Case Summary (G.R. No. 142779-95)
Procedural History
Petitioner filed a claim for total and permanent disability benefits before the Panel of Voluntary Arbitrators (PVA). The PVA, by Decision dated August 1, 2017, awarded petitioner permanent and total disability benefits. Respondents filed for reconsideration, which the PVA denied. The Court of Appeals (CA) reversed and set aside the PVA decision, dismissing petitioner’s claim for lack of merit and holding petitioner guilty of material concealment; the CA denied reconsideration. Petitioner sought review by the Supreme Court, which granted the petition, reversed the CA, and reinstated entitlement to benefits.
Facts
Petitioner was declared fit for sea duty after a Pre-Employment Medical Examination (PEME) in December 2015 and embarked January 17, 2016. On April 23, 2016, while on board performing routine duties, he suffered a cardiac arrest and was diagnosed abroad with Non-ST-Elevation Myocardial Infarction and two-vessel coronary artery disease; he underwent coronary angiography and PCI stenting and was repatriated May 3, 2016. Post-repatriation, he was treated locally and had subsequent hospital confinement for dizziness (May 23–27, 2016). Company-designated medical personnel provided treatment and issued medical reports; petitioner later obtained an independent cardiologist’s certification (Dr. Efren R. Vicaldo) dated September 16, 2016, opining that petitioner’s cardiovascular disease was work-aggravated and that he was unfit to resume sea work.
Parties’ Contentions
Petitioner contends he did not conceal any pre-existing cardiovascular condition prior to PEME and that his April 2016 myocardial infarction occurred while performing onboard duties and was work-related, entitling him to disability benefits under the POEA-SEC. Respondents contend petitioner had prior diagnoses (hypertension and chest pain) and materially concealed these during PEME and information submissions; they further contend the illness was not work-related and that petitioner’s work duties were not sufficiently strenuous to cause or aggravate his heart condition.
Issues Presented
- Whether petitioner was guilty of material concealment of a previous medical condition. 2. Whether petitioner is entitled to total and permanent disability benefits under the POEA-SEC and related instruments.
Governing Legal Framework
The decision applies the 2010 POEA-SEC (as amended by POEA Memorandum Circular No. 10, series of 2010) and the parties’ CBA. Relevant provisions include Section 20 (compensation and benefits for injury or illness, obligations regarding post-employment medical examinations, reporting, and the procedure for differing medical assessments) and Section 32-A (occupational diseases and specific conditions for cardiovascular disease to be compensable). Jurisprudence on material concealment, assessment deadlines (120/240 days), and compensability of cardiovascular diseases was applied.
Analysis — Material Concealment
The Court found no proof of material concealment. First, the company-designated doctor’s assertion that petitioner admitted prior hypertension and long-standing chest pains was treated as hearsay and lacked independent corroboration; respondents did not present the purported PEME records that would support the alleged prior diagnosis. Failure to produce available medical records created a presumption unfavorable to respondents. Second, petitioner passed the pre-embarkation PEME and was declared fit for duty; had he been suffering from the asserted conditions, standard PEME tests would likely have detected them. Third, the May 5, 2016 information sheet in which petitioner answered “yes” to heart trouble/chest pain was contemporaneous to his April 2016 cardiac event and was reasonably read to refer to that recent event, not to an earlier diagnosis. Finally, even assuming a prior diagnosis existed, respondents failed to prove deliberate concealment with intent to deceive for malicious purpose—an essential element for fraud-based disqualification. On these bases, the Court concluded petitioner was not guilty of material concealment.
Analysis — Compensability and Causal Relationship
Under Section 32-A of the POEA-SEC, cardiovascular events are compensable if certain conditions are met, including proof that an acute exacerbation was precipitated by unusual strain at work, immediate onset and persistence of symptoms following the strain, or onset of symptoms during performance of work in an apparently asymptomatic person. The Court emphasized that petitioner was asymptomatic at PEME, began showing symptoms while performing his duties on April 23, 2016, and continued to exhibit symptoms thereafter. The Court accepted the PVA’s factual finding regarding petitioner’s duties being strenuous and involving hard manual labor (lifting, pushing, pulling heavy loads), and observed respondents did not sufficiently dispute or rebut that characterization. Given petitioner’s asymptomatic pre-embarkation status, symptom onset during work, persistent symptoms, and the nature of his duties, the Court found a reasonable causal relationship between petitioner’s work and his cardiovascular event, making the illness compensable under the POEA-SEC.
Analysis — Failure to Provide Final Medical Assessment within Mandatory Period
The POEA-SEC requires a company-designated physician to provide a definitive disability assessment within prescribed periods (120/240 days). The Court noted that respondents' company-designated physician initially opined the illness was not work-related but did not render a final, definitive assessment within the mandatory period: treatment records continued until June 24, 2016
...continue readingCase Syllabus (G.R. No. 142779-95)
Case Citation and Court
- Second Division, Supreme Court of the Philippines, G.R. No. 252195, Decision dated June 30, 2021.
- Ponente: Justice Lazaro-Javier.
- Voting/concurring justices noted: Perlas-Bernabe, Senior Associate Justice (Chairperson), M. Lopez, Rosario, and J. Lopez, JJ.; additional member designated per S.O. No. 2822 dated April 7, 2021.
Nature of the Proceeding and Relief Sought
- Petition for review on certiorari seeking reversal and setting aside the Court of Appeals dispositions in CA-G.R. SP No. 154289:
- Decision dated November 29, 2019 dismissing petitioner’s claim for total and permanent disability benefits; and
- Resolution dated March 3, 2020 denying petitioner’s motion for reconsideration.
- Petitioner prays that the Court of Appeals dispositions be reversed and set aside and that he be declared entitled to total and permanent disability benefits.
Antecedent Facts — Employment and Duties
- Petitioner (Jolly R. Carandan) was hired on January 15, 2016 by respondent Dohle Seafront Crewing Manila, Inc., on behalf of its principal Dohle (IOM) Limited, as an Able Seaman of the vessel “MV Favourisation” for nine months, with monthly salary of US$592.00.
- Petitioner’s responsibilities on board included strenuous physical activities at sea and in port, specifically:
- Operation of ballast tank valves and sounding during ballast operations;
- Cleaning the bridge, radio room, chart room and adjacent places as instructed by master or other officers;
- Stationing at mooring station during entering and leaving harbor and steering operations at the bridge as ordered by master;
- Preparing and securing cranes, cargo holds, windlass and other deck machinery before entering and leaving harbor; and
- Other tasks assigned by the master.
Pre-Employment Medical Examination (PEME) and Deployment
- In December 2015, petitioner underwent routine PEME prior to deployment.
- PEME inquiries included whether petitioner was aware of, diagnosed with, or treated for hypertension and heart disease; petitioner answered in the negative.
- Based on his PEME results, petitioner was declared fit for sea duty and deployed on January 17, 2016.
Incident On Board, Initial Medical Events, and Repatriation
- On April 23, 2016, about three months after boarding and while performing routine tasks, petitioner suffered a cardiac arrest, lost consciousness and passed out.
- He was taken to a doctor in Germany where diagnoses included coronary artery disease and myocardial infarct.
- Procedures performed: coronary angiography and percutaneous coronary intervention (PCI) stenting for two vessels.
- Final hospital discharge diagnosis: Non-ST-Elevation Myocardial Infarction (NSTEMI); Coronary Two Vessel Disease (LAD and LCX); Normal Ejection Fraction (50%).
- Petitioner was repatriated on May 3, 2016, and upon return was referred to the company-designated doctor and treated at Cardinal Santos Medical Center.
- From May 23–27, 2016, petitioner was confined again for dizziness and diagnosed with Benign Paroxysmal Vertigo; Ischemic Heart Disease secondary to Coronary Artery Disease; status post Percutaneous Coronary Angiogram for 2 Vessel Disease; and status post NSTEMI (February 2016).
Medical Opinions and Reports
- Company-designated medical evaluation (June 24, 2016): opined petitioner’s recuperation may last 124 days.
- Marine Medical Services’ Medical Coordinator (Dr. Esther Go) issued a brief clinical history and final diagnosis on June 24, 2016: Non-ST-Elevation Myocardial Infarction; Coronary Two Vessel Disease; S/P Percutaneous Coronary Intervention with Drug Eluting Stenting of LCX and LAD.
- Petitioner’s independent cardiologist (Dr. Efren R. Vicaldo), in a medical certificate dated September 16, 2016, opined:
- Petitioner’s cardiovascular disease was work aggravated;
- Recommended maintenance medication for one year, monitoring of lipid profile to maintain low LDL, low salt/low fat diet;
- Concluded petitioner is unfit to resume work as a seaman in any capacity.
Parties’ Contentions — Respondents
- Respondents contended petitioner was guilty of material concealment by answering “no” on his PEME regarding diagnosis or treatment for hypertension and heart disease.
- They claimed that upon repatriation petitioner admitted to Dr. Go that he had chest pains since 2000 and had been diagnosed with hypertension during his 2012 PEME for which he received maintenance medication.
- Respondents asserted petitioner later answered “yes” in May 2016 to questions on whether he had suffered from or been told he had heart trouble/chest pain, stroke, or undergone operations.
- Respondents argued petitioner’s illness was not work-related and that he was not exposed to extreme manual labor or noxious gases; they described his work as limited and with adequate rest.
- Because of alleged concealment and the non-work-related nature of the illness, respondents denied liability for disability benefits and halted treatment based on Dr. Go’s opinion.
Parties’ Contentions — Petitioner
- Petitioner vehemently denied ever telling Dr. Go that he had been previously diagnosed with hypertension or any cardiovascular disease.
- He maintained there is nothing on record substantiating Dr. Go’s allegation and that respondents did not present the purported PEME showing prior diagnosis.
- Petitioner explained that his “yes” answer on the May 5, 2016 Information Sheet referred to the April 2016 heart attack (the subject of the present claim), not to any pre-existing condition prior to deployment.
- He argued his cardiovascular disease was work related because he performed manual and strenuous labor on board and did not show signs of heart ailment prior to boarding in January 2016.
- Petitioner demanded payment of disability benefits; respondents allegedly ignored the demand.
Procedural History — Mandatory Conference and PVA Proceedings
- Parties failed to amicably settle during the mandatory conference.
- Panel of Voluntary Arbitrators (PVA) Decision dated August 1, 2017:
- Granted petitioner’s claim for total and permanent disability benefits in the amount of US$98,848.00 (representing permanent and total disability benefits) plus ten percent (10%) attorney’s fees or equivalent in Philippine Peso at time of payment.
- Other claims dismissed for lack of merit.
- Rationale of PVA:
- Found petitioner’s cardiovascular disease is listed under Section 32-A of POEA-SEC and that his duties on board aggravated his condition.
- Did not give credence to Dr. Go’s alleged statement about prior diagnosis for lack of proof.
- Noted respondents failed to present the purported PEME or rebut petitioner’s denial of any admission.
- Observed respondents did not give a definite and final medical assessment within the mandatory 120/240 days from repatriation.
- PVA Resolution dated January 5, 2018 denied respondents’ motion for reconsideration.
Court of Appeals Ruling
- Court of Appeals Decision dated November 29, 2019 reversed and set aside the PVA decision and dismissed petitioner’s claim for permanent total disability benefits for lack of merit.
- Court of Appeals rationale:
- Held petitioner guilty of material concealment for not disclosing a 2012 diagnosis of hypertension and chest pains with nocturnal dyspnea, and relied on discrepancies between PEME answers and the May 2016 Information Sheet.
- Found illness not work related: petitioner failed to show exposure to rigorous activities causing or aggravating heart condition; on the contrary, he was shown to have been given adequate rest.
- Held Dr. Vicaldo failed to show reasonabl