G.R. No. 250806 - Avior Marine, Inc. vs. Turreda

Case Summary (G.R. No. 250806)

Factual Background: Employment, Medical Events, and Repatriation

Respondent’s initial sea deployment followed a pre-employment check-up in which he was declared fit for sea duties. During his voyage on the Water Phoenix, he experienced severe headaches. He reported his condition to the ship captain, who advised that he be examined in Ecuador. The attending doctor diagnosed migraine and prescribed analgesics. On June 14, 2016, respondent underwent further examination in Puerto Bolivar and was declared not fit for sea duties, leading to repatriation.

Upon arrival in the Philippines on June 19, 2016, respondent reported immediately to the company-assigned clinic under the supervision of the company-designated physician. He underwent a chest x-ray and electrocardiogram (ECG) and was prescribed medications including Losartan, Amlodipine, Afrovastatin, Celicoxib, and Febuxostat, which are consistent with treatment for hypertension and related cardiovascular risk factors.

Subsequently, on July 11, 2016, respondent underwent additional diagnostic tests, including a two-dimensional ECG and a treadmill stress test. He was diagnosed with sinus bradycardia and aortic valve sclerosis. Despite those findings, the company-designated physician issued a certificate of fitness to work on July 12, 2016, the very next day, without issuing any separate document indicating that respondent’s condition had already been resolved.

As symptoms persisted, respondent consulted his doctor of choice, Dr. Efren R. Vicaldo, in February 2017, who advised another two-dimensional ECG. Dr. Vicaldo diagnosed respondent with hypertensive cardiovascular disease, mitral regurgitation, and migraine headache, and certified him as unfit to resume work as a seaman in any capacity. Petitioners allegedly did not redeploy respondent to his former post despite the earlier company-issued certificate of fitness to work. Respondent then applied for work with other manning agencies but remained unemployed due to his medical condition.

Disability Complaint and the Parties’ Positions

Respondent filed a disability complaint against petitioners. He notified petitioners on May 27, 2017 of his willingness to refer the case to a third doctor, but petitioners did not set into motion the procedure for selecting such a doctor. Petitioners maintained that respondent did not establish total and permanent disability and argued that the company-designated physician’s assessment controlled over that of respondent’s doctor of choice.

Respondent contended that his illness was deemed work-related because petitioners presented no contrary evidence. He also argued that, since he had been declared fit during the pre-employment medical examination, the illness suffered aboard the Water Phoenix should be considered work-related or at least aggravated by his employment conditions.

Proceedings Before the Labor Arbiter: Dismissal of the Complaint

In a Decision dated February 12, 2018, the Labor Arbiter dismissed respondent’s complaint for lack of merit. The Labor Arbiter reasoned, first, that there was no basis for disability benefits because respondent had already been cleared of the migraine that caused his repatriation. Second, it held that respondent’s hypertensive cardiovascular disease was neither work-related nor aggravated by his work conditions, and it was also not the cause of the repatriation. Third, the Labor Arbiter characterized respondent’s claim as dubious because he sought his doctor of choice’s opinion only after eight months from the issuance of the company-designated physician’s certificate of fitness to work.

NLRC Review: Grant of Total and Permanent Disability Benefits

Respondent appealed to the NLRC. In a Decision dated May 21, 2018, the NLRC granted respondent’s appeal and vacated the Labor Arbiter’s dismissal. The NLRC held that respondent was entitled to total and permanent disability benefits in the amount of US$60,000.00, plus ten percent (10%) attorney’s fees.

In explaining its grant, the NLRC emphasized perceived weaknesses in the employer’s medical basis. It noted that the company-designated physician examined respondent only on two dates—June 22, 2016 and July 12, 2016—and that petitioners failed to attach copies of laboratory results, chemical examinations, and specialist reports to support the company physician’s findings beyond unsigned reports. The NLRC further observed that the company-designated physician issued a certificate of fitness to work on July 12, 2016, despite advising respondent to continue medications for high blood pressure, and it characterized the manner and timing of the declaration as hasty.

The NLRC concluded that there was no conclusive and definite medical assessment of respondent’s condition. It therefore ruled that the provisional nature of the “fit to work” declaration effectively transformed the disability into one that should be treated as total and permanent.

CA Ruling: Affirmance Based on Lack of a Final and Definitive Company Assessment

On August 16, 2019, the CA affirmed the NLRC. The CA agreed that respondent was entitled to total and permanent disability benefits and focused on the validity and completeness of the company-designated physician’s medical assessment.

The CA observed that the company-designated physician issued an unsigned Final Report on July 12, 2016—treated in the decision as the twenty-fifth day after respondent’s repatriation—stating that respondent had conditions such as Hypertension Stage 1, controlled, Hyperuricemia, and Dyslipidemia, and that respondent was “fit to return to work as of today 12 July 2016.” In the CA’s view, respondent’s medical condition remained uncertain because he was diagnosed with conditions requiring continued medication. The CA also doubted the quality of the assessment because it lacked the signature of the company-designated physician and allegedly did not reflect a final, conclusive resolution of respondent’s ailments.

The CA concluded that, without a valid final and definitive assessment from the company-designated physician, respondent’s temporary and total disability became permanent and total by operation of law. On November 27, 2019, the CA denied petitioners’ motion for reconsideration, prompting the petition to the Court.

Issues Presented

The petition raised two principal questions:
First, whether the illness suffered by respondent on board the Water Phoenix was work-related or aggravated by his employment.
Second, whether the medical assessment issued by the company-designated physician was complete and definitive.

Legal Basis and Reasoning: Work-Relatedness and the POEA-SEC Presumptions

The Court ruled that the petition lacked merit. It began by restating the compensability framework under the POEA-SEC, particularly that any disability caused by an occupational disease is deemed work-related. Under the 2000 POEA-SEC, a work-related illness is one resulting in disability or death as a result of an occupational disease listed under Section 32-A of the Contract with the conditions set therein satisfied.

The Court cited Bautista v. Elburg Shipmanagement Philippines, Inc., where hypertensive cardiovascular disease is treated as an occupational disease under Section 32(A)(11), but only when the case meets any of the enumerated proof conditions. These conditions include proof that, when the disease was known to have been present during employment, there was an acute exacerbation precipitated by unusual strain; or that the severity of work-related strain was followed within twenty-four hours by clinical signs of cardiac insult; or that the seafarer had been apparently asymptomatic prior to the strain and showed signs and symptoms of cardiac injury during work that persisted thereafter.

Petitioners asserted that respondent suffered only a simple migraine, which caused his repatriation. The Court found that argument unpersuasive in light of medical evidence gathered during the post-repatriation company examination. It noted that upon respondent’s arrival, petitioners’ physician immediately subjected him to chest x-ray and ECG testing and prescribed drugs used for high blood pressure and prevention of heart disease, heart attacks, and strokes. The Court further relied on subsequent diagnostics showing sinus bradycardia and aortic valve sclerosis. It explained that aortic valve sclerosis is defined as calcification and thickening of a trileaflet aortic valve without obstruction and is treated as a potential marker of coexisting coronary disease and as an antecedent to clinically significant obstruction.

Given that respondent had exhibited no signs or symptoms of cardiac injury prior to deployment and had been declared fit for sea duty after the pre-employment medical examination, the Court treated respondent’s cardiovascular ailment as appearing in the course of employment. Absent any showing of a pre-existing cardiovascular ailment at embarkation, the Court applied the presumption recognized in the POEA-SEC framework. It held that petitioners failed to present countervailing evidence to overcome the disputable presumption of compensability of respondent’s hypertensive cardiovascular disease.

Medical-Conflict Procedure and the Third-Doctor Requirement Under the POEA-SEC

The Court also addressed the procedural issue concerning the conflict between medical assessments. It emphasized that for disputes in disability cases under the POEA-SEC, the process for referral to a third doctor requires joint agreement between the employer and the seafarer. It cited Section 20(A)(3) of the POEA-SEC providing that if the seafarer disagrees with the company-designated physician’s assessment, a third doctor may be agreed jointly, and that the third doctor’s decision shall bind both parties.

The Court cited INC Navigation Co. Philippines, Inc., et al. v. Rosales, clarifying that when the seafarer challenges the company doctor’s assessment through his own doctor, the seafarer must signify the ch

Case Syllabus (G.R. No. 250806)

Avior Marine, Inc., together with Carina Marine N.V. and/or Edna L. Ranara, filed a Petition for Review on Certiorari under Rule 45 seeking to reverse the Court of Appeals (CA) decisions that affirmed the National Labor Relations Commission (NLRC) ruling granting disability benefits.
The CA had affirmed the NLRC Decision finding Arnaldo R. Turreda entitled to total and permanent disability benefits.
The Supreme Court denied the petition for lack of merit and affirmed both CA dispositions.

Parties and Procedural Posture

Petitioners were Avior Marine, Inc. (a domestic corporation engaged in recruitment and placement of seafarers) and its local agents Carina Marine N.V. and Edna L. Ranara.
Respondent was Arnaldo R. Turreda, who pursued a disability claim arising from his medical condition during seafaring service.
The Labor Arbiter dismissed respondent’s disability complaint in a Decision dated February 12, 2018.
The NLRC reversed and granted respondent’s appeal, ordering payment of US$60,000.00 as total permanent disability benefits, plus 10% attorney’s fees.
The CA affirmed the NLRC through a Decision dated August 16, 2019 and denied petitioners’ Motion for Reconsideration in a Resolution dated November 27, 2019.
Petitioners elevated the case to the Supreme Court via a Rule 45 petition.

Key Factual Allegations

Petitioners hired respondent as Chief Cook for a nine-month contract with a basic monthly salary of US$725.00.
After a pre-employment medical examination, respondent was declared fit for sea duties and boarded the vessel Water Phoenix.
In the first week of June 2016, respondent experienced episodes of headache causing severe pain and reported the condition to the ship captain, who recommended examination in Ecuador.
A doctor in Ecuador diagnosed respondent with migraine and provided analgesics.
On June 14, 2016, respondent was examined in Puerto Bolivar and declared not fit for sea duties, resulting in repatriation.
On June 19, 2016, after arriving in the Philippines, respondent reported to the company-assigned clinic under Dr. George Y. Hernandez, underwent an x-ray and ECG, and received medications including Losartan, Amlodipine, Afrovastatin, Celicoxib, and Febuxostat.
On July 11, 2016, respondent underwent additional tests including a two-dimensional ECG and a treadmill stress test, and the results led to diagnoses of sinus bradycardia and aortic valve sclerosis.
Despite these test results, the company-designated physician issued a certificate of fitness to work on July 12, 2016, and no other document stated that respondent’s illness had already resolved.
As symptoms persisted, respondent consulted his doctor of choice, Dr. Efren R. Vicaldo, in February 2017, and was advised to undergo another two-dimensional ECG.
Dr. Vicaldo diagnosed respondent with hypertensive cardiovascular disease, mitral regurgitation, and migraine headache, and certified him unfit to resume work as a seaman in any capacity.
Petitioners did not redeploy respondent to his former post even after the company-designated physician issued a fitness-to-work certificate.
Respondent remained unemployed and filed a disability complaint against petitioners.
Respondent notified petitioners of his willingness to refer the case to a third doctor, but petitioners allegedly did not set the third-doctor process in motion.
Petitioners maintained that respondent failed to prove total and permanent disability and argued that the opinion of the company-designated physician controlled over the doctor-of-choice opinion.
Petitioners also argued that respondent failed to comply with the procedure for disputing the company-designated assessment because the third-doctor referral request was made after the case had already been instituted before the Labor Arbiter.

Labor Arbiter’s Ruling

The Labor Arbiter dismissed respondent’s complaint for lack of merit.
The Labor Arbiter held that there was no basis for the claimed total and permanent disability benefits because respondent had already been cleared of the migraine that caused the repatriation.
The Labor Arbiter found that respondent’s hypertensive cardiovascular disease was neither work-related nor aggravated by work conditions.
The Labor Arbiter also found that the hypertensive cardiovascular disease was not the cause of repatriation.
The Labor Arbiter considered respondent’s claim dubious because he sought the opinion of his doctor of choice only after eight months from the issuance of the company-designated physician’s fitness to work certificate.

NLRC’s Ruling

The NLRC granted respondent’s appeal and vacated the Labor Arbiter’s Decision.
The NLRC held that respondent was entitled to total and permanent disability benefits, ordering petitioners to pay US$60,000.00 (or its Philippine peso equivalent at the time of payment) plus 10% attorney’s fees.
The NLRC found that the company-designated physician examined respondent only twice in June 2016, on June 22, 2016 and July 12, 2016.
The NLRC noted that petitioners submitted only unsigned medical reports by the company-designated physician and did not attach copies of laboratory results, chemical examinations, or specialist’s reports.
The NLRC observed that the company-designated physician issued a fitness-to-work certification hastily, three weeks after instructing respondent to continue medications, and despite the ongoing clinical picture.
Based on the absence of a conclusive and definite medical assessment, the NLRC concluded that respondent’s condition should be treated as permanent and total disability.

CA’s Ruling

The CA affirmed the NLRC’s finding of entitlement to total and permanent disability benefits.
The CA emphasized that the company-designated physician’s unsigned Final Report dated July 12, 2016 (issued after respondent’s repatriation) indicated diagnoses of Hypertension Stage 1 (controlled), Hyperuricemia, and Dyslipidemia, and also stated that respondent was declared fit to return to work as of that date.
The CA reasoned that because the medical condition involved continued medication requirements, the condition was uncertain and the company-designated physician’s assessment was not treated as final.
The CA further held that the assessment was doubtful due to the lack of the company-designated physician’s signature.
The CA ruled that without a valid final and definitive assessment from the company-designated physician, respondent’s temporary and total disability became permanent and total by operation of law.
The CA denied petitioners’ Motion for Reconsideration in the assailed November 27, 2019 Resolution.

Issues Presented

The first iss