G.R. No.

196122               November 12, 2014

JOEL B. MONANA, Petitioner,
vs.
MEC GLOBAL SHIPMANAGEMENT AND MANNING CORPORATION AND HD HERM
DAVELSBERG GMBH, Respondents.

DECISION

LEONEN, J.:

This labor case involves a seafarer's claim for disability benefits. It involves an application of Section
20(B) of the Philippine Overseas Employment Administration Standard Employment Contract (POEA
contract). The POEA contract states that for an illness to be compensable, (1) it must be work-
related and (2) it must have existed during the term of the seafarer's employment contract. 1

Joel B. Monana (Monana) filed this petition for review  in relation to his disability benefits claim for
2

hypertension. The Labor Arbiter ruled in favor of Monana and granted US$60,000.00 as disability
benefits. The National Labor Relations Commission vacated the Labor Arbiter’s decision, but
granted US$3,000.00 as financial assistance. The Court of Appeals agreed with the National Labor
Relations Commission and dismissed Monana’s petition. Monana now seeks to reinstate the Labor
Arbiter's judgment.3

On September 5, 2006, MEC Global Ship Management and Manning Corporation and its foreign
principal, HD Herm Davelsberg GMBH, employed Monana as an ordinary seafarer for a six-month
duration on board M/V Bellavia.  Monana boarded on September 11, 2006 and performed his tasks
4

that "included cleaning, chipping, painting, and assisting in deck work."  On January 22, 2007,
5

Monana felt dizzy with blurring of vision and body weakness associated with slurred speech and
numbness of the right side of the face.  The ship doctor prescribed oral anti-hypertensive
6

medication.  Monana was airlifted to Honolulu Medical Center the next day where he was treated
7

and diagnosedto have suffered a stroke.  He then transferred to a rehabilitation hospital where he
8

underwent physical therapy for two days. 9

On January 31, 2007, Monana was repatriated to the Philippines and referred to Dr. Susannah Ong-
Salvador (Dr. Ong-Salvador), the company designated physician.  He was first confined atthe
10

University of Sto. Tomas hospital, then he continued his physical therapy and treatment with
company-designated doctors in Iloilo. 11

On February 19, 2007, Dr. Ong-Salvador wrote respondents a reply to a medical query,  stating that
12

"patient’s condition is regarded as non-work related, as the disease is mainly of a heredofamilial

etiology that is enhanced by a number of modifiable and non-modifiable risk factors. . . ."  Monana
13

did not dispute this report.

14

Nevertheless, respondents continued providing Monana with medical assistance. 15

On March 3, 2007, Monana was referred to neurologist Dr. Generoso D. Licup, who found
thatMonana "still experience[d] occasional heaviness and clumsiness of the right upper and lower
extremities especially during strenuous and prolonged activities." 16

On July 18, 2007, Monana was referred to cardiologist Dr. Glenn A. Mana-ay (Dr. Mana-ay), who
also diagnosed him with S/P Stroke secondary to Acute Ischemic Infarct, Left Periventicular Parietal
Lobe and Hypertensive Cardio vascular Disease.  Dr. Mana-ay reported that Monana’s blood
17

pressure was controlled, and he had minimal weakness on the right side of the body.  Monana’s
18

condition steadily improved.19

On August 23, 2007, Monana sought a second opinion with cardiologist Dr. Efren R. Vicaldo (Dr.
Vicaldo) from the Philippine Heart Center. 20Dr. Vicaldo declared that Monana’s illness was work-
related/-aggravated, and that Monana was unfit toresume work as a seafarer in any capacity. 21

Consequently, Monana claimed disability and illness allowance. Respondents refused, prompting
Monanato file a complaint with the Regional Arbitration Branch. The Labor Arbiter, in his
decision  dated May 30, 2008, ruled in favor of Monana and ordered respondents to pay
22

US$60,000.00 or its peso equivalent as disability benefits:

WHEREFORE, judgment is hereby rendered ordering respondent-entities to pay complainant jointly

and severally the sum of US$60,000.00 or its Philippine Peso equivalent at the time of payment,
representing his disability benefits.

Further, respondents jointly and severally are hereby ordered to pay complainant 10% of the total
judgment award as and [sic] way of attorney’s fees.

Other claims are hereby denied for lack of merit.

SO ORDERED.  (Emphasis in the original)

23

The National Labor Relations Commission, in its resolution  dated January 30, 2009, vacated the
24

Labor Arbiter’s decision and instead ordered respondents to grant financial assistance of
US$3,000.00 or its peso equivalent:

WHEREFORE, premises considered, the appeal is PARTLY GRANTED and the Decision dated 30
May 2008 is ordered VA C ATE D and SET ASIDE.

A new decision is hereby promulgated ordering respondents appellants to grant financial assistance
to complainant-appellee in the amount of US$3,000.00 in its Philippine Peso equivalent at the time
of payment.

SO ORDERED.  (Emphasis in the original)

25

The Court of Appeals, in its decision  dated February 26, 2010, agreed with the National Labor
26

Relations Commission and dismissed Monana's petition.  It likewise denied reconsideration.
27 28

Hence, Monana filed this petition.

Petitioner argues that hypertension is a compensable illness, and there was a causal relation
between his work and his illness. 29

Pursuant to Section 20(B)(3) of the POEA contract, the right to secure a third doctor’s opinion is
optional.  Petitioner submits that the findings of independent cardiologist Dr. Vicaldo deserves more
30

credence than those of company-designated physician Dr. Ong-Salvador, who is neither a

cardiologist nor a neurologist.  Petitioner alleged that Dr. Ong-Salvador signed the report as a
31

medical coordinator, and that she is a dermatologist. 32

Petitioner contends that his disability continued beyond 240 days without any assessment from a
company-designated physician on his fitness, thus, his disability must be deemed total and
permanent.  Petitioner prays for disability benefits and attorney’s fees.
33 34

Respondents counter that the lower court’s factual findings on petitioner’s non-entitlement to total
and permanent disability benefits are well-supported by evidence, thus, shouldbe deemed final and
conclusive upon this court. 35

Section 20(B) of the POEA contract provides that entitlement to disability benefits requires that the
seafarer’s disability be work-related and that it occur during the contract’s term.  Respondents cite
36

the Court of Appeals’ decision at length on petitioner’s failure to prove that his medical condition is
work-related. 37

Respondents submit that the company-designated physician Dr. Ong Salvador’s extensive
assessment based on medical treatments should prevail over Dr. Vicaldo’s unsupported medical
opinion.  Respondents submit that Dr. Vicaldo only saw petitioner once as an
38

outpatient.  Respondents also quote at length the 2012 case of Andrada v. Agemar Manning
39

Agency  where this court gave greater credence to the company-designated physician’s extensive
40

assessment over those of Dr. Vicaldo’s cryptic and unsupported conclusions since Dr. Vicaldo only
examined petitioner once.  Respondents also cite Vergara v. Hammonia Maritime Services, Inc.  in
41 42

that a company-designated physician’s assessment must be sustained unless a third doctor’s

opinion is obtained. 43

Respondents quote Millan v. Wallem Maritime Services, Inc.  in that "[a] seafarer’s inability to
44

resume his work after the lapse of more than 120 days from the time he suffered an injury and/or
illness is not a magic wand that automatically warrants the grant of total and permanent disability
benefits in his favor." 45

Lastly, respondents argue that Monana’s claim for illness allowance is baseless since this was
paid.  Monana’s claim for attorney’s fees also lacks basis as respondents are not in bad faith.
46 47

The main issue for this court’s resolution is whether petitioner Joel B. Monana is entitled to total and
permanent disability benefits.

We affirm the Court of Appeals in dismissing petitioner’s petition.

The POEA contract, deemed read and incorporated into petitioner’s employment contract,  governs
48

petitioner’s claims for disability benefits. These guidelines were amended in recent years,  but the
49

year 2000 version applies since he was hired in 2006,  and he filed his complaint in 2007.
50 51

Section 20(B) provides for the two requisites of compensable disability as follows:

SECTION 20. COMPENSATION AND BENEFITS

....

B. 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 contractare as follows: . . . 52
There is no dispute that petitioner suffered a stroke during the term of his contract.  Upon
53

repatriation, he underwent extensive medical treatment and therapy from January 31, 2007 toAugust
2007. He was provided physical therapy even in his hometown, Iloilo.  He was diagnosed with
54

"hypertension Stage ASHD, CAD at risk S/P stroke." 55

In contention is the other requisite that the illness claimant suffered must be work-related.

The POEA contract defines "work-related illness" as"any sickness resulting to disability or death as a
result of an occupational disease listed under Section 32-A of this contractwith the conditions set
therein satisfied."  The relevant portions of Section 32-A are as follows: SECTION 32-A
56

Occupational Diseases

For an occupational disease and the resulting disability or death to be compensable, all of the
following conditions mustbe satisfied:

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

(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 other factors
necessary to contract it;

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

The following diseases are considered as occupational when contracted under working conditions
involving the risks described herein: . . . .

11. Cardio-Vascular Diseases. Any of the following conditions must be met:

a. If the heart disease was known to have been present during employment, there
must be proof that an acute exacerbation was clearly precipitated by the unusual
strain by reasons of the nature of his work.

b. The strain of work that brings about an acute attack must be sufficient severity and
must befollowed within 24 hours by the clinical signs of a cardiac insult to constitute
causal relationship.

c. If a person who was apparently a symptomatic before being subjected to strain at

work showed signs and symptoms of cardiac injury during the performance of his
work and such symptoms and signs persisted, it is reasonable to claim a causal
relationship.

12. Cerebro-Vascular Accidents. All of the following conditions must be met:

a. There must be a history, which should be proved, or trauma at work (to the head
specially) dueto unusual and extraordinary physical or mental strain or event, or
undue exposure to noxious gases in industry.

b. There must be a direct connection between the trauma or exertion in the course of
employment and the worker’s collapse.
 c. If the trauma or exertion then and there caused a brain hemorrhage, the injury may
be considered as arising from work.

....

20. Essential Hypertension

Hypertension classified as primary or essential is considered compensable if it causes impairment of

function of body organs like kidneys, heart, eyes and brains, resulting in permanent disability;
Provided, that, the following documents substantiate it: (a) chest x-ray report, (b) ECG re[p]ort (c)
blood chemistry report, (d) funduscopy report, and (f) C-T scan.  The POEA contract also states that
57

"illnesses not listed in Section 32 of this contract are disputablypresumed as work related." 58

Petitioner argues that all four conditions for compensability under Section 32-A were satisfied.  He
59

discusses the stressful nature of his work considering the changing weather conditions and
compounded by being away from loved ones.  He mentions that he was declared fit to work after his
60

pre-employment medical examination, thus, he contracted his illness after exposure to the stressful
working conditions.  Lastly, he alleges that there was no notorious negligence on his part.
61 62

Both the National Labor Relations Commission and Court of Appeals63 found that petitioner failed
toprove compliance with the conditions under Section 32 of the POEA contract, thus, failing to show
a causal connection between his illness and his work. The National Labor Relations Commission
discussed as follows:

The main issue that would determine complainant-appellee’s entitlement to permanent disability is
whether his illness is work-related or not. We rule in the negative. For one, complainant-appellee
failed to discharge the burden of proving the conditions set forth in Section 32-A particularly, that his
work as ordinary seaman involved the risks of having a stroke; that complainant-appellee’s
hypertension was contracted as a result of his exposure to his work; that the disease was contracted
within the period of exposure and such other factors necessary to contract it and that there was no
notorious negligence on complainant-appellee’s part. For another and on the contrary, complainant-
appellee admitted that he had a family history of hypertension and that he smoked about one pack a
day for thirty (30) years. Further, complainant-appellee also failed to prove that his hypertension can
be classified as primary oressential; that he has suffered impairments in his vital organs; and that he
failed to submit documents to substantiate his claim for compensability. Furthermore, we find that
despite the non work relatedness of the illness of complainant-appellee, respondents-appellants in
good faith exerted efforts and caused complainant-appellee’s treatment in a foreign country,
shouldered his repatriation expenses and caused his examinations and treatment for more than
eight (8) months shouldering the expenses therein.

Under the circumstances, respondents-appellants is not liable for the disability benefits of
complainant-appellee considering that his illness of hypertension was not proven by substantial
evidence to be workrelated. 64

A petition for review is limited to questions of law.  This court does not "re-examine conflicting
65

evidence, re-evaluate the credibility of witnesses, or substitute the findings offact of the NLRC, an
administrative body that has expertise in its specialized field."  This court has held that "factual
66

findings of the NLRC, when affirmed by the Court of Appeals, are generally conclusive on this
court."
67
Petitioner presents no compelling reason for this court to deviate from this general rule. Petitioner’s
reliance on Dr. Vicaldo’s medical opinion also fails to convince. Section 20(B)(3) of the POEA
contract provides:

3. Upon sign-off from the vessel for medical treatment, the seafarer is entitled to sickness allowance
equivalent to his basic wage until he is declared fit to work or the degree of permanent disability has
been assessed by the company-designated physician but in no case shall this period exceed one
hundred twenty (120) days.

For this purpose, the seafarer shall submit himself to a post employment medical examination by a
company-designated physician within three working days upon his return except when he is
physically incapacitated to do so, in which case, a written notice to the agency within the same
period is deemed as compliance. Failure of the seafarer to comply with the mandatory reporting
requirement shall result inhis forfeiture of the right to claim the above benefits.

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.  (Emphasis supplied)
68

Petitioner did not consult with a third doctor chosen by both parties. His contention is that the
National Labor Relations Commission and Court of Appeals both erred in giving more credence to
the assessment of the company-designated physician, Dr. Ong-Salvador, as opposed to the opinion
of his private physician, Dr. Vicaldo.69

The question of weighing the credibility of two opposing medical opinions involves a factual review
beyond the scope of a petition under Rule 45.

There appears to be no reason to overturn the lower court’s factual findings giving more weight to
the assessment of the company-designated physician.

As discussed by the Court of Appeals, "as between the company designated doctor who has all the
medical records of petitioner for the duration of his treatment and as against the latter’s private
doctor who merely examined him for a day as an outpatient, the former’s finding must prevail." 70

Several jurisprudence have given more weight to the assessment of the doctor that closely
monitored and actually treated the seafarer.

In Philman Marine v. Cabanban,  this court gave more credence to the company-designated
71

physician’s assessment since "records show that the medical certifications issued by Armando’s
chosen physician were not supported by such laboratory tests and/or procedures that would
sufficiently controvert the "normal" results of those administered to Armando at the St. Luke’s
Medical Center. . . [while] the medical certificate of the petitioners’ designated physician was issued
after three months of closely monitoring Armando’s medical condition and progress, and after careful
analysis of the results of the diagnostic tests and procedures administered to Armando while in
consultation with Dr. Crisostomo, a cardiologist."  Philman discussed as follows:
72

In several cases, we held that the doctor who have had a personal knowledge of the actual medical
condition, having closely, meticulously and regularly monitored and actually treated the seafarer’s
illness, is more qualified to assess the seafarer’s disability. In Coastal Safeway Marine Services, Inc.
v. Esguerra, the Court significantly brushed aside the probative weight of the medical certifications of
the private physicians, which were based merely on vague diagnosis and general impressions.
Similarly in Ruben D. Andrada v. Agemar Manning Agency, Inc., et al., the Court accorded greater
weight to the assessments of the company designated physician and the consulting medical
specialist which resulted from an extensive examination, monitoring and treatment of the seafarer’s
condition, in contrast with the recommendation of the private physician which was "based only on a
single medical report . . . [outlining] the alleged findings and medical history . . . obtained after . . .
[one examination]."  (Emphasis supplied)
73

In the recent case of Dalusong v. Eagle Clarc Shipping Philippines, Inc.,  we ruled that "the findings
74

of the company-designated doctor, who, with his team of specialists . . . periodically treated
petitioner for months and monitored his condition, deserve greater evidentiary weight than the single
medical report of petitioner’s doctor, who appeared to have examined petitioner only once." 75

Regardless of who the doctor is and his or her relation to the parties, the overriding consideration by
boththe Labor Arbiter and the National Labor Relations Commission should be that the medical
conclusions are based on (a) the symptoms and findings collated with medically acceptable
diagnostic tools and methods, (b) reasonable professional inferences anchored on prevailing
scientific findings expected to be known to the physician given his or her level of expertise, and (c)
the submitted medical findings or synopsis, supported by plain English annotations that will allow the
Labor Arbiter and the National Labor Relations Commission to make the proper evaluation. The
Court of Appeals in a petition for review should be limited to determining whether there was grave
abuse of discretion committed by the National Labor Relations Commission.

In this case, the company-designated physician and her associated specialists provided petitioner
with extensive medical attention and treatment from January 31, 2007 to August 2007.  These are
76

supported by medical reports.

In Dr. Ong-Salvador’s initial medical report dated January 31, 2007, she provided a chronological
history of petitioner’s present illness, mentioning that he had a family history of hypertension on his
paternal side, and smoked a pack a day for 30 years.  She then outlined the results of petitioner’s
77

physical examination and neurological examination.  Under "Working Impression," the initial medical
78

report states "Hypertension Stage II, ASHD, CAD at risk, S/P Stroke."  Under "Plan of
79

Management," the initial medical report states that petitioner was "admitted atthe Santo Tomas
Hospital today for further evaluation and management" and that he was "under the care of our
specialists."  These specialists included neurologist Dr. Generoso D. Licup and cardiologist Dr.
80

Glenn A. Mana-ay who both diagnosed petitioner and provided medical reports on their findings. 81

In Dr. Ong-Salvador’s reply to medical query dated February 19, 2007, she discussed that "patient’s
condition is regarded as non-work related, as the disease is mainly of a heredo familial etiology that
is enhanced by a number of modifiable and non-modifiable risk factors."  Dr. Ong-Salvador, having
82

access to all of petitioner’s medical records, was in the best position to make this conclusion.

Nevertheless, despite the non-work-related nature of petitioner’s condition, respondents continued

providing him with medical assistance.

In Dr. Ong-Salvador’s medical progress report dated April 30, 2007, she discussed that petitioner
"has continued with his medical treatment in his province in Iloilo . . . has been under physical
therapy sessions to help him recover muscular functions and strength . . . [and] [c]ontinuous physical
improvements were noted." 83

Dr. Ong-Salvador continued to issue progress reports on petitioner’s examinations with the
company-designated cardiologist in Iloilo, and scheduling him for more re-evaluation by their
specialists. The medical progress report dated August 21, 2007 stated that petitioner "underwent
blood work-ups today [and] he tolerated the procedure well." 84

On the other hand, Dr. Vicaldo’s medical certificate provides as follow:

JUSTIFICATION OF IMPEDIMENT GRADE VII (41.80%) FOR

SEAMAN Joel B. Monana

● This patient/seaman presented with history of sudden weakness of the right upper and lower
extremities associated with slurred speech and numbness on the right side of the face noted on
January 2007 while on board ship. He was confined in Honolulu, Hawaii on January 24 to January
31, 2007. He underwent cranial CT scan and was diagnosed as cerebrovascular disease, infarct at
the left parietal and periventiculararea. He was started on medication as well as physical
rehabilitation.

● He was repatriated on January 31, 2007 and was subsequently admitted at UST hospital where he
was diagnosed and managed as a case of hypertension, coronary artery disease an[d] recent
stroke.

● When seen at the clinic his blood pressure was 110/80 mmHg; PE of the heart and lungs were
unremarkable. There were no significant motor deficits on the extremities but he complains of
numbness on the right side of his body. He claims being forgetful after his stroke.

● He is now unfit to resume work as seaman in any capacity.

● His illness is considered work aggravated/related.

● He requires maintenance medication to control his blood pressure to prevent cardiovascular

complications such as a repeat stroke, coronary artery disease and renal insufficiency.

● He requires regular follow up with his cardiologist and neurologist as well as regularblood
chemistry examination to monitor his lipid profile aswell as renal function to anticipate possible other
risk factors.

● He has to modify his lifestyle to include low salt diet, regular exercise and nicotine abstinence.

● He is not expected to land a gainful employment given his medical background.  (Emphasis
85

supplied)

The above medical certificate reveals that Dr. Vicaldo’s findings were not based on results from
medical tests and procedures. In fact, Dr. Vicaldo recognizes that petitioner already has a
cardiologist and neurologist with whom he should regularly follow up with.

Dr. Ong-Salvador is familiar withpetitioner’s medical history and condition, thus, her medical opinion
on whether his illness is workaggravated/-related deserves more credence as opposed to Dr. Efren
Vicaldo’s unsupported conclusions.

This court notes that in several cases filed before this court on seafarer’s disability claims, Dr.
Vicaldo’s findings have not been given due merit due to their unsubstantiated nature. 86
It, therefore, behooves the National Labor Relations Commission, perhaps, to cause an investigation
on why, in spite of the unsupported nature of Dr. Vicaldo’s submissions, Labor Arbiters still give him
credence. This unnecessarily clogs their administrative dockets, and the dockets of the Court of
Appeals and this court. Judicial efficiency requires that Labor Arbiters and the National Labor
Relations Commission keep guard against these types of doctors and their medical findings.

Since petitioner’s illness is not work-related, this court need not labor on petitioner’s argument that
his illness must be deemed total and permanent since 240 days had lapsed withoutany assessment
by the companydesignated physician on his fitness to work. 87

We observe that most seafarer complaints for compensation pursue the cause of action petitioner
took in this case — breach of contractual obligations by its employer by invoking provisions of the
POEA contract. This course follows a procedure that considers a balance of interests in the amount
of compensation for the occupational hazards a seafarer suffers, and the process to recover such
compensation. 88

Seafarers who suffer from occupational hazards are not necessarily constrained to contractual
breach as cause of action in claiming compensation. Our laws allow seafarers, in a proper case, to
seek damages based on tortious violations by their employers by invoking Civil Code provisions, and
even special laws such as environmental regulations requiring employers to ensure the reduction of
risks to occupational hazards. 89

Lastly, petitioner failed to substantiate his claim for attorney’s fees.  Attorney’s fees are awarded by
1âwphi1

way ofexception when a defendant acted in evident and gross bad faith. 90

Quite the opposite, "respondents merely relied on the company designated physician’s finding that
petitioner’s illness was not work-related [and] [d]espite of [sic] such finding, private respondents still
extended to petitioner the required medical assistance and therapy." 91

Respondents also submit that they already paid petitioner illness allowance.  Respondents’ 92

comment attached copies of approved illness allowance payments for petitioner in the amounts of
US$555.87 for January and February 2007, US$589.29 for February and March 2007, and
US$854.84 for April and May 2007. 93

Petitioner no longer mentioned illness allowance in his memorandum. This court’s

resolution  requiring the filing of memoranda explained that "issues raised in the pleadings but
94

notincluded in the memorandum shall be deemed waived or abandoned." 95

This court’s commitment to providefull protection to labor "does not prevent us from sustaining the
employer when it is in the right."  In any event, the lower court has awarded US$3,000.00 as
96

financial assistance in the interest of equity and compassionate justice. WHEREFORE, the petition
is DENIED. The Court of Appeals’ decision and resolution are AFFIRMED.

SO ORDERED.