G.R. No. 203472 July 9, 2014
MAGSAYSAY MARITIME CORPORATION, EDUARDO U. MANESE and NORWEGIAN CRUISE LINE, Petitioners, vs. HENRY M. SIMBAJON, Respondent.

FACTS

Respondent Henry M. Simbajon was hired as a cook by petitioner Norwegian Cruise Line (NCL) through its manning agent, petitioner Magsaysay Maritime Corporation, under a POEA-SEC. This was his fourth contract with NCL. He underwent a Pre-Employment Medical Examination (PEME) where he disclosed no history of diabetes and was declared “fit for employment.” Six days after embarkation on July 24, 2004, Simbajon complained of increased urination and thirst. He was diagnosed with Diabetes Mellitus Type II (DM Type II) and was repatriated on August 15, 2004. He was treated by company-designated physicians who, after a series of evaluations and treatments, declared him “fit to work” on February 2, 2005. He received illness allowance from disembarkation until February 2, 2005. Petitioners did not rehire him. Simbajon sought a second opinion from Dr. Efren R. Vicaldo, who diagnosed him with DM Type II, diabetic retinopathy, and declared him unfit for sea duty with a 50% disability rating. Simbajon filed a complaint for disability benefits. The Labor Arbiter ruled in his favor, finding the illness work-related and compensable, and considered it a permanent total disability due to treatment exceeding 120 days. The NLRC reversed, finding the illness not work-related, noting the six-day onset as insufficient for exposure and citing jurisprudence that diabetes is hereditary. The Court of Appeals reversed the NLRC, ruling that reasonable proof of work-connection was established and that Simbajon’s inability to work for over 120 days constituted permanent total disability.

ISSUE

1. Whether Simbajon’s Diabetes Mellitus Type II is compensable as a work-related illness.
2. Whether Simbajon is entitled to permanent total disability benefits.
3. Whether Simbajon is entitled to attorney’s fees.

RULING

1. No, Simbajon’s Diabetes Mellitus Type II is not compensable. The Court held that for an illness to be compensable under the POEA-SEC, the seafarer must prove that the work conditions caused or at least increased the risk of contracting the disease. Simbajon failed to provide substantial evidence that his work as a cook caused or aggravated his DM Type II. The onset of symptoms merely six days after embarkation strongly suggests a pre-existing condition. The Court cited jurisprudence stating that diabetes is a hereditary disease not directly caused by employment conditions. Simbajon’s general claims of strenuous work and stress were insufficient to establish reasonable proof of work-connection.
2. No, Simbajon is not entitled to permanent total disability benefits. The Court clarified that the 120-day treatment period is not an automatic basis for permanent total disability. The company-designated physician declared Simbajon “fit to work” within the 120-day period (from August 15, 2004 to February 2, 2005). The declaration of fitness by the company-designated physician, absent a conflicting opinion from another physician within the prescribed period, is binding. The Court emphasized that the inability to work for more than 120 days applies only if the illness is work-related, which was not proven in this case.
3. No, Simbajon is not entitled to attorney’s fees. The Court found no evidence of bad faith on the part of the petitioners in denying Simbajon’s claim. The petitioners relied on the company-designated physician’s assessment and legal grounds to dispute the claim. Therefore, the award of attorney’s fees was deleted.
The Supreme Court GRANTED the petition, REVERSED and SET ASIDE the Court of Appeals’ decision, and REINSTATED the NLRC decision dismissing Simbajon’s complaint.