Grossman v. North Sea Marine Services Corporation
REITERATIONFacts
The Antecedents: Petitioner Alexei Joseph P. Grossman was hired as Galley Utility on board the vessel Silver Whisper. While on duty in July 2016, he experienced pain in his left knee, which was diagnosed as "Tumor of distal metaepiphysis of left femur, which damage medial condyle with lysis of cortical rim with soft tissue component[.] Extremely high risk for pathological fracture." He was repatriated on August 5, 2016. Procedural History: Petitioner reported to the company-designated physicians who diagnosed him with Giant Cell Tumor (GCT). He underwent surgery and physical therapy. On April 11, 2017, he was required to report for follow-up treatment on May 12, 2017. Petitioner alleged that on May 12, 2017, Dr. Chua declared him unfit to work and assessed his condition as not work-related, but no medical report was issued. Dr. Lim, in an affidavit dated March 2, 2018, stated GCT is benign, not work-related, and not caused by trauma or stress. Petitioner consulted Dr. Runas, who declared him permanently and totally unfit to work as a seafarer. Petitioner filed a complaint for disability benefits. The Voluntary Arbitrator (VA) found petitioner totally and permanently disabled and ordered respondents to pay benefits. The Court of Appeals (CA) reversed the VA ruling, dismissing the claim. The Petition: Petitioner seeks review of the CA decision, arguing that respondents failed to overthrow the presumption of work-relation and that the company-designated physicians failed to issue a final assessment within the prescribed period.
Issue(s)
Whether the Court of Appeals reversibly erred in declaring that petitioner is not entitled to total and permanent disability benefits under the POEA-SEC. Whether the company-designated physicians failed to issue a final and definitive assessment of the petitioner's disability within the prescribed periods. Whether the petitioner's illness, Giant Cell Tumor (GCT), is work-related.
Ruling
The petition is meritorious. The Court REVERSED and SET ASIDE the Decision of the Court of Appeals and REINSTATED the Decision of the Voluntary Arbitrators, ordering respondents to pay petitioner total and permanent disability benefits in the amount of US$60,000.00, or its equivalent in Philippine currency, plus ten percent (10%) attorney's fees and six percent (6%) legal interest per annum from finality of the Decision until fully paid.
Ratio Decidendi
On the entitlement to total and permanent disability benefits: The Court held that the petitioner is entitled to total and permanent disability benefits. It reiterated that a seafarer's entitlement is governed by medical findings, law, and contract. The POEA-SEC mandates that if the company-designated physician fails to issue a final and definitive assessment of the seafarer's disability within 120 days, or 240 days with justification, the disability is conclusively presumed to be total and permanent. In this case, the company-designated physicians failed to issue such a final assessment within the prescribed periods, despite the petitioner's continued treatment and re-evaluation until May 12, 2017, which was beyond the 240-day period. Consequently, the respondents failed to discharge their burden of controverting the presumption of work-relation, and the petitioner's obligation to present further evidence did not arise. On the failure to issue a final and definitive assessment: The Court found that the Medical Report dated December 27, 2016, and the Affidavit of Dr. Lim dated March 2, 2018, were insufficient to constitute the required final and definite assessment. The December 27, 2016 report lacked a categorical statement of unfitness and clear justification for non-work relation, and it was addressed to the employer, not the seafarer, failing the due process requirement. The Affidavit of Dr. Lim was issued far beyond the 240-day period and was considered a "mere afterthought." The Court emphasized that a final and definite assessment must inform the seafarer of their fitness or non-fitness, the disability rating, and whether the illness is work-related, with sufficient justification, and should no longer require further action from the physician. On the work-relation of the illness: The Court agreed with the VA that the presumption of work-relation was not successfully overthrown. Since illnesses not listed under Section 32-A of the POEA-SEC are disputably presumed work-related, the burden was on the employer to prove otherwise. The company-designated physicians' reports and affidavits did not sufficiently discharge this burden. The Court noted that the nature of GCT, with its unclear cause, further supports the probability that working conditions could have increased the risk, as suggested in Panotes v. ECC. The failure to provide a timely and definitive assessment meant the legal presumption of work-relation prevailed.
Main Doctrine
The failure of the company-designated physician to issue a final and definite assessment of a seafarer's disability within the 120/240-day period, without justifiable reason, results in the seafarer's disability being conclusively presumed total and permanent, entitling them to disability benefits.