Diabetes and Hypertension: Proving Work Relatedness in Seafarer Disability Claims

The Supreme Court, in BW Shipping Philippines, Inc. v. Ong (G.R. No. 202177, November 17, 2021), clarified the strict rules on when a seafarer's diabetes and hypertension can be considered work-related for purposes of disability compensation. The case underscores that a diagnosis alone is not enough—the seafarer must prove a real connection between the illness and the work performed, and must follow the proper procedure for challenging a company doctor's findings.

The Case: A Chief Cook's Claim for Permanent Disability

Mario H. Ong was a veteran seafarer who had worked for BW Shipping since 1999. In March 2008, he was hired as Chief Steward and Chief Cook on board the vessel BW Hemina for a nine-month contract. Before boarding, he was declared "fit for sea duty" by the company-designated physician.

Two months into the voyage, Ong complained of dizziness, headaches, frequent urination, and shortness of breath. A doctor in Florida diagnosed him with "uncontrolled diabetes and uncontrolled hypertension," and he was repatriated on June 20, 2008. After a series of tests and treatment, the company-designated physician declared him "fit to resume sea duties" on October 2, 2008—104 days after repatriation.

Ong disagreed. He consulted his own cardiologist, who found him suffering from "Essential Hypertension, Stage 2 and Diabetes Mellitus, Type 2," with no prior history of these diseases. When the company refused to pay for his medications, Ong filed a complaint for permanent total disability benefits.

The Issue: What Must a Seafarer Prove?

The central question was whether Ong's diabetes and hypertension were work-related and whether they entitled him to permanent total disability benefits under the POEA-Standard Employment Contract (POEA-SEC).

The Labor Arbiter and the NLRC initially ruled in Ong's favor, and the Court of Appeals affirmed. But the Supreme Court reversed, laying down the governing rules.

The Ruling: Two Conditions for Compensability

Under Section 20(B), paragraph 6 of the 2000 POEA-SEC, a seafarer must prove two things: (1) the illness is work-related, and (2) it existed during the term of the employment contract.

Diabetes is not an occupational disease. The Court noted that diabetes is "ordinarily acquired through inheritance" and is "remotely caused by environmental and occupational conditions." It is a metabolic and familial disease, often the result of heredity, obesity, or old age—not work. The mere fact that a seafarer has diabetes does not automatically warrant disability benefits.

Hypertension requires proof of gravity. While essential hypertension is a recognized occupational disease under Section 32-A of the POEA-SEC, the seafarer must show that the hypertension is severe enough to impair the function of body organs such as the kidneys, heart, eyes, or brain, resulting in permanent disability. The evidence "must be real and substantial, and not merely apparent."

In Ong's case, he failed to show how his duties as Chief Cook caused or aggravated his conditions. His doctor's certificate merely stated a conclusion without adequate medical support, while the company-designated physician's findings were backed by laboratory tests that yielded normal results.

The Importance of the Company-Designated Physician

The Court gave greater weight to the company-designated physician's assessment. Ong was examined, treated, and monitored for months, and was declared fit to work after 104 days. He did not contest this finding immediately—he waited over three months before consulting his own doctor.

More critically, Ong failed to follow the conflict-resolution mechanism under Section 20(A)(3) of the POEA-SEC. When a seafarer disagrees with the company doctor's assessment, he must refer the dispute to a third doctor jointly agreed upon by both parties. Instead, Ong filed a complaint before the Labor Arbiter. Because he bypassed this procedure, the company doctor's diagnosis was upheld.

Practical Takeaways

• A diagnosis of diabetes or hypertension is not enough. Seafarers must prove that the illness is work-related and, for hypertension, that it is severe enough to cause permanent disability.
• Follow the POEA-SEC procedure. If you disagree with the company-designated physician's assessment, you must refer the conflict to a third doctor jointly chosen by both parties. Filing a case without doing so may result in dismissal.
• Document everything. Keep records of consultations, laboratory tests, and medications. A doctor's certificate without supporting medical evidence carries little weight.
• Company doctors' findings are given great weight. Their assessments, especially when supported by laboratory results, are generally preferred over a seafarer's doctor of choice unless the latter provides substantial medical basis.
• Controlled conditions may not be disabling. The POEA-SEC allows employment of seafarers with hypertension or diabetes if the condition is controlled by medication and lifestyle changes.

This article is general information and not legal advice. For your specific situation, consult a lawyer or ask ASG Legal AI.