4/29/2020 E-Library - Information At Your Fingertips: Printer Friendly term of the seafarer’s employment in order for compensability to arise.[14] Work-relation must, therefore, be established. As a general rule, the principle of work-relation requires that the disease in question must be one of those listed as an occupational disease under Sec. 32-A of the POEA-SEC. Nevertheless, should it be not classified as occupational in nature, Section 20 (B) paragraph 4 of the POEA-SEC[15] provides that such diseases are disputably presumed as work-related. In this case, it is undisputed that NPC afflicted respondent while on board the petitioners’ vessel. As a nonoccupational disease, it has the disputable presumption of being work-related. This presumption obviously works in the seafarer’s favor.[16] Hence, unless contrary evidence is presented by the employers, the workrelatedness of the disease must be sustained.[17] In this wise, the petitioners, as employers, failed to disprove the presumption of NPC’s work-relatedness. They primarily relied on the medical report issued by Dr. Co Peña. The report, however, failed to make a categorical statement confirming the total absence of work relation. Thus: Dear Dr. Lim, This is with regards [sic] to Mr. Eleno Babol, 45 y/o male, diagnosed case of Nasopharyngeal Carcinoma; S/P Incisional Biopsy of Left Neck Mass on April 2, 2007. Risk factors include: Diet – salt cured fish Viral agents – Epstein Barr Virus (EBV) Genetic Susceptibility – H2 locus antigens, Singapore Antigen BW46 and B17 Antigen His condition is likely not work-related. (Underscoring supplied) Black’s Law Dictionary defines likely as “probable”[18] and likelihood as “probability.”[19] The use of the word likely indicates a hesitant and an uncertain tone in the stated medical opinion and does not foreclose the possibility that respondent’s NPC could be work-related. In other words, as the doctor opined only a probability, there was no certainty that his condition was not work related. There being no certainty, the Court will lean in favor of the seafarer consistent with the mandate of POEA-SEC to secure the best terms and conditions of employment for Filipino workers.[20] Hence, the presumption of NPC’s work-relatedness stays. The Principle of Work-aggravation Assuming for the sake of argument that the presumption of work-relation was refuted by petitioners, compensability may still be established on the basis of the theory of work aggravation if, by substantial evidence,[21] it can be demonstrated that the working conditions aggravated or at least contributed in the advancement of respondent’s cancer.[22] As held in Rosario v. Denklav Marine,[23] “the burden is on the beneficiaries to show a reasonable connection between the causative circumstances in the employment of the deceased employee and his death or permanent total disability.” To determine if indeed respondent sufficiently established the link between his cancer and the working conditions on board MV Glasgow Express, understanding the disease is of utmost importance. Respondent’s cancer is by far, the most common malignant tumor of the nasopharynx.[24] Risk factors for this cancer, as derived from the position paper filed by the petitioners and consistent with many medical literatures[25] on the matter, include (1) salt-cured foods; (2) preserved meats, (3) Epstein-Barr virus, and (4) family history.[26] In every detail, it is clear that the dietary factor plays a vital role in increasing the risk of acquiring the disease. For medical purposes, salt-cured fish and preserved meat can, thus, be considered as elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/56454 4/8