SECOND DIVISION

D E C I S I O N

BRION, J.:

We review in this petition for review on certioraric�fa1c�fac�fal�.w the December 15, 2008 decisionc�fa2c�fac�fal�.w and January 28, 2009 resolutionc�fa3c�fac�fal�.w of the Court of Appeals (CA) in CA-G.R. SP. No. 105625 that affirmed the April 30, 2008 and July 31, 2008 resolutions of the National Labor Relations Commission (NLRC). The NLRC resolutions affirmed the Labor Arbiters decision granting respondent Rommel M. Cedol (respondent) disability benefits and attorneys fees in the amounts of US$60,000.00 and US$6,000.00, respectively.chanroblesvirtua|awlibary

ANTECEDENT FACTS

 cralaw

On July 14, 2004, the respondent entered into a seven-month contract of employment with petitioner Magsaysay Maritime Corporation (Magsaysay Maritime) for its foreign principal, Cruise Ships Catering and Services International N.V. (Cruise Ships); he was employed as an assistant housekeeping manager on board the vessel Costa Mediterranea with a basic monthly salary of US$482.00. The respondent submitted himself to the required Pre-Employment Medical Examination (PEME), and was pronounced fit to work. He boarded the vessel Costa Mediterranea on July 19, 2004.chanroblesvirtua|awlibary

Prior to the execution of this employment contract, the respondent had previously worked as housekeeping cleaner and assistant housekeeping manager on board the petitioners other vessels from 2000 to 2004.c�fa4c�fac�fal�.w

In November 2004, the respondent felt pain in his lower right quadrant. He was brought to and conferred at the Andreas Constantinou Medical Center in Cyprus for consultation.On January 18, 2005, he underwent a procedure called exploratory laparotomy which revealed a massive tumor in the terminal ileum and in the ascending colon near the hepatic flexture. On the same day, the respondent underwent a surgical procedure called right hemicolectomy with end to end ilectransverse anastomosis.c�fa5c�fac�fal�.w The Histopathology Report showed the following findings:

CONCLUSION

 cralaw

The appearances are consistent with a malignant lymphoid infiltration of the ileum and the mesenteric lymph nodes.chanroblesvirtua|awlibary

The appearances are consistent [with] the interstinal lymphoma of small and large sized lymphoid cells.chanroblesvirtua|awlibary

xxxxc�fa6c�fac�fal�.w

The respondent was discharged from the hospital and repatriated to the Philippines on February 1, 2005.chanroblesvirtua|awlibary

Upon repatriation, the respondent was placed under the medical care and supervision of the company-designated physician, Dr. Susannah Ong-Salvador (Dr. Ong-Salvador).In Dr. Ong-Salvadors Initial Medical Reportc�fa7c�fac�fal�.w dated February 10, 2005, she found the respondent to be suffering from lymphoma, and declared his illness to be non-work related.

On April 14, 2005, the respondent was brought to the Chinese General Hospital, where he underwent a surgical procedure called excision biopsy.c�fa8c�fac�fal�.w Dr. Ong-Salvadors Medical Progress Report found the respondents recurrent lymphoma to be in complete remission, and declared him fit to resume sea duties after undergoing six (6) sessions of chemotherapy.c�fa9c�fac�fal�.w

On June 16, 2006, the respondent filed before the Labor Arbiter a complaint for total and permanent disability benefits, reimbursement of medical and hospital expenses, damages, and attorneys feesc�fa10c�fac�fal�.w against the petitioners. He claims that he contracted his illness while working on board the petitioners vessel.chanroblesvirtua|awlibary

The Labor Arbiters Decision

 cralaw

Labor Arbiter Marita V. Padolina (LA Padolina) ruled in respondents favor. She found the respondent permanently and totally disabled and awarded him disability compensation of US$60,000.00 or its peso equivalent; and US$6,000.00 attorneys fees.chanroblesvirtua|awlibary

LA Padolina ruled the respondents illness to be work-related, hence compensable. She held that the respondents illness was aggravated by his work, as he had always passed the companys physical examinations since 2000. She explained that the respondents work need not be the main cause of his illness; it is enough that his employment had contributed even in a small degree to the development of the disease.chanroblesvirtua|awlibary

LA Padolina likewise held that each person has his own physical tolerance. That it was only the respondent who had contracted lymphoma among the petitioners workers did not remove the fact that his illness was aggravated by his employment. She also ruled that the respondent was not fit to work as a seafarer because he had undergone chemotherapy.c�fa11c�fac�fal�.w

The labor arbiter likewise awarded attorneys fees in respondents favor, as he was forced to litigate to protect his rights.chanroblesvirtua|awlibary

The NLRC Ruling

 cralaw

The NLRC affirmed the labor arbiters decision in toto in its resolution dated April 30, 2008.c�fa12c�fac�fal�.w The NLRC held that the respondent is not fit to work as a seafarer because he is suffering from recurrent lymphoma - a sickness that required him undergo chemotherapy. The NLRC explained that the respondent is in a state of permanent total disability because he can no longer 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.chanroblesvirtua|awlibary

The NLRC ruled that there was a reasonable connection between the nature of the respondents work as assistant housekeeping manager and the development of his illness. The NLRC explained that the respondent had passed every PEME before signing the six employment contracts with the petitioner from 2000 to 2005, and was declared fit to work each time. It was only after the respondent was exposed to an extreme working environment in the petitioners vessel that he developed his sickness. At any rate, the law merely requires a reasonable work connection, and not a direct causal connection for a disability to be compensable.chanroblesvirtua|awlibary

The petitioners moved to reconsider this resolution, but the NLRC denied their motion in its resolution of July 31, 2008.c�fa13c�fac�fal�.w

The CA Decision

 cralaw

The petitioners filed a petition for certiorari with prayer for the issuance of a writ of preliminary injunction and/or temporary restraining orderc�fa14c�fac�fal�.w before the CA, docketed as CA-G.R. SP. No. 105625. The CA, in its decisionc�fa15c�fac�fal�.w of December 15, 2008, denied the petition for lack of merit.chanroblesvirtua|awlibary

The CA held that under the provisions of the POEA Standard Employment Contract (POEA-SEC), it is enough that the work has contributed, even in a small degree, to the development of the workers disease. The CA further held that the Courts are not bound by the assessment of the company-designated physician. According to the CA, Dr. Ong-Salvadors pronouncement that the respondent is fit to resume sea duties was inconsistent with the fact that the respondent had previously undergone chemotherapy, and needed to undergo periodic check-ups.chanroblesvirtua|awlibary

The CA affirmed the award of attorneys fees because Article 2208 of the Civil Code allows the recovery of attorneys fees in actions for indemnity under the workmans compensation and employer liability laws.chanroblesvirtua|awlibary

The petitioners moved to reconsider this decision, but the CA denied their motion in its resolution of January 28, 2009.c�fa16c�fac�fal�.w

The Petition

 cralaw

In the present petition, the petitioners argue that the CA erred in holding the petitioners liable for US$60,000.00 in total and permanent disability benefits despite the company-designated physicians finding that the respondents illness was not work-related. They assert that under the 2000 POEA-SEC, only work-related injury or illness is compensable. They likewise maintain that the company-designated physicians finding that the respondents illness was not work-related should be given credence. Aside from the fact that lymphoma is not listed as an occupational disease under Section 32-A of the POEA-SEC, the respondents work could not have exposed him to carcinogenic fumes or chemicals that cause cancer because his duties merely involved housekeeping and cleaning.chanroblesvirtua|awlibary

 cralaw

The Respondents Position

 cralaw

In his Comment,c�fa17c�fac�fal�.w the respondent claims that the company-designated physician had no factual basis in ruling that his illness was not work-related. He posits that the opinions of company-designated physicians should not be taken as gospel truth because of their non-independent nature. Finally, he claims that his illness could have only been acquired on board since he passed the companys PEME.chanroblesvirtua|awlibary

THE COURTS RULING

 cralaw

We find the petition meritorious.chanroblesvirtua|awlibary

The petitioners essentially claim that the evidence on record does not support the findings of the labor tribunals and the CA that the respondents illness was work-related.This argument clearly involves a factual inquiry whose determination is not a function of this Court. We emphasize, however, that we are reviewing in this Rule 45 petition the decision of the CA on a Rule 65 petition filed by the petitioners with that court.In so doing, we review the legal correctness of the CA decision from the prism of whether it correctly determined the presence or absence of grave abuse of discretion in the NLRC decision before it.chanroblesvirtua|awlibary

In this task, the Court is allowed, in exceptional cases, to delve into and resolve factual issues when insufficient or insubstantial evidence to support the findings of the tribunal or court below is alleged, or when too much is concluded, inferred or deduced from the bare and incomplete facts submitted by the parties, to the point of grave abuse of discretion.c�fa18c�fac�fal�.wThe present case constitutes one of these exceptional cases.chanroblesvirtua|awlibary

The Rule on Disability Benefits

Entitlement of seamen on overseas work to disability benefits is a matter governed, not only by medical findings, but by law and by contract. 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, the POEA-SEC, as provided under Department Order No. 4, series of 2000 of the Department of Labor and Employment, and the parties Collective Bargaining Agreement (CBA) bind the seaman and his employer to each other.c�fa19c�fac�fal�.w

Section 20 (B), paragraph 3 of the 2000 POEA-SECc�fa20c�fac�fal�.w reads:

Section 20-B. Compensation and Benefits for Injury or Illness.chanroblesvirtua|awlibary

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:

xxxx

6. In case of permanent total or partial disability of the seafarer caused by either injury or illness the seafarer shall be compensated in accordance with the schedule of benefits enumerated in Section 32 of this Contract. Computation of his benefits arising from an illness or disease shall be governed by the rates and the rules of compensation applicable at the time the illness or disease was contracted. Emphasis supplied.]

 cralaw

For disability to be compensable under Section 20 (B) of the 2000 POEA-SEC, two elements must concur: (1) the injury or illness must be work-related; and (2) the work-related injury or illness must have existed during the term of the seafarers employment contract.c�fa21c�fac�fal�.wIn other words, to be entitled to compensation and benefits under this provision, it is not sufficient to establish that the seafarers illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a causal connection between the seafarers illness or injury and the work for which he had been contracted.22c�fac�fal�.w

The 2000 POEA-SEC defines work-related injury as injury(ies) resulting in disability or death arising out of and in the course of employment and 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 contract with the conditions set therein satisfied.chanroblesvirtua|awlibary

Under Section 20 (B), paragraphs (2) and (3) of the 2000 POEA-SEC, it is the company-designated physician who is entrusted with the task of assessing the seamans disability, thus:

Section 20-B. Compensation and Benefits for Injury or Illness.chanroblesvirtua|awlibary

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:

xxxx

However, if after repatriation, the seafarer still requires medical attention arising from said injury or illness, he shall be so provided at cost to the employer until such time he is declared fit or the degree of his disability has been established by the company-designated physician.

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 orthe degree of permanent disability has been assessed by thecompany-designated physician but in no case shall this period exceed one hundred twenty (120) days.chanroblesvirtua|awlibary

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 in his forfeiture of the right to claim the above benefits.chanroblesvirtua|awlibary

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 doctors decision shall be final and binding on both parties.

xxxx [Emphasis supplied.

Thus, the seafarer, upon sign-off from his vessel, must report to the company-designated physician within three (3) days from arrival for diagnosis and treatment. For the duration of the treatment but in no case to exceed 120 days, the seaman is on temporary total disabilityas he is totally unable to work. He receives his basic wage during this period until he is declared fit to work or his temporary disability is acknowledged by the company to be permanent, either partially or totally, as his condition is defined under the POEA-SEC and by applicable Philippine laws. If the 120-day initial period is exceeded and no such declaration is made because the seafarer requires further medical attention, then the temporary total disability period may be extended up to a maximum of 240 days,c�fa23c�fac�fal�.w subject to the right of the employer to declare within this period that a permanent partial or total disability already exists. The seaman may of course also be declared fit to work at any time such declaration is justified by his medical condition.c�fa24c�fac�fal�.w

In the case before us, there is no dispute that the respondent reported to the company-designated physician for treatment immediately upon repatriation. Problems arose when he was diagnosed with lymphoma, and the company-designated physician ruled this illness to be non-work-related.chanroblesvirtua|awlibary

Lymphoma is a cancer that begins in the lymphocites of the immune system and presents as a solid tumor of lymphoid cells. Like other cancers, lymphoma occurs when lymphocytes are in a state of uncontrolled cell growth and multiplication.It is treatable with chemotherapy, and, in some cases, radiotherapy and/or bone marrow transplantation, and can be curable, depending on the histology, type, and stage of the disease. These malignant cells often originate in lymph nodesc�fal�.w, presenting as an enlargement of the node (a tumor).c�fa25c�fac�fal�.w

Lymphoma is neither listed as a disability under Section 32 (Schedule of Disability or Impediment for Injuries Suffered and Diseases Including Occupational Diseases or Illness Contracted) of the 2000 POEA-SEC nor listed as an occupational disease under Section 32-A thereof. Nonetheless, Section 20 (B), paragraph (4) provides that those illnesses not listed in Section 32 of this Contract are disputably presumed as work-related. The burden is therefore placed upon the respondent to present substantial evidence, or such relevant evidence which a reasonable mind might accept as adequate to justify a conclusion that there is a causal connection between the nature of his employment and his illness, or that the risk of contracting the illness was increased by his working conditions.This, the respondent failed to do. In fact, a careful review of the records shows that the respondent did not, by way of a contrary medical finding, assail the diagnosis arrived at by the company-designated physician. For clarity and precision, we reproduce the pertinent parts of Dr. Ong-Salvadors Initial Medical Report dated February 10, 2005, thus:

WORKING IMPRESSION: To Consider Lymphoma

Status post Right hemilectomy with anastomosis with end to end ileotransverse anastomosis with extensive removal of the mesenteries

Lymphoma is the cancer of the lymph nodes. It has 2 types: Hodgkins and Non-hodgkins lymphoma. Etiology of this condition may arise from genetic predisposition (family history of cancer), cytogenetic abnormalities, viral infection or exposure to highly carcinogenic fumes.chanroblesvirtua|awlibary

By history, the patient has not been exposed to any carcinogenic fumes nor did he contact any viral infection such as Epstein Barr virus in his workplace nor was there a family history of cancer. His condition may be brought about by cytogenetic abnormalities. Hence, his condition is non-work related.chanroblesvirtua|awlibary

xxxxc�fa26c�fac�fal�.wEmphasis supplied.

While it is true that medical reports issued by the company-designated physicians do not bind the courts, our examination of Dr. Ong-Salvadors Initial Medical Report leads us to agree with her findings.Dr. Ong-Salvador was able to sufficiently explain her basis in concluding that the respondents illness was not work-related: she found the respondent not to have been exposed to any carcinogenic fumes, or to any viral infection in his workplace. Her findings were arrived at after the respondent was made to undergo a physical, neurological and laboratory examination, taking into consideration his (respondents) past medical history, family history, and social history.In addition, the respondent was evaluated by a specialist, a surgeon and an oncologist.The series of tests and evaluations show that Dr. Ong-Salvadors findings were not arrived at arbitrarily; neither were they biased in the companys favor.chanroblesvirtua|awlibary

The respondent, on the other hand, did not adduce proof to show a reasonable connection between his work as an assistant housekeeping manager and his lymphoma. There was no showing how the demands and nature of his job vis--vis the ships working conditions increased the risk of contracting lymphoma. The non-work relatedness of the respondents illness is reinforced by the fact that under the Implementing Rules and Regulations of the Labor Code (ECC Rules), lymphoma is considered occupational only when contracted by operating room personnel due to exposure to anesthetics. The records do not show that the respondents work as an assistant housekeeping manager exposed him to anesthetics.chanroblesvirtua|awlibary

In short, the evidence on record is totally bare of essential facts on how the respondent contracted or developed lymphoma and how and why his working conditions increased the risk of contracting this illness. In the absence of substantial evidence, we cannot just presume that respondents job caused his illness or aggravated any pre-existing condition he might have had.chanroblesvirtua|awlibary

The fact that respondent passed the companys PEME is of no moment.We have ruled that in the past the PEME is not exploratory in nature. It was not intended to be a totally in-depth and thorough examination of an applicants medical condition. The PEME merely determines whether one is fit to work at sea or fit for sea service, it does not state the real state of health of an applicant.c�fa27c�fac�fal�.w In short, the fit to work declaration in the respondents PEME cannot be a conclusive proof to show that he was free from any ailment prior to his deployment.Thus we held in NYK-FIL Ship Management, Inc. v. NLRC:28c�fac�fal�.w

While a PEME may reveal enough for the petitioner (vessel) to decide whether a seafarer is fit for overseas employment, it may not be relied upon to inform petitioners of a seafarers true state of health. The PEME could not have divulged respondents illness considering that the examinations were not exploratory.

The respondent was declared fit to resume sea duties

Another factor that further militates against the respondents claim for permanent and total disability benefits is Dr. Ong-Salvadors Medical Progress Report declaring him to be fit to resume sea duties. The relevant portions of this report are hereunder reproduced:

MEDICAL PROGRESS REPORT

xxxx

CT Scan of the abdomen

-         cralawComparison is made with the previous examination dated November 29, 2005

-         cralawThe previously noted irregular soft tissue module inferior to the pancreatic is no longer evident

-         cralawThere is no gross lymph node enlargement

-         cralawFatty changes in the liver and gallstones are again demonstrated

-         cralawThe rest of the findings are stationary

-         cralawImpression: Further disease regression since November 2005.

Our Oncologist examined the patient today who opines that patient has responded well after undergoing 6 sessions of chemotherapy. His present state of remission is supported by further disease regression in his latest CT Scan of the abdomen. Blood chemistry result of his createnine and lactate dehydrogenase levels are within normal limits. Check-up from year to year was suggested to evaluate periodically his health condition. Since Mr. Cedol is noted asymptomatic he is therefore cleared from Oncology standpoint.chanroblesvirtua|awlibary

After thorough evaluation by our specialists, Mr. Cedol is now deemed fit to resume sea duties.

FINAL DIAGNOSIS: Recurrent Lymphoma, in complete remission.c�fa29c�fac�fal�.w

As previously discussed, it is the company-designated physician who is entrusted with the task of assessing the seamans disability. Since Dr. Ong-Salvador deemed the respondent as fit to resume sea duties, then such declaration should be given credence, considering the amount of time and effort she gave to monitoring and treating the respondents condition.c�fa30c�fac�fal�.w It bears emphasizing that the respondent has been under the care and supervision of Dr. Ong-Salvador since his repatriation in February 2005 and no contrary medical evidence exists on record disputing Dr. Ong-Salvadors medical conclusions.The extensive medical attention she has given the respondent undeniably enabled her to acquire familiarity and detailed knowledge of the latters medical condition. We cannot help but note that the Medical Progress Report was replete with details justifying its fit to work conclusion. In addition, the respondent did not contest the findings contained in this Medical Progress Report; neither did he seek the opinion of other doctors.

We emphasize that the constitutional policy to provide full protection to labor is not meant to be a sword to oppress employers.  The commitment of this Court to the cause of labor does not prevent us from sustaining the employer when it is in the right.c�fa31c�fac�fal�.w We should always be mindful that justice is in every case for the deserving, to be dispensed with in the light of established facts, the applicable law, and existing jurisprudence.c�fa32c�fac�fal�.w

In sum, we hold that the respondent is not entitled to total and permanent disability benefits for his failure to refute the company-designated physicians findings that: (1) his illness was not work-related; and (2) he was fit to resume sea duties. The CA thus erred in not finding grave abuse of discretion on the part of the NLRC when the latter affirmed the labor arbiters decision to grant permanent and total disability benefits to the respondent despite insufficient evidence to justify this grant.

WHEREFORE, in view of all the foregoing, the instant petition is GRANTED.The assailed decision of the Court of Appeals in CA-G.R. SP. No. 105625 is REVERSED and SET ASIDE. Accordingly, the respondents complaint before the Labor Arbiter is DISMISSED.chanroblesvirtua|awlibary

SO ORDERED.

ARTURO D. BRION

Associate Justice

WE CONCUR:

CARPIO, J., Chairperson, DEL CASTILLO, ABAD and PEREZ, JJ.

ATTESTATION

I attest that the conclusions in the above Decision had been reached in consultation before the case was assigned to the writer of the opinion of the Courts Division.chanroblesvirtua|awlibary

ANTONIO T. CARPIO

Associate Justice

Chairperson

CERTIFICATION

Pursuant to Section 13, Article VIII of the Constitution, and the Division Chairpersons Attestation, it is hereby certified that the conclusions in the above Decision were reached in consultation before the case was assigned to the writer of the opinion of the Courts Division.

REYNATO S. PUNO

Chief Justice