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clear that Macahilas's illness was assessed by the company-designated physician as not
work-related and he was declared, later on, as fit-to-work. Finally, awarding permanent
and total disability benefits is not based on the measure of time. Although Macahilas
was unable to return to work within 120 days from repatriation or that a fit-to-work
assessment was issued beyond 240 days, this cannot mean that Macahilas's disability is
permanent and total. It is the assessment of the doctor that is the measure of the
degree of disability suffered by the seafarer. Once the company-designated physician
has recommended a disability impediment grading within the 240-day period, the same
is considered conclusive. In this case, the company-designated physician issued a "not
work-related" assessment within 120 or 240 days.[22]
Ruling of the Court
Section 20(A) of the POEA-SEC provides two elements that must concur for an illness
to be compensable: (1) the injury or illness must be work-related; and (2) the workrelated injury or illness must have existed during the term of the seafarer's
employment contract. From the facts, Macahilas manifested symptoms on board the
vessel and was repatriated for perforated appendicitis. Hence, it becomes relevant to
determine if this illness is work-related.
Section 32-A of the POEA-SEC provides a list of occupational illnesses with conditions to
be observed for compensability. Illnesses not listed therein are disputably presumed
work-related.[23] Appendicitis is not a listed illness under the POEA-SEC but enjoys the
presumption that it is work-related. However, a reasonable connection between the
nature of work on board the vessel and the illness contracted or aggravated must still
be shown in order for the illness to be compensable.[24]
On record, Macahilas was diagnosed by the physician on board the vessel to be
suffering from acute appendicitis.[25] It is a severe and sudden case of appendicitis[26]
or the inflammation of the appendix.[27] The symptoms tend to develop quickly over
the course of one to two days.[28] This illness can be diagnosed when a person already
manifests the symptoms and is further physically examined, particularly, in the
abdomen area,[29] or conducting of blood tests, urine test or imaging test of the
abdomen.[30] As the onset of acute appendicitis can be unexpected, it is likely that
Macahilas did not have said illness or was undetected when he was redeployed. In fact,
he was declared fit to work in his PEME. It was only four months into his employment
contract or on December 29, 2013 that he manifested symptoms of acute appendicitis,
particularly, stomach pain, chills and nausea.[31] Considering that Macahilas manifested
symptoms while working on board the vessel, logically, his illness was contracted or
aggravated on board the vessel.
In an attempt to show that Macahilas's illness is not work-related, BSM emphasizes the
company-designated physicians' medical opinion that the probable cause of Macahilas's
illness is "due to the blockage of the appendix, usually a fecalith, causing
inflammation."[32] There was no explanation how the blockage by a fecalith or stool
could not have developed due to Macahilas's work. Macahilas, on the other hand,
explained that blockage by a fecalith could have been due to the limited food options
on board the vessel, such as frozen and processed meat, canned goods, and other
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