G.R. No. 156643 - Acejas III vs. People

Petitioner Kennedy R. Quines had been employed by United Philippine Lines, Inc. (UPLI) since 2002 and was assigned to board vessels without needing to re-apply.
On March 18, 2015, he signed an employment contract with UPLI on behalf of Shell International Trading and Shipping Co. as an Able Seaman under a POEA-approved contract incorporating the AMOSUP/IMEC Collective Bargaining Agreement.
Despite his pre-existing condition of hypertension, he underwent pre-employment medical examinations (PEME) and was repeatedly declared “fit for sea duties” before deployment.

On July 22, 2015, while on duty, petitioner experienced headache, nausea, muscle cramps, and stomach pain; he was initially given paracetamol by the vessel’s Captain.
On July 25, 2015, he was repatriated from Texas, USA, after being diagnosed with hypertension, neuropathy in the hands and feet, and nausea.
Upon arrival in the Philippines, petitioner was referred to a company-designated physician and later sent for a PEME on September 15, 2015, during which he disclosed his pre-existing condition.
On December 10, 2015, he again signed up for a six-month employment contract and was required to execute a Crew Medication Declaration stating he was carrying his maintenance antihypertensive medicines.

During the first week of March 2016, while aboard the vessel Silver Ebuna, petitioner experienced severe symptoms including chest pains, shivering of the limbs, dizziness, and shortness of breath.
His condition, marked by a blood pressure reading of 170/100 mmHg, led to his urgent repatriation on April 1, 2016, upon which he sought immediate medical attention from the company-designated physicians.
Further evaluations by cardiologists were performed: initially, Dr. Melissa Co Sia continued his treatment, whereas on November 15, 2016, new medications were prescribed; and subsequently, on December 7, 2016, Dr. Antonio C. Pascual diagnosed him with Ischemic Heart Disease and Hypertension Stage 2, declaring him “medically unfit to work as a seaman.”
Despite these developments, petitioner’s requests for a grievance meeting with UPLI over his prolonged incapacity were ignored.

Company-designated doctors issued conflicting medical reports on November 18, 2016:

One report noted that while his blood pressure was controlled and no absolute cardiovascular contraindication existed, petitioner continued experiencing episodes of dizziness and chest pain attributed to hyperventilation syndrome/anxiety and recommended psychiatric evaluation.
The other report ambiguously stated that petitioner was “not permanently unfit for sea duties” contingent upon the improvement of his symptoms.

Both assessments were incomplete and inconclusive, lacking a final and definitive disability rating as required under law.
The failure of the company-designated physicians to provide a conclusive assessment within the prescribed 120/240-day period raised the question of petitioner's actual capacity to resume seafaring duties.

Before the NCMB-Panel of Voluntary Arbitrators (PVA), petitioner claimed entitlement to total and permanent disability benefits due to work-related aggravation of his pre-existing hypertension leading to cardiovascular complications.
On December 1, 2017, the PVA ruled in petitioner’s favor, awarding him a total disability benefit of US$98,848.00, plus an additional 10% for attorney’s fees.
The PVA found that there was a reasonable connection between his strenuous job, the aggravation of his condition (including coronary or ischemic heart disease), and his ensuing repatriation.

Respondents contested the PVA’s award, arguing that petitioner’s evidence did not support a definitive diagnosis of Coronary/Ischemic Heart Disease and that mere hypertension does not automatically render one unfit for sea duties.
The Court of Appeals reversed the PVA award in its Decision dated April 24, 2019, holding that there was no final, conclusive diagnosis of permanent unfitness despite the medical reports.
The Court of Appeals also granted a modest financial assistance award of US$3,000.00, and petitioner was ordered to return the larger award adjusted by this amount.
Petitioner then elevated the case via a Rule 45 petition for a certiorari review of the appellate decision, asserting that the absence of a final disability assessment should result in a legal presumption of total and permanent disability.

Petitioner maintained that his condition, although pre-existing in terms of hypertension, was aggravated by the physical and emotional stress inherent in his duties as a seaman.
He argued that the failure of the company-designated physicians to give a final and definite medical assessment within the mandated period legally deems him as totally and permanently disabled.
Respondents, meanwhile, contended that the evidence did not establish a definite diagnosis of a work-related cardiovascular disease and that their medical assessments, which attributed symptoms to anxiety and transient conditions, should stand.

Whether petitioner is entitled to total and permanent disability benefits based on the aggravation of his pre-existing hypertension and the subsequent development of coronary/ischemic heart disease triggered by the strenuous nature of his work.

Does the failure of the company-designated physicians to issue a final and conclusive medical assessment within the prescribed 120/240-day period legally result in a presumption of total and permanent disability?
Is the aggravation of a pre-existing condition by work-related stress sufficient to render petitioner permanently unfit for sea duties under the applicable medical and legal standards?