8/26/2020 E-Library - Information At Your Fingertips: Printer Friendly c. If a person who was apparently asymptomatic before being subjected to strain at work showed signs and symptoms of cardiac injury during the performance of his work and such symptoms and signs persisted, it is reasonable to claim a causal relationship; d. If a person is a known hypertensive or diabetic, he should show compliance with prescribed maintenance medications and doctorrecommended lifestyle changes. The employer shall provide a workplace conducive for such compliance in accordance with Section 1(A) paragraph; e. In a patient not known to have hypertension or diabetes, as indicated in his last PEME.[71] Respondent's aortic valve stenosis cannot be considered to have developed under any of the first three instances precisely because of his failure to show that the nature of his work as fitter involved "unusual strain" as to bring about an acute attack or acute exacerbation of his heart disease that he supposedly contracted in the course of employment. Even the CA conceded at the outset that there is absolutely no showing in the records "as to how [respondent's] nature of work caused or contributed to the aggravation of his illness." As to the last two instances, there is no evidence that respondent has hypertension or diabetes; neither is there any allegation or proof that he was taking prescribed maintenance medicines or observing doctor-recommended lifestyle changes. While his blood pressure reading of 130/80mmHG is considered pre-hypertensive, there is no indication in his PEME that he was suffering from high blood pressure.[72] The medical reports issued by the company-designated physicians also failed to disclose that respondent suffered from either of these conditions. Neither can respondent rely on the fact that he passed the PEME prior to his engagement. Thus, we underscored in Loadstar International Shipping, Inc. v. Yamson, et al.[73]: x x x The "fit to work" declaration in the PEME cannot be a conclusive proof to show that he was free from any ailment prior to his deployment. In this regard, it is also true that the pre-existence of an illness does not irrevocably bar compensability because disability laws still grant the same provided the seafarer's working conditions bear causal connection with his illness. These rules, however, cannot be asserted perfunctorily by the claimant as it is incumbent upon him to prove, by substantial evidence, as to how and why the nature of his work and working conditions contributed to and/or aggravated his illness.[74] x x x Indeed, respondent was unable to present substantial evidence to show that his work conditions caused, or at the least increased the risk of contracting his illness. Neither was he able to prove that his illness was preexisting and that it was aggravated by the nature of his employment.[75] https://elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/65335 16/24