C.F. SHARP CREW MANAGEMENT, INC.

/MANNY SABINO AND/OR NORWEGIAN CRUISE

LINE LTD., Petitioners, v. JOWELL P. SANTOS, Respondent.

Facts: Jowell P. Santos (respondent) was hired as an environmental operator by Petitioners, on board the
vessel "MIS Norwegian Gem" for a period of nine (9) months. Sometime in December 2011, respondent
experienced dizziness, over fatigue, frequent urination and blurring of the eyesight. He was brought to the
ship's clinic for initial medical examination and was found to have elevated blood sugar and blood pressure.
He was immediately referred to Cape Canaveral Hospital in Miami, Florida, USA, where he was found to
have a history of diabetes and has been smoking a pack of cigarettes daily for ten (10) years. On January
12, 2012, respondent was repatriated to the Philippines. The next day, he was immediately referred to CF
Sharp's company-designated physicians. It was confirmed that he had Diabetes Mellitus II and
hypertension. Respondent was advised to continue his medications. On May 4, 2012, respondent was
examined by a nephrologist who noted that he was asymptomatic with a blood pressure (BP) of 120/70. His
urinalysis and serum creatinine were normal. Thereafter, after 118 days from repatriation, the company-
designated physicians issued a certification stating that respondent's condition was not work-related and
that his final disability grading assessment for hypertension and diabetes was Grade 12. Unconvinced,
respondent consulted Dr. Donato-Tan, a specialist in Internal Medicine and Cardiology. In her medical
certificate, Dr. Donato-Tan noted that respondent had high blood pressure and uncontrolled diabetes
mellitus. She also opined that respondent's condition was work-related due to the pressure in the cruise ship,
which elevated his blood pressure, and that the food therein was not balanced, which elevated his blood
sugar. She concluded that respondent was permanently disabled to discharge his duties as a seafarer.
Hence, respondent filed a complaint for disability and sickness benefits with damages
LA- in favor of respondent
NLRC- modified- the grant of total and permanent disability benefits is set aside but the award of sickness
pay remains.
CA- reinstated LA
Issue: Whether respondent is entitled to permanent and total disability benefits due to his hypertension and
diabetes.
Held: No, The company-designated physicians timely gave their medical assessment within the 120-day
period The CA found that since respondent was unable to work as a seafarer for more than 120 days, he is
deemed to have a permanent and total disability. The SC disagrees, while a seafarer is entitled to temporary
total disability benefits during his treatment period, it does not follow that he should likewise be entitled to
permanent total disability benefits when his disability was assessed by the company-designated physician
after his treatment. He may be recognized to have permanent disability because of the period he was out of
work and could not work, but the extent of his disability (whether total or partial) is determined, not by the
number of days that he could not work, but by the disability grading the doctor recognizes based on his
resulting incapacity to work and earn his wages. Indeed, the mere inability of a seafarer to work for a period
of 120 days is not the sole basis to determine a seafarer's disability. After 118 days from repatriation, the
company-designated physicians issued a certification stating that respondent's condition was not work-
related and that his final disability grading assessment for his hypertension and diabetes was Grade 12.
More importantly, respondent never signified his intention to resolve the disagreement with petitioners'
company-designated physicians by referring the matter to a third doctor. It is only through the procedure
provided by the POEA-SEC, in which he was a party, can he question the timely medical assessment of the
company-designated physician and compel the petitioners to jointly seek an appropriate third doctor.
 Hypertension and diabetes does not ipso facto result into a permanent and total disability.
Respondent's hypertension was not essential or primary, hence, it was not severe. Thus, the company-
designated physicians concluded that respondent's hypertension was only a partial disability. The mere
occurrence of hypertension does not suffice because the POEA-SEC requires that it be severe or grave in
order to become a permanent and total disability. Notably, Sec. 32-A of the POEA-SEC recognizes that a
seafarer can still be employed even if he has hypertension and/or diabetes provided that he shows
compliance with the prescribed maintenance medications and doctor-recommended lifestyle changes.
LORNA B. DIONIO, Petitioner, v. ND SHIPPING AGENCY AND ALLIED SERVICES, INC.,
CARIBBEAN TOW AND BARGE (PANAMA) LTD., Respondents.

Facts: In 2006, Gil T. Dionio, Jr. (Gil), the husband of Lorna B. Dionio (petitioner), was hired by
respondents to serve as a Second Engineer on board the vessel MT Caribbean Tug. In, 2007, while in the
course of his extended employment (until February 13,2007), Gil suffered from a Urinary Tract Infection
(UTI) and prostate enlargement. While the vessel was in Turk and Caicos Islands, he was examined by Dr.
Smith. She declared him unfit for work and recommended his repatriation. On February 13, 2007, Gil was
medically repatriated. A representative of the ND Shipping sent an email10 to K. Arnesen Shipping, the
owner of the vessel, requesting for the medical check-up of Gil at the ship owner's expense. The request
was denied and stated that Gil must arrange for his own medical check-up. Thus, Gil was never examined
by the company-designated physician. Gil's health condition became worse. Sometime in February 2007,
he went for a medical examination at Biñan Doctor's Hospital in Biñan, Laguna at his own expense. As
Gil's health was deteriorating, he went home to his hometown in Iloilo. On June 5, 2007, he was admitted
at the Iloilo Doctor's Hospital. In the Medical Certificate Dr. Maclang diagnosed Gil with "Prostatic Cancer
Stage IV with wide spread metastasis." He also remarked that Gil undergo bilateral orchiectomy. After
more than a year of battling cancer, Gil succumbed to his illness. Thus, petitioner, the legal wife of Gil,
filed a complaint before the LA for payment of death benefits, sickness allowance, burial expenses, moral
and exemplary damages, and attorney's fees respondents denied any liability. They contended that Gil's
death is not compensable because he did not die during the term of his contract and his illness is not one of
those listed as an occupational disease. Respondents also argued that Gil failed to submit himself for a post-
employment medical examination within three (3) days after repatriation even though he was issued a
referral slip to the company-designated physician.
LA: In favor of petitioner
NLRC: Reversed the decision of LA
CA: Approved the decision of NLRC
Issue: Whether or not Gil complied with the mandatory post-employment examination and work-
relatedness of his illness.

Held: Yes, The rationale for requirement of post-employment examination is that reporting the illness or
injury by the seafarer within three (3) working days from repatriation fairly makes it easier for a physician
to determine the cause of the illness or injury. Ascertaining the real cause of the illness or injury beyond
the period may prove difficult. To ignore the rule might set a precedent with negative repercussions, like
opening floodgates to a limitless number of seafarers claiming disability benefits, or causing unfairness to
the employer who would have difficulty determining the cause of a claimant's illness because of the passage
of time. There are exceptions to the mandatory post-employment examination, to wit; (1) when he is
physically incapacitated to do so. (2) due to the employer's fault (an employer's unscrupulous practice of
deliberately or inadvertently refusing to refer the seafarer to the company-designated physician to deny his
disability claim). The burden to prove with evidence whether the seafarer was referred to a company-
designated doctor rests on the employer as the latter has custody of the documents, and not the seafarer.
Glaringly, respondents did not even state when Gil should visit the company-designated physician, raising
doubts on their sincerity to medically assess and treat him. Respondents left Gil to fend for himself. As he
could not secure the medical assistance from respondents, Gil had no choice but to seek medical treatment
elsewhere at his own expense- it is the employer that shall shoulder the cost of the seafarer's medical
treatment after his repatriation until such time that he is declared fit to work or the degree of his disability
has been established by the company-designated physician.
The list of illness/diseases in Sec. 32-A does not exclude other illnesses/diseases not so listed from
being compensable. The POEA-SEC cannot be presumed to contain all the possible injuries that render a
seafarer unfit for further sea duties. Those illnesses not listed in Sec. 32 of this Contract are disputably
presumed as work-related. In other words, a disputable presumption is created in favor of compensability.
. In other words, the disputable presumption does not signify an automatic grant of compensation and/or
benefits claim; the seafarer must still prove his entitlement to disability benefits by substantial evidence of
his illness' work-relatedness.Gil was already within the age group that is susceptible to prostate cancer. To
add to his dilemma, Gil was exposed to the stress and strains on board the vessel that every seafarer faces.
Respondents should have been mindful of the health condition of Gil, especially when Dr. Smith already
found him to be suffering from UTI and an enlarged prostate during his employment. The Court finds that
petitioner proved with substantial evidence that the illness of Gil was work-related. Thus, she can invoke
the disputable presumption that her husband's decease was worked-related. It is now the burden of
respondent to overcome such disputable presumption by presenting their own evidence. However,
respondents miserably failed to overcome the said disputable presumption of the work-related illness.
 MAGSAYSAY MOL MARINE v. MICHAEL PADERES ATRAJE

Facts: In 2014, Atraje entered into a Contract of Employment with petitioner, to work on board on vessel
as a cook. On March 4, 2014, at around noontime, Atraje slipped and fell while holding a casserole
containing water and sliced vegetables. His head hit the stainless disposer and the floor. He had seizure
and lost his consciousness for about five (5) hours. The incident was witnessed by the messman who was
with him at that time. When the vessel reached Singapore on March 8, 2014, he was brought to Singapore
General Hospital; he was diagnosed to have suffered Epileptic Seizure with post-fit neurological deficit.
He was declared unfit to work and recommended to be repatriated. Atraje arrived in the Philippines on
March 12, 2014, and was referred to Shiphealth, Inc. (Shiphealth) for further medical evaluation and
treatment. He was noted to have left-sided hemiparesis. He underwent repeat brain CT scan, and brain
MRI, which showed normal results. He was advised to undergo physical therapy for motor function and
muscle strength improvements. On April 25, 2014, Shiphealth issued a medical report stating that there
was no indication for Atraje to undergo further diagnostic or treatment intervention neurology-wise.
Hence, Atraje was discharged from Neurology service, although referral to Orthopedic Spine Surgery was
recommended. Atraje continued to suffer from shoulder and neck pain, and had difficulty in using his
upper extremities. On June 25, 2014 or 105 days from disembarkation, Shiphealth issued an Interim
Disability Grading of Grade 10: "Head, moderate paralysis of two (2) extremities producing moderate
difficulty in movements with self--care activities." Atraje sought payment of disability benefits from
Magsaysay Mol and Mol Ship However, Atraje's demands proved futile. Thus, he filed a Complaint
against Magsaysay Mol and Mol Ship for payment of total and permanent disability benefits, damages,
and attorney's fees. Petitioners insist that respondent's illnesses are not work-related.

Issue: Whether or not respondent is entitled with permanent and total disability benefits

Held: Yes, The facts of this case show that respondent was never issued any medical assessment or
progress report by the company-designated physicians, from his initial check up on March 13, 2014 until
his last consultation on October 2, 2014, spanning a total of 204 days. Neither the interim disability rating
issued on June 25, 2014 nor Dr. Quetulio's letter dated October 2, 2014 was given to respondent. Under
POEA-SEC, it is the primary responsibility of the company-designated doctor to determine the disability
grading or fitness to work of seafarers. To be conclusive, however, the medical assessment or report of
the company-designated physician must be complete and definite to give the seafarer proper disability
benefits. A final and definite disability assessment is necessary in order to truly reflect the true extent of
the sickness or injuries of the seafarer and his or her capacity to resume work as such. urthermore, while
the assessment of the company-designated physician vis a vis the schedule of disabilities under the
POEA-SEC is the basis for compensability of a seafarer's disability, it is still subject to the periods
prescribed in the law. Evidently, his illnesses disabled him to continue his job on board the vessel.
Despite medication and physical therapy, he was not restored to his pre-injury health status. Moreover,
there was no declaration from the company-designated doctors about his fitness to return to work, while
his own physician advised him to refrain from undergoing strenuous activities. Respondent's inability to
perform his customary sea duties, coupled with the company-designated physicians' abdication of their
primary duty to declare his fitness or unfitness to work within the prescribed period, transforms his
disability to permanent and total by operation of law