 3 February 2003.
 On 21 February 2003, Trans-Global, in behalf of Ventnor, paid Masangcay his full 120 days Sick Leave pay of
Ninety Five Thousand Five Hundred Sixty Four and 52/100 (P95,564.52) Pesos representing One Thousand
Seven Hundred Seventy Nine Dollars and 60/100 (US$1,779.60) U.S. Dollars, as well as all his medical and
hospital expenses, professional fees of his attending physicians, the total amount of which reached One
Hundred Seventy Four Thousand Seventy Five and 10/100 (P174,075.10) Pesos.
 Sometime in the first week of March 2003, Masangcay was asked to report back to the office of Trans-Global
for deployment line-up. He was also asked to undergo medical examination in view of his impending
deployment.
 When Masangcay reported to the premises of Trans-Global, however, he was informed by the Port Captain that
he (Masangcay) can no longer be deployed due to negative reports about him coming from its principal, Ventnor.
 More than six months later, or on 16 October 2003, however, armed with a Medical Certificate issued by one
Dr. Efren R. Vicaldo (Dr. Vicaldo), a cardiologist, Masangcay instituted a complaint against Trans-Global and
Ventnor, including Trans-Globals President, Michael Estaniel, before the National Labor Relations Commission
(NLRC) for the payment of disability benefit, damages and attorneys fees.
 Masangcay is claiming disability benefit under Section 20(b), paragraph 5 of the Philippine Overseas
Employment Administration (POEA) Revised Standard Terms and Conditions Governing the Employment of
Filipino Seafarers on Board Ocean-Going Vessels, as amended by Memorandum Circular No. 55, Series of
1996, which is deemed integrated in every contract of employment of Filipino seafarers on ocean-going vessels,
and which provides:
SECTION 20. COMPENSATION AND BENEFITS
xxxx

B. COMPENSATION AND BENEFITS FOR INJURY OR ILLNESS

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of
his contract are as follows:
xxxx
5. In case of permanent total or partial disability of the seafarer during the term of employment
caused by either injury or illness, the seafarer shall be compensated in accordance with the
schedule of benefits enumerated in Section 30 of this Contract. Computation of his benefits
arising from an illness or disease shall be governed by the rates and the rules of compensation
applicable at the time the illness or disease was contracted.
  In view of the above-quoted provision, Masangcay alleged that his illness was contracted during the term of his
Contract of Employment.

 Trans-Global, Ventnor, and Estaniel, the respondents therein, countered that [s]ince complainant had fully
recovered and was pronounced fit for employment, his claim for disability benefits has no basis; that [t]he right
to compensation for disability arises only when it is shown that the seafarer is disabled on account of an illness
or injury suffered while in the employ of his employer; that, in this case, the company-designated physician had
certified that complainant is fit for employment ; that assuming arguendo but without admitting that their
assessments and findings, including Dr. Barrientos, are disputed, however, under Sec. 20B, there must be a
third doctor chosen by both parties who should resolved the issue and make a decision thereon; and that
[a]bsent such determination, the complaint is premature and without basis since it is that third doctors decision
which will be considered as final.

 LABOR ARBITER: ruled in favor of Masangcay

 The labor arbiter opined that the compensability of an ailment does not depend on whether or not the injury or
disease was pre-existing at the time of employment, but rather, if the injury or disease was related to or was
aggravated by Masangcays work. The labor arbiter gave great weight to the medical opinion of Dr. Vicaldo
rather than that of Trans-Globals designated physicians considering that respondents accredited doctors
opinion has (sic) more than meets the eye and should not be taken at face value. For most often than not, they
are palpably self-serving and bias (sic) in favor of the employer and certainly cannot be considered independent.

 NLRC: AFFIRMED the decision of the LA.

 CA: GRANTED the petition for certiorari filed by Ventnor and Trans-Global.

It held that when the NLRC affirmed the LA, it arbitrarily set aside the fact that Masangcay was precluded from
any entitlement to disability benefits after he was already fully recovered and declared to be fit for employment
by the company-designated physician. Under the Standard Terms, supra, the right to compensation for disability
arises only when the seafarer has been disabled on account of his illness or injury that he suffered while in the
employ of his employer; otherwise, gross injustice would result to the petitioners.

 The NLRC did not require the opinion of a third doctor after Dr. Vicaldo (as Masangcays chosen physician) had
disagreed with the findings and opinions of the company-designated physician.

Issue:
Whether or not Masangcay is entitled to disability benefits on account of his present condition. - NO.

Held:
SC DENIED THE PETITION OF MASANGCAY.

The permanent total or partial disability suffered by a seafarer during the term of his contract must be caused by work-
related illness or injury.

In other words, to be entitled to compensation and benefits under said provision, it is not sufficient to establish that the
seafarers illness or injury has rendered him permanently or partially disabled, but it must also be shown that there is a
causal connection between the seafarers illness or injury and the work for which he had been contracted for.

Accordingly, in order to hold Trans-Global and Ventnor liable for payment of his claims under Sec. 20(b), paragraph 6,
of the 2000 POEA Amended Standard Terms and Conditions Governing the Employment of Filipino Seafarers on Board
Ocean-Going Vessels, Masangcay must prove:
 that he is suffering from permanent total or partial disability due to a work-related illness occurring during the
term of his contract.
 must also present evidence that such infirmity was work-related, or at the very least aggravated by the conditions
of the work for which he was contracted for.

But even assuming that Masangcay is suffering from chronic renal failure, it still does not entitle him to compensation
and benefits for a permanent disability. Moreover, chronic renal failure, is neither listed as a disability under Sec. 32 of
the 2000 POEA Amended Standard Terms and Conditions Governing the Employment of Filipino Seafarers on Board
Ocean-Going Vessels; nor an occupational disease under Sec. 32-A thereof, which provides for the schedule of disability
or impediment for injuries suffered and diseases including occupational diseases or illness.

Under Sec. 32 of the POEA Amended Standard Terms and Conditions, it is the loss of a kidney, i.e., its removal, that is
compensated, and not merely the presence and subsequent removal of kidney stones. And under Sec. 32-A of the
same, Masangcays illness cannot also be classified as an occupational disease. A compensable occupational disease
must satisfy several conditions, to wit:
 SECTION 32-A. OCCUPATIONAL DISEASES

For an occupational disease and the resulting disability or death to be compensable, all of the following
conditions must be satisfied:

(1) The seafarers work must involve the risks 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;

(4) There was no notorious negligence on the part of the seafarer.

Consequently, the labor arbiter and the NLRC had no basis at all to rule that Masangcay is deserving of other disability
benefits espoused by Sec. 20(b), paragraph 6 of the 2000 POEA Amended Standard Terms and Conditions other than
that already extended to him by Trans-Global and Ventnor.
MAGSAYSAY MARITIME CORPORATION AND/OR CRUISE SHIPS CATERING AND SERVICES INTERNATIONAL
N.V., v. NATIONAL LABOR RELATIONS COMMISSION (SECOND DIVISION) AND ROMMEL B. CEDOL (G.R. No.
186180, March 22, 2010)

Facts:
 Rommel Cedol was employed as an assistant housekeeping manager on board the vessel Costa Mediterranea
of Magsaysay Maritime.
 In November 2004, the respondent felt pain in his lower right quadrant. He was brought to and conferred at the
Andreas Constantinou Medical Center in Cyprus for consultation. On January 18, 2005, he underwent a
procedure called exploratory laparotomy which revealed a massive tumor in the terminal ileum and in the
ascending colon near the hepatic flexture. On the same day, the respondent underwent a surgical procedure
called right hemicolectomy with end to end ilectransverse anastomosis.
 Cedol was discharged from the hospital and repatriated to the Philippines on February 1, 2005.
 Upon repatriation, the respondent was placed under the medical care and supervision of the company-
designated physician, Dr. Susannah Ong-Salvador (Dr. Ong-Salvador).
 In Dr. Ong-Salvadors Initial Medical Report dated February 10, 2005, she found the respondent to be suffering
from lymphoma, and declared his illness to be non-work related.
 Dr. Ong-Salvadors Medical Progress Report found the respondents recurrent lymphoma to be in complete
remission, and declared him fit to resume sea duties after undergoing six (6) sessions of chemotherapy.
 Cedol filed before the Labor Arbiter a complaint for total and permanent disability benefits, reimbursement of
medical and hospital expenses, damages, and attorneys fees against Magsaysay Maritime and claims that he
contracted his illness while working on board Magsaysay's vessel.

 LABOR ARBITER: ruled in favor of Cedol and found him permanently and totally disabled and awarded him
disability compensation of US$60,000.00 or its peso equivalent; and US$6,000.00 attorneys fees.
 She ruled that Cedol's illness is work-related, hence compensable.
 She held that the respondents illness was aggravated by his work, as he had always passed
the companys physical examinations since 2000.
 She explained that the respondents work need not be the main cause of his illness; it is enough
that his employment had contributed even in a small degree to the development of the disease.
 She also ruled that the respondent was not fit to work as a seafarer because he had undergone
chemotherapy.

 NLRC: AFFRIMED the ruling of LA in toto.

 The NLRC held that the respondent is not fit to work as a seafarer because he is suffering from
recurrent lymphoma - a sickness that required him undergo chemotherapy.
 The NLRC explained that the respondent is in a state of permanent total disability because he
can no longer 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.
 The NLRC ruled that there was a reasonable connection between the nature of the respondents
work as assistant housekeeping manager and the development of his illness.
 The NLRC explained that the respondent had passed every PEME before signing the six
employment contracts with the petitioner from 2000 to 2005, and was declared fit to work each
time. It was only after the respondent was exposed to an extreme working environment in the
petitioners vessel that he developed his sickness. At any rate, the law merely requires a
reasonable work connection, and not a direct causal connection for a disability to be
compensable.

 CA: held that under the provisions of the POEA Standard Employment Contract (POEA-SEC), it is enough that
the work has contributed, even in a small degree, to the development of the workers disease.
 The CA further held that the Courts are not bound by the assessment of the company-
designated physician. Dr. Ong-Salvadors pronouncement that the respondent is fit to resume
sea duties was inconsistent with the fact that the respondent had previously undergone
chemotherapy, and needed to undergo periodic check-ups.

Issue:
Whether or not Cedol is entitled to disability benefits. - NO

Held:
SC GRANTED THE PETITION OF MAGSAYSAY MARITIME.

Entitlement of seamen on overseas work to disability benefits is a matter governed, not only by medical findings, but by
law and by contract. The material statutory provisions are Articles 191 to 193 under Chapter VI (Disability Benefits) of
the Labor Code, in relation with Rule X of the Rules and Regulations Implementing Book IV of the Labor Code. By
contract, the POEA-SEC, as provided under Department Order No. 4, series of 2000 of the Department of Labor and
Employment, and the parties Collective Bargaining Agreement (CBA) bind the seaman and his employer to each other.

Section 20 (B), paragraph 3 of the 2000 POEA-SEC reads:

Section 20-B. Compensation and Benefits for Injury or Illness.

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his
contract are as follows:

xxxx

6. In case of permanent total or partial disability of the seafarer caused by either injury or illness the seafarer
shall be compensated in accordance with the schedule of benefits enumerated in Section 32 of this Contract.
Computation of his benefits arising from an illness or disease shall be governed by the rates and the rules of
compensation applicable at the time the illness or disease was contracted. [Emphasis supplied.]

For disability to be compensable under Section 20 (B) of the 2000 POEA-SEC, two elements must concur:
(1) the injury or illness must be work-related; and
(2) the work-related injury or illness must have existed during the term of the seafarers employment contract.

In other words, to be entitled to compensation and benefits under this provision, it is not sufficient to establish that the
seafarers illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a
causal connection between the seafarers illness or injury and the work for which he had been contracted.

The 2000 POEA-SEC defines work-related injury as injury(ies) resulting in disability or death arising out of and
in the course of employment and work-related illness as any sickness resulting to disability or death as a result
of an occupational disease listed under Section 32-A of this contract with the conditions set therein satisfied.

Under Section 20 (B), paragraphs (2) and (3) of the 2000 POEA-SEC, it is the company-designated physician who is
entrusted with the task of assessing the seamans disability.

The seafarer, upon sign-off from his vessel, must report to the company-designated physician within three (3) days from
arrival for diagnosis and treatment. For the duration of the treatment but in no case to exceed 120 days, the seaman is
on temporary total disability as he is totally unable to work. He receives his basic wage during this period 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. If the 120-day initial period
is exceeded and no such 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. The seaman may of course also be
declared fit to work at any time such declaration is justified by his medical condition.

Lymphoma is neither listed as a disability under Section 32 (Schedule of Disability or Impediment for Injuries Suffered
and Diseases Including Occupational Diseases or Illness Contracted) of the 2000 POEA-SEC nor listed as an
occupational disease under Section 32-A thereof. Nonetheless, Section 20 (B), paragraph (4) provides that those
illnesses not listed in Section 32 of this Contract are disputably presumed as work-related. The burden is therefore
placed upon the respondent to present substantial evidence, or such relevant evidence which a reasonable mind might
accept as adequate to justify a conclusion that there is a causal connection between the nature of his employment and
his illness, or that the risk of contracting the illness was increased by his working conditions. This, the respondent failed
to do. In fact, a careful review of the records shows that the respondent did not, by way of a contrary medical finding,
assail the diagnosis arrived at by the company-designated physician.

While it is true that medical reports issued by the company-designated physicians do not bind the courts, our examination
of Dr. Ong-Salvadors Initial Medical Report leads us to agree with her findings. Dr. Ong-Salvador was able to sufficiently
explain her basis in concluding that the respondents illness was not work-related: she found the respondent not to have
been exposed to any carcinogenic fumes, or to any viral infection in his workplace. The series of tests and evaluations
show that Dr. Ong-Salvadors findings were not arrived at arbitrarily; neither were they biased in the companys favor.

Cedol did not adduce proof to show a reasonable connection between his work as an assistant housekeeping manager
and his lymphoma. There was no showing how the demands and nature of his job vis--vis the ships working conditions
increased the risk of contracting lymphoma. The non-work relatedness of the respondents illness is reinforced by the
fact that under the Implementing Rules and Regulations of the Labor Code (ECC Rules), lymphoma is considered
occupational only when contracted by operating room personnel due to exposure to anesthetics. The records do not
show that the respondents work as an assistant housekeeping manager exposed him to anesthetics.
The fact that respondent passed the companys PEME is of no moment. We have ruled that in the past the PEME is not
exploratory in nature. It was not intended to be a totally in-depth and thorough examination of an applicants medical
condition. The PEME merely determines whether one is fit to work at sea or fit for sea service, it does not state the real
state of health of an applicant. In short, the fit to work declaration in the respondents PEME cannot be a conclusive
proof to show that he was free from any ailment prior to his deployment.

As previously discussed, it is the company-designated physician who is entrusted with the task of assessing the
seamans disability. Since Dr. Ong-Salvador deemed the respondent as fit to resume sea duties, then such declaration
should be given credence, considering the amount of time and effort she gave to monitoring and treating the respondents
condition.

In sum, we hold that the respondent is not entitled to total and permanent disability benefits for his failure to refute the
company-designated physicians findings that: (1) his illness was not work-related; and (2) he was fit to resume sea
duties.
DOMINGO VICENTE v. EMPLOYEES' COMPENSATION COMMISSION (G.R. No. 85024, January 23, 1991)

Facts:
 Domingo Vicente was a nursing attendant at the Veterans Memorial Medical Center in Quezon City.
 At the age of 45, and after having rendered more than 25 years of government service, Domingo applied for
optional retirement under Section 12 (c) of RA 1616, giving as reason therefor his inability to continue working
as a result of his physical disability.
 He also filed with the GSIS an application for "income benefits claim for payment".
 Both applications were accompanied by a Physician's Certification issued by his attending doctor at Veterans
which has classified him as beinf under "permanent total disability".
 His application for ncome benefits claim payment was granted but only for permanent partial disability (PPD)
compensation or for a period of 19 months.
 He was granted an additional 4 months benefits upon requesting for reconsideration from GSIS General
Manager.
 Still unsatisfied, he sent a letter again to GSIS Disability Compensation Department Manager insisting that he
should be compensated for permanent total disanility.
 However, the request was denied.
 Hence, his case was elevated to Employees Compensation Commission.

Issue:
Whether or not Domingo Vicente shall be compensated for permanent total disability. - YES.

Held:
SC RULED IN FAVOR OF DOMINGO VICENTE.

Employee's disability under the Labor Code is classified into three distinct categories:
(a) temporary total disability;
(b) permanent total disability; and
(c) permanent partial disability.

Likewise, in Section 2, Rule VII of the Amended Rules on Employees Compensation, it is provided that:

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
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 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.

While "permanent total disability" invariably results in an employee's loss of work or inability to perform his usual work,
"permanent partial disability," on the other hand, occurs when an employee loses the use of any particular anatomical
part of his body which disables him to continue with his former work.

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 Compensability (which, in a 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.

In the case at bar, the petitioner's permanent total disability is established beyond doubt by several factors and
circumstances. Noteworthy is the fact that from all available indications, it appears that the petitioner's application for
optional retirement on the basis of his ailments had been approved. The decision of the respondent Commission even
admits that the petitioner "retired from government service at the age of 45." Considering that the petitioner was only 45
years old when he retired and still entitled, under good behavior, to 20 more years in service, the approval of his optional
retirement application proves that he was no longer fit to continue in his employment. For optional retirement is allowed
only upon proof that the employee-applicant is already physically incapacitated to render sound and efficient service.

Further, the appropriate physicians of the petitioner's employer, the Veterans Memorial Medical Center, categorically
certified that the petitioner was classified under permanent total disability. On this score, "the doctor's certification as to
the nature of the claimant's disability may be given credence as he normally would not make a false certification." And,
"[N]o physician in his right mind and who is aware of the far-reaching and serious effect that his statements would cause
on a money claim filed with a government agency, would issue certifications indiscriminately without even minding his
own interests and protection."

The fact that the petitioner was granted benefits amounting to the equivalent of twenty-three months shows that the
petitioner was unable to perform any gainful occupation for a continuous period exceeding 120 days. This kind of
disability is precisely covered by Section 2(b), Rule VII of the Amended Rules on Employees' Compensability which we
again quote, to wit:

Sec. 2. Disability—(a) . . .

(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 those Rules.

xxx xxx xxx

There being no showing, as we mentioned earlier, that the petitioner's disability is "temporary total" as defined by the
law, the inescapable conclusion is that he suffers from permanent total disability.
PABLO AUSTRIA v. CA and ECC (G.R. No. 146636, August 12, 2002)

Facts:
 Pablo Austria was employed as a bag piler at Central Azucarera de Tarlac.
 He began to feel severe back pain and it was revealed that he has osteoarthritis of the lumbar spine.
 On account of his osteoarthritis, Austria filed with SSS a claim for compensation benefits.
 The claim was granted and he was awarded permanent partial disability benefits for 30 months.
 He requested the SSS for conversion of his permanent partial disability benefit to permanent total disability.
 SSS denied the request.
 ECC affirmed the decision of SSS. It held that considering the degree of his disability at the time he was
separated from the service, he has already availed of the maximum benefits to which he is entitled.
 CA dismissed the petition and ruled that the law does not allow the conversion of permanent partial disability to
permanent total disability.

Issue:
Whether or not Pablo Austria shall be compensated for permanent total disability. -YES

Held:
SC GRANTED THE PETITION OF PABLO AUSTRIA.

PD 626 as amended provides three types of disability benefits to qualified employees:

(1) temporary total disability,
(2) permanent total disability, and
(3) permanent partial disability.

Under Section 2 Rule VII of the Amended Rules on Employees Compensation, 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; and 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.

We held in Vicente vs. Employees Compensation Commission that:

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 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.

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.

In Gonzaga vs. Employees Compensation Commission, the Court characterized permanent total disability as:

x x x disablement of an employee to earn wages in the same kind of work, or work of a similar nature that she
was trained for, or accustomed to perform, or any kind of work which a person of her mentality and attainment
could do. It does not mean an absolute helplessness but rather an incapacity to perform gainful work which is
expected to be permanent. 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 she cannot pursue her usual work and earn
therefrom.

Applying the foregoing standards, we find petitioner entitled to permanent total disability benefit under the law. Petitioner
has been employed as bag piler for twenty (20) years at the Central Azucarera de Tarlac. His duties require him to carry
heavy loads of refined sugar and to perform other manual work. Since his work obviously taxes so much on his back,
his illness which affects his lumbar spine renders him incapable of doing his usual work as bag piler. Hence, his disability
to perform his regular duties may be considered total and permanent.

Contrary to the assertion of the Court of Appeals, there is nothing in the law that prohibits the conversion of permanent
partial disability benefit to permanent total disability benefit if it is shown that the employees ailment qualifies as such.
Furthermore, the grant of permanent total disability benefit to an employee who was initially compensated for permanent
partial disability but is found to be suffering from permanent total disability would not be prejudicial to the government to
give it reason to deny the claim. The Court has in fact allowed in the past the conversion of permanent partial disability
benefit to permanent total disability benefit. These rulings are consistent with the primary purpose of PD 626, that is, to
provide meaningful protection to the working class against the hazards of disability, illness and other contingencies
resulting in the loss of income, as well as the Constitutional mandate to afford full protection to labor.
KESTREL SHIPPING CO., INC. v. FRANCISCO D. MUNAR (G.R. No. 198501, January 30, 2013)

Facts:
 Kestrel and Francisco Munar forged a 6-month employment contract designating Munar as pump man for M/V
Souhtern Unity.
 On October 12, 2006, after Munar assisted in manually lifting the ship’s anchor windlass motor that weighs
about 350 kilograms, he started to limp and experience severe pain in his lumbar region.
 Munar was admitted at the Entabeni Hospital in Durban, South Africa. According to his attending physician, Dr.
Soma T. Govender (Dr. Govender), the x-ray and magnetic resonant image (MRI) of Munar’s lumbar spine
showed degenerative changes, which required him to take pain medication, use pelvic traction, and undergo
physiotherapy.
 On October 24, 2006, Dr. Govender issued another medical report where he stated that while Munar’s improved
condition allowed him to travel, he would require assistance in carrying his things and should be lying down for
the entire duration of the trip. Munar should undergo further treatment and management in a spine rehabilitation
facility but if he would not register a positive response thereto, he must undergo surgery.
 Dr. Govender also declared Munar unfit to perform his usual sea duties. Whether he has further surgery or not,
it will not be possible for Mr. Munar to continue performing the "heavy manual duties" that hisjob requires any
longer, as this could exacerbate his lumbar spine problem. From this perspective he is medically unfit to continue
such duties.
 When he went back to the Philippines, he was admitted in the hospital and had undergone a lot of treatments.
 Based on Amended POEA Contract Section 32-CHEST-TRUNK-SPINE # 5-disability grade 8.
 Munar filed a complaint for total and permanent disability benefits and claimed that the mere fact that his medical
condition, which incapacitated him to engage in any gainful employment, persisted for more than 120 days
automatically entitles him to total and permanent disability benefits.

 LABOR ARBITER: AWARDED Munar with total and permanent disability benefits in the amount of
US$60,000.00.

 NLRC: AFFIRMED the decision of the LA.

 CA: AFFIRMED the decision of LA and NLRC and ruled that Munar’s continued inability to perform his usual
sea duties, which is attributable to his medical condition that is work-related, despite surgery and seven (7)
months of physical therapy, conclusively indicate that he is totally and permanently disabled. The CA noted that
while the company-designated doctors did not categorically state that Munar is unfit for sea duties, this is easily
inferable from their statement that he continues to experience pain, weakness and tenderness and would take
a long time to recover.

Issue:
Whether or not Francisco Munar's disability is considered as total and permanent. - YES.

Held:
SC DENIED THE PETITION OF KESTREL.

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.

Moreover, the company-designated physician is expected to arrive at a definite assessment of the seafarer’s fitness to
work or permanent disability within the period of 120 or 240 days. That should he fail to do so and the seafarer’s medical
condition remains unresolved, the seafarer shall be deemed totally and permanently disabled.

The Court has applied the Labor Code concept of permanent total disability to the case of seafarers.

In Philippine Transmarine Carriers v. NLRC, seaman Carlos Nietes was found to be suffering from congestive
heart failure and cardiomyopathy and was declared as unfit to work by the company-accredited physician.
 The Court affirmed the award of disability benefits to the seaman, citing ECC v. Sanico, GSIS v. CA, and
Bejerano v. ECC 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."

It likewise cited Bejerano v. ECC, that in a 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.

In Vergara v. Hammonia Maritime Services, Inc., this Court read the POEA-SEC in harmony with the Labor Code and
the AREC in interpreting in holding that:

(a) the 120 days provided under Section 20-B(3) of the POEA-SEC is the period given to the employer to
determine fitness to work and when the seafarer is deemed to be in a state of total and temporary disability;
(b) the 120 days of total and temporary disability may be extended up to a maximum of 240 days should the
seafarer require further medical treatment; and
(c) a total and temporary disability becomes permanent when so declared by the company-designated physician
within 120 or 240 days, as the case may be, or upon the expiration of the said periods without a declaration of
either fitness to work or permanent disability and the seafarer is still unable to resume his regular seafaring
duties.

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 company-designated physicians and their familiarity with his medical condition.

It may be argued that these provide sufficient grounds for the dismissal of Munar’s complaint. Considering that the 240-
day period had not yet lapsed when the NLRC was asked to intervene, Munar’s complaint is premature and no cause
of action for total and permanent disability benefits had set in. While beyond the 120-day period, Dr. Chua’s medical
report dated May 3, 2007 was issued within the 240-day period. Moreover, Munar did not contest Dr. Chua’s findings
using the procedure outlined under Section 20-B(3) of the POEA-SEC. For being Munar’s 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. Chua’s disability grading. As Munar did not allege, much less, prove the contrary, there exists
no reason why Dr. Chiu’s 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 Munar’s 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 seafarer’s incapacity to perform his customary sea duties for more than 120 days.

Consequently, that after the expiration of the 120-day period, Dr. Chua had not yet made any declaration as to Munar’s
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.
NORIEL R. MONTIERRO v. RICKMERS MARINE AGENCY PHILS. INC. (G.R. No. 210634, January 14, 2015)

Facts:
 Rickmers hired Noriel Montierro as Ordinart Seaman with a basic monthly salary of USD420. He was assigned
to work on board the vessel MIV CSAV Maresias.
 Sometime in May 2010, while on board the vessel and going down from a crane ladder, Montierro lost his
balance and twisted his legs, thus injuring his right knee.
 Thereafter, on 31 May 2010, he was examined in Livorno, Spain by Dr. Roberto Santini, who recommended
surgical treatment at home and found him unfit for duty.
 Thus, Montierro was repatriated to the Philippines for further medical treatment.
 On the 91st day of Montierro’s treatment, Dr. Alegre (company-designated physician) issued an interimdisability
grade of 10 for "stretching leg of ligaments of a knee resulting in instability of the joint." He advised Montierro to
continue with the latter’s physical therapy and oral medications.
 On the 213th day of his treatment, Dr. Alegre issued a final assessment which states that he has Disability
Grade of 10 based on Section 32 of POEA contract.
 A month before Dr. Alegre’s issuance of the final disability grading, Montierro filed with the labor arbiter a
complaintfor recovery of permanent disability compensation in the amount of USD89,000, USD2,100 as
sickness allowance, plus moral and exemplary damages and attorney’s fees.
 To support his claim for total permanent disability benefits, Montierro relied on a Medical Certificate dated 3
December 2010 issued by his physician of choice, Dr. Manuel C. Jacinto, recommending total permanent
disability grading.

 LABOR ARBITER: ruled in favor of Montierro and held that he is entitled to permanent total disability benefits.
 The LA relied on the 120-day rule introduced by the 2005 case Crystal Shipping, Inc. v. Natividad. The
rule equates the inability of the seafarer to perform work for more than 120 days to permanent total
disability, which entitles a seafarer to full disability benefits.

 NLRC: AFFIRMED the decision of LA.

 CA: held that Montierro is merely entitled to "Grade 10" permanent partial disability benefits.
 The CA ruled that his disability could not be deemed total and permanent under the 240-day rule
established by the 2008 case Vergara v. Hammonia Maritime Services, Inc. Vergara extends the period
to 240 days when, within the first 120-day period (reckoned from the first day of treatment), a final
assessment cannot be made because the seafarer requires further medical attention, provided a
declaration has been made to this effect.
 The CA pointed out that only 215 days had lapsed from the time of Montierro’s medical repatriation
when the company-designated physician issued a "Grade 10" final disability assessment.
 Further, the CA upheld the jurisprudential rule that, in case of conflict, it is the recommendation issued
by the company-designated physician that prevails over the recommendation of the claimant’s
physician of choice.

Issues:
(1) whether it is the 120-day rule or the 240-day rule that should apply to this case; and – 240 DAY
(2) whether it is the opinion of the company doctor or of the personal doctor of the seafarer that should prevail –
COMPANY DOCTOR

Held:
SC DENIED THE PETITION OF NORIEL MONTIERRO.

120 day rule vs. 240 day rule

Based on Kestrel, if the maritime compensation complaint was filed prior to 6 October 2008, the 120-day rule applies;
if, on the other hand, the complaint was filed from 6 October 2008 onwards, the 240-day rule applies.

In this case, Montierro filed his Complaint on 3 December 2010, which was after the promulgation of Vergara on 6
October 2008. Hence, it is the 240-day rule that applies to this case, and not the 120-day rule.

Applying the 240-day rule to this case, Montierro’s condition cannot be deemed a permanent total disability.

Company doctor vs. personal doctor

The procedure is as follows: when a seafarer sustains a work-related illness or injury while on board the vessel, his
fitness for work shall be determined by the company-designated physician. The physician has 120 days, or 240 days, if
validly extended, to make the assessment. If the physician appointed by the seafarer disagrees with the assessment of
the company-designated physician, the opinion of a third doctor may be agreed jointly between the employer and the
seafarer, whose decision shall be final and binding on them.
In this case, Montierro and Rickmers are covered by the provisions of the same 2000 POEA-SEC. It is the law between
them. Hence, they are bound by the mechanism for determining liability for a disability benefits claim.

Montierro, however, preempted the procedure when he filed on 3 December 2010 a Complaint for permanent disability
benefits based on his chosen physician’s assessment, which was made one month before the company-designated
doctor issued the final disability grading on 3 January 2011, the 213th day of Montierro’s treatment. Hence, for failure
of Montierro to observe the procedure provided by the POEA-SEC, the assessment of the company doctor should
prevail.

Having extensive personal knowledge of the seafarer's actual medical condition, and having closely, meticulously and
regularly monitored and treated his injury for an extended period, the company designated physician is certainly in a
better position to give a more accurate evaluation of Montierro's health condition. The disability grading given by him
should therefore be given more weight than the assessment of Montierro's physician of choice.