G.R. No. 256495 - Alexei Joseph P. Grossman vs. North Sea Marine Services Corporation, et al.

On February 26, 2016, respondents V. Ships Leisure S.A.M. (through its agent North Sea Marine Services Corporation) hired petitioner Alexei Joseph P. Grossman as a Galley Utility aboard the vessel Silver Whisper for a period of eight (8) months, with a possible variation of plus or minus one (1) month.
The petitioner’s employment contract was covered by the International Transport Workers’ Federation (ITF) Cruise TCC-FIT/CISL Collective Bargaining Agreement (CBA) and the standard provisions of the POEA-Standard Employment Contract (POEA-SEC).

While on board the vessel in July 2016, petitioner experienced pain in his left knee radiating to his leg and thigh.
The ship doctor, upon being notified, referred petitioner for medical attention abroad.

A diagnosis was made indicating a “Tumor of distal metaepiphysis of left femur, which damaged the medial condyle with lysis of cortical rim and soft tissue component,” signifying an extremely high risk for a pathological fracture.

Due to the seriousness of his condition, petitioner was repatriated to the Philippines on August 5, 2016.
On August 8, 2016, petitioner reported to respondents' office and was referred to physicians designated by the company, specifically those of Trans Global Health System, Inc.
Medical assessments included:

Dr. Fidel Chua’s examination, which led to the conclusion of Giant Cell Tumor (GCT).
Dr. Tiong Sam Lim’s concurrence with Dr. Chua’s findings and his recommendation for resection of the tumor along with bone grafting.

On August 17, 2016, petitioner underwent surgery involving excision of the left femur mass, curettage, and application of bone cement, which resulted in left leg deformity and muscle atrophy.
Post-surgical rehabilitation included physical therapy from September 2016 until April 2017.

A Notice dated April 11, 2017 required petitioner to report for follow-up treatment; petitioner complied by reporting on May 12, 2017.
At the May 12, 2017 re-evaluation, Dr. Chua allegedly declared petitioner unfit for work and opined that his condition was not work-related; however, no formal medical report was issued regarding this assessment.
On March 2, 2018, Dr. Lim executed an Affidavit stating:

GCT is a benign tumor with unclear histogenesis.
The tumor is not known to be caused by trauma, environmental factors, or diet.
According to Dr. Lim, the condition was not work-related and bore no relation to seafaring activities.

Dissatisfied with the absence of a definitive final report, petitioner sought further medical evaluation from orthopedic specialist Dr. Renato P. Runas, whose Medical Evaluation Report (dated August 23, 2017) indicated:

Petitioner continued to experience pain in his deformed knee.
Physical therapy was no longer viable as it risked causing a fracture.
Petitioner was thereby declared “permanently and totally unfit to work in any capacity as a seafarer.”

Based on these conflicting medical findings, petitioner, through counsel, sent a letter on September 18, 2017 to North Sea requesting a meeting to discuss disability benefits, but received no favorable response.
Consequently, petitioner filed a Notice to Arbitrate before the Regional Conciliation and Mediation Board-NCR, resulting in voluntary arbitration.

Declared petitioner totally and permanently disabled.
Ordered respondents to pay full disability benefits under the POEA-SEC amounting to US$60,000 plus 6% per annum interest and 10% attorney’s fees.

The VA dismissed petitioner’s additional claims for lack of merit, stating that while the CBA did not cover non-accident-related illnesses, petitioner was still entitled to benefits under the POEA-SEC due to the company-designated physicians’ failure to render a final definitive assessment within the prescribed 120/240-day period.
Respondents filed a motion for reconsideration which was denied in a Resolution dated January 15, 2019, leading to the filing of a petition for review under Rule 43 before the Court of Appeals (CA).

In its Decision dated January 28, 2020, the CA reversed the VA’s ruling and dismissed petitioner’s claim by holding:

Although petitioner’s disability was initially presumed work-related pursuant to Section 32-A of the POEA-SEC, respondents successfully rebutted this presumption based on the explanations in the Medical Report by Dr. Chua (dated December 27, 2016) and the Affidavit by Dr. Lim (dated March 2, 2018).
Petitioner failed to prove, by substantial evidence, that his working conditions as a Galley Utility either caused or increased the risk of contracting GCT.
In a gesture of equity, the CA awarded petitioner financial assistance amounting to US$3,000.00.

Petitioner’s subsequent motion for reconsideration before the CA was denied in a Resolution dated May 21, 2021, which eventually led to the present petition for review before the Supreme Court.

Whether the CA reversibly erred in dismissing petitioner’s claim for total and permanent disability benefits under the POEA-SEC.

Whether the absence of a final and definite medical report from the company-designated physicians within the prescribed 120/240-day period warrants a declaration of total and permanent disability.
Whether the legal presumption of work-relation for illnesses not expressly listed under Section 32 of the POEA-SEC should have prevailed in petitioner’s favor, requiring respondents to discharge the burden of evidence proving the contrary.
Whether the conflicting medical opinions of Dr. Chua, Dr. Lim, and Dr. Runas were properly reconciled by the CA in addressing the work-relatedness of petitioner’s condition.