G.R. No. 237487 - Ilustricimo vs. NYK-Fil Ship Management, Inc.

Petitioner Aldrine B. Ilustricimo was employed as a Quarter Master by respondent International Cruise Services Ltd. through respondent NYK-Fil Ship Management, Inc.
His period of employment spanned from 1993 until his last assignment onboard the vessel MV Crystal Serenity in April 2014.
Prior to embarking on duty, petitioner underwent a routine Pre-Employment Medical Examination and was declared physically fit.

In November 2014, while aboard the MV Crystal Serenity en route to Florida, USA, petitioner experienced gross hematuria (blood in his urine).
He reported the condition to his superiors and was given antibiotics for an initially suspected urinary tract infection.
Subsequent hospitalization in Key West, Florida, and a CT scan revealed three polypoid masses in his bladder.
Following medical repatriation on November 22, 2014, petitioner was referred to a company-accredited hospital.
Company-designated doctor, Dr. Nicomedes Cruz, diagnosed him with “urothelial carcinoma of the urinary bladder, low grade” (bladder cancer).

Petitioner underwent a series of chemotherapy sessions and operations.
A report dated March 6, 2015, by Dr. Cruz provided an interim disability assessment of Grade 7, noting contributory risk factors such as occupational exposure to aromatic amines and cigarette smoking.
A later report on June 23, 2015, mentioned persistent symptoms (on and off hypogastric pain) and recommended repeat cystoscopy.
On June 30, 2015, Dr. Cruz issued a final assessment confirming a Grade 7 disability (moderate residuals/disorder of the intra-abdominal organ).
In September 2015, petitioner had another operation at his own expense.
Seeking a second opinion, petitioner consulted Dr. Richard Combe who certified his condition as one warranting regular instillation chemotherapy and cystoscopy every three months, thereby declaring him unfit to work.

On October 16, 2015, petitioner’s counsel sent a letter to respondents formally claiming total and permanent disability benefits.

The letter highlighted petitioner’s prolonged incapacitation, his consultation with a second physician, and attached supporting medical reports.
It also expressed his willingness to undergo further examinations to prove the extent of his disability.

On October 25, 2016, the Panel of Voluntary Arbitrators (VA) issued a decision in favor of petitioner, awarding total and permanent disability benefits amounting to USD95,949.00.

The VA’s decision was based on the severity of petitioner’s bladder cancer and the risk factors noted by the company-designated doctor.

Respondents elevated the case to the Court of Appeals (CA).
The CA modified the award by ruling petitioner was entitled only to partial permanent disability benefits (USD40,106.98).

CA’s reasoning was anchored on petitioner's failure to secure a second and, subsequently, a third medical opinion as mandated by the 2010 POEA Standard Employment Contract (POEA-SEC).

Petitioner moved for reconsideration before the CA but was denied, prompting the current petition for review under Rule 45.

Whether the CA erred in ruling that petitioner is not entitled to total and permanent disability benefits.

Whether petitioner’s illness (bladder cancer) is work-related and compensable under Section 20(A) of the POEA-SEC.
Whether the reliance on the company-designated doctor’s Grade 7 assessment was proper given petitioner’s submission of a second medical opinion.
Whether petitioner’s failure to activate the third doctor referral procedure constituted a breach of his contractual obligation under the POEA-SEC.
The extent to which the respondents’ non-referral to a third doctor affected the due process of assessing the proper disability rating.