In Andres L. Dizon vs. Naess Shipping Philippines, Inc. and DOLE UK (Ltd.), the Supreme Court reiterated that a seafarer’s failure to undergo a post-employment medical examination by a company-designated physician within three working days of repatriation, as mandated by the POEA-SEC, results in the forfeiture of their right to claim disability benefits. This ruling emphasizes the importance of strict compliance with procedural requirements in pursuing claims for work-related illnesses or injuries sustained during overseas employment. The decision clarifies that the mandatory reporting requirement applies not just to claims for sickness allowance but to all disability benefits under the POEA-SEC, safeguarding employers from unrelated disability claims and ensuring timely assessment of a seafarer’s condition.

Lost at Sea: When a Seafarer’s Delayed Check-Up Sinks His Disability Claim

Andres L. Dizon, a cook with decades of service on vessels managed by Naess Shipping Philippines, Inc. and DOLE UK (Ltd.), sought disability benefits after being declared unfit for sea duty due to uncontrolled hypertension and coronary artery disease during a pre-employment medical examination. Dizon had been continuously employed by the respondents since 1976, with his last contract ending in February 2007. A month later, during a routine pre-employment check for a new contract, he was deemed unfit, prompting his claim for permanent total disability benefits, arguing that his condition arose from the stressful working conditions on board the vessels. The respondents, however, denied liability, asserting that Dizon completed his last contract without incident and that his illness was not work-related. The legal crux centered on whether Dizon’s failure to comply with the mandatory post-employment medical examination within three days of repatriation forfeited his right to disability benefits.

The Labor Arbiter initially ruled in Dizon’s favor, awarding him US$60,000 in disability benefits, plus attorney’s fees, finding a logical connection between his illness and his long-term employment with the respondents. The National Labor Relations Commission (NLRC), however, reversed this decision, emphasizing Dizon’s non-compliance with the post-employment medical examination requirement. The NLRC acknowledged Dizon’s 30 years of service but deemed the failure to adhere to the mandatory examination a critical lapse, ultimately leading to the denial of his claim, though they granted him financial assistance of P50,000 for humanitarian considerations. This decision was later affirmed by the Court of Appeals, prompting Dizon to elevate the case to the Supreme Court, arguing that the failure to report within 72 hours should only forfeit claims for sickness allowance, not total disability benefits, and that his illness was indeed work-related.

The Supreme Court, in its analysis, turned to the governing law, specifically Section 20(B), paragraph 3 of the 2000 Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC). This provision explicitly outlines the liabilities of the employer when a seafarer suffers a work-related injury or illness during their contract. A key component of this section requires the seafarer to submit to a post-employment medical examination by a company-designated physician within three working days upon their return, unless physically incapacitated. The provision emphatically states that “failure of the seafarer to comply with the mandatory reporting requirement shall result in his forfeiture of the right to claim the above benefits.” This stipulation is crucial in determining the outcome of Dizon’s case, as his non-compliance directly impacted his ability to claim disability benefits.

The Court referred to Coastal Safeway Marine Services, Inc. v. Esguerra, where it was held that the company-designated physician is primarily responsible for assessing a seaman’s disability. However, the seafarer is not without recourse. They can seek a second opinion from a physician of their choice, and the labor tribunal and court will evaluate the medical reports based on their merit. Nevertheless, the Supreme Court emphasized that compliance with the three-day post-repatriation examination by the company-designated physician is mandatory.

“For the seaman’s claim to prosper, however, it is mandatory that he should be examined by a company-designated physician within three days from his repatriation. Failure to comply with this mandatory reporting requirement without justifiable cause shall result in forfeiture of the right to claim the compensation and disability benefits provided under the POEA-SEC.”

In Interorient Maritime Enterprises, Inc. v. Creer, the Court further justified the rationale behind this rule, stating that early reporting facilitates accurate diagnosis of the illness or injury’s cause. Delaying the examination makes it difficult to ascertain the cause and opens the door to potentially unrelated disability claims, which would unfairly burden the employer.

The Supreme Court found that Dizon did not comply with the mandatory post-employment medical examination requirement and offered no valid explanation for his non-compliance. He argued that failure to comply should only forfeit his claim for sickness allowance, invoking rules of statutory construction. However, the Court rejected this interpretation, stating that the term “above benefits” in Section 20(B), paragraph 3 of the POEA-SEC refers to all compensation and disability benefits outlined in the contract, not just sickness allowance. The Court underscored that Dizon’s non-compliance with the three-day post-employment medical examination was fatal to his claim. The high court further asserted that a person claiming entitlement to benefits must establish their right with substantial evidence. The burden rests on the seafarer to prove that they suffered a work-related injury or illness during their contract.

Section 20 (B), paragraph 6 of the 2000 POEA-SEC specifies that in cases of permanent disability caused by injury or illness, the seafarer shall be compensated according to the schedule of benefits in Section 32 of the contract. For disability to be compensable, two elements must concur: the injury or illness must be work-related, and it must have existed during the term of the seafarer’s employment contract. It is not enough to show that the seafarer is disabled; a causal connection between the illness and the work must be established. Work-related illness, as defined in the 2000 POEA-SEC, is any sickness resulting in disability or death as a result of an occupational disease listed under Section 32-A of the contract, with the conditions set therein satisfied. For cardiovascular disease to be considered an occupational disease, the seafarer must demonstrate that they developed the disease under specific conditions outlined in Section 32-A (11) of the 2000 POEA-SEC. Dizon’s repatriation was due to the expiration of his contract, not medical reasons, and his coronary artery disease was diagnosed during a pre-employment medical examination, not a post-employment one.

The Supreme Court emphasized that Dizon needed to provide concrete proof that he acquired his illness during the term of his employment contract. Dizon failed to demonstrate that his illness developed under the specific conditions set forth in the POEA-SEC for it to be considered a compensable occupational disease. The court noted the absence of evidence to suggest that Dizon, as a Chief Cook, manifested any symptoms of heart illness during his contract or that the strain of his work aggravated his condition. He also did not report any illness during or after his repatriation. While the Court acknowledged the principle of liberally construing the POEA-SEC in favor of seafarers, it could not sanction the award of benefits based on flimsy evidence and unjustified non-compliance with the mandatory reporting requirement. The failure to establish both compliance with the medical examination and a causal link between his work and illness led to the denial of his claim.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer’s failure to undergo a post-employment medical examination within three days of repatriation, as required by the POEA-SEC, forfeited his right to claim disability benefits. The court also examined whether his illness was work-related.
What is the POEA-SEC?	The POEA-SEC (Philippine Overseas Employment Administration-Standard Employment Contract) is a standard employment contract that governs the employment of Filipino seafarers on board ocean-going vessels. It outlines the terms and conditions of their employment, including compensation and benefits for injury or illness.
What is the three-day mandatory reporting requirement?	The three-day mandatory reporting requirement under the POEA-SEC requires a seafarer to submit to a post-employment medical examination by a company-designated physician within three working days of repatriation. Failure to comply with this requirement, without justifiable cause, results in the forfeiture of the right to claim disability benefits.
Why is the three-day reporting requirement important?	The three-day reporting requirement is important because it allows for a timely and accurate assessment of the seafarer’s medical condition by the company-designated physician. Early reporting makes it easier to determine the cause of the illness or injury, and it protects employers from unrelated disability claims.
What constitutes a work-related illness under the POEA-SEC?	A work-related illness under the POEA-SEC is any sickness resulting in disability or death as a result of an occupational disease listed under Section 32-A of the contract, with the conditions set therein satisfied. For cardiovascular disease, specific conditions must be met to establish it as a compensable occupational disease.
What evidence is needed to prove a work-related illness?	To prove a work-related illness, a seafarer must present substantial evidence showing that the illness was contracted during the term of their employment contract and that there is a causal connection between the illness and their work. This may include medical records, incident reports, and testimonies.
Can a seafarer seek a second medical opinion?	Yes, a seafarer has the right to seek a second medical opinion from a physician of their choice if they disagree with the assessment of the company-designated physician. The labor tribunal and court will evaluate both medical reports based on their merit.
What happens if a seafarer’s repatriation is due to contract expiration, not medical reasons?	If a seafarer’s repatriation is due to contract expiration and their illness is diagnosed during a pre-employment medical examination for a new contract, it becomes more challenging to establish that the illness was work-related and contracted during the previous employment. Compliance with the three-day reporting rule is then more critical.

The Supreme Court’s decision underscores the importance of adhering to the procedural requirements outlined in the POEA-SEC for seafarers seeking disability benefits. While the law aims to protect seafarers, it also requires them to comply with specific rules to ensure fairness and accuracy in disability claims. The strict enforcement of the three-day reporting rule serves to safeguard employers from potentially fraudulent claims and ensures that legitimate claims are processed efficiently.

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: Andres L. Dizon vs. Naess Shipping Philippines, Inc. and DOLE UK (Ltd.), G.R. No. 201834, June 01, 2016