This case clarifies that a seafarer declared “fit to work” by a company-designated physician is generally not entitled to permanent total disability benefits unless this assessment is successfully challenged. However, the Supreme Court acknowledged that the seafarer was entitled to temporary total disability benefits for the period of treatment and recovery, aligning with the POEA-SEC guidelines regarding injury compensation.

When Can a Seafarer Claim Disability Benefits Despite a “Fit to Work” Certification?

The case of Acomarit Phils. vs. Dotimas (G.R. No. 190984, August 19, 2015) revolves around the claim for disability benefits by Gomer L. Dotimas, a seafarer who sustained an injury during his employment. Despite being initially declared fit to work by the company-designated physician after undergoing surgery and treatment, Dotimas sought total and permanent disability benefits, arguing that his injury rendered him unfit for further sea service. This case highlights the importance of the company-designated physician’s assessment in determining disability claims, while also recognizing exceptions where a seafarer’s actual condition warrants compensation despite a seemingly favorable medical assessment.

The central question before the Supreme Court was whether Dotimas was entitled to disability benefits, considering the “fit to work” certification issued by the company-designated physician. The petitioners, Acomarit Phils. and Acomarit Hong Kong Limited, argued that the CA erred in granting disability benefits because Dotimas was declared fit to work and that the assessment of the company-designated physician is conclusive. The seafarer, on the other hand, contended that despite the assessment, his inability to work for more than 120 days due to his injury constituted permanent total disability.

The Supreme Court turned to the guidelines provided by the POEA Standard Employment Contract (POEA-SEC) and relevant jurisprudence. According to the POEA-SEC, when a seafarer suffers a work-related injury or illness, the employer is liable to provide sickness allowance until the seafarer is declared fit to work or the degree of permanent disability has been assessed by the company-designated physician. This period, however, shall not exceed 120 days. The seafarer is required to submit to a post-employment medical examination by a company-designated physician within three working days upon return, or risk forfeiting their right to claim benefits.

However, the Court also recognized that the 120-day period isn’t a strict, non-extendable deadline. If the seafarer requires further medical attention, the period of temporary total disability may be extended to a maximum of 240 days, as interpreted in harmony with the Amended Rules on Employee Compensation (AREC). This is in line with the landmark case of Vergara v. Hammonia Maritime Services, Inc., where the Supreme Court clarified that a temporary total disability becomes permanent when declared so by the company-designated physician within the allowed period, or upon the expiration of the 240-day medical treatment period in the absence of a fitness declaration.

Crucially, the Court outlined specific scenarios in which a seafarer may pursue an action for total and permanent disability benefits. These include situations where the company-designated physician fails to issue a declaration within the 120/240-day period, issues a declaration contrary to the seafarer’s own physician’s assessment, acknowledges partial disability while other doctors believe it is total, or declares the condition non-compensable despite contrary findings from other doctors. These circumstances provide avenues for seafarers to challenge the company-designated physician’s assessment and seek appropriate compensation.

In Dotimas’ case, the company-designated physician declared him fit to work 144 days after his medical repatriation. The Supreme Court found that he could not be considered under the state of permanent total disability, as he was declared fit to work before the lapse of 240 days. In this case, the seafarer did not consult another physician to dispute the declaration of being fit to work.

Despite finding that Dotimas was not entitled to permanent total disability benefits, the Court recognized his entitlement to temporary total disability benefits. Both the company-designated physician and Dotimas’ physician concluded that his left tibia was fractured and healed after surgery. Referring to the Schedule of Disability or Impediment for Injuries Suffered and Diseases or Illness Contracted in Section 30 of 1996 POEA SEC, the Court determined that the slight atrophy of Dotimas’ calf muscles corresponded to an Impediment Grade of 13. Thus, he was awarded US$3,360.00, equivalent to 6.72% of US$50,000.00.

The Court also addressed the procedural issue raised by the petitioners regarding the CA’s alleged failure to provide them with an opportunity to file a comment on Dotimas’ petition for certiorari. The Supreme Court clarified that the CA had indeed issued a Resolution ordering the petitioners to file their comment, which they failed to do. Therefore, the CA did not err in proceeding with the case without their comment.

The decision also reinforces the importance of adhering to procedural requirements in legal proceedings. Failure to comply with court orders and deadlines can have adverse consequences, as demonstrated by the petitioners’ failure to file a comment before the CA.

FAQs

What was the key issue in this case?	The key issue was whether a seafarer was entitled to permanent total disability benefits despite a “fit to work” certification from the company-designated physician. The Court clarified the conditions under which a seafarer can claim disability benefits despite such a certification.
What is the role of the company-designated physician in disability claims?	The company-designated physician plays a crucial role in assessing the seafarer’s condition and determining fitness to work or the degree of disability. The assessment of the company-designated physician is the basis for disability claims under the POEA Standard Employment Contract (POEA-SEC).
What is the significance of the 120/240-day period?	The 120-day period is the initial timeframe within which the company-designated physician must assess the seafarer’s condition. It can be extended to 240 days if further medical treatment is required, as per the Amended Rules on Employee Compensation (AREC).
Under what circumstances can a seafarer challenge the assessment of the company-designated physician?	A seafarer can challenge the company-designated physician’s assessment if the physician fails to issue a declaration within the 120/240-day period, issues a contrary declaration to other physicians, or acknowledges partial disability while others believe it is total. It is important to secure another doctor’s opinion in order to challenge the company doctor’s assessment.
What is the difference between temporary total disability and permanent total disability?	Temporary total disability refers to a period where the seafarer is unable to work but is expected to recover. Permanent total disability is when the seafarer is deemed unable to return to their previous work due to the injury or illness.
What benefits is a seafarer entitled to during temporary total disability?	During temporary total disability, the seafarer is entitled to sickness allowance equivalent to their basic wage until they are declared fit to work or the degree of permanent disability is assessed. This period cannot exceed 120 days, extendable to 240 days if needed.
What evidence did the seafarer present to support the claim for total disability benefits?	The seafarer presented the certification of an independent physician suggesting a disability grade of 13 for his injury. He also argued that his injury rendered him permanently unfit for sea service.
Was the company required to allow the seafarer to comment on the petition for certiorari?	Yes, the appellate court issued a resolution requiring the petitioners to file a comment on the petition for certiorari. Since they failed to do so, the CA did not err in proceeding without their comment.

In conclusion, while the “fit to work” certification from a company-designated physician carries significant weight, it is not the ultimate determinant of a seafarer’s entitlement to disability benefits. The Supreme Court’s decision in Acomarit Phils. vs. Dotimas underscores the importance of considering the seafarer’s actual condition, the duration of the disability, and the opinions of other medical professionals.

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: Acomarit Phils. vs. Dotimas, G.R. No. 190984, August 19, 2015