327 Cases Penned by Associate Justice Amy Lazaro-Javier: 2025 Bar Examination
Can a seafarer's pre-existing illness, later aggravated
by his work, still entitle him to permanent and total disability benefits even
if the company-designated physician failed to issue a definitive disability
rating within the 120/240-day period?
Case Title:
G.R. No. 237063, July 24, 2019
Facts of the Case:
Franciviel Derama Sestoso was hired as a team headwaiter by
United Philippine Lines Inc. (UPLI) on behalf of Carnival Cruise Lines for a
six-month period starting July 2014. On October 31, 2014, while performing his
usual tasks, he experienced a sharp pain in his right knee. After docking in
Los Angeles, he underwent an MRI, which revealed a complex tear of the medial
meniscus and degenerative joint changes. Despite this, he continued to work
with the aid of pain relievers until he finished his contract and was
repatriated in February 2015.
Upon his return to the Philippines, he was treated by
company-designated physicians, who noted his condition but did not issue a
final disability rating within the required 120/240-day period. The company’s
orthopedic surgeon recommended surgery and assessed a Grade 10 disability
rating. However, Dr. Mylene Cruz-Balbon, the company-designated physician,
failed to provide a definitive disability rating before ceasing treatment on
June 26, 2015. Sestoso later consulted a private physician who diagnosed him with
severe degenerative osteoarthritis and assessed him as unfit for further work
as a seafarer.
Sestoso filed a claim for total and permanent disability
benefits, which the Labor Arbiter initially granted, awarding him Grade 10
disability benefits. However, on appeal, the National Labor Relations
Commission (NLRC) ruled that he was entitled to total and permanent disability
benefits, as the company-designated doctor failed to issue a final assessment
within 240 days. The respondents (UPLI and Carnival) contested the NLRC ruling
before the Court of Appeals (CA), arguing that Sestoso’s illness was pre-existing
and not work-related. The CA reversed the NLRC’s decision, ruling that
Sestoso’s disability was not compensable.
Legal Issue:
Did the Court of Appeals commit reversible error in denying
the award of total and permanent disability benefits to Sestoso?
Supreme Court Ruling:
The Supreme Court found in favor of Sestoso. The Court
reiterated that the compensability of an illness does not depend on whether the
illness was pre-existing but rather on whether the illness is work-related or
aggravated by the seafarer’s work conditions. Since the company-designated
physician failed to issue a final and definitive disability rating within the
120/240-day period, Sestoso’s disability became permanent and total by
operation of law. The Court further ruled that Sestoso’s osteoarthritis, though
pre-existing, was aggravated by the strenuous nature of his job as a
headwaiter, which involved tasks like carrying heavy loads and working in
extreme temperature conditions.
The Court reinstated the NLRC’s decision, awarding Sestoso
permanent and total disability benefits amounting to US$60,000.00 plus 10% in
attorney's fees.
Dispositive Portion:
The Supreme Court reversed and set aside the Court of
Appeals' ruling, ordering the respondents to pay Sestoso US$60,000.00 or its
peso equivalent as total and permanent disability benefits, with an additional
10% in attorney's fees. Interest of 6% per annum was imposed from the finality
of the decision until full payment.
If a company-designated physician fails to issue a final
assessment of a seafarer's disability within the prescribed 240 days, should
the seafarer automatically be entitled to permanent disability benefits,
regardless of whether the illness was pre-existing?
Important Doctrines:
- Work-Relatedness
of Illness
"The compensability of an illness does not depend on whether the injury or disease was pre-existing at the time of employment but rather on whether the injury or illness is work-related or has aggravated the seafarer's condition." - 120/240-Day
Rule
"If the company-designated physician fails to issue a final disability rating within 120/240 days from the seafarer’s repatriation, the seafarer's disability is considered permanent and total by operation of law." - Legal
Presumption of Work-Relatedness
"Under the 2010 POEA-SEC, illnesses not listed in Section 32 are disputably presumed work-related. The employer bears the burden of proving that the illness is not work-related."
Classification:
Labor Law
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🎓 Welcome, future lawyers
and bar examinees! In this post, we’ll explore a crucial jurisprudence on
seafarer disability claims that tackles the 120/240-day rule, pre-existing
illness, and compensability. Our goal is to help law students and baristas
better recall and digest key doctrines from labor law jurisprudence.
⚖️ CASE OVERVIEW
Date of Promulgation: July 24, 2019
Nature: Labor Law – Disability Benefits (Seafarers under
POEA-SEC)
🔍 Brief Summary:
Sestoso, a cruise ship headwaiter, suffered a right knee
injury. Despite a pre-existing condition, the strenuous nature of his work
aggravated it. The issue: Was he entitled to total and permanent disability
benefits despite the pre-existence of the illness?
✅ The Supreme Court ruled YES,
citing non-issuance of a final medical assessment within 240 days, thereby
making the disability permanent and total by operation of law.
💭 Should employers
still be liable when pre-existing conditions are aggravated by work?
👇 Comment your thoughts
and join the legal discourse.
📘 10 IMPORTANT DOCTRINES
(for YouTube/Bar Review)
- Work-Aggravation
Doctrine
Even pre-existing illnesses are compensable if aggravated by work. Employers take workers “as is.” (See More Maritime Agencies Inc. v. NLRC, cited in the case.) - 120/240-Day
Rule
Disability becomes permanent and total if no final assessment is issued within 240 days from repatriation. (Sestoso v. UPLI, 2019) - Presumption
of Work-Relatedness
Illnesses not listed in Section 32 of the POEA-SEC are disputably presumed work-related. Burden of proof lies on the employer. (Romana v. Magsaysay, 2017) - No
Presumption of Compensability
Unlike work-relatedness, compensability must be proven by the seafarer with substantial evidence. (Atienza v. Orophil, 2017) - Definition
of Permanent Disability
An employee unable to perform his job beyond 120 days is considered permanently disabled, regardless of actual medical condition. (Hanseatic Shipping v. Ballon, 2015) - Job
Nature as Basis for Aggravation
Repetitive tasks like kneeling, lifting, exposure to temperature changes can aggravate osteoarthritis, making it compensable. (Sestoso Case) - Final
Assessment Requirement
A doctor’s recommendation is not enough. The assessment must be definite, conclusive, and issued timely. (Sestoso Case) - Total
Disability Means Loss of Earning Capacity
Disability is total if one cannot earn in the same or similar occupation, not just based on medical ratings. (Pastor v. Bibby Shipping, 2018) - Attorney’s
Fees for Forced Litigation
When a worker is compelled to litigate to recover benefits, 10% attorney’s fees may be awarded. (Sestoso Case) - Legal
Interest on Monetary Awards
Monetary awards are subject to 6% annual interest from the finality of judgment until full payment. (Nacar v. Gallery Frames, 2013)
📌 DISCLAIMER:
This video is for educational purposes only. While it
uses official Supreme Court rulings, we do not guarantee that the content is infallible.
Made using premium AI to assist in your legal review.
❓ FREQUENTLY ASKED QUESTIONS
(FAQs)
- Q:
Is a pre-existing illness automatically non-compensable?
A: No. If the illness is aggravated by work, it may still be compensable. - Q:
What if the doctor does not give a final assessment within 240 days?
A: The seafarer is deemed totally and permanently disabled by law. - Q:
Who has the burden to prove non-work-relatedness?
A: The employer must disprove the legal presumption of work-relatedness. - Q:
Is a medical recommendation the same as a final disability rating?
A: No. The law requires a definite and final assessment. - Q:
Can attorney’s fees be granted in labor cases?
A: Yes, especially when the employee is forced to litigate to claim rightful benefits.
📚 Case Title: Franciviel
Derama Sestoso v. UPLI, Carnival Cruise Lines, and Lising
📑 G.R. No.: 237063
📅 Promulgation Date: July
24, 2019
📲 Like, Comment, Save,
and Subscribe for more case doctrines simplified!
Franciviel Derama Sestoso vs. United Philippine Lines,
Inc., Carnival Cruise Lines, and Fernandino T. Lising
G.R. No. 237063 | Promulgated: July 24, 2019
Nature: Labor Law – Disability Benefits (Seafarers)
📌 Case Summary:
Sestoso, a cruise ship headwaiter, suffered a right knee injury while
performing his duties. The core issue was whether a pre-existing illness
aggravated by employment can entitle a seafarer to total and permanent
disability benefits, especially if no final assessment was issued within
the 240-day period.
✅ The Supreme Court ruled in
favor of Sestoso, holding that failure by the employer’s physician to give
a definitive assessment within the allowable period made the disability
permanent and total by operation of law.
📝 Answer Key will be
provided at the end.
✅ 10 HOTS MULTIPLE CHOICE
QUESTIONS (EASY DIFFICULTY)
- What
was the primary job of Sestoso when he suffered his knee injury?
A. Chef
B. Bartender
C. Team Headwaiter
D. Maintenance Officer - Why
did the Supreme Court rule that Sestoso's disability became permanent and
total?
A. He resigned voluntarily
B. He was hospitalized for more than a year
C. No final disability assessment was issued within 240 days
D. He failed to submit medical records - What
did the employer argue to deny Sestoso’s claim?
A. He did not finish his contract
B. He had a fake medical certificate
C. His illness was pre-existing and not work-related
D. He was already compensated abroad - What
medical condition was Sestoso diagnosed with?
A. Spinal stenosis
B. Osteoarthritis and meniscal tear
C. Hernia
D. Broken ankle - Which
court initially reversed the NLRC's award of total disability?
A. Sandiganbayan
B. Court of Tax Appeals
C. Court of Appeals
D. Supreme Court - What
legal presumption favors seafarers when their illness is not listed as
occupational?
A. It is automatically dismissed
B. It is presumed to be non-work-related
C. It is presumed to be work-related unless disproved
D. It is presumed to be due to negligence - What
factor strengthened Sestoso's claim that work aggravated his condition?
A. He had a written confession from his supervisor
B. He had pre-employment medical clearance
C. His work involved physically strenuous tasks
D. He was working for the first time abroad - What
was the NLRC’s decision regarding Sestoso’s disability?
A. Declared him fit to work
B. Awarded temporary partial disability benefits
C. Awarded permanent and total disability benefits
D. Ordered retraining for alternative work - What
amount was awarded by the Supreme Court as disability compensation?
A. US$100,000
B. US$50,000
C. US$60,000
D. US$80,000 - What
additional compensation was granted to Sestoso besides disability pay?
A. Re-employment abroad
B. Travel reimbursement
C. 10% attorney’s fees
D. Insurance refund
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