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)

Osteoarthritis as a compensable seafarer’s illness

Degenerative changes of the spine, also known as osteoarthritis, is considered as a work-related.   due to the seafarer’s performance of  tasks that clearly involved unduly heavy physical labor  and  joint   strain.  

A job of a seafarer is not exactly a walk in the park.  He performs duties and responsibilities as instructed or as necessary. The job obviously entails laborious manual tasks conducted in a moving ship, which makes for increased work-related stress aside from exposure to fluctuating temperatures caused by variant weather changes. 

The compensability of osteoarthritis was favorably ruled upon by The Supreme Court in the case of   Oscar  D.  Gamboa vs. Maunlad Trans. Inc ( G.R. No. 232905, August 20, 2016)

Seafarer  Gamboa  entered into a nine (9)-month contract of employment as Bosun on board the vessel, MV OrienteShine, a cargo vessel transporting logs from Westminster, Canada to several Asian countries

During the voyage, the seafarer slipped and lost his footing while going down the ship's galley, which caused awrithing pain on the upper left side of his back. The ship master initially  gave him Salonpas for his back. Due to  experienced back pain and difficulty in breathing,   the captain  was prompted to disembark him for medical consultation in Canada.  While the foreign port doctor  took note of the seafarer's back pain, it was his diagnosed asthma thatprompted the said doctor to declare him unfit for duty.  The seafarer  was medically repatriated

Subsequent check-ups in the Philippines noted   that the seafarer was suffering from "Degenerative  Changes, Thoracolumbar  Spine" and was found to have a "metallic foreign body on the anterior cervical area noted on x-ray”. The company-designated physician opined this illness  as  not related to the cause of the seafarer's repatriation.

The company denied liability for payment of the seafarer’s disability benefits. They alleged  his osteoarthritis  was declared to be not work-related by the specialist since it may have occurred overtime and could not have developed during his 22-day stay on board the vessel, hence, was a pre-existing condition.

The entitlement of a seafarer on overseas employment to disability benefits is governed by law, by the parties'contracts, and by the medical findings.

The POEA contract  governs the procedure for compensation and benefits for a work-related injury or illness suffered by a seafarer on board sea-going vessels during the term of his employment contract. A "work-related" illness is defined as "any sickness as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.

Osteoarthritis is associated with a breakdown of cartilage in joints and can occur in almost any joint in the body. It commonly occurs in the weight-bearing joints of the hips, knees, and spine. Osteoarthritis occurs when the cartilage that cushions the ends of bones in the  joints gradually deteriorates. Cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. The slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, one  may be left with bone rubbing on bone.

At any rate, in medical parlance, spinal disc degeneration/desiccation and osteoarthritis can be taken as the same. Degenerative disc disease is a spinal condition caused by the breakdown of the intervertebral discs which results in the loss of flexibility and ability to cushion the spine.33 When discs degenerate, the vertebral bodies become closer together and this increased bone on bone friction causes the wearing away of protective cartilage and results in the condition known as osteoarthritis.34 The degenerating discs place excessive stress on the joints of the spine and the supporting ligaments, which, overtime, can lead to the formation of osteoarthritis.35 Osteoarthritis is a stage of degenerative disc disease. (CENTENNIAL TRANSMARINE, INC vs PASTOR M. QUIAMBAO, G.R. No. 198096               July 8, 2015) 

There are conditions that should be met before an illness, such as osteoarthritis, can be considered as pre-existing, namely: (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 illness or condition but failed to disclose the same during PEME, and such cannot be diagnosed during the PEME. The Supreme Court ruled that  none of these conditions had been established in this case.

The Court explained that  osteoarthritis is a listed occupational disease if the occupation involves any of the following:

a.       Joint strain from carrying heavy loads, or unduly heavy physical labor, as among laborers andmechanics;

b.      Minor or major injuries to the joint;

c.       Excessive use or constant strenuous usage of a particular joint, as among sportsmen,particularly  those  who  have  engaged  in  the  more  active sports  activities;

d.      Extreme temperature changes (humidity, heat and cold exposures) and;

e.       Faulty work posture or use of vibratory tools

The seafarer, as Bosun of the principal’s  cargo vessel that transported logs, undeniably performed tasks that clearly involved unduly heavy physical labor  and  joint   strain.  

The  Court declared that the seafarer's sustained back injury was not the result of an accident but nonetheless ordered the payment of his disability in accordance with the provisions of the Collective Bargaining Agreement (CBA.)

(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)