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DOCTRINE:

In the present case, since there is a conflict in the assessment of the company-designated physicians and an employee’s physician of choice, the matter should have been referred to a third doctor for final determination as required by the POEA-SEC and the parties’ CBA. Since the employee was responsible for the non-referral to the third doctor because of his failure to inform the manning agency that he would be consulting a doctor of his choice, he should suffer the consequences of the absence of a binding third opinion.

FACTS:

Pellazar was deployed to the M/T Delphina under an employment contract for eight months. While he was on duty onboard the vessel, his right hand was injured after it was struck by a solid iron pipe. He was given medical attention in a hospital in Braziland was later on medically repatriated.

Upon his arrival in Manila, Pellazar reported to OSG Manila and was referred to the company-designated physicians, Dr. De Guzman and Dr. Banaga. Pellazar’s working diagnosis was “complete fracture, distal part of 5th finger, right hand post-casting.” The company-designated physicians gave Pellazar a Grade 10 disability rating7 for “loss of grasping power for large objects between fingers and palm of one hand.

Pellazar consulted a physician of his choice,Dr. Sabado who diagnosed him with “loss of grasping power of 5th finger, loss of opposition between finger and thumb (r) and ankylosis of the 5thfinger (r),” and certified that he was “permanently unfit for any sea duty.”

Petitioners denied liability alleging that Pellazar failed to comply with his duty to observe the dispute resolution provisions of the CBA. Also, that Pellazar was not entitled to disability compensation higher than what was provided under a Grade 10 disability rating as that was the company-designated physician’s assessment of his disability. A Grade 10 disability is compensated US$10,075.00 under the POEA Standard Employment Contract (POEA-SEC).

LA RULING: in favor of Pellazar

NLRC: affirmed but modified the labor arbiter’s decision ruling that Pellazar is entitled only to an award of

$10,075.01 which is the equivalent of a Grade 10 disability in accordance with the disability rating given to him by the company-designated physicians

CA RULING: reversed the challenged NLRC rulings and, reinstated LA’s award of permanent total disability

benefits to Pellazar

ISSUE: Whether Pellazar is entitled to a Grade 10 disability or a permanent total disability. SC RULING:

Entitlement to disability benefits by seamen on overseas work is a matter governed, not only by medical findings but, by Philippine law and by the contract between the parties. The material statutory provisions are Articles 191 to 193 under Chapter VI (Disability Benefits) of the Labor Code, in relation with Rule X of the Rules and Regulations Implementing Book IV of the Labor Code. By contract, Department Order No. 4, series of 2000 of the Department of Labor and Employment (the POEA Standard Employment Contract) and the parties' CBA bind the seaman and his employer to each other. The terms under the POEA-SEC are to be read in accordance with what the Philippine law provides.

Under the POEA-SEC and the AMOSUP/IMEC TCCC CBA, the degree of disability arising from a work- connected injury or illness of a seafarer or his fitness to work shall be assessed by the company-designated

choice, whose findings are in conflict with those of the company-designated physicians. This conflict invariably leads to the question of whose findings should prevail.

In the present case, since there is a conflict in the assessment of the company-designated physicians and Dr. Sabado’s certification in relation to Pellazar’s fitness or unfitness to work, the matter should have been referred to a third doctor for final determination as required by the POEA-SEC and the parties’ CBA. Since Pellazar was responsible for the non-referral to the third doctor because of his failure to inform the manning agency that he would be consulting Dr. Sabado, he should suffer the consequences of the absence of a binding third opinion. Thus, the NLRC was well within the bounds of its jurisdiction, in upholding the disability assessment of Drs. De Guzman and Banaga as against Pellazar’s physician of choice.

Since the company-designated physicians gave Pellazar only a Grade 10 disability - and not a permanent total disability - he cannot be entitled to the full disability benefits of US$75,000.00 under the CBA

91. ESTRELLA D. S. BAÑEZ v. SOCIAL SECURITY SYSTEM AND DE LA SALLE UNIVERSITY G.R. No. 189574 July 18, 2014

DOCTRINE:

For death benefits the law requires proof by substantial evidence, or such relevant evidence which a reasonable mind might accept as adequate to justify a conclusion, that the nature of his employment or working conditions increased the risk of contracting the ailment or that its progression or aggravation was brought about thereby.

FACTS:

Baylon, the husband of petitioner, was employed by DLSU. From 21991-2006, Baylon worked as a Laboratory Technician at the Chemistry Department.

In 2006, Baylon was confined at Manila Doctors Hospital due to fever, weakness, dysuria and flank pains. He was diagnosed to be suffering from urinary tract infection. A month later he was confined again for functional dyspepsia. Later, he was diagnosed to be suffering from Systemic Lupus Erythematosus (SLE).

Dr. Castillo prepared a clinical abstract/toxicologic assessment on Baylon and she stated that “based on the occupational history of the patient, x x x the probability of a chemically induced disease cannot be discounted. Baylon succumbed to the complications of his disease on 27 August 2006. Baylon’s attending physician, Dr. Torres, issued a Medical Certificate stating that Baylon who was confined and expired in Medical Center Manila for Systemic Lupus Erythematosus may have been precipitated by the chronic exposure to chemicals which is an occupational hazard in his performance of being a laboratory technician. Based on medical opinions of Dr. Castillo and Dr. Torres, petitioner filed a claim for death benefits under the Employees’ Compensation Law before the Social Security System (SSS).

SSS: Denied claim on two grounds: 1) the cause of death, cardiac complication of SLE, is not considered work-

related; and 2) SLE is not included in the list of occupational diseases.

ECC: Also denied claim on the ground that “SLE is caused by a genetic tendency to mount an abnormal

immune response against one’s own tissues or organs leading to their destruction or malfunction.”

CA RULING: dismissed petition for review for being filed out of time. ISSUE: Whether petitioner’s claim should prosper.

pesticides and crystalline silica, the law requires proof by substantial evidence, or such relevant evidence which a reasonable mind might accept as adequate to justify a conclusion, that the nature of his employment or working conditions increased the risk of contracting the ailment or that its progression or aggravation was

brought about thereby.

Petitioner relied unqualifiedly on the toxicological report which failed to prove the causal relationship between Baylon’s work and his illness. The report made an indirect link between SLE and chemicals through “drug-

induced lupus.”

SLE and Drug-Induced Lupus Erythematosus are both autoimmune diseases. Drug-induced lupus is a temporary and mild form of lupus caused by certain prescription medications. They include some types of high blood pressure drugs (such as hydralazine, ACE inhibitors, and calcium channel blockers) and diuretics (hydrochlorothiazide). Symptoms resolve once the medication is stopped.

Furthermore, the toxicological report made mention of “certain drugs with chemical structures related to aromatic amines or substituted hydrazines, listed in the inventory of the school, can affect the immune system. This would include Benzenes, Naphthylamine, Toluene, Dinitrophenylhydrazine, etc.” However, these drugs were not proven to have been administered on Baylon. These substances which can induce the disease all pertain to drugs which are orally administered on the patient. There is no showing that the drugs given to Baylon had increased his risk of contracting Drug-Induced Lupus and SLE.

92. ALPHA SHIP MANAGEMENT CORPORATION/JUNEL M CHAN and/or CHUO-KAIUN COMPANY, LIMITED v. ELEOSIS v. CALO

G.R. No. 192034 January 13, 2014