Maersk-Filipinas Crewing v. Lumagas
REITERATIONFacts
The Antecedents: Eugenio T. Lumagas, a 57-year-old Electrical Engineer with 12 years of service, was hired by Maersk-Filipinas Crewing, Inc. and A.P. Moller A/S. He underwent pre-employment medical examinations and was declared fit to work. While on board the vessel Thomas Maersk, Lumagas was exposed to the strenuous conditions of seafaring, including long working hours (8-16 hours daily) and the inherent stress of being away from family. On May 7, 2015, while performing maintenance, he experienced severe chest pains and difficulty breathing. He received initial medical attention upon docking and was repatriated on May 16, 2015. Subsequent examinations by company-designated physicians diagnosed him with Deep Vein Thrombosis, Ischemic Heart Disease, and Protein-S Deficiency. Lumagas also disclosed a pre-existing Hepatitis B diagnosis. Despite treatment, the company-designated physician eventually issued a Grade 7 disability grading. Lumagas sought a second opinion from his own physician, who concluded that his condition permanently and totally prohibited him from working. Procedural History: Lumagas filed a complaint for total and permanent disability benefits. The Labor Arbiter ruled in his favor, awarding total and permanent disability benefits, sickness allowance, and attorney's fees. Maersk-Filipinas and A.P. Moller appealed to the National Labor Relations Commission (NLRC), which modified the ruling to grant permanent and partial disability benefits based on the Grade 7 assessment of the company-designated physician, citing Lumagas's failure to adhere to the conflict resolution procedure. Both parties moved for reconsideration, which the NLRC denied. Subsequently, both parties filed separate petitions for certiorari before the Court of Appeals (CA). The CA denied both petitions, affirming the NLRC's decision and resolution, holding that the Grade 7 disability grading was final and binding due to Lumagas's non-compliance with the third-doctor referral rule. The Petition: Two consolidated petitions for review on certiorari were filed. Maersk-Filipinas and A.P. Moller argue that the NLRC gravely abused its discretion by allowing Lumagas to recover partial and permanent disability benefits, asserting Lumagas failed to prove a work-related connection and that he concealed a pre-existing Hepatitis B condition. They also contest the awards of attorney's fees and sickness allowance. Eugenio T. Lumagas, in his petition, argues that the company-designated physician's assessment lacked finality and definiteness, and that his own physician's diagnosis should prevail, leading to a conclusive presumption of total and permanent disability. He seeks full benefits based on his condition.
Issue(s)
Whether Lumagas's illnesses are work-related and compensable. Whether the Grade 7 disability assessment issued by the company-designated physician is final and controlling. Whether Lumagas is entitled to attorney's fees and sickness allowance.
Ruling
The Petitions are DENIED. The assailed September 19, 2019 Decision and the February 23, 2021 Resolution of the Court of Appeals in CA-G.R. SP No. 08058-MIN and CA-G.R. SP No. 08062-MIN are AFFIRMED.
Ratio Decidendi
On Issue 1: The Court affirmed the uniform finding of the CA, NLRC, and LA that Lumagas's illness was work-related and compensable, supported by facts and evidence. The Court reiterated that the compensability of an illness does not depend on whether it was pre-existing at the time of employment, but rather on whether it is work-related or aggravated by work. It is sufficient that there exists a reasonable work connection for the condition to be compensable, with probability being the touchstone. Lumagas was diagnosed with Deep Vein Thrombosis and Ischemic Heart Disease, which are cardiovascular events listed as occupational diseases under Section 32-A of the POEA-SEC. The Court noted the strenuous nature of Lumagas's duties, his 8 to 16-hour daily shifts, and the responsibility for maintaining all electrical devices and systems on the ship, leading to mental and physical stress that made him susceptible to cardiovascular diseases. The Court also dismissed the employer's claim that Lumagas concealed his pre-existing Hepatitis B condition, as records showed he disclosed it during his pre-employment medical examination (PEME). On Issue 2: The Court held that the Grade 7 disability rating issued by the company-designated physician was final and controlling. The Court emphasized that a final, conclusive, and definite medical assessment must clearly provide the seafarer's fitness to work or their exact disability rating, without any further treatment required. The company-designated physician's report stated, "If patient is entitled to disability, his final disability grading is Grade 7 – moderate [or residual] disorder," marking the end of his treatment of Lumagas. Lumagas failed to comply with the dispute resolution procedure in Section 20(A)(3) of the POEA-SEC, which requires referral to a third doctor jointly agreed upon by both parties if the seafarer's doctor disagrees with the company-designated physician's assessment. Because Lumagas filed his complaint shortly after securing a second opinion without referring the matter to a third doctor, the Grade 7 disability rating issued by the company-designated physician is controlling. On Issue 3: The Court upheld the CA's ruling affirming the award of attorney's fees and sickness allowance. In labor cases, attorney's fees are justified when wages or benefits are unpaid without justification, regardless of bad faith. Lumagas was compelled to litigate because Maersk-Filipinas and A.P. Moller refused to honor his claims even after the final disability rating. The Court also upheld the award of sickness allowance, finding that the evidence presented by Maersk-Filipinas and A.P. Moller to prove prior payment was unpersuasive, as the alleged bank transactions were not duly authenticated.
Main Doctrine
The case reiterates the established doctrine that the compensability of an illness for a seafarer does not depend on whether it was pre-existing at the time of employment, but rather on whether such illness is work-related or if the employee's condition was aggravated by work. It emphasizes that the degree to which the employee's work caused or aggravated the illness or injury need not be established with certainty, as it is enough that there exists a reasonable work connection for such condition to be compensable. The Court deems it sufficient that the worker's claim is probable, as probability, not certainty, is the touchstone. Furthermore, the case reinforces the mandatory nature of the third doctor referral rule in the POEA-SEC when there is a conflict in medical assessments between the company-designated physician and the seafarer's physician.