In a seafarer’s claim for disability benefits, the Supreme Court clarified the application of the 240-day rule for determining permanent disability and the primacy of the company-designated physician’s assessment. The Court emphasized that if a complaint is filed after October 6, 2008, the 240-day rule applies, allowing the company doctor up to 240 days to assess the seafarer’s condition. Moreover, the assessment of the company-designated physician prevails if the seafarer fails to follow the proper procedure for disputing it, as outlined in the POEA-SEC, ensuring a fair and structured approach to disability claims in the maritime industry.

When Shoreside Assessments Clash: Evaluating Seafarer Disability After an Injury at Sea

This case revolves around Noriel Montierro, a seafarer who sustained a knee injury while working aboard a vessel. After being repatriated to the Philippines, he underwent medical treatment, including surgery. The central legal question is whether Montierro is entitled to permanent total disability benefits, considering the assessments made by the company-designated physician and his personal physician, and the applicable time frame for determining disability.

The legal framework governing this case is primarily the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC). The POEA-SEC outlines the rights and obligations of both the seafarer and the employer in cases of work-related injuries or illnesses. It also specifies the procedure for determining disability benefits, including the role of the company-designated physician and the process for resolving conflicting medical assessments. Central to the dispute are two conflicting rules regarding the period within which a seafarer must be assessed. The first, established in Crystal Shipping, Inc. v. Natividad, is the 120-day rule, which equates the inability of a seafarer to perform work for more than 120 days to permanent total disability. The second, introduced in Vergara v. Hammonia Maritime Services, Inc., is the 240-day rule, which extends the period to 240 days under certain conditions.

The Supreme Court addressed the conflicting application of the 120-day and 240-day rules. It explicitly stated in Kestrel Shipping Co. Inc. v. Munar that the 240-day rule applies to complaints filed from October 6, 2008, onwards. Since Montierro filed his complaint on December 3, 2010, the 240-day rule applies. This ruling has significant implications, as it clarifies the timeframe within which a company-designated physician must issue a final assessment of a seafarer’s disability.

Applying the 240-day rule to Montierro’s case, the Court found that the company-designated physician’s final assessment was made within the prescribed period. The treatment began on June 4, 2010, and the final assessment was issued on January 3, 2011, which is the 213th day. The extension to 240 days was justified because the company doctor issued an interim disability grade within the initial 120-day period, indicating the need for further medical attention. Therefore, Montierro’s condition could not be deemed a permanent total disability, aligning with the CA’s ruling.

The Court also addressed the issue of conflicting medical assessments. It reiterated the procedure outlined in the POEA-SEC, which requires that the company-designated physician determine the seafarer’s fitness for work. If the seafarer’s chosen physician disagrees with the company doctor’s assessment, the opinion of a third doctor, jointly agreed upon, should be sought. The third doctor’s decision is final and binding. Vergara emphasized the strict adherence to this procedure, stating that failure to comply results in the company-designated physician’s assessment prevailing.

The Supreme Court found that Montierro preempted the established procedure. He filed a complaint based on his chosen physician’s assessment before the company-designated physician issued a final grading.

“Vergara ruled that the procedure in the 2000 POEA-SEC must be strictly followed; otherwise, if not availed of or followed strictly by the seafarer, the assessment of the company-designated physician stands.”

Because Montierro failed to observe this procedure, the assessment of the company doctor should prevail.

The Court further noted that the employer, Rickmers, made genuine efforts to provide medical assistance to Montierro. The company-designated physician monitored his case and recommended surgery and physical therapy. This demonstrated a commitment to the seafarer’s well-being, further supporting the validity of the company doctor’s assessment.

Furthermore, the Court contrasted the two medical assessments, pointing out the thoroughness of the company-designated physician’s evaluation compared to the brevity of Montierro’s chosen physician’s assessment. The company-designated physician’s finding was entitled to greater weight because it was based on regular examinations, medications, and physical therapy sessions over an extended period. As the Court of Appeals noted,

“Having extensive personal knowledge of the seafarer’s actual medical condition, and having closely, meticulously and regularly monitored and treated his injury for an extended period, the company-designated physician is certainly in a better position to give a more accurate evaluation of Montierro’s health condition.”

Regarding attorney’s fees, the Court acknowledged the general rule that attorney’s fees are not awarded absent a showing of bad faith. However, in labor cases, attorney’s fees may be awarded if lawful wages are withheld without justification, compelling the employee to litigate, in accordance with Article 111 of the Labor Code. Even applying this rule, the Court found that Montierro was not entitled to attorney’s fees because he prematurely filed his complaint before the company-designated physician issued a final disability grading. Therefore, there was no unlawful withholding of benefits to justify the award of attorney’s fees.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer was entitled to permanent total disability benefits based on the 120-day or 240-day rule, and whether the company doctor’s assessment or the seafarer’s personal doctor’s assessment should prevail.
Which disability rule applies to this case, the 120-day or 240-day rule?	The 240-day rule applies because the complaint was filed after October 6, 2008, the date of promulgation of the Vergara case, which established the 240-day rule.
Why does the 240-day rule allow for an extension of the initial 120-day period?	The extension is allowed when, within the initial 120-day period, a final assessment cannot be made, and the seafarer requires further medical attention, provided that a declaration has been made to this effect.
What happens if the company-designated physician and the seafarer’s personal physician disagree on the disability assessment?	The POEA-SEC provides a procedure where a third doctor, jointly agreed upon by the employer and the seafarer, should provide a final and binding opinion; failure to follow this procedure gives primacy to the company doctor’s assessment.
What is the significance of the POEA-SEC in resolving disability claims?	The POEA-SEC is the standard employment contract that governs the relationship between the seafarer and the employer, outlining the rights and obligations of both parties, and its provisions are considered the law between them.
Under what circumstances are attorney’s fees awarded in labor cases?	Attorney’s fees are typically awarded in labor cases when lawful wages are withheld without justification, compelling the employee to litigate, as provided under Article 111 of the Labor Code.
Why was the seafarer not awarded attorney’s fees in this case?	The seafarer was not awarded attorney’s fees because he filed his complaint prematurely, before the company-designated physician had issued a final disability grading, meaning there was no unlawful withholding of benefits.
What is the role of the company-designated physician in assessing a seafarer’s disability?	The company-designated physician is responsible for determining the seafarer’s fitness for work and providing a disability assessment, which is given significant weight, especially when the proper procedures are followed.

This case underscores the importance of adhering to the procedures outlined in the POEA-SEC for resolving disability claims of seafarers. It also highlights the significance of the 240-day rule in cases where a seafarer requires extended medical treatment. By following these guidelines, both seafarers and employers can ensure a fair and efficient resolution of disability claims in the maritime industry.

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: Montierro vs. Rickmers Marine Agency Phils., Inc., G.R. No. 210634, January 14, 2015