1/5/2021 E-Library - Information At Your Fingertips: Printer Friendly Hospital in Al-Khobar Saudi Arabia to have contracted diabetes mellitus. In fact, while on board the vessel, he was twice sent to As Salama Hospital in Al-Khobar Saudi Arabia for medical treatment. To support his claim, Apolinario presented the medical record issued by the hospital and the different medical certificates of his physicians after his repatriation in Manila stating that he is already physically unfit to return to work due to his diabetes mellitus. While the illness is not listed as one of the occupational diseases under Section 32(A) of the POEA-SEC, the ailment is presumed work-related under Section 20(B)(4) of the contract. Respondents are duty bound to overcome this presumption. However, other than their bare allegation, respondents did not present a scintilla of proof to establish the lack of casual connection between Apolinario's disease and his employment as a seafarer. Had respondents granted Apolinario's request to undergo a post-employment medical check-up, they could have presented a medical finding to contradict the presumption of work-relatedness of Apolinario's illness. The post-employment medical check-up could have been the proper basis to determine the seafarer's illness, whether it was work-related, or its specific grading of disability.[20] Having failed to present any evidence to defeat the presumption of work-relatedness of Apolinario's diabetes mellitus, the prima facie case that it is work-related prevails. Nonetheless, the presumption provided under Section 20(B)(4) is only limited to the "work-relatedness" of an illness. It does not cover and extend to compensability.[21] In this sense, there exists a fine line between the work-relatedness of an illness and the matter of compensability.[22] The former concept merely relates to the assumption that the seafarer's illness, albeit not listed as an occupational disease, may have been contracted during and in connection with one's work, whereas compensability pertains to the entitlement to receive compensation and benefits upon a showing that a seafarer's work conditions caused or at least increased the risk of contracting the disease.[23] It is medically accepted that stress has major effects on a person's metabolic activity. The effects of stress on glucose metabolism are mediated by a variety of counterregulatory hormones that are released in response to stress and that result in elevated blood glucose levels and decreased insulin action. In diabetes, because of a relative or absolute lack of insulin, the increase in blood glucose on account of stress cannot be adequately metabolized. Thus, stress is a potential contributor to chronic hyperglycemia in diabetes.[24] At this juncture, the case of Millora v. ECC[25] is instructive. The petitioner therein was the widow of Prisco Millora. The latter was a public school teacher and was diabetic during the last 11 years of his life. Upon his discharge from the hospital for treatment of his illness, he forthwith filed a claim for benefits due to diabetes mellitus, but it was denied. At the age of 40, Prisco died. Petitioner requested the Government Service Insurance System (GSIS) to reconsider its denial of the deceased's claim, but to no avail. This compelled petitioner to elevate the case to the Employees' Compensation Commission (ECC) for review, but the commission affirmed the dismissal of the case on the ground that the cause of the deceased's ailment was not work-connected. The ECC relied on the evaluation made by the GSIS that diabetes mellitus is hereditary in nature https://elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/65782 5/14