Title
Dizon vs. Naess Shipping Philippines, Inc.
Case
G.R. No. 201834
Decision Date
Jun 1, 2016
Seafarer denied disability benefits due to failure to undergo timely post-employment medical exam and insufficient proof of work-related illness.
disability benefits
medical expenses
seafarer

Case Summary (G.R. No. 208086)

Factual Background

On the pre-employment medical examination in March 2007 for Dizon’s next contract, the examining doctors at the Marine Medical and Laboratory Clinic (MMLC) declared him unfit for sea duties, citing uncontrolled hypertension and coronary artery disease, based on medical certification. Dizon underwent further diagnostic procedures, including a stress test and electrocardiogram (ECG), at PMP Diagnostic Center Inc., and was also recommended to undergo angioplasty. His treadmill stress test showed abnormalities, including evidence of stress-inducible ischemic myocardium with risk involving specified coronary territories.

Unconvinced, Dizon sought another examination at the Seamen’s Hospital and presented a different medical result, which indicated that he was fit for sea duty. He then returned to MMLC and requested a re-examination, but MMLC denied it. In November 2008, Dizon filed a complaint before the Department of Labor and Employment, but later withdrew it.

On January 6, 2009, Dizon filed a complaint before the Labor Arbiter, seeking payment of total and permanent disability benefits, sickness allowance, reimbursement of medical, hospital and transportation expenses, moral damages, attorney’s fees, and interest. He alleged that his condition was incurred while working on board respondents’ vessel. He specifically asserted that his working conditions involved stress, heavy workload, and over-fatigue, and claimed that on February 16, 2009 Dr. Marie T. Magno re-evaluated his condition and declared him unfit to resume seafaring because his heart condition could not tolerate moderate to severe exertions.

Respondents denied work-relatedness. They alleged that Dizon completed his last contract without incident and that his sickness was not connected to his employment. They also refused his redeployment on the ground that he was declared unfit for sea duty based on his pre-employment medical examination.

Labor Arbiter Proceedings

In a Decision dated May 29, 2009, the Labor Arbiter ruled in Dizon’s favor and held him entitled to full disability benefits. The Labor Arbiter reasoned that it could logically be concluded that Dizon’s illness arose during his employment because less than a month elapsed between his repatriation and the pre-employment medical examination. The Labor Arbiter further noted Dizon’s long and continuous employment record of thirty (30) years in similar duties under the same working conditions, and it found that respondents failed to present evidence sufficient to overcome the presumption of compensability.

The dispositive portion ordered respondents jointly and severally to pay Dizon the Philippine peso equivalent at the time of actual payment of US$60,000.00 representing permanent total disability benefits, plus ten percent (10%) as attorney’s fees, for an aggregate of US$66,000.00.

NLRC Ruling

Respondents appealed. In its Decision dated May 29, 2009, the NLRC reversed and set aside the Labor Arbiter’s award. The NLRC concluded that Dizon did not comply with the mandatory requirement of a post-employment medical examination within three working days upon his return. It further held that Dizon failed to prove by substantial evidence that his working conditions increased the risk of contracting coronary artery disease.

Even so, the NLRC directed respondents, for humanitarian considerations, to pay P50,000.00 as financial assistance, citing Dizon’s thirty years of service. It thus reversed the award for US$66,000.00 but still provided limited assistance.

Court of Appeals Proceedings

Dizon then filed a petition for certiorari with the Court of Appeals, contesting the NLRC’s reversal. The Court of Appeals denied the petition and affirmed the NLRC’s disposition in a Decision dated February 28, 2012 and a subsequent Resolution dated May 9, 2012, sustaining the NLRC’s findings.

Issues Before the Supreme Court

Dizon’s petition to the Supreme Court raised issues framed around: whether he was barred from disability benefits for failure to report within seventy-two (72) hours from repatriation; whether his illness was work-related despite allegedly lacking factual and medical basis for the finding that it was not; and whether the courts erred in denying moral and exemplary damages and attorney’s fees. The Court treated the central question as entitlement to disability benefits.

Legal Basis and Reasoning

The Supreme Court reiterated that a seafarer’s entitlement to disability benefits is governed not only by medical findings but also by law and contract. It specifically applied Section 20(B), paragraph 3 of the 2000 POEA-SEC, which provides that when a seafarer signs off from the vessel for medical treatment, the seafarer is entitled to sickness allowance until declared fit to work or until permanent disability is assessed, but not exceeding one hundred twenty (120) days. For that purpose, the seafarer must submit to a post-employment medical examination by a company-designated physician within three working days upon return, except when physically incapacitated, in which case a written notice to the agency within the same period is deemed compliance. Failure to comply with the mandatory reporting requirement results in forfeiture of the right to claim the benefits.

Relying on prior jurisprudence, the Court emphasized that the mandatory post-employment medical examination is entrusted to the company-designated physician to assess the seafarer’s disability or illness. While that physician’s assessment is not necessarily final in a strict sense and the seafarer may seek a second opinion, the seafarer must still undergo the mandatory medical examination within three days. The Court held that non-compliance without justifiable cause results in forfeiture. It also stressed the rationale for the rule: prompt reporting makes it easier to determine the cause of the illness, and ignoring the rule would impair the employer’s ability to assess whether a claim is unrelated due to the passage of time.

Applying these principles, the Court found that Dizon did not submit himself to a post-employment medical examination within the three-day period after completing his contract and arriving back from the vessel. The Court noted that Dizon did not offer any explanation or reason for his failure to comply. Dizon argued that the failure merely forfeited his claim for sickness allowance and not his entitlement to disability benefits.

The Court rejected this construction. It held that Dizon’s reliance on the phrase “above benefits” in the POEA-SEC to limit forfeiture to sickness compensation was specious. The Supreme Court ruled that the forfeiture for failing to comply with the mandatory reporting requirement was not confined to sickness allowance; it extended to the right to claim the compensation and disability benefits under the POEA-SEC. It thus held that Dizon’s failure to comply was fatal to his claim for disability benefits.

The Court further addressed work-relatedness. It reiterated that a claimant must establish entitlement to benefits by substantial evidence and that the burden lies with the seafarer to prove that the injury or illness is work-related and existed during the term of the employment contract. Under the POEA-SEC framework, the Court required that two elements concur: (one) the illness must be work-related, and (two) the work-related illness must have existed during the term of the seafarer’s contract. For occupational diseases, including resulting disability or death, specific conditions must be met, including that the work involves the relevant risks, the disease is contracted as a result of exposure, and the disease is contracted within the period of exposure under relevant factors, with absence of notorious negligence.

For cardiovascular disease, which the POEA-SEC treats as an occupational disease under specified conditions, the Court required proof that if the heart disease was known to have been present during employment, an acute exacerbation had been clearly precipitated by unusual strain attributable to the nature of the work. The strain must be of sufficient severity and must be followed within twenty-four (24) hours by clinical signs of cardiac insult to establish causal relationship, or, alternatively, if a person had shown no symptoms prior to strain and then developed signs and symptoms during work with persistence thereafter, causal relationship may be inferred.

In Dizon’s case, the Supreme Court found that his repatriation occurred because his employment contract expired rather than due to medical reasons. It also emphasized that his coronary artery disease was diagnosed during the pre-employment medical examination and not through the required post-employment examination. The Court held it was crucial for Dizon to present concrete proof that he acquired or contracted the illness during his period of employment and that it was work-related.

The Court conclud

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