seafarer's diet and colon/ colorectal cancer

The interplay of dietary factors, age and  working environment  while at sea contribute to the development of    colon cancer among seafarers.

The Supreme Court ruled in the case of Skippers vs. Lagne ( G.R. No. 217036 August 20, 2018 ) that  rectal illness is compensable for permanent and total disability due to his dietary provisions.

Colon cancer, also known as colorectal cancer or large bowel cancer, includes cancerous growths in the colon, rectum and appendix. Colorectal cancer can invade and damage adjacent tissues and organs. Cancer cells can also break away and spread to other parts of the body (such as liver and lung) where new tumors form.

Companies usually deny liability for payment of disability or death benefits since there only three  types of cancers  listed as occupational diseases under the POEA Standard Employment Contract– (1) Cancer of the epithelial lining of the bladder (papilloma of the bladder); (2) cancer, epithellematous or ulceration of the skin or of the corneal surface of the eye due to tar, pitch, bitumen, mineral oil or paraffin, or compound products or residues of these substances and (3) acute myeloid leukemia and chronic lymphocytic leukemia.  

 Jurisprudence provides that to establish compensability of a non-occupational disease, reasonable proof of work-connection and not direct causal relation is required. Probability, not the ultimate degree of certainty, is the test of proof in compensation proceedings.

Settled is the rule that for illness to be compensable, it is not necessary that the nature of the employment be the sole and only reason for the illness suffered by the seafarer. It is sufficient that there is a reasonable linkage between the disease suffered by the employee and his work to lead a rational mind to conclude that his work may have contributed to the establishment or, at the very least, aggravation of any pre-existing condition he might have had.

The  Supreme Court stressed that the seafarer  acquired or developed his illness during the term of his contract due to the  strenuous nature of his  job, his advanced age at the time of hiring combined with his poor diet which consists of mostly carbohydrates, high-fat, high­ cholesterol, and low-fiber foods.

His dietary provisions while at sea increased his risk of contracting colon cancer because he had no choice of what to eat on board.

Being a seafarer, the food provisions on a ship  are designed for long journeys across the oceans and seas. The food provided are mostly frozen or processed meat, and  canned goods. Seldom are there vegetables which easily rot and wilt and, therefore, impracticable for long trips.

These provisions undoubtedly contribute to the aggravation of the seafarer's rectal illness.

While there is no specific cause of colorectal cancer, the Supreme Court noted that  certain factors can increase risk of developing the disease, including diet, age and health. Diets high  in fat, red meat, total calories, and alcohol are significantly associated with the formation of cancer-causing chemicals known as carcinogens which predisposes humans to contracting the disease.

 

The compensability of colorectal cancer has also been ruled upon in the case of Leonis Navigation v. Heirs of the late Catalina V. Villamater  (G.R. No. 179169               March 3, 2010) wherein the Supreme Court noted that factors that increase a person's risk of colorectal cancer include high fat intake.  

Diets high in fat are believed to predispose humans to colorectal cancer. It is believed that the breakdown products  of fat metabolism lead to the formation of cancer-causing chemicals (carcinogens). Diets high in vegetables and high-fiber foods may rid the bowel of these carcinogens and help reduce the risk of cancer.

Living in typically confined environments on board vessels for prolonged periods of time leaves seafarers exposed to various ongoing health problems including obesity and vitamin deficiency, as they choose convenience foods heavy in sugar and salt and low in protein.  Poor diet has even been found to be a key factor in altering physiological and psychological functions, which can have a devastating impact not only on the individual but also on the smooth running of daily operations.

Seafarers are exposed to occupational risk factors, as well as environmental risk factors, as part of their normal everyday activities since they spend a large part of their lives at sea. Most seafarers live and work under extremely hazardous conditions that can cause serious short-term and long-term damage to their health. In some cases, they are exposed to conditions that can even be fatal.

 Atty. Gorecho heads the seafarers’ division of the Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786

psychosis, severe depression or schizophrenia

A seafarer’s psychosis, severe depression  or schizophrenia may be  considered  compensable due to the work-related  stressful environment  on board the vessel.

Seafarers are susceptible to mental health issues due to  harassment and bullying  that can take a wide variety of forms, ranging from physical or verbal aggression, ill-treatment, cyber-bullying or sexual discrimination. There is even a high risk of suicide for seafarers with psychosis.  

While the physical effect of harassment and bullying is fairly easy to identify on account of the obvious external signs, the same cannot be said of their  emotional effects  which are often denied or distorted.

In Cabuyoc vs. Inter-Orient Navigation   (G.R. No. 166649,              November 24, 2006) , the Supreme Court ruled that  the seafarer’s illness was the direct result of the demands of his shipboard employment contract and the  hostile treatment and mental trauma in the hands of German ship officers . This led to his nervous breakdown and untimely repatriation to the Philippines.

The  Court disregarded the company’s argument that  psychosis or schizophrenia is not compensable under the POEA contract as his illness  is not caused by a  traumatic head injury which contemplates accidents involving physical or head contacts.

The Court noted the trauma  under the POEA contract  is not limited to  physical in nature but the same may involve mental or emotional hurt, damage or loss sustained. The word "trauma"  is defined as "a bodily injury caused by a physical force applied from without or  a disordered psychic or behavioral state resulting from stress or injury."

The seafarer's disability is not only physical but mental as well because of the severe depression, mental torture, anguish, embarrassment, anger, sleepless nights and anxiety that befell him.

In Leonis Navigation vs. Obrero (G.R. No. 192754, September 07, 2016), the Court ruled that  work-related stress may precipitate the disorder noting that the seafarer’s prolonged stint at sea eventually taxed his coping abilities which rendered him incapable of handling the stress.

The Court pointed out that  Schizophrenia is the most common form of psychotic disorder which involves a complex set of disturbances of thinking, perception, and social behavior and whose causes are still largely unknown, primarily associated with stressful life events.

In NFD International. v. NLRC (G.R. No. 107131, March 13, 1997),  schizophrenia was declared  to be work-related after the employer failed to negate the causal confluence between the epilepsy suffered by the seafarer after a mauling incident while on-board the vessel and his subsequent affliction of schizophrenia.

In Career Phils. vs Godinez, (G.R. No. 206826, October 2, 2017), the neophyte young seafarer's grave illness was directly caused by the unprofessional and inhumane treatment, as well as the physical, psychological, and mental abuse inflicted upon him by his superiors, aggravated by their failure and refusal to provide timely medical and/or professional intervention, and their neglect and indifference to his condition even as it was deteriorating before their very eyes.

 In C.F. Sharp vs. Perez (G.R. No. 194885,                January 26, 2015)  psychotic disorder was not considered  an injury as a result of an accident from any cause whatsoever which would entitle the seafarer  to higher disability benefits under the CBA.

Accident is one  which happens by chance or fortuitously, without intention and design, that does not occur in the usual course of events or that could not be reasonably anticipated, and  not attributable to mistake, negligence, neglect or misconduct.

There is no proof that seafarer  met an accident or an unintended and unforeseen injurious occurrence while on board the vessel. But his  disability was deemed  permanent and total, citing the company doctor’s  findings that recurrence of the same psychotic disorder is possible if the seafarer  is placed in the same situation.

In disability compensation, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairment of one's earning capacity.  Permanent total disability means disablement  to earn wages in the same kind of work, or work of similar nature that he was trained for or accustomed to perform, or any kind of work which a person of his  mentality and attainment could do. It does not mean absolute helplessness.

Probability and not the ultimate degree of certainty is the test of proof. The precise medical causation of the illness is not significant, as long as the illness supervened in the course of employment and is reasonably shown to have been either precipitated or aggravated by work condition.

Atty. Gorecho heads the seafarers’ division of the Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786

Tuberculosis among seafarers

Seafarers by nature of their work are exposed to a variety of occupational hazards making exposure to biological agents and the concomitant risk of communicable diseases extremely  high.

Because of their nature of work, seafarers are bound to visit many ports in different parts of the world and are thus exposed to various pandemic and epidemic diseases such as tuberculosis.

In Inter-Orient Maritime  vs. Creer (G.R. No. 181921 September 17, 2014) , the Supreme Court pointed out that pulmonary tuberculosis is airborne and easily transmissible by infected patients. The risk of being infected, or acquiring, the tuberculosis infection is mainly determined by exogenous factors. 

The probability of contact with a case of tuberculosis, the intimacy and duration of that contact, the degree of infectiousness of the case, and the shared environment of the contact are all important determinants of transmission.

On the other hand, the risk of developing the disease after being infected is largely dependent on endogenous factors. The tuberculosis bacteria may lie dormant in the infected person’s immune system for years before it becomes reactivated, or he may ultimately develop the disease within the first year or two after infection, depending on the innate susceptibility to disease of the person and level of immunity.

In ruling for the compensability of tuberculosis, the Supreme Court held in the case of BARKO vs. Alcayno (G.R. No. 188190               April 21, 2014) that  a certification declaring the seafarer  as fit to work contrary to a prior finding of tuberculosis can be considered as a ploy to circumvent the law intended to defeat the seafarer’s  right to be compensated for a disability which the law considers as permanent and total.

The Supreme Court  explained that tuberculosis is a contagious infection caused by the airborne bacterium Mycobacterium tuberculosis. It is usually transmitted by inhaling air contaminated by the bacterium. Active tuberculosis usually begins in the lungs (pulmonary tuberculosis). Tuberculosis that affects other part of the body (extrapulmonary tuberculosis) usually comes from pulmonary tuberculosis that has spread through the blood. Tuberculosis adenitis is a form of tuberculosis which affects the lymph nodes. 

The court noted that under the  POEA contract, "Pulmonary Tuberculosis" shall be considered as an occupational disease in "any occupation involving constant exposure to harmful substances in the working environment in the form of gases, fumes, vapors and dust."

The seafarer’s daily tasks as an able bodied seaman were to paint and chip rust on deck or superstructure of ship and to give directions to crew engaged in cleaning wheelhouse and quarterdeck, which constantly exposed him to different types of hazardous chemicals, such as paints, thinners, and other forms of cleaning agents and harmful substances, that may have invariably contributed to the aggravation of his illness.

The Supreme Court noted the suspicious  gesture of the company in having a medical certification declaring him as "fit to work" despite apparent clear knowledge that he has been subjected to a long period of medical treatment.

For a sick  seafarer to be entitled to medical benefits under the  POEA Contract,  it is not sufficient to simply establish that the seafarer’s illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a causal connection between the seafarer’s illness or injury and the work for which he had been contracted .

TB bacteria most commonly grow in the lungs, and can cause symptoms such as a bad cough that lasts three  weeks or longer, pain in the chest and coughing up blood or sputum (mucus from deep inside the lungs). Other symptoms of TB disease may include weakness or fatigue, weight loss, no appetite, chills, fever, and sweating at night.

Since one of the requirement for an illness to be compensable is that the seafarer suffered said illness during the effectivity of the POEA contract, it is imperative that his condition or symptoms  must be documented while he is on board the vessel.

Otherwise, his claim for disability benefits might be denied due to failure to prove that said illness occurred while his contract is still in force.

(Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)

Malaria in the seafaring industry

It is   a well-known fact that seafaring is one of the most hazardous occupations, in regards to personal health and safety concerns of seafarers.

The work on seagoing vessels is long associated with an increased risk of loss of health and life.  Because of their nature of work, seafarers are bound to visit many ports in different parts of the world and are thus exposed to various pandemic and epidemic diseases,  sometimes with fatal consequences.

Falling ill at sea or at a port far away from home can be a very difficult situation for the seafarer and his family and a challenge for the remaining crew and the ship operator

Apart from accidents, seafarers are prone to certain serious diseases and health hazards due to the nature of onboard work, change in climatic conditions, type of cargo carried, working hours, materials being handled, epidemic and endemic diseases, and  personal habits.

 One of the infections that a seafarer may suffer while on board the vessel  is malaria which  is predominantly a disease affecting Africa, South and Central America, Asia, and the Middle East.

Malaria is a preventable, life-threatening disease that can disrupt the blood supply to vital organ.

The plasmodium parasite which causes malaria is spread by the bite of infected female Anopheles mosquitoes and cannot be transmitted directly between humans.

Malaria as one of the listed  infectious disease that a seafarer may suffer during the effectivity of his contract  is  a disease resulting from the presence and activity of pathogenic microbial agents in the body. Infectious diseases are recognized as an occupational hazard in seafaring and are closely connected to the conditions of working and living onboard.

For a sick  seafarer to be entitled to medical benefits under the  POEA-Standard Employment Contract (SEC),   he must have suffered work related illness which is defined as any sickness resulting to disability or death as a result of one of the  twenty-four (24) occupational diseases listed under Section 32-A of the said contract. .

It is also  not sufficient to simply establish that the seafarer's illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a causal connection between the seafarer's illness or injury and the work for which he had been contracted .

Symptoms are flu-like, including : fever (often exceeding 40°C), chills, malaise. nausea and vomiting, fatigue, myalgia (muscle pain), headaches, and sweating.  

The symptoms of the most life-threatening type of malaria are usually experienced between one week and two months after infection.  A typical attack lasts 8-12 hours.

 On rare occasions, the symptoms do not occur until 3 months after the infection in case of falciparum malaria, and more than 1 year after for the 3 other types.

A seafarer  with severe falciparum malaria may show signs of  confusion, drowsiness, extreme weakness and may develop cerebral malaria with convulsions, an unrousable coma and rapid death.

Since one of the requirement for an illness to be compensable is that the seafarer suffered said illness during the effectivity of the POEA contract, it is imperative that his condition or symptoms  must be documented while he is on board the vessel.

Otherwise, his claim for disability benefits might be denied due to failure to prove that said illness occurred while his contract is still in force.

(Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)

Smoking and stress

Smoking , by itself, cannot  be a factor that bars compensation for the  seafarer’s death due to  illnesses such as aneurism.

 The tendency of seafarers to smoke is  often associated with  the stress experienced at sea.

 Seafarers are exposed to extreme weather conditions: rough seas and storms result in the rolling and pitching of the ship, leading to an unstable environment that makes physical work difficult.

Most seafarers are exposed to ongoing elevated stress levels something which has a negative impact on physical and mental health not to mention that it can lower work performance.  There might be variations of stress levels due to the type and nature of the work depending on the duties that have been assigned to the seafarer.

 Extremely high number of working hours over a lengthier period of time combined with lack of      sleep can elicit chronic fatigue, health problems and safety risks on the vessels.

 What makes the job more difficult, aside from exposure to fluctuating temperatures caused by variant weather changes, the job obviously entails laborious manual tasks conducted in a moving ship, which makes for increased work-related stress.

 In most cases, employers use as a defense the seafarer’s admission of being smoker  to deny claims for disability or death benefits  as they argue that genetic predisposition has caused his ailment and that his smoking habits hastened its development.

In the case of Dohle vs. Heirs of Gazzingan (G.R. No. 199568, June 17, 2015) the Supreme Courtstressed that  smoking, by itself, can not  be a factor that bars compensation for the illness such as  dissecting aneurysm.   

While smoking may contribute to the development of the disease, it is not the only possible cause. Other factors such as working and living under stressful conditions also contribute to its development.

 Aortic dissection, also called dissecting aneurysm, is a potentially life threatening condition in which there is bleeding into and along the wall of the aorta, the major artery leaving the heart. The condition starts with a tear in the wall of the major artery carrying blood out of the heart and as the tear extends along the wall of the aorta, blood enters the aortic wall and "dissects" or separates the layers of the aorta from one another which leads to aortic rupture or decreased blood flow to the organs. This can then result in heart attacks, strokes, paralysis, and renal failure among other medical conditions.

The Supreme Court noted that the  ailment’s risk factors, which include but are not limited to aging, connective tissue and rare genetic disorders, atherosclerosis, inflammation, trauma, high blood pressure, heart surgery/procedures, and pregnancy, do not seem to be direct causes of the disease, such that having one makes the chances of getting the condition higher but does not always lead to aortic dissection.

The Supreme Court then stressed that smoking habit cannot be used to deny the claims as  the exact cause of aortic dissection (as well as other illnesses)  is still unknown and remains under investigation.

(Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)

Spine injuries at sea

Back pains or spine injuries or illnesses are inherent in a seafarer’s  job characterized by excessive and strenuous physical activities, such as lifting, carrying, pushing, pulling and moving heavy equipment and materials.

The injury or illness may occur over a period of time or on the spot depending upon the physical strength and posture of the workers as well.   

The common back injuries or illness include lumbar spondylosis, lumbar radiculopathy, multi-level disc dessication, posterior disc herniation, or canal stenosis.

In compensation  claims, employers usually  argue that the nature of disability and the benefits are determined by the manner they are graded or classified under the POEA contract and not by the number of days that a seafarer is under treatment.  If a seafarer has an injury or medical condition that is not considered a Grade 1 impediment, then he cannot claim that he is totally or permanently disabled. To allow the contrary, they argue, would render naught the schedule of disabilities.

Under the POEA contract, Grade 1 disability grading will be given if a seafarer suffered  injury to the spinal cord  if (a) it  makes walking impossible even with the aid of a pair of crutches or (b) results to incontinence of urine and feces.

Partial disability  benefits will be given if the assessment is as follows: (a) Grade 4 if it caused walking impossible without the aid of a pair of crutches; (b) Grade 6  if he suffered fracture of the dorsal or lumber spines resulting severe or total rigidity of the trunk or total loss of lifting power of heavy objects ; (c) Grade 8 if he  suffered moderate rigidity or two thirds (2/3) loss of motion or lifting power of the trunk; and (d) Grade 11 if he  suffered slight rigidity or one third (1/3) loss of motion or lifting power of the trunk.

In some instances, any seafarer who suffered these  medical conditions is in essence should be declared total permanent disabled, and not merely partial temporary. The findings and the disability grading of a company-designated physician could be set aside in the determination of disability compensation.

The  Supreme Court  usually considers the glaring apparent inconsistency in the company doctor's medical report between the classification of seafarer's disability and the fact that he had been unable to work for long period of time, which condition makes his disability permanent and total. (Crystal Shipping, Inc. vs. Natividad, 473 SCRA 559).

Permanent total disability means disablement of a seafarer to earn wages in the same kind of work, or work of similar nature that he was trained for or accustomed to perform, or any kind of work which a person of his mentality and attainment could do. Disability need not render the seafarer absolutely helpless or feeble to be compensable; it is enough that it incapacitates to perform his customary work. (Seagull Maritime Corporation vs. Dee, 520 SCRA 109).  

If those injuries or disabilities with a disability grading from 2 to 14, hence, partial and permanent, would incapacitate a seafarer from performing his usual sea duties for a period of more than 120 or 240 days, depending on the need for further medical treatment, then he is, under legal contemplation, totally or permanently disabled (Kestrel Shipping Co., Inc. v. Munar, 689 SCRA 795)

Companies cannot deny the fact that a seafarer suffering from any of these medical conditions will be considered more of a liability than an asset if he is allowed to go on board the vessel.He would no longer be able to perform strenuous activities such as the rigorous duties of a seafarer.

The Supreme Court acknowledge that  symptoms following surgery are relieved only to recur after a variable period. The causes may include insufficient removal of disc material and further extrusion, rupture of another disc, adhesions about the nerve root and formation of an osteophyte at the site of removal of bone. Even a successful disc removal  does not guarantee a permanent cure as fibrosis can produce a dense constricting scar tissue, which is presumed to be a prime cause of recurrent symptoms(NFD . v. Illescas, G.R. No. 183054, September 29, 2010.)

Surgery can never stop the pathological process nor restore the back to its previous state. Similar poor results have been found with repeated attempts at surgical intervention for the relief of chronic low back pain. If long term relief is desired, continued mechanical stress of postural or occupational type must be avoided.

Resuming a seafarer’s  usual work, which includes increased loading, twisting, or bending and extension of the back, will further expose him  to dangers of  aggravating his medical condition. 

(Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)

Stroke and seafarer's stress

A seafarer who suffered stroke on board the vessel must be compensated due to work-related stress.

 In the case of  Magsaysay Mitsui OSK Marine, Inc, v. Bengson (G.R. No. 198528, October 13, 2014⁾  disregarded the employer’s   claim that the seafarer’s hypertensive cardio-vascular disease is not compensable on the sole basis of its company-designated physician’s declaration that such illness is not work-related.

The Supreme Court ruled that the seafarer’s  illness, which has likewise been diagnosed as intracerebral hemorrhage or hemorrhagic stroke, is a serious condition, and could be deadly.

The Supreme Court noted  that the  seafarer has been working for the company since 1988 and has been serving as Third Mate for twelve (12) years.  

Having worked for the principal  since 1988 under employment contracts that were continuously renewed, it can be said that the seafarer  spent much of his productive years with the principal; his years of service certainly took a toll on his body, and he could not have contracted his illness elsewhere except while working for the principal. 

As Third Mate, he was saddled with heavy responsibilities relative to navigation of the vessel, ship safety and management of emergencies. 

The seafarer  was subjected to physical and mental stress and strain: as Third Mate, he is the ship’s fourth in command, and he is the ship’s safety officer; these responsibilities have been heavy burdens on his shoulders all these years, and certainly contributed to the development of his illness. 

Besides, it is already recognized that any kind of work or labor produces stress and strain normally resulting in wear and tear of the human body.

An overseas worker, having to ward off homesickness by reason of being physically separated from his family for the entire duration of his contract, bears a great degree of emotional strain while making an effort to perform his work well.

The strain is even greater in the case of a seafarer who is constantly subjected to the perils of the sea while at work abroad and away from his family.c

The Court has ruled that the list of illnesses/diseases in Section 32-A of the  POEA Standard Employment Contract (SEC) does not preclude other illnesses/diseases not so listed from being compensable. The POEA contract  cannot be presumed to contain all the possible injuries that render a seafarer unfit for further sea duties.   And equally significant, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairment of one’s earning capacity.

An employee’s disability becomes permanent and total when so declared by the company-designated physician, or, in case of absence of such a declaration either of fitness or permanent total disability, upon the lapse of the 120 or 240-day treatment period while the employee’s disability continues and he is unable to engage in gainful employment during such period, and the company-designated physician fails to arrive at a definite assessment of the employee’s fitness or disability.

In many cases decided in the past, the Supreme  Court has held that cardiovascular disease, coronary artery disease, and other heart-related  ailments (including stroke)  are compensable. 

Thus, in Fil-Pride Shipping Co., Inc. v. Balasta, (G.R. No. 193047, March 3, 2014) severe 3-vessel coronary artery disease which the seaman contracted while serving as Able Seaman was considered an occupational disease.  In Villanueva, Sr. v. Baliwag Navigation, Inc., (702 SCRA 311).  it was held that the 2000 POEA-SEC considers heart disease as an occupational disease. 

 In Jebsens Maritime, Inc. v. Undag (662 SCRA 670) the Court held that hypertensive cardiovascular disease may be a compensable illness, upon proof.  In Oriental Shipmgt. Co., Inc. v. Bastol ( 622 SCRA 352) and Heirs of the late Aniban v. NLRC (347 Phil. 46)  it was held that myocardial infarction as a disease or cause of death is compensable, such being occupational.  Iloreta v. Philippine Transmarine Carriers, Inc (607 SCRA 796)  held that hypertensive cardiovascular disease/coronary artery disease and chronic stable angina are compensable.  

Micronesia Resources v. Cantomayor (552 Phil. 130)  stated that a finding of coronary artery disease entitles the claimant – a seaman Third Officer – to disability compensation.  In Remigio v .NLRC (521 Phil. 330) the Court held that the claimant – a musician on board an ocean-going vessel – was entitled to recover for suffering from coronary artery disease.  In Sepulveda v. ECC, (174 Phil. 242) it was declared that the employee’s illness, myocardial infarction, was directly brought about by his employment as schoolteacher or was a result of the nature of such employment.

 (Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)

Compensability of a seafarer's pre-existing illness

A  pre-existing illness, or an ailment that was contracted prior to his employment,   will not   deprive a seafarer  of compensation benefits as long as it is diagnosed during the effectivity of his recent contract.

The Supreme Court recently considered colorectal cancer as a compensable  illness   in the recent case of Skippers United Pacific, Inc., vs Estelito Lagne (G.R. No. 217036 August 20, 2018).

 

The company argued that the seafarer is not entitled to any disability compensation since rectosigmoidadenocarcinoma, or colorectal cancer,  is not listed as one of the occupational diseases under Section 32-A ofthe POEA Standard Employment Contract . They insisted that the same is not connected with his duties as anoiler and, therefore, is not compensable under the provisions of the POEA contract.

For disability to be .compensable under Section 20(B)(4) of the POEA contract, two elements mustconcur: (I) the injury or illness must be work-related; and (2) the work-related injury or illness must have existedduring the term of the seafarer's employment contract.

The POEA contract defines a work-related injury as "injury(ies) resulting in disability or death arising outof and in the course of employment," and a work-related illness as "any sickness resulting to disability ordeath as a result of an occupational disease listed under Section 32-A of this Contract with the conditions settherein satisfied."

For illnesses not mentioned under Section 32, the POEA contract  creates a disputable presumption infavor of the seafarer that these illnesses are work­ related. However, notwithstanding the presumption, the Supreme Court have held that on due process grounds, the claimant-seafarer must still prove by substantialevidence that his work conditions caused or, at least, increased the risk of contracting the disease. This isbecause awards of compensation cannot rest entirely on bare assertions and presumptions. In  order toestablish compensability of a non-occupational disease, reasonable proof of work­ connection is sufficient -direct causal relation is not required. Thus, probability, not the ultimate degree of certainty, is the test of proofin compensation proceedings.

Under the POEA contract, an illness shall be considered as pre-existing if prior to the processing of the POEA contract, any of the following conditions are present (a)  the advice of a medical doctor on treatment was given for such continuing illness or condition; or (b) the seafarer had been diagnosed and has knowledge of such an illness or condition but failed to disclose the same during pre-employment medical examination (PEME), and such cannot be diagnosed during the PEME

            Despite its non-inclusion in the list of occupational illnesses, the Supreme Court held that the seafarer is entitled to compensation for his colorectal cancer  when it  utilized the aggravation principle wherein his work conditions caused or, at least, increased the risk of contracting the disease.

Even if colorectal cancer is considered as a pre-existing illness, the Supreme Court granted  the compensation as it noted that   what matters is that his work had contributed, even in a small degree, to the development of the disease. Neither  is it necessary, in order to recover compensation, that the seafarer  must have been in perfect health at the time he contracted the disease. A worker brings with him possible infirmities in the course of his employment, and while the employer is not the insurer of the health of the employees, he takes them as he finds them and assumes the risk of liability.

The Court took judicial notice of the seafarer’s  food provisions on a ship which are produced at one timefor long journeys across the oceans and seas. The food provided to seafarers are mostly frozen meat,canned goods and seldom are there vegetables which easily rot and wilt and, therefore, impracticable for long trips. These provisions undoubtedly contributed to the aggravation of seafarer's rectal illness.

Moreover, considering the manual and laborious job that the seafarer  does, the seafarer  was able to reasonably prove that his working conditions exposed him to factors that could have aggravated his medical condition. He felt pain on his anus whenever he carries heavy weights, chest pains and difficulty in  breathing during his work, and the increasing size of the protruding rectal mass.

(Atty. Gorecho heads the seafarers’ division of the  Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786)