Ventura, Jr. vs. Crewtech Shipmanagement Philippines, Inc.

A seafarer claiming total and permanent disability benefits must establish by substantial evidence a reasonable causal link between his work and his illness; the disputable presumption of work-relatedness for non-occupational illnesses does not automatically entitle him to compensation, and failure to refer conflicting medical assessments to a jointly agreed third doctor under the 2010 POEA-SEC leaves the company-designated physician's assessment binding.

Petitioner Teodoro V. Ventura, Jr. was employed as Chief Cook by Crewtech Shipmanagement Philippines, Inc. for its principal, Rizzo-Bottiglieri-De Carlini Armatori S.P.A., under a nine-month contract governed by the 2010 Philippine Overseas Employment Administration Standard Employment Contract (2010 POEA-SEC). On April 4, 2014, the vessel to which he was assigned was transferred to Elburg Shipmanagement Phils., Inc., which assumed full responsibility for all contractual obligations to seafarers originally recruited and processed by Crewtech. The dispute concerns entitlement to total and permanent disability benefits, sickness allowance, and attorney's fees under the 2010 POEA-SEC, Articles 197 to 199 of the Labor Code, and Section 2(a), Rule X of the Amended Rules on Employees' Compensation.

Petitioner Teodoro V. Ventura, Jr. was employed by respondent Crewtech Shipmanagement Philippines, Inc. (Crewtech), for its principal, Rizzo-Bottiglieri-De Carlini Armatori S.P.A. (Rizzo), as Chief Cook on board the vessel MV Maria Cristina Rizzo under a nine-month contract signed on October 18, 2013, with a basic monthly salary of US$710.00 exclusive of overtime pay and other benefits. After undergoing the required pre-employment medical examination (PEME), where he was declared fit for sea duty by the company-designated physician, petitioner boarded the vessel on October 31, 2013. He claimed to have been consistently employed as Chief Cook by Crewtech for the past three years and assigned to its different vessels.

On April 4, 2014, the vessel MV Maria Cristina Rizzo was transferred to Elburg Shipmanagement Phils., Inc. (Elburg), which assumed full responsibility for all contractual obligations to its seafarers that were originally recruited and processed by Crewtech. Sometime in April 2014, petitioner complained to the Chief Mate that he was having a hard time urinating, accompanied by lower abdominal pain. He was given pain relievers and advised to take a substantial amount of water. Upon reaching the port of Singapore on April 30, 2014, petitioner was brought to a specialist at the Maritime Medical Centre and was diagnosed to have "prostatitis" and declared "unfit for duty." Petitioner disclosed to the foreign doctor that he had a history of prostatitis that occurred three years earlier, was treated for kidney stone in August 2013, and was not under any regular medication.

On May 1, 2014, petitioner was medically repatriated and referred to a company-designated physician for further evaluation and treatment. His ultrasound revealed "Cystitis with Cystolithiases; Prostate Gland Enlargement, Grade III with Concretions; and Bilateral Renal Cortical Cysts," while his CT stonogram showed "Cystolithiases; Bilateral Non-Obstructing Nephrolithiases; Bilateral Renal Cortical Cysts; Prostatomegaly." In a Medical Report dated May 5, 2014, the company-designated physician diagnosed petitioner's illnesses as "Cystitis with Cystolithiases; and Benign Prostatic Hyperplasia (BPH)," which he declared to be not work-related, explaining that cystitis secondary to cystolithiasis was usually due to a combination of genetic predisposition, diet, and water intake, while BPH involved changes in hormone levels that occur with aging.

Notwithstanding this finding, petitioner was consistently monitored by the company-designated physician and was recommended to undergo "Open Prostatectomy with possible Transurethral Resection of the Prostate" for his BPH and "Open Cystolithotripsy with Possible Laser Intracorporeal Lithotripsy and Endoscopic Extraction Bladder Stones" for his cystolithiasis. He was thereafter subjected to three sessions of "Extracorporeal Shockwave Lithotripsy," and the length of treatment was estimated at three months barring unforeseen circumstances. While awaiting approval of the procedures, the company-designated physician noted petitioner's increasing complaints of pain during urination accompanied by blood, for which he was prescribed medications. He was also inserted with an Indwelling Foley Catheterization to address his persistent hypogastric pain and difficulty in urination.

On July 10, 2014, petitioner underwent Open Prostatectomy with possible Transurethral Resection of the Prostate, as well as Open Cystolithotomy on his own account. On July 14, 2014, he also underwent "Cystoscopy, Evacuation of Blood Clots and Coagulation of Bleeders" and was subjected to continuous cystoclysis. Despite these procedures, petitioner still suffered from intermittent pain in his hypogastric area, and attempts to remove his indwelling foley catheter were unsuccessful. The specialist further opined that petitioner was suffering from urethral stricture and possible urinary bladder neck contracture, for which he was recommended to undergo "Urethroscopy, Visual Internal Urethrotomy, Cystoscopy, Transurethral Resection of Bladder Neck Contracture." In letters dated August 4, 2014 and September 18, 2014, the company-designated physician reiterated that petitioner's illnesses were not work-related, while his subsequent urethral stricture was only secondary to the series of surgeries he had undergone and was likewise not work-related.

On October 8, 2014, or prior to the expiration of the 240-day period reckoned from his repatriation on May 1, 2014, petitioner claimed that he was verbally informed by the company-designated physician that it would be his last check-up session and that subsequent consultations would be for his own account. Considering that his illnesses remained unresolved and he was still on catheters, petitioner sought an independent physician of his choice, Dr. May S. Donato-Tan, who, in a Medical Certificate dated October 20, 2014, declared him to be permanently disabled in view of his existing indwelling catheter that caused frequent urinary tract infection and rendered him incapable of performing his job effectively. Consequently, petitioner filed a complaint for total permanent disability benefits, sickness allowance, transportation and medical expenses, damages, and attorney's fees against Crewtech, Rizzo, and its President/Manager, Angelita Ancheta, before the NLRC, docketed as NLRC NCR Case No. (M)-10-13052-14.

The Labor Arbiter found that petitioner had a history of prostatitis in 2011 and did not take regular medication for it, and that there was no clear and convincing indication that his work as Chief Cook had aggravated his condition. The NLRC found no fraudulent concealment because Crewtech was aware of his past medical history, and that his work as Chief Cook may have increased the development, if not aggravation, of his illness. The CA found that petitioner willfully concealed his previous treatment for prostatitis in 2011 during his 2013 PEME and failed to establish a reasonable connection between the nature of his work and his illness.

• Grave Abuse of Discretion: Petitioner contended that the CA erred in holding that the NLRC gravely abused its discretion when it ruled that he was entitled to total and permanent disability benefits.
• Entitlement to Disability Benefits: Petitioner maintained that his illnesses remained unresolved and he was still on catheters, and that he was compelled to seek an independent physician who declared him permanently disabled because his indwelling catheter caused frequent urinary tract infections and rendered him incapable of performing his job effectively.

• Fraudulent Misrepresentation and Concealment: Respondents denied petitioner's claim for disability benefits, contending that he was guilty of fraudulent misrepresentation for failing to disclose his previous medical history of prostatitis and kidney stone treatment during his last PEME, disqualifying him from compensation and benefits under Section 20(E) of the 2010 POEA-SEC.
• Lack of Work-Relatedness: Respondents contended that petitioner's ailments, Cystitis with Cystolithiases and BPH, had no causal connection to his work and were declared by the company-designated physician to be not work-related, hence not compensable.
• Independent Physician and Third-Doctor Procedure: Respondents added that petitioner's independent physician did not contradict the finding that his illnesses were not work-related, and that his failure to observe the procedure for the joint appointment of a third doctor under Section 20(A)(3) of the 2010 POEA-SEC was fatal to his cause.
• Sickness Allowance and Damages: Respondents denied petitioner's claim for sickness allowance in view of his concealment, and averred that they had shouldered all necessary treatments, surgery, laboratory, hospital, professional fees, and medicines; they likewise denied moral and exemplary damages and attorney's fees for lack of basis.
• Substitution of Party: Respondents prayed that Crewtech be dropped as party-respondent and be substituted by Elburg.

• Grave Abuse of Discretion: Whether the CA erred in holding that the NLRC gravely abused its discretion when it ruled that petitioner was entitled to total and permanent disability benefits.
• Concealment: Whether petitioner's failure to disclose his previous prostatitis treatment in his 2013 PEME amounted to willful concealment under Section 20(E) of the 2010 POEA-SEC.
• Work-Relatedness: Whether petitioner's illnesses, Cystitis with Cystolithiases and BPH, were work-related and compensable.
• Third-Doctor Procedure: Whether petitioner's failure to observe the third-doctor conflict-resolution procedure under Section 20(A)(3) of the 2010 POEA-SEC made the company-designated physician's non-work-related assessment prevail.

• Grave Abuse of Discretion: No. The CA correctly held that the NLRC gravely abused its discretion because the claim for disability benefits was unsupported by substantial evidence.
• Concealment: No. Non-disclosure did not amount to willful concealment because respondents were aware of petitioner's past medical history, his 2011 prostatitis had been treated without further medication, and he was rehired in 2012.
• Work-Relatedness: No. Petitioner failed to establish by substantial evidence a reasonable link between his work as Chief Cook and his illnesses; mere allegations of stressful duties and hazardous conditions were conjectural.
• Third-Doctor Procedure: Yes. Under Section 20(A)(3), any disagreement between the company-designated physician and the seafarer's physician must be referred to a jointly agreed third doctor; non-observance means the company-designated physician's assessment prevails.

• Grave Abuse of Discretion: The Court denied the petition because the NLRC's award of total and permanent disability benefits was not supported by substantial evidence. Entitlement to disability benefits is governed by medical findings, law, and contract, particularly Articles 197 to 199 of the Labor Code in relation to Section 2(a), Rule X of the Amended Rules on Employees' Compensation, and the 2010 POEA-SEC. Since the evidence negated compensability, the NLRC's findings and conclusions were tainted with grave abuse of discretion, and the CA did not err in granting Elburg's certiorari petition. While liberality in favor of seafarers is observed, claims cannot be based on whims and caprices; when evidence negates compensability, the claim must fail to avoid injustice to the employer.
• Concealment: The Court disagreed with the CA's finding of willful concealment. Section 20(E) of the 2010 POEA-SEC disqualifies a seafarer who knowingly conceals a pre-existing illness in the PEME. Here, the company-designated physician's Medical Report dated May 2, 2014 provided a detailed medical history showing petitioner's past illnesses, the year he was treated, and where he obtained treatment, demonstrating that respondents were aware of his history. Petitioner's prostatitis had been treated in 2011 with no indication that further medical attention or maintenance medication was required, and he was rehired in 2012 and no longer found suffering from prostatitis during his PEME. Thus, his non-disclosure in 2013 did not amount to willful concealment, and he was truthful in answering "no" to whether he was suffering from any medical condition likely to be aggravated by sea service or render him unfit.
• Work-Relatedness: The Court agreed with the CA that the illnesses were not work-related. Under Section 20(A) of the 2010 POEA-SEC, the employer is liable only when the seafarer suffers a work-related injury or illness during the term of his contract. As a general rule, the disease must be listed as an occupational disease under Section 32-A; if not, Section 20(A) paragraph 4 provides that it is disputably presumed work-related. However, the presumption does not automatically result in disability compensation; the claimant still bears the burden of presenting substantial evidence that his work conditions caused or at least increased the risk of contracting the illness. Petitioner's prostatitis, cystitis with cystolithiases, and BPH became manifest while he was on board, but that alone did not entitle him to benefits. He had to show a reasonable link between his work and his illness, such that a rational mind could determine that the work contributed to or at least aggravated the illness. His general averments that he was exposed to stressful demands and hazardous conditions were mere allegations couched in conjectures; no evidence established how and why his working conditions increased the risk. Mere possibility was insufficient, and probability of work-connection had to be anchored on credible information. Even his physician of choice, Dr. Tan, failed to refute the company-designated physician's non-work-related assessment; she merely reiterated his medical history and declared him permanently disabled due to the catheter and frequent urinary tract infections.
• Third-Doctor Procedure: The company-designated physician's diagnosis bears vital significance because the 2010 POEA-SEC mandates the company-designated physician to arrive at a definite assessment of the seafarer's fitness to work or permanent disability. While the seafarer is not irrevocably bound and may seek a second opinion, Section 20(A)(3) provides that any disagreement in the findings may be referred to a third doctor jointly agreed upon by the parties, whose findings shall be final and binding. The Court has consistently held that non-observance of this requirement means the assessment of the company-designated physician prevails. Since petitioner failed to observe the conflict-resolution procedure, the company-designated physician's opinion that his illnesses were not work-related, hence not compensable, was upheld.

• Work-Relatedness in Seafarer Disability Claims — Under the 2010 POEA-SEC, an employer is liable for disability benefits only when the seafarer suffers a work-related injury or illness during the term of his contract. For a disease not listed as an occupational disease under Section 32-A, Section 20(A) paragraph 4 provides a disputable presumption of work-relatedness, but the presumption does not automatically entitle the seafarer to compensation. The claimant must still present substantial evidence that his work conditions caused or at least increased the risk of contracting the illness. In this case, the Court found that petitioner's general allegations of stressful duties and hazardous conditions were conjectural and did not establish a reasonable link between his work as Chief Cook and his cystitis with cystolithiases and BPH.
• Third-Doctor Conflict Resolution under the 2010 POEA-SEC — Section 20(A)(3) of the 2010 POEA-SEC provides that if a seafarer's doctor disagrees with the company-designated physician's assessment, a third doctor may be agreed jointly by the employer and the seafarer, and the third doctor's decision shall be final and binding. Non-observance of this procedure means the company-designated physician's assessment prevails. The Court applied this rule because petitioner failed to refer the conflicting assessments to a third doctor, leaving the company-designated physician's non-work-related finding binding.
• Willful Concealment under Section 20(E) of the 2010 POEA-SEC — A seafarer who knowingly conceals a pre-existing illness or condition in the PEME is liable for misrepresentation and disqualified from any compensation and benefits. The Court held that petitioner's failure to disclose his 2011 prostatitis treatment in his 2013 PEME did not amount to willful concealment because respondents were already aware of his medical history, the illness had been treated without further medication, he was rehired in 2012, and he truthfully answered "no" to whether he was suffering from a condition likely to be aggravated by sea service.
• Substantial Evidence and Grave Abuse of Discretion — A claim for disability benefits must be supported by substantial evidence; mere possibility or conjecture will not suffice. When the evidence presented negates compensability, the claim must fail. The Court held that the NLRC's award of total and permanent disability benefits was unsupported by substantial evidence and was therefore tainted with grave abuse of discretion.
• Liberality in Favor of Seafarers — While the Court adheres to the principle of liberality in favor of the seafarer, it cannot allow claims for compensation based on whims and caprices. When the evidence negates compensability, the claim must fail, lest injustice be caused to the employer. The Court applied this principle to deny the petition despite petitioner's status as a seafarer.

• "A seafarer who knowingly conceals a pre-existing illness or condition in the Pre-Employment Medical Examination (PEME) shall be liable for misrepresentation and shall be disqualified from any compensation and benefits." — This is the text of Section 20(E) of the 2010 POEA-SEC quoted by the Court; it supplies the disqualification rule that the Court applied in finding no willful concealment.
• "However, the presumption does not necessarily result in an automatic grant of disability compensation. The claimant still has the burden to present substantial evidence that his work conditions caused or at least increased the risk of contracting the illness." — This passage states the ratio on work-relatedness: the disputable presumption for non-occupational illnesses does not dispense with the seafarer's evidentiary burden.
• "The Court has consistently held that non-observance of the requirement to have the conflicting assessments determined by a third doctor would mean that the assessment of the company-designated physician prevails." — This passage articulates the consequence of failing to follow the third-doctor procedure under Section 20(A)(3) of the 2010 POEA-SEC.
• "Verily, while the Court adheres to the principle of liberality in favor of the seafarer, it cannot allow claims for compensation based on whims and caprices. When the evidence presented negates compensability, the claim must fail, lest injustice be caused to the employer." — This closing principle explains why the Court denied the petition despite its professed liberality toward seafarers.

• Doehle-Philman Manning Agency, Inc. vs. Haro, G.R. No. 206522, April 18, 2016, 790 SCRA 41, 52 — Cited for the rule that the disputable presumption of work-relatedness does not automatically result in a grant of disability compensation; the claimant still has the burden to present substantial evidence that his work conditions caused or at least increased the risk of contracting the illness.
• Gabunas, Sr. vs. Scanmar Maritime Services, Inc., 653 Phil. 457, 468 (2010) — Cited for the principle that mere possibility will not suffice; a claim will fail if there is only a possibility that the employment caused the disease.
• Status Maritime Corporation vs. Spouses Delalamon, 740 Phil. 175, 197 (2014) — Cited for the rule that probability of work-connection must at least be anchored on credible information, and bare allegations do not discharge the required quantum of proof.
• Ayungo vs. Beamko Shipmanagement Corporation, 728 Phil. 245, 255 (2014) — Cited for the rule that non-observance of the requirement to have conflicting assessments determined by a third doctor means the assessment of the company-designated physician prevails.
• Ace Navigation Company vs. Garcia, 760 Phil. 924, 936 (2015) — Cited for the principle that while the Court adheres to liberality in favor of the seafarer, it cannot allow claims for compensation based on whims and caprices; when the evidence presented negates compensability, the claim must fail.

• Section 20(E), 2010 POEA-SEC — A seafarer who knowingly conceals a pre-existing illness or condition in the PEME shall be liable for misrepresentation and disqualified from any compensation and benefits. The Court applied this provision but found no willful concealment because respondents were aware of petitioner's medical history and his prior prostatitis had been treated without further medication.
• Section 20(A), 2010 POEA-SEC — The employer is liable for disability benefits only when the seafarer suffers a work-related injury or illness during the term of his contract. The Court used this provision to require proof of work-relation before awarding benefits.
• Section 20(A)(4), 2010 POEA-SEC — Illnesses not listed in Section 32 are disputably presumed as work-related. The Court held that this presumption does not automatically result in disability compensation; the claimant must still present substantial evidence that his work conditions caused or at least increased the risk of the illness.
• Section 20(A)(3), 2010 POEA-SEC — If a doctor appointed by the seafarer disagrees with the company-designated physician's assessment, a third doctor may be agreed jointly between the employer and the seafarer, and the third doctor's decision shall be final and binding. The Court held that petitioner's failure to observe this procedure meant the company-designated physician's assessment prevailed.
• Section 32-A, 2010 POEA-SEC — Lists occupational diseases. The Court noted that as a general rule, work-relation requires that the disease be listed as an occupational disease under this section.
• Articles 197 to 199, Labor Code — Govern temporary total disability, permanent total disability, and permanent partial disability. The Court cited these provisions, in relation to Section 2(a), Rule X of the Amended Rules on Employees' Compensation, as part of the statutory framework for seafarer disability benefits.
• Section 2(a), Rule X, Amended Rules on Employees' Compensation — Provides the period of entitlement for temporary total disability benefits. The Court cited it as part of the governing statutory framework.

Antonio T. Carpio, Diosdado M. Peralta, and Alfredo Benjamin S. Caguioa. Andres B. Reyes, Jr. was on official leave.