In a significant ruling, the Supreme Court held that a seafarer’s bladder cancer, aggravated by occupational exposure, is work-related and entitles him to total and permanent disability benefits. This decision underscores the importance of protecting seafarers’ rights and ensuring fair compensation for illnesses linked to their work environment. The court emphasized that even if an illness is not explicitly listed as an occupational disease, it can still be considered work-related if there’s a reasonable connection between the job and the condition, especially when the employer’s own doctor acknowledges occupational risk factors.

From the High Seas to the Courtroom: Can a Seafarer’s Cancer Claim Total Disability?

Aldrine Ilustricimo, a seafarer, experienced blood in his urine while working on a vessel. He was diagnosed with bladder cancer, and the company-designated doctor assessed him with a Grade 7 disability. Ilustricimo sought a second opinion, which deemed him unfit to work. Despite this, the company insisted on the Grade 7 rating. The central legal question revolves around whether Ilustricimo is entitled to total and permanent disability benefits, considering his illness’s potential link to his occupation and the conflicting medical assessments.

The case hinges on whether Ilustricimo’s bladder cancer is work-related. The Philippine Overseas Employment Agency Standard Employment Contract (POEA-SEC) stipulates that for an illness to be compensable, it must be work-related and exist during the employment contract. A work-related illness includes any sickness resulting from an occupational disease listed in Section 32-A of the POEA-SEC. Illnesses not listed are disputably presumed to be work-related. However, the seafarer must still provide substantial evidence that their work conditions caused or increased the risk of contracting the disease. It’s important to note that the employment doesn’t need to be the sole reason for the illness, it’s enough to show a reasonable link between the work and the disease.

In Ilustricimo’s case, the company doctor noted that risk factors for his bladder cancer included “occupational exposure to aromatic amines and cigarette smoking.” Given Ilustricimo’s 21 years of service, the court found it plausible that his work contributed to or aggravated his illness. Moreover, the company did not dispute Ilustricimo’s entitlement to disability benefits, but contested the extent of the disability. The VA considered the illness as work-related based on Section 32 of POEA-SEC, adding that even if the petitioner’s illness is not among those specifically mentioned in Section 32, the same is deemed work-related since the risk factors for the illness include occupational exposure to aromatic amines as stated on the company doctors’ medical certification. This admission significantly shifted the burden of proof.

The Supreme Court addressed the issue of compliance with the third-doctor referral procedure outlined in Section 20(A)(3) of the POEA-SEC. This section states that if the seafarer’s doctor disagrees with the company-designated doctor’s assessment, a third doctor may be jointly agreed upon, and their decision will be final and binding. The court emphasized that while this referral is mandatory, the company bears the burden of initiating the process once the seafarer expresses disagreement with the company doctor’s assessment.

The POEA-SEC stipulates:

SECTION 20. COMPENSATION AND BENEFITS
COMPENSATION AND BENEFITS FOR INJURY OR ILLNESS
The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:
If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the Employer and the seafarer. The third doctor’s decision shall be final and binding on both parties.

Despite Ilustricimo informing the company of his intent to seek a third opinion, the company failed to initiate the referral process. This failure is crucial because it prevents the company from insisting on its initial disability rating. The court noted that the company was notified of such intent. In Formerly INC Shipmanagement Incorporated v. Rosales, We reiterated Our earlier pronouncement in Bahia Shipping Services, Inc. v. Constantino that when the seafarer challenges the company doctor’s assessment through the assessment made by his own doctor, the seafarer shall so signify and the company thereafter carries the burden of activating the third doctor provision.

Moreover, the court clarified that the company-designated physician’s findings are not absolutely binding. Labor tribunals and courts can weigh the inherent merits of medical findings and consider other evidence. Ilustricimo’s condition required continuous medical intervention and the company doctors’ requirement for him to undergo periodic cystoscopy despite having undergone chemotherapy and surgery. This ongoing need for treatment, even after the 240-day period, indicated a total and permanent disability.

Considering that petitioner’s illness is serious in nature considering the company doctors’ requirement for him to undergo periodic cystoscopy despite having undergone chemotherapy and surgery. It further observed that petitioner was never declared “cancer-free” and “fit to work” by his attending physicians and his illness persisted despite the final disability grade of 7 given. For the VA, this means that petitioner could no longer return to the seafaring profession and is, thus, permanently and totally disabled.

The concept of disability extends beyond medical definitions, focusing on the worker’s ability to earn a living. As the court held in Hanseatic Shipping Philippines Inc. v. Ballon, total disability refers to “the disablement of an employee to earn wages in the same kind of work of similar nature that he was trained for, or accustomed to perform, or any kind of work which a person of his mentality and attainments could do.” In Ilustricimo’s case, the risk of recurrence associated with his previous occupation as Quarter Master made it unreasonable to expect him to resume sea duties. Given these circumstances, the court ruled that Ilustricimo is entitled to total and permanent disability benefits, aligning with the State’s policy to protect labor rights and ensure fair compensation.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer’s bladder cancer was work-related and entitled him to total and permanent disability benefits. The court considered the connection between his occupation and illness.
What is the significance of the company doctor’s assessment?	The company doctor’s assessment is initially important, but it is not absolutely binding. The courts and labor tribunals can consider other evidence and the merits of the medical findings.
What is the third-doctor referral procedure?	If the seafarer’s doctor disagrees with the company doctor, a third, jointly agreed-upon doctor can provide a final and binding assessment. The company bears the burden of initiating this referral process.
What happens if the company fails to initiate the third-doctor referral?	If the company fails to initiate the third-doctor referral, it cannot insist on its initial disability rating. The court can then consider other evidence to determine the extent of the disability.
What constitutes total and permanent disability for a seafarer?	Total and permanent disability refers to the inability to earn wages in the same kind of work or similar nature for which the seafarer was trained. It focuses on the loss of earning capacity.
Is an illness not listed in the POEA-SEC automatically not compensable?	No, illnesses not listed in Section 32 of the POEA-SEC are disputably presumed to be work-related. The seafarer must present substantial evidence linking their work conditions to the illness.
What evidence did the seafarer present to prove his bladder cancer was work-related?	The seafarer presented the company doctor’s report stating that risk factors included occupational exposure to aromatic amines. The VA considered this to be enough proof that his work had indeed caused, contributed, or at least aggravated his illness.
Why was the seafarer awarded total disability benefits in this case?	Because the court considered it unreasonable for him to continue being a seafarer due to the recurrence of the disease. The company doctor even required the seafarer to have periodic cystoscopy despite his previous chemotherapy and surgery.

This case reinforces the seafarer’s right to just compensation when occupational hazards contribute to serious illnesses. By emphasizing the company’s duty to initiate the third-doctor referral process and considering the broader impact of disability on earning capacity, the Supreme Court has strengthened the protections available to Filipino seafarers.

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: ALDRINE B. ILUSTRICIMO v. NYK-FIL SHIP MANAGEMENT, INC., G.R. No. 237487, June 27, 2018