2025 Bar Chair's Cases Bar Q and A Labor Law - Q2

 

Francivel Derama Sestoso (Sestoso) was employed as a Team Headwaiter on board M/V Carnival Inspiration for six months under a contract between United Philippine Lines, Inc. (UPLI) and Carnival Cruise Lines (CCL). While performing his usual duties in 2014, he experienced sharp pain radiating down his right knee. An MRI conducted in Los Angeles, California, revealed a complex tear of the medial meniscus and degenerative joint changes. It was also found that he had undergone knee surgery earlier that year but continued working with the aid of pain relievers.

Upon his repatriation in 2015, the company-designated physician, Dr. Mylene Cruz-Balbon, referred him to an orthopedic specialist, Dr. William Chuasuan, who recommended surgery and stated that Sestoso had reached maximum medical improvement. On July 28, 2015, Dr. Cruz-Balbon issued a final diagnosis of osteoarthritis and medial meniscal tear in Sestoso’s right knee but did not assign a final disability rating within the 120/240-day period.

Sestoso sought a second opinion from Dr. Victor Gerardo E. Pundavela, who diagnosed him with severe degenerative osteoarthritis. He then filed a complaint against UPLI, CCL, and UPLI’s owner for total disability benefits.

The Labor Arbiter awarded him Grade 10 disability benefits, despite acknowledging that his illness was pre-existing. On appeal, the National Labor Relations Commission (NLRC) upgraded the award to permanent and total disability benefits, reasoning that the company-designated physician failed to issue a valid and final disability assessment within the 240-day period. However, the Court of Appeals (CA) reversed the ruling, holding that Sestoso’s illness was pre-existing, and he failed to prove that his working conditions aggravated his condition. It ruled that the 120/240-day rule was inapplicable.

Is Sestoso entitled to disability benefits?

Ans:

Yes, Sestoso is entitled to disability benefits because of the failure of the company-designated physician on the final assessment of his disability on the 240 days extension.

In one of the cases decided by the Supreme Court, if the 120-day period is exceeded and no definitive 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. The non-compliance within the extended period of the required assessment is likewise the ipso jure grant to the seafarer of permanent and total disability benefits, regardless of any justification.

Here, the records are bereft of any showing that the company-designated physician gave Sestoso a final and definite disability rating within the 120/240 days prescribed. The company-designated physician failed to issue a valid and final disability assessment within the extended 240-day period. Hence, Sestoso’s disability became total and permanent for which he is entitled to the corresponding benefits.