G.R. No. 252347 - Ampolitod vs. Top Ever Marine Management Phils., Inc.

Rudy T. Ampolitod was hired on June 27, 2015, by Top Ever Marine Management Philippines Inc. for and on behalf of TEMM Maritime Company, Ltd., as an Able-Bodied Seaman to work on board the vessel "M/V Coral Opal" for nine months.
Prior to this, Ampolitod had continuous employment since 2009 with the same entities onboard various vessels in various positions.
Before deployment, he obtained a clean bill of health from company-designated doctors.

After joining the vessel on August 25, 2015, Ampolitod began feeling dizzy, weak, and tired in October 2015.
On October 22, 2015, he underwent a Complete Blood Count (CBC) test in Baton Rouge, Louisiana, USA; results showed a platelet count of 51, below the normal range (150-400).
On October 25 and 26, 2015, he experienced bruising, dizziness, and blurred vision; he was sent to West Jefferson Medical Center where he was diagnosed with Thrombocytopenia and declared unfit to work.
He was medically repatriated to the Philippines on October 29, 2015.
Admitted at Manila Doctors Hospital on October 31, 2015, where he was diagnosed with Pancytopenia Secondary to Idiopathic Thrombocytopenia Purpura, compatible with Myelodysplastic Syndrome (MDS), as confirmed by bone marrow biopsy on November 16, 2015.
Cytogenetic analysis showed no genetic cause for MDS.

Company contended that Ampolitod had Isolated Anemia in June 2015 but was cleared for employment.
Underwent treatment for seven months until May 2016 when treatment was discontinued after normal CBC results and declared fit to work, though recommended to continue monitoring CBC.
Ampolitod continued regular CBC tests at Capital University Medical Center, showing below-normal counts through August 2017, with symptoms persisting.
Consulted his personal hematologist, Dr. Alisa Q. Queja, who declared him not fit to work in September 2017.
Another doctor, Dr. May S. Donato-Tan, declared him permanently disabled.

Ampolitod filed a complaint on November 3, 2017, to recover permanent total disability benefits.
Parties agreed to refer the case to an internal medicine-adult hematologist, Dr. Ivy Mae Escasa.
Dr. Escasa confirmed MDS diagnosis with a survival estimate of 8.8 years and recommended that Ampolitod not work as a seafarer again; report did not indicate work-relatedness.

Labor Arbiter (LA) ruled in favor of Ampolitod, awarding total and permanent disability benefits, citing exposure to harmful chemicals at work as cause.
NLRC reversed the LA decision, dismissing the claim for lack of proof that illness was work-related.
Court of Appeals upheld the NLRC, affirming dismissal due to lack of substantial evidence to prove compensability.

Whether or not petitioner’s Myelodysplastic Syndrome (MDS) was work-related and hence compensable.
Whether petitioner is entitled to total and permanent disability benefits.
Whether the failure of the company-designated physician to issue a final, definite, and conclusive medical assessment and promptly inform the petitioner triggers the presumption of total and permanent disability.