FIRST DIVISION
[G.R. No. 251803. July 14, 2021.]
HEIRS OF THE LATE ROMMEL S. DIZON, REPRESENTED BY MRS. EDNALYN CASTRO DIZON, petitioners, vs.INTERORIENT MARITIME ENTERPRISES, INC., ET AL., respondent.
NOTICE
Sirs/Mesdames :
Please take notice that the Court, First Division, issued a Resolution dated July 14, 2021which reads as follows: HTcADC
"G.R. No. 251803 (Heirs of the Late Rommel S. Dizon, represented by Mrs. Ednalyn Castro Dizon v. Interorient Maritime Enterprises, Inc., et al.). This appeal by certiorari1 under Rule 45 of the Rules of Court assails the Decision 2 dated September 23, 2019 of the Court of Appeals (CA) in CA-G.R. SP No. 157695 denying petitioners' payment of death benefits and other emoluments provided under the 2010 Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC).
Facts of the Case
On May 21, 2016, respondent Interorient Maritime Enterprise, Inc. (IMEI), on behalf of its foreign principal, Sea Globe Management and Trading, Inc., rehired the late Rommel S. Dizon (Rommel) as Bosun on board a bulk carrier, MV Globe Pegasus. The contract term was for a period of nine months. Sea service records of Rommel showed that he had been previously hired by IMEI in successive contracts for 18 years. 3 Most, if not all of the vessels, including MV Globe Pegasus, were bulk carrier vessels carrying oil, petroleum, lead and other chemical products.
Prior deployment, Rommel underwent the Pre-employment Medical Examination (PEME), where he was declared "Fit for Sea Duty." The company-designated physicians submitted its medical findings to IMEI stating the following results:
1. Asymptomatic Hepatitis B Carrier/healthy carrier
Hepatitis B Surface antigen: REACTIVE
Hepatitis B Envelope Antigen: NONREACTIVE
Hepatitis B Envelope Antibody: REACTIVE
2. ISHARA DEFECTIVE but patient CAN IDENTIFY PRIMARY COLORS CLEARED BY OPHTHALMOLOGIST
3. ASSESSMENT: PTB TREATED — CLEARED BY PULMONOLOGIST 4
On August 9, 2016, IMEI deployed Rommel onboard MV Globe Pegasus. Sometime in November 2016 or three months into the contract, Rommel complained of abdominal pain on his right side and reported his conditions to the Chief Mate. He was then referred to a medical facility in Thailand for an ultrasound, where he was initially diagnosed with suspected HCC or Hepatocellular Carcinoma (cancer of liver) and an underlying disease or past illness of Chronic Hepatitis B. For this reason, on November 19, 2016, Rommel was medically repatriated to the Philippines.
Upon repatriation, IMEI immediately referred Rommel to the company-designated physicians. On his medical examination, the company-designated physicians confirmed that he has a chronic Hepatitis B infection during his PEME. 5 The company-designated physicians then recommended Rommel to undergo laboratory examinations 6 and an MRI of the upper abdomen with intravenous contrast. 7 In an assessment dated December 1, 2016, the company designated physicians held that the laboratory examinations showed normal results. The MRI results showed a mass. 8 Thus, the company-designated physicians recommended the biopsy of Rommel's liver "to aid in diagnosis and treatment." 9
Before the conduct of the biopsy, the company-designated physicians issued an assessment 10 dated December 13, 2016 stating that based from the mass shown in the MRI results, they were to consider Hepatocellular Carcinoma. The company-designated physicians also stated that "Hepatitis B Virus Infection is the major etiology of hepatocellular cancer, other causative factors are alcohol, induced cirrhosis, smoking, carcinogen (aflatoxin) chronic liver disease." The assessment further stated that this condition is not work-related and "usually arises from chronic liver diseases." 11 On December 16, 2016, the company-designated physicians performed the biopsy. 12 Rommel was then discharged on December 18, 2016 and was instructed to return for his histopathology results. 13
In an assessment dated December 28, 2016, it stated that "the specialist opines that while histopathology does not show malignancy, markedly elevated alpha fetoprotein and the clinical picture of the patient's condition point to hepatocellular carcinoma." Rommel was diagnosed for cancer of the liver and referred to an Oncologist for medical examinations. In an assessment dated January 30, 2017, Rommel was recommended to start chemotherapy "followed by CT Scan after 2 months to monitor treatment response." 14 On February 7, 2017, the company-designated physicians issued a medical opinion stating:
Regarding the case of Mr. Rommel S. Dizon diagnosed case of post hepatic Hepatocellular carcinoma. The time between Hepatitis B Infection and development of Hepatocellular cancer can be years and even decades. Its prognosis is poor. The average survival rate is 3-6 months. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, it is an aggressive malignancy with a poor prognosis. The pathogenesis of the disease is liver hepatocyte injury by Hepatitis virus causing liver inflammation and fibrosis leading to cirrhosis. Liver cirrhosis exhibit local areas of dysplastic foci a pre-malignant lesion later deteriorating to malignancy. 15
Twelve days thereafter or on February 19, 2017, Rommel passed away at the age of 43 years old. Per the death certificate, the immediate and antecedent causes of his death are respectively due to an acute liver failure and hepatocellular cancer. 16 The death certificate likewise indicated that Rommel's Hepatitis B infection for 14 years is a contributing factor to the cause of his death. 17
Petitioner Ednalyn Dizon, wife and representative of the minor heirs of Rommel, filed a complaint with the National Labor Relations Commission (NLRC) seeking from the company payment of death benefits and other compensation granted under the POEA-SEC. IMEI denied liability for her claims as the company-designated physicians assessed Rommel's liver cancer, which was the cause of his death, as not work-related. His illness is not even a listed occupational disease under the POEA-SEC. IMEI asserted Ednalyn Dizon's failure to present substantial evidence to prove that Rommel's illness is work-related or work-aggravated. Finally, the company argued that Rommel passed away after the term of his contract, which confirms that his death is not work-related.
Ruling of the Labor Arbiter
In a Decision 18 dated December 29, 2017, the Labor Arbiter (LA) ruled in favor of Ednalyn Dizon. The LA found that Rommel's death was on account of a work-aggravated illness of Hepatitis B infection developing into liver cancer. Prior Rommel's deployment, IMEI knew that Rommel was an asymptomatic Hepatitis B carrier for which he was declared fit for sea duties. As he experienced symptoms while on board the vessel, the LA concluded that the symptoms were indicative that Rommel's work contributed to some degree to the development of liver cancer. Rommel's liver cancer was a result from the multitudinous exposure to chemicals, stress onboard the vessel, and poor diet in the 18 years of his employment with IMEI. The LA held that IMEI failed to disprove the work-relation of Rommel's illness. The company-designated physicians did not provide for explanations to support its "not work-related" assessment. There was also no categorical declaration that the working conditions on board the vessel did not cause or aggravate Rommel's conditions. The medical reports of the company designated physicians were insufficient to overcome the presumption of work-relation created under the POEA-SEC. Despite the not work-related assessment of the company-designated physicians, the LA observed that IMEI continued Rommel's treatment. The LA considered such acts of the company as validation of the relation of Rommel's work as a seafarer and his illness. Thus, Ednalyn Dizon was awarded payment of death benefits amounting to US$50,000.00, burial benefits amounting to US$1,000.00 and benefits for Rommel's two minor children and attorney's fees.
Ruling of the National Labor Relations Commission
IMEI appealed the Decision of the LA with the NLRC. On April 30, 2018, the NLRC rendered its Decision 19 reversing and setting aside the LA Decision. The NLRC found that Rommel's underlying Hepatitis B infection caused the development of liver cancer. Such condition could not have been brought about by his work as Bosun. While Hepatitis B is a listed occupational illness, the NLRC held Rommel's Hepatitis B infection cannot be concluded as work-related. Citing a medical research from the World Health Organization, the NLRC stated that Hepatitis B may be spread at birth by an infected mother to her child or by exposure to infected blood, various body fluids such as saliva, menstrual, vaginal and seminal fluids. Transmission of the virus may also occur through the reuse of needles and syringes either in healthcare or among persons who use drugs. The tasks of Rommel as Bosun do not involve exposure to any of the foregoing. Thus, Ednalyn Dizon's claim for payment of death benefits should be denied. The NLRC, however, awarded financial assistance amounting to P200,000.00 for Rommel's long service with IMEI.
Ruling of the Court of Appeals
Ednalyn Dizon raised the Decision of the NLRC to the CA by certiorari under Rule 65 of the Rules of Court. In the assailed Decision 20 dated September 23, 2019, the CA affirmed the Decision of the NLRC finding that Rommel's liver cancer, which was the cause of his death, is not work-related. The CA held that Rommel's tasks as Bosun is supervisory in nature. Thus, the claim of Ednalyn Dizon that Rommel was subjected to a hazardous and stressful work environment which increased or aggravated his risk of contracting liver cancer lacks sufficient substantiation. The CA also upheld the company-designated physician's medical opinions that the Hepatitis B infection is the major cause of liver cancer. The assessments were consistent in stating that Rommel's condition is not work-related. The CA reiterated the findings of the NLRC holding that risk factors of Hepatitis B infection may be acquired through blood transfusions, injectable drug use and unprotected sex. The heirs of Rommel failed to show that the decedent was exposed to the foregoing risk factors in his work. Thus, there was no proof showing that the liver cancer, which is the cause of Rommel's death, is work-related. Evidence to prove that his conditions were worsened by the work environment were also absent.
Proceedings before this Court
Petitioner's Arguments
Ednalyn Dizon assailed the Decision of the CA before this Court through an appeal by certiorari under Rule 45 of the Rules of Court. She reiterated her argument that the liver cancer, which is the cause of Rommel's death, is work-related. This illness, albeit not listed in the POEA-SEC, enjoys a disputable presumption of work-relation, which IMEI failed to overcome. She also asserted that both the CA and IMEI erred in fixating on Rommel's Hepatitis B infection. She emphasized that Rommel died of liver cancer and not of his Hepatitis B infection. Ednalyn Dizon stressed that Rommel's liver cancer was contracted or aggravated by his work with IMEI. She claimed that Rommel was always healthy and was declared fit to work for sea duties in his contracts. Thus, the only reason that caused Rommel's illness and eventual death was his exposure to toxic, carcinogenic chemical substances, poor diet and stressful environment for 18 years as Bosun under multiple contracts with the company. Accordingly, she claimed entitlement for payment of death benefits and other compensation, allowances and medical reimbursements. Ednalyn Dizon also claimed payment of damages and attorney's fees. 21
Respondent's Comment
In their Comment, 22 IMEI countered that Ednalyn Dizon failed to prove by substantial evidence the work-relation of Rommel's condition. Ednalyn Dizon only surmised that the food and work environment onboard the vessel caused the development of Rommel's liver cancer. IMEI asserted that such position has been rebutted by the medical opinion of its physicians. The medical assessments of the company-designated physicians have stated that his liver cancer is not work related because such condition "usually arises from chronic liver diseases." IMEI emphasized that Rommel was a Hepatitis B carrier for 14 years. The medical assessments of the company-designated physicians have stated that the "time between Hepatitis B infection and development of hepatocellular cancer can be years even decades." Thus, IMEI claimed that it is improbable to acquire liver cancer within a three-month period, or such time that Rommel was on board MV Globe Pegasus.
In medical opinions issued a year after Rommel's death, the company designated physicians also stated that the process of "molecular transformation" which leads to liver cancer by the Hepatitis B infection "cannot be altered by the patient's nature of work, diet or environment. Once the disease is contracted, the possibility of cirrhosis and hepatocellular carcinoma is likely." 23 IMET also opposed Ednalyn Dizon's claim that Rommel had been exposed to toxic and carcinogenic substances during his 18-year tenure with the company. The company argued that in the 18-year service of Rommel, there had been intervals from one contract to another. Thus, Rommel could have contracted his Hepatitis B infection during such time. Furthermore, Ednalyn Dizon failed to substantiate if the vessels boarded by Rommel indeed carried chemicals. There was also no medical record showing that his diet onboard the vessel contributed to his condition. Finally, Rommel must have passed away during the term of his contract. Here, Rommel passed away on February 19, 2017 or three months from his disembarkation on November 18, 2016.
Ruling of the Court
Death benefits and other remunerations granted under the POEA-SEC may be claimed when the seafarer died of a: (a) work-related death; and (b) the death occurred during the term of the contract. 24 For death to be considered work-related, it must have resulted from a work-related injury or illness. 25
It is undisputed that the cause of Rommel's death is due to his liver cancer. Thus, We must determine if this illness is work-related. Section 20 A (4) of the 2010 POEA-SEC provides that illnesses not listed in Section 32 of the same law are disputably presumed work-related. This presumption is applicable when the seafarer suffers from the unlisted illness during the term of the contract. 26 The unlisted illness suffered onboard the vessel enjoys the disputable presumption of work-relation because it is at such time that the seafarer is under the direct control and supervision of the employer, who is tasked to "take all necessary precautions to x x x protect the health of the seafarer." 27 The disputable presumption under Section 20 (A) (4) operates in favor of the employee and the burden rests upon his or her employer to overcome the statutory presumption. 28 Applying the foregoing provision of law and principles, We hold that Rommel's illness of liver cancer enjoys the presumption of work relation. The liver cancer, which is the cause of Rommel's death, is an unlisted illness which he suffered from onboard the vessel. As the presumption is applied, the employer-company is burdened to disprove that the liver cancer is not work-related.
We hold that IMEI failed to dispute the presumption of work-relation. IMEI mainly argued that Rommel's cause of death is not work related because it developed from his chronic Hepatitis B infection. Based on the series of medical assessments 29 issued by the company designated physicians from Rommel's repatriation until before he passed away, the company-designated physicians only sought to confirm the initial diagnosis of hepatocellular carcinoma by the physicians from Thailand. No tests or examinations were conducted on Rommel showing that he had not been exposed to stress, chemicals or food that could have aggravated his illness. The assessment dated December 13, 2016, 30 stating that the "condition (liver cancer) is not work related" 31 could not he considered as a final and definitive assessment as it also stated that the physicians were still "to consider Hepatocellular Carcinoma." 32 Notably, this assessment was issued prior the conduct of Rommel's biopsy procedure, which the company-designated physicians stated as necessary "to aid in diagnosis." 33 The same assessment even identified other causative factors of liver cancer which were not ruled out. The last assessment of the company-designated physicians dated February 7, 2017 34 also made no categorical finding that Rommel's illness is not work-related or that his work could not have aggravated his illness.
IMEI cited another medical opinion of its physicians stating that the Hepatitis B infection "cannot be altered by the patient's nature of work, diet or environment" 35 to develop into liver cancer. We remain unconvinced as such is a general opinion. The medical assessment only identified the period of development of liver cancer and the mutation of the Hepatitis B infection to liver cancer. It still failed to support how Rommel's work could not have contributed to the hastening of his pre-existing illness to develop liver cancer. The not work-related assessment is a foregone conclusion as long as the hepatocellular cancer is proven. Moreover, IMEI repeatedly stated in its pleadings 36 that this medical opinion was issued on 19 February 2018, 37 which is a year after Rommel's death. To Our mind, the company belatedly sought this medical opinion to remedy the lack of explanations from its physicians to support the claim that Rommel's liver cancer is not work-related.
At any rate, We have held that the condition or illness suffered by the seafarer shall be compensable when it is shown that the seafarer's work may have contributed to the establishment or, at the very least, aggravation of any pre-existing disease. 38 Probability, not the ultimate degree of certainty, is the test of proof in compensation proceedings. 39
Based on the facts, when IMEI hired Rommel to board MV Globe Pegasus, he was known to be a chronic Hepatitis B carrier. The company was already put to notice of a condition that would affect Rommel's fitness for sea duty. IMEI should have conducted a more exhaustive test to determine Rommel's chronic hepatitis B infection or if there could have been latent liver cancer. Here, while Hepatitis B tests were conducted on Rommel, We find no clearance from a specialist, such as a gastroenterologist, which could have been secured similar to the other illnesses of Rommel that had been declared cleared by respective specialists. To reiterate the assessment prior Rommel's deployment reads:
1. Asymptomatic Hepatitis B Carrier/healthy carrier
Hepatitis B Surface antigen: REACTIVE
Hepatitis B Envelope Antigen: NONREACTIVE
Hepatitis B Envelope Antibody: REACTIVE
2. ISHARA DEFECTIVE but patient CAN IDENTIFY PRIMARY COLORS CLEARED BY OPHTHALMOLOGIST
3. ASSESSMENT: PTB TREATED — CLEARED BY PULMONOLOGIST40 (Emphasis supplied)
The employer is expected to know the physical demands of a seafarer's engagement. It is equally expected that the employer peruse the results of the P.ENLE's to ensure that, health-wise, its recruits are up to par. 41 Considering that the company doctors assessed Rommel as fit for sea duty, even if there is an existing medical condition, it would mean that he was well in a position to engage in employment in the sea vessel without danger to his health. 42 The employer who admits a physician's "fit to work" determination binds itself to that conclusion and its necessary consequences. 43This includes compensating the seafarer for the aggravation of negligently or deliberately overlooked conditions.44
We find it highly probable that Rommel's work as bosun aggravated his illness. The company designated physicians opined that the average survival rate of a person with liver cancer is three to six months. 45 Here, Rommel was deployed on August 9, 2016 and while on board the vessel and three months into the contract, he experienced abdomen pain on his right side, for which he was medically repatriated. On February 19, 2017, Rommel passed away. We note that as symptoms manifested onboard the vessel, logically, Rommel's pre-existing illness was aggravated by his working-condition. Furthermore, the period between the date of his deployment until the date of his death only confirms the six-month survival period estimation of the company-designated physician.
The fact that Rommel's death occurred three months after his medical repatriation does not disqualify the heirs from payment of death benefits and other compensation under the 2010 POEA-SEC. While the general rule is that the seafarer's death should occur during the term of his employment, the seafarer's death occurring after the termination of his employment due to his medical repatriation on account of a work-related illness constitutes an exception thereto. 46 As discussed, Rommel experienced his symptoms, sometime in November 2016, while on board the vessel. He was medically repatriated for such symptoms which the company-designated physicians confirmed to be due to liver cancer, an illness which the company failed to dispute as work-related. Thus, Rommel's case falls under the exception entitling his heirs to payment of death benefits amounting to US$50,000.00.
As to payment of benefits to the children of Rommel, Section 20 (B) (1) of the 2010 POEA-SEC, provides that the employer shall pay an additional benefit amounting to US$7,000.00 to each child under the age of 21 but not exceeding four children. Based from the birth certificates 47 of the two children of Rommel, they are born in 2003 and in 2009, making them below the age of 21 at the time of Rommel's death in February 19, 2017. Hence, the total amount of US$14,000.00 is awarded aside from the death and burial benefits mandated under the 2010 POEA-SEC.
WHEREFORE, the Decision dated September 23, 2019 of the Court of Appeals in CA-G.R. SP No. 157695 is REVERSED and SET ASIDE. The Heirs of Rommel S. Dizon, namely, Mrs. Ednalyn Castro Dizon and her children, Hawkins and Hayessagail Faith, both surnamed Dizon, are awarded with the payment of death benefits in the Philippine currency equivalent of US$50,000.00, burial expenses in the Philippine currency equivalent of US$1,000.00, and benefits for the children of the late Rommel Dizon in the Philippine currency equivalent of US$14,000.00. All monetary award shall earn an interest rate of six percent (6%) per annum from finality of this Resolution until full satisfaction. aScITE
SO ORDERED."
By authority of the Court:
(SGD.) LIBRADA C. BUENADivision Clerk of Court
by:
MARIA TERESA B. SIBULODeputy Division Clerk of Court
Footnotes
1.Rollo, pp. 43-101.
2. Penned by Associate Justice Rafael Antonio M. Santos, with the concurrence of Associate Justices Manuel M. Barrios and Ruben Reynaldo G. Roxas, id. at 13-35.
3.Id. at 207.
4.Id. at 15.
5.Id. at 483.
6.Id. Per the medical assessment dated 21 November 2016, laboratory examinations recommended to performed on Rommel are "complete blood count, creatinine, hepatitis profile, SGPT, SGOT, total bilirubin, direct biliburin, indirect biliburin, total protein, albumin and globulin, serum alpha fetoprotein, alkaline phosphatase."
7.Id.
8.Id. at 486.
9.Id.
10.Id. at 493.
11.Id.
12.Id. at 489.
13.Id. at 490.
14.Id. at 496.
15.Id. at 499.
16.Id. at 267.
17.Id.
18. Penned by Labor Arbiter Renaldo O. Hernandez; id. at 297-321.
19. Penned by Commissioner Mercedes R. Posada-Lacap, with the concurrence of Presiding Commissioner Grace E. Maniquiz-Tan and Commissioner Dolores M. Peralta-Beley; id. at 206-217.
20.Supra note 2.
21.Rollo, pp. 57-98.
22.Id. at 630-654.
23.Id. at 641.
24. Section 2B of the 2010 POEA-SEC, Memorandum Circular No. 10, Series of 2010.
25. See Canuel v. Magsaysay Maritime Corporation, 745 Phil. 252 (2014).
26.Ventis Maritime Corporation v. Salenga, G.R. No. 238578, June 8, 2020.
27.Id.
28.Magsaysay Maritime Corporation v. Heirs of Buenaflor, G.R. No. 227447, June 23, 2020.
29.Rollo, pp. 482-499.
30.Id. at 493.
31.Id.
32.Id.
33.Id. at 493.
34.Id. at 499.
35.Id. at 641.
36.Id.
37.Id.
38.Mabute v. Bright Maritime Corporation, G.R. No. 219872, September 9, 2020.
39.Id.
40.Rollo, p. 15.
41.Manansala v. Marlow Navigation Phils., Inc., 817 Phil. 84, 104 (2017).
42.Id.
43.Id.
44.Id.
45.Rollo, p. 499.
46.Magsaysay Maritime Corp. v. Heirs of Buenaflor, supra note 24.
47.Rollo, pp. 269-270.