Disputable presumption in seafarer’s claims

Disputable presumption in seafarer’s claims
Dennis Gorecho 1 Sept 2018 https://www.panaynews.net/disputable-presumption-in-seafarers-claims/

A SEAFARER’S illness will be considered work-connected if the company doctor makes an unsubstantiated assessment of the nature of seafarer’s illness.

This was the ruling of the Supreme Court in the recent case of Phil-Man Marine / Dohle Ltd. vs Dedace (G.R. No. 199162, July 4, 2018) involving a seafarer diagnosed to be suffering from “Disseminated Sepsis with Multiple Liver Abscesses” . The case illustrated the importance of making a full, complete and categorical medical assessment.

For disability to be compensable under Section 20(B) of the Philippine Overseas Employment Administration – Standard Employment Contract (POEA-SEC), it must be the result of a work-related injury or a work-related illness.

The POEA-SEC defines work-related injury as “injuries resulting in disability or death arising out of and in the course of employment.”

On the other hand, work-related illness has been defined as “any sickness resulting in disability or death as a result of one of the 24 occupational diseases listed under Section 32-A of this contract.”

A seafarer suffering from an occupational disease would still have to satisfy four conditions before his or her disease may be compensable:

(1) the seafarer’s work must involve the risks described

(2) the disease was contracted as a result of the seafarer’s exposure to the described risks

(3) the disease was contracted within a period of exposure and under such factors necessary to contract it

(4) there was no notorious negligence on the part of the seafarer

However, the POEA-SEC’s definition of a work-related illness does not necessarily mean that only those illnesses listed under Section 32-A are compensable.

The POEA contract cannot be presumed to contain all the possible injuries that render a seafarer unfit for further sea duties.

Section 20(B)(4) of the POEA-SEC provides that illnesses not listed under Section 32 are disputably presumed as work-related. This disputable presumption is made in the law to signify that the non-inclusion in the list of compensable diseases/illnesses does not translate to an absolute exclusion from disability benefits.

This disputable presumption operates in favor of the seafarer as the burden rests upon his employer to overcome the statutory presumption. Hence, unless contrary evidence is presented by the seafarer’s employer, this disputable presumption stands.

In the instant case, the company failed to overcome the presumption that the seafarer’s illness (Disseminated Sepsis with Multiple Liver Abscesses) is work-related. The company doctor’s statement, in response to the company’s query on whether the seafarer’s illness is work-related, cannot be considered as an effective assessment for purposes of the POEA-SEC.

The said statement was based merely on the opinion of another specialist, a gastroenterologist, who was not even named. The records do not show that seafarer was examined by or was placed under the care of any gastroenterologist. Neither the company nor the unnamed gastroenterologist gave an explanation for the statement that seafarer’s illness is not work-related.

While the company-designated physician must declare the nature of a seafarer’s disability, the former’s declaration is not conclusive and final upon the seafarer or the court. Its inherent merit will still be weighed and duly considered.

It is not enough that the company-designated physician merely states or claims that the illness is not work-related, or that the seafarer is fit for sea duties. He must justify said assessment using the medical findings he had gathered during his treatment of the patient-seafarer.

The POEA-SEC requires a medical assessment, not a bare claim. An unsubstantiated assessment, even if made by the company-designated physician, is tantamount to a bare claim which must be rejected by the courts.

Notwithstanding the presumption in favor of compensability, on due process grounds, the Supreme Court ruled in some cases that claimant-seafarer must still prove by substantial evidence that his work conditions caused or, at least, increased the risk of contracting the disease.