In a significant ruling, the Supreme Court has affirmed the rights of seafarers to disability benefits when illnesses are contracted during their employment. This decision clarifies the burden of proof in establishing work-relatedness, especially when the illness is not explicitly listed as an occupational disease. The court emphasized that a disputable presumption exists in favor of the seafarer, requiring employers to provide a sufficient basis to refute the connection between the illness and the working conditions. This ruling offers crucial protection for seafarers, ensuring they receive just compensation for health issues arising from their service.

When a Laundryman’s Illness Unravels the Presumption of Work-Relatedness

Wero Jocosol Grona, a laundryman on the M/V Queen Elizabeth, suffered a bout of fever and flu-like symptoms during his employment. After being treated in Mexico, Grona was diagnosed with ruptured diverticulitis. Upon repatriation to the Philippines, the company-designated physician declared his condition as non-work-related, leading to the denial of disability benefits. The central legal question emerged: Is diverticulitis a work-related illness entitling Grona to compensation, and what evidence is sufficient to overcome the presumption in favor of the seafarer?

The Supreme Court began its analysis by recognizing that while diverticulitis is not specifically listed as an occupational disease under Section 32 of the 2010 POEA-SEC, it falls under the broader category of “Abdomen – Severe residuals of impairment of intra-abdominal organs which requires regular aid and attendance that will unable worker to seek any gainful employment.” This classification corresponds to a Grade 1 disability, indicating total and permanent disablement. Common sense dictates that the residuals of the impairment of Grona’s intra-abdominal organs are severe. The respondents recognized such severity when it enumerated the long list of ailments and the numerous procedures that Grona underwent after he was assessed with infection of the abdominal cavity in Mexico and eventually diagnosed with diverticulitis upon repatriation in the Philippines.

Building on this, the Court invoked Section 20(A)(4) of the 2010 POEA-SEC, which provides a disputable presumption of work-relation for illnesses not listed in Section 32. This presumption arises when a seafarer suffers an illness or injury during the term of their contract. The burden then shifts to the employer to prove that the illness is not work-related. As the Court explained in Ventis Maritime Corporation v. Salenga:

The disputable presumption of work-relatedness provided in paragraph 4 above arises only if or when the seafarer suffers from an illness or injury during the term of the contract and the resulting disability is not listed in Section 32 of the POEA-SEC. That paragraph 4 above provides for a disputable presumption because the injury or illness is suffered while working at the vessel. Thus, or stated differently, it is only when the illness or injury manifests itself during the voyage and the resulting disability is not listed in Section 32 of the POEA-SEC will the disputable presumption kick in. This is a reasonable reading inasmuch as, at the time the illness or injury manifests itself, the seafarer is in the vessel, that is, under the direct supervision and control of the employer, through the ship captain.

Therefore, the Court emphasized that the statutory presumption stands unless refuted by the employer. The employer can only overcome this presumption of work-relation if there is a sufficient basis to support the assessment that the seafarer’s illness was not work-related. The mere finding that the illness is not work-related is not automatically a valid medical assessment.

The Court found the respondents’ assessment lacking. The medical assessment merely defined diverticulitis but failed to provide a reasonable professional inference as to how Grona contracted the condition. While acknowledging the numerous procedures Grona underwent, the respondents did not present results from diagnostic tools demonstrating that Grona was exposed to the causes of diverticulitis (low fiber diet, constipation, and obesity) without any relation to his work as a laundryman.

The Court also noted the contradiction in the company-designated physicians’ statements. Dr. Olalia issued a medical certificate stating that diverticulitis refers to inflammation associated with diverticulosis, which cannot be acquired from dietary provisions. In light of these inconsistencies, the Court concluded that there was no sufficient medical assessment of non-work relation, thus failing to overturn the presumption of work-relation in favor of Grona.

The Court also addressed the respondents’ argument that Grona did not prove a causal connection between his illness and nature of work. The Court clarified that the general conditions enumerated under Section 32-A of the 2010 POEA-SEC are used to prove work-relation only when the illness is suffered after the term of the contract. Because Grona suffered his illness during the term of the contract, these conditions did not apply.

The Supreme Court then discussed the importance of a final and definitive medical assessment. The company-designated physician has 120 days, extendable to 240 days, from the seafarer’s repatriation to issue this assessment. Without a final and definitive medical assessment from the company-designated physician within the 120-days or 240-day extended period, the law steps in to consider the seafarer’s disability as total and permanent. Here, while the company-designated physicians issued a medical certificate stating that diverticulitis is not work-related, such medical assessment of non-work relation is not sufficient. Because the medical assessment was premature and far from being final since additional assessments may still be made up to November 7, 2015, or the expiration of the 240-day extended period, Grona is entitled to total and permanent disability benefits by operation of law.

Lastly, the Court addressed the opinion of a third doctor. While the 2010 POEA-SEC provides that the third doctor’s decision shall be final and binding on both parties, there was no third doctor appointed by both parties whose decision would be binding on the parties. Hence, it is up to the labor tribunal and the courts to evaluate and weigh the merits of the medical reports of the company-designated doctor and the seafarer’s doctor. Moreover, Grona cannot be faulted for not complying with the third-doctor referral provision of the 2010 POEA-SEC. As already explained, there was no final and definitive disability grading issued within the 120-day or 240-extended period.

Despite recognizing the respondents’ efforts to provide medical assistance to Grona, the Court awarded him disability benefits, reimbursement of medical expenses, and attorney’s fees. The Court found no bad faith on the part of the respondents to justify the award for moral and exemplary damages.

FAQs

What was the key issue in this case?	The central issue was whether Grona’s diverticulitis was a work-related illness entitling him to disability benefits under the 2010 POEA-SEC. The Court also examined the sufficiency of evidence to overcome the presumption in favor of the seafarer.
What is the disputable presumption of work-relatedness?	Section 20(A)(4) of the 2010 POEA-SEC provides a disputable presumption that an illness suffered by a seafarer during their employment is work-related. This shifts the burden to the employer to prove otherwise.
What constitutes a sufficient medical assessment from the company-designated physician?	A sufficient assessment must be final and definitive, reflecting the true extent of the seafarer’s sickness or injuries. It must also be based on medically acceptable diagnostic tools and methods, and provide reasonable professional inferences.
What is the 120/240-day rule?	The company-designated physician has 120 days from the seafarer’s repatriation to issue a final and definitive disability assessment. This period may be extended to 240 days if the seafarer requires further medical attention.
What happens if the company-designated physician fails to issue a final assessment within the 120/240-day period?	If no final assessment is made within the prescribed period, the law considers the seafarer’s disability as total and permanent. This entitles the seafarer to disability benefits.
What is the role of a third doctor in disability claims?	If the seafarer’s doctor disagrees with the company-designated physician, a third doctor may be jointly agreed upon. The third doctor’s decision is final and binding on both parties.
When are the general conditions under Section 32-A of the 2010 POEA-SEC used?	The general conditions under Section 32-A of the 2010 POEA-SEC are used to prove work-relation only when the illness is suffered after the term of the contract. The seafarer’s work must involve the risks described, the disease was contracted as a result of the seafarer’s exposure to the described risks, the disease was contracted within a period of exposure and under such other factors necessary to contract it; and there was no notorious negligence on the part of the seafarer.
What benefits is a seafarer entitled to if their illness is deemed work-related?	A seafarer with a work-related illness is entitled to disability benefits, reimbursement of medical expenses, and attorney’s fees. The specific amount of disability benefits depends on the disability grade assigned.

This Supreme Court decision reinforces the protection afforded to seafarers under Philippine law, particularly in cases where the work-relatedness of an illness is disputed. By clarifying the burden of proof and emphasizing the importance of a thorough and well-supported medical assessment, the Court has ensured that seafarers receive the compensation they deserve for illnesses contracted during their service.

For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.

Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: WERO JOCOSOL GRONA VS. SINGA SHIP MANAGEMENT PHILS. INC., G.R. No. 247532, October 06, 2021