The Supreme Court’s decision underscores the importance of protecting the rights of Filipino seafarers, especially concerning disability claims. It clarifies that a seafarer is entitled to seek a second medical opinion, even after being examined by a company-designated physician, to properly assess their condition and eligibility for disability benefits. This ruling ensures that seafarers receive fair compensation for work-related injuries and illnesses, acknowledging the risks they face at sea. If a company doctor fails to declare the seafarer fit to work within 120 days, they are entitled to total disability benefits.

Navigating Conflicting Medical Opinions: Can a Seafarer Challenge the Company Doctor’s Assessment?

Leopoldo Abante, a seafarer, sustained a back injury while working aboard the M/T Rathboyne. Upon repatriation, he was examined by a company-designated physician who, after initial treatment and surgery, eventually declared him fit to work. Dissatisfied with this assessment, Abante sought a second opinion from another doctor, who diagnosed him with a “failed back syndrome” and deemed him unfit for sea duty. This conflict in medical opinions led Abante to file a complaint for disability benefits, sparking a legal battle that reached the Supreme Court. The central legal question was whether Abante was bound by the company-designated physician’s assessment, or if he had the right to challenge it and claim disability benefits based on an independent medical evaluation.

The Supreme Court sided with Abante, emphasizing the seafarer’s right to seek a second opinion. The Court grounded its decision on Section 20(B)(3) of the POEA Standard Employment Contract of 2000, which outlines the compensation and benefits for injury and illness suffered during the term of a seafarer’s contract. This provision states that:

SECTION 20. COMPENSATION AND BENEFITS FOR INJURY AND ILLNESS

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:

x x x x

3. Upon sign-off from the vessel for medical treatment, the seafarer is entitled to sickness allowance equivalent to his basic wage until he is declared fit to work or the degree of permanent disability has been assessed by the company-designated physician but in no case shall this period exceed one hundred twenty (120) days.

For this purpose, the seafarer shall submit himself to a post-employment medical examination by a company-designated physician within three working days upon his return except when he is physically incapacitated to do so, in which case, a written notice to the agency within the same period is deemed as compliance. Failure of the seafarer to comply with the mandatory reporting requirement shall result in his forfeiture of the right to claim the above benefits.

If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the Employer and the seafarer. The third doctor’s decision shall be final and binding on both parties. (emphasis supplied)

The Court clarified that this provision does not prevent a seafarer from seeking a second opinion to determine their condition for claiming disability benefits, citing the case of NYK-Fil Ship Management v. Talavera. The Court emphasized that while the company-designated physician initially assesses the seaman’s disability, the seafarer retains the right to consult a physician of their choice, reinforcing the seafarer’s prerogative to request a second opinion.

The Supreme Court addressed the appellate court’s reliance on POEA Memo Circular No. 55, series of 1996, which does not contain a similar provision for a third doctor’s opinion. The Court cited Seagull Maritime Corporation v. Dee, where it applied the 2000 Circular even to a contract entered into in 1999, before the circular’s promulgation. The ruling underscores the Court’s commitment to protecting labor rights, especially in cases of disability or ailment. The Court firmly stated that doubts regarding the company-designated physician’s assessment should prompt a resort to other competent medical professionals. This ensures that the seafarer has the opportunity to assert their claim by proving the nature of their injury, which will then be used to determine the benefits rightfully accruing to them.

The Court also noted that Dr. Lim’s medical findings were not significantly different from those of Dr. Caja’s. Despite Dr. Lim declaring Abante fit to resume sea duties, the diagnosis of “foraminal stenosis and central disc protrusion” remained six months post-surgery. The Court acknowledged that a company-designated physician might be more inclined to provide a positive assessment, which is why the POEA Standard Employment Contract allows seafarers to seek a second opinion. The Court emphasized the protective intent of the POEA standard employment contract for seamen, designed to benefit Filipino seamen working on ocean-going vessels, mandating that its provisions be construed and applied fairly, reasonably, and liberally in their favor.

Referencing HFS Philippines v. Pilar, the Supreme Court affirmed the preference for independent medical opinions over those of company-designated physicians when discrepancies arise. The Court held that when evidence can be reasonably interpreted in two divergent ways, one prejudicial and the other favorable to the laborer, the balance must tilt in favor of the latter, in line with the principle of social justice. This principle underscores the judiciary’s role in protecting the rights and welfare of workers, especially when faced with conflicting interpretations of medical evidence.

The Court addressed the issue of whether Abante could claim disability benefits, ruling affirmatively. Permanent disability is defined as the inability of a worker to perform their job for more than 120 days, irrespective of the loss of any body part. The Court determined that Abante’s entitlement to permanent disability benefits rested on his inability to work for more than 120 days. In Abante’s case, the Certificate of Fitness for Work was issued by Dr. Lim on February 20, 2001, over six months after his initial evaluation on July 24, 2000, and after his surgery on August 18, 2000. This delay of more than 120 days qualified Abante for permanent disability benefits.

Evidence from Dr. Lim’s office revealed that Abante was seen by him thirteen times between July 24, 2000, and February 20, 2001. Excluding the final two reports, Dr. Lim consistently recommended continued physical rehabilitation and therapy, with clinic revisits for re-evaluation. This implied that Abante was not yet fit to work, further supporting his claim for disability benefits. Given a seafarer’s entitlement to permanent disability benefits when they cannot work for more than 120 days, the failure of the company-designated physician to declare Abante fit to work within that period entitled him to permanent total disability benefits of US$60,000.00, as per Sec. 30-A of the POEA Standard Employment Contract.

The Court denied the claims for moral and exemplary damages due to the absence of bad faith or malice on KJGS’s part, noting that the company had covered all expenses related to Abante’s surgery and rehabilitation and consistently inquired about his condition. However, the claim for attorney’s fees was granted under Article 2208 of the New Civil Code, allowing recovery in actions for wages and indemnity under employer’s liability laws. The Court awarded attorney’s fees of ten percent (10%) of the monetary award, citing the need to protect the plaintiff’s interests after the respondent’s refusal to settle the claims, consistent with prevailing jurisprudence.

FAQs

What was the key issue in this case?	The key issue was whether a seafarer is bound by the company-designated physician’s assessment of fitness to work or if they can seek a second opinion to claim disability benefits. The Supreme Court affirmed the seafarer’s right to a second opinion.
What is the significance of the 120-day period?	The 120-day period is crucial because if the company-designated physician fails to declare the seafarer fit to work within this time frame, the seafarer is entitled to permanent total disability benefits. This is regardless of any subsequent fitness declaration.
What does the POEA Standard Employment Contract say about medical assessments?	The POEA Standard Employment Contract mandates that seafarers undergo a post-employment medical examination by a company-designated physician. It also allows the seafarer to seek a second opinion if they disagree with the initial assessment.
What happens if there are conflicting medical opinions?	If there are conflicting opinions between the company-designated physician and the seafarer’s chosen doctor, the POEA contract suggests agreeing on a third, independent doctor whose decision will be final and binding.
What benefits is a seafarer entitled to if deemed permanently disabled?	A seafarer deemed permanently and totally disabled is entitled to disability benefits, which can include a lump-sum payment. In this case, the amount was US$60,000.00, as well as attorney’s fees to cover legal expenses.
Why did the Court award attorney’s fees in this case?	Attorney’s fees were awarded because the employer’s refusal to settle the claim compelled the seafarer to incur expenses to protect their interests. This is in line with Article 2208 of the New Civil Code.
Can a seafarer claim moral and exemplary damages?	Moral and exemplary damages are not automatically granted. They require concrete evidence of bad faith or malice on the part of the employer, which was not sufficiently demonstrated in this case.
What if the employment contract was entered before POEA Memo Circular No. 9?	Even if the employment contract predates POEA Memo Circular No. 9, the courts may still apply the 2000 Circular, especially concerning the seafarer’s right to seek a second medical opinion.

In conclusion, the Supreme Court’s decision in the Abante case serves as a crucial reminder of the rights afforded to Filipino seafarers under the POEA Standard Employment Contract. It reinforces the importance of seeking independent medical evaluations and ensures that seafarers receive fair compensation for work-related disabilities.

For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.

Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: Leopoldo Abante vs. KJGS Fleet Management Manila, G.R. No. 182430, December 04, 2009