6/8/2020 E-Library - Information At Your Fingertips: Printer Friendly while on sea duty. He also failed to specifically state how he contracted or developed varicose veins while on sea duty and how and why his working conditions aggravated it. Neither did he present any expert medical opinion regarding the cause of his varicose veins. No written document whatsoever was presented that would clearly validate his claim or visibly demonstrate that the working conditions on board the vessels he served increased the risk of acquiring varicose veins. Moreover, although petitioner was rehired by respondent company several times, his eight-year service as a seaman was not actually without a “sign-off” period. His contract with respondent company was considered automatically terminated after the expiration of each overseas employment contract. Upon the termination of each contract, he was considered “signed-off” and he would have to go back and re-apply by informing respondent company as to his availability. Thereafter, he would have to sign an Availability Advise Form. Meanwhile, he would have to wait for a certain period of time, probably months, before he would be called again for sea service. Thus, respondent company can argue that petitioner’s eight (8) years of service with it did not automatically mean that he acquired his varicose veins by reason of such employment. His sea service was not an unbroken service. The fact that he never applied for a job with any other employer is of no moment. He enjoyed month-long “sign-off” vacations when his contract expired. It is possible that he acquired his condition during one of his “sign-off” periods. As discussed in the decision of the CA, varicose veins may be caused by trauma, thrombosis, inflammation or heredity. Although the exact cause of varicose veins is still unknown, a number of factors contribute to it which include heredity, advance aging, prolonged standing, being overweight, hormonal influences during pregnancy, use of birth control pills, post-menopausal hormonal replacement therapy, prolonged sitting with legs crossed, wearing tight undergarments or clothes, history of blood clots, injury to the veins, conditions that cause increased pressure in the abdomen including liver disease, fluid in the abdomen, previous groin injury, heart failure, topical steroids, trauma or injury to the skin, previous venous surgery and exposure to ultra-violet rays. Lastly, there is also no proof that petitioner’s varicose veins caused him to suffer total and permanent disability. The Pre-Employment Medical Examination[6] (PEME) he underwent cannot serve as enough basis to justify a finding of a total and permanent disability because of its non-exploratory nature. The fact that respondent passed the company’s 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 applicant’s 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. In short, the "fit to work" declaration in the respondent’s 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: elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/26253 9/11