Sestoso v. United Philippine Lines, Inc.
REITERATIONFacts
The Antecedents: Petitioner Franciviel Derama Sestoso was hired as Team Headwaiter on board M/V Carnival Inspiration by respondent United Philippine Lines, Inc. (UPLI) for its foreign principal Carnival Cruise Lines. On October 31, 2014, while performing his duties, he experienced sharp pain in his right knee. An MRI revealed a complex tear of the medial meniscus and degenerative joint changes, noting a prior arthroscopy in February 2014. He continued working until his repatriation on February 13, 2015. Upon arrival, company-designated physicians treated him and referred him to an orthopedic surgeon who recommended surgery and assessed him with a Grade 10 disability rating, opining he had reached maximum medical improvement. Another company physician issued a final diagnosis of Osteoarthritis, Medial Meniscal Tear, Right Knee; SIP Arthroscopic Partial Menisectomy and Debridement of Osteophytes, Right Knee, but without a disability rating or fitness to work certification. Neither company physician issued a final disability rating within the 120/240-day period. A private physician diagnosed him with Severe Degenerative Osteoarthritis, right knee; Degenerative Osteoarthritis, left knee; Medial Meniscal Tear, right knee sip Arthroscopic Meniscectomy and Debridement, assessing him as partially and permanently disabled/unfit to work as a seafarer. Procedural History: Petitioner filed a complaint for total and permanent disability benefits, moral and exemplary damages, and attorney's fees. The Labor Arbiter awarded Grade 10 disability benefits. The National Labor Relations Commission (NLRC) awarded permanent and total disability benefits, citing the company-designated physician's failure to issue a definite assessment within the 240-day period. The Court of Appeals reversed the NLRC, ruling the illness was pre-existing and not work-related, thus the 120/240 window was inapplicable. The Petition: Petitioner seeks to reverse the Court of Appeals' decision, arguing his illness is work-related, as evidenced by the Grade 10 rating from the company-designated physician, and that the failure to issue a final assessment within the 120/240-day window entitles him to total and permanent disability benefits.
Issue(s)
Whether the Court of Appeals committed reversible error when it denied the award of total and permanent disability benefits to petitioner. Whether petitioner's illness is work-related and compensable. Whether petitioner's illness had become total and permanent due to the lapse of the 120/240-day window.
Ruling
The petition is meritorious. The Supreme Court reversed and set aside the decision of the Court of Appeals, ordering respondents to jointly and severally pay petitioner US$60,000.00 or its peso equivalent, representing total and permanent disability benefits, and ten percent (10%) attorney's fees, with legal interest.
Ratio Decidendi
On the issue of whether petitioner's illness is work-related and compensable: The Court held that compensability of an illness or injury does not depend on whether it was pre-existing, but on whether it is work-related or aggravated the seafarer's condition. Applying the principle from More Maritime Agencies, Inc. v. NLRC, the employer bears the burden of disproving the presumption of work-relatedness for illnesses not listed in the POEA-SEC. The Court found that respondents failed to refute this presumption. Furthermore, Osteoarthritis, the petitioner's condition, is listed as an occupational disease under Section 32-A (21) of the 2010 POEA-SEC. The nature of a headwaiter's work, involving carrying heavy loads, strenuous physical labor, joint strain, and exposure to temperature changes, directly aligns with the risks described for Osteoarthritis. The Court noted that petitioner had experienced symptoms even before his last contract, and his work conditions, including faulty posture and lifting heavy provisions, contributed to or aggravated his condition, making it work-related and compensable. On the issue of whether petitioner's illness had become total and permanent due to the lapse of the 120/240-day window: The Court reiterated that permanent disability means the inability to perform one's job for more than 120 days, and total disability means the inability to earn wages in the same or similar kind of work. Under the Labor Code and its Implementing Rules, temporary total disability lasting continuously for more than 120 days is deemed permanent and total, except as otherwise provided. The 120-day period can be extended up to 240 days if further medical attention is required, but the company-designated physician must issue a definitive assessment within this extended period. The records showed no such definitive assessment was issued by the company-designated physician within the 120/240-day period from petitioner's repatriation. The medical reports and certifications provided were not final assessments. Consequently, by operation of law, petitioner's disability became total and permanent, entitling him to the corresponding benefits. On the issue of whether the Court of Appeals committed reversible error when it denied the award of total and permanent disability benefits to petitioner: Considering that petitioner was compelled to litigate and incur expenses to protect his rights, the award of ten percent (10%) attorney's fees was deemed in order, consistent with established jurisprudence. Pursuant to Nacar v. Gallery Frames, the Court imposed legal interest at six percent (6%) per annum on the monetary awards from the date of finality of the decision until full payment.
Main Doctrine
A seafarer's illness is compensable if it is work-related or aggravated by his employment, even if pre-existing. Failure of the company-designated physician to issue a final disability assessment within the 120/240-day period results in the ipso jure grant of permanent and total disability benefits.