overtime pay of US$2.01 per hour and a monthly vacation leave with pay of 4 days.[3] In his pre-employment medical examination, he was found fit for sea duty, although his electrocardiogram (ECG) report revealed a mild left axis deviation.[4]   Virgilio boarded ship on May 20, 1999.[5] He became ill while on board. On March 3, 2000, the Marine Medical Unit at New Orleans, Louisiana, USA diagnosed him to be suffering from umbilical hernia. The attending physician advised Virgilio to avoid tasks involving heavy lifting and to undergo surgical repair.[6] He was later repatriated.   Upon his arrival in Manila on March 8, 2000, Virgilio was immediately referred to the company-designated physicians at the Metropolitan Hospital for further evaluation and management. He was found positive of peri-umbilical mass[7] due to the presence of ascites.[8] On March 24, 2000, Virgilio was subjected to umbilical herniorrhapy[9] (surgical repair), ultrasound of the upper abdomen[10] and aspiration of ascitic fluid.[11] The ultrasound done on the day of the operation further revealed that Virgilio had liver cirrhosis with a possible regenerating nodule,[12] for which he was given medication.[13] Five days later, or on March 29, 2000, he was discharged from the hospital.[14] All medical and hospitalization expenses for the herniorrhapy were shouldered by petitioners.   On June 20, 2000, after several post-operation check-ups, Virgilio signed a Certificate of Fitness for Work[15] where he released his employer and the manning company from all actions, claims and liabilities.[16] ZSIL and PSMC later paid his sick wages.[17]   Almost eight (8) months later, on February 13, 2001, Virgilio was brought to the Philippine General Hospital (PGH). His HBT ultrasonography (of the liver and gallbladder) revealed massive ascites, liver cirrhosis, thickening of the gallbladder wall (probably reactive) and splenomegaly, while his chest ultrasonography revealed left massive pleural effusion.[18] On electrocardiogram, he was discovered to have sinus tachycardia and left axis deviation.[19] His roentgenological report further revealed an atherosclerotic aorta which confirmed the earlier finding of pleural effusion.[20] On March 13, 2001, he was confined at the PGH for acidosis secondary to liver cirrhosis probably secondary to alcoholic liver disease; hepatocellular carcinoma and left pleural effusion, probably malignant.[21] Virgilio died on March 18, 2001. The immediate cause of death was cardiopulmonary