In a significant ruling concerning the rights of Filipino seafarers, the Supreme Court has underscored the importance of adhering to the prescribed timelines and procedures for assessing disability claims. The Court held that a seafarer’s claim for permanent total disability benefits was premature because the company-designated physician was still within the extended 240-day period to make a final assessment. This decision clarifies that the mere lapse of the initial 120-day period does not automatically entitle a seafarer to permanent total disability benefits; the full 240-day period must be exhausted, especially if further medical treatment is required. This ruling provides clarity on the obligations of both seafarers and employers in navigating disability claims under the POEA-SEC.

From Ship to Shore: When Does a Seafarer’s Injury Become Permanent?

The case of Jose Yoac Estrella v. BSM Crew Service Centre Phils. and Hanseatic Shipping Co., Ltd., arose from an injury sustained by Estrella, a Second Engineer, while working on a vessel. After falling and hurting his shoulder, Estrella underwent medical examinations revealing a possible scapular fracture and soft tissue mass. Upon repatriation, he was referred to a company-designated clinic, where he received treatment and physical therapy. The central legal question revolves around whether Estrella was entitled to permanent total disability benefits, given that the company-designated physician had not yet issued a final assessment within the extended period allowed under the law.

The Supreme Court anchored its decision on the established principle that disability compensation is not for the injury itself, but for the resulting incapacity to work and impairment of earning capacity. The Court emphasized that entitlement to disability benefits is governed by the Labor Code, its implementing rules, the POEA-SEC, and the employment contract. Notably, Section 20-B(3) of the POEA-SEC stipulates the process for medical treatment and disability assessment:

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.

Building on this provision, the Court reiterated the guidelines established in Vergara v. Hammonia Maritime Services, Inc., which clarifies the timeline for disability assessment. The seafarer must report to the company-designated physician within three days of arrival for diagnosis and treatment. The seafarer is on temporary total disability, receiving basic wage, for a period not exceeding 120 days. This period can be extended up to 240 days if further medical attention is needed, allowing the employer to declare a permanent disability within this extended timeframe. The seafarer can also be declared fit to work during this period if medically justified.

The Court underscored that it is the **company-designated physician** who bears the responsibility of declaring the seaman’s fitness to work or assessing the degree of permanent disability within the 120-day period, which can be extended to 240 days. The Court then outlined the circumstances under which a seaman can pursue an action for permanent and total disability benefits, including failure of the company-designated physician to issue a declaration within the specified period, conflicting opinions from different doctors, or disputes regarding the disability grading.

In Estrella’s case, the Court found that his situation did not fall under any of the enumerated circumstances that would warrant an immediate claim for permanent total disability benefits. Estrella was referred to the company-designated physicians, underwent examinations, and received an interim disability rating. He was advised to continue rehabilitation, indicating an ongoing treatment process. The court noted that the interim disability assessment was given only 82 days after referral to the company physicians.

The Supreme Court emphasized that the 120-day period can be extended to 240 days when further treatment is required. Estrella was advised to return for re-evaluation, which would have fallen within the 240-day period. By filing his complaint prematurely, Estrella failed to allow the company-designated physician to complete the assessment process. The court noted that Estrella had undergone treatment and rehabilitation for only 150 days when he filed his complaint, making his claim premature.

The Court clarified that the mere passage of the initial 120-day period does not automatically trigger the payment of permanent total disability benefits. Temporary total disability only becomes permanent when the company-designated physician declares it so within the 240-day period or fails to make such a declaration. Since Estrella filed his complaint before the expiration of the extended period, he did not yet have a valid cause of action for permanent total disability benefits. Instead, he was entitled to the income benefit corresponding to the period of temporary total disability during his rehabilitation.

The Court acknowledged the POEA-SEC’s aim to protect the well-being of Filipino workers overseas but stressed that its provisions should not be interpreted to cover situations not contemplated or to extend benefits not intended. The decision underscores the importance of adhering to the prescribed timelines and procedures for assessing disability claims, ensuring fairness and clarity for both seafarers and employers. It reinforces the role of the company-designated physician in making the initial assessment and highlights the significance of allowing the full 240-day period for a comprehensive evaluation.

FAQs

What was the key issue in this case?	The key issue was whether a seafarer was entitled to permanent total disability benefits when the company-designated physician had not yet issued a final assessment within the extended 240-day period.
What is the significance of the 120-day period?	The initial 120-day period is the time frame for the company-designated physician to assess the seafarer’s condition, but it can be extended to 240 days if further medical treatment is required.
When can a seafarer claim permanent total disability benefits?	A seafarer can claim permanent total disability benefits if the company-designated physician fails to issue a declaration within the 240-day period, or if there are conflicting medical opinions.
What is the role of the company-designated physician?	The company-designated physician is responsible for assessing the seafarer’s fitness to work or the degree of permanent disability within the prescribed period.
What happens if the seafarer disagrees with the company-designated physician’s assessment?	If the seafarer disagrees, a third doctor may be agreed upon jointly between the employer and the seafarer, and the third doctor’s decision shall be final and binding.
What is temporary total disability?	Temporary total disability refers to the period when the seafarer is totally unable to work, and it lasts until a final assessment of fitness or permanent disability is made.
Does the lapse of the 120-day period automatically entitle a seafarer to permanent disability benefits?	No, the mere lapse of the 120-day period does not automatically warrant the payment of permanent total disability benefits; the full 240 days should be exhausted.
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.
Why was the seafarer’s claim in this case considered premature?	The seafarer’s claim was premature because he filed his complaint before the expiration of the extended 240-day period for assessment.

This case emphasizes the need for seafarers to understand the procedures and timelines involved in claiming disability benefits. Strict compliance with the POEA-SEC provisions is essential for a successful claim. It also clarifies the employer’s right to utilize the full 240-day period for proper assessment, especially when ongoing medical treatment is required.

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: JOSE YOAC ESTRELLA, VS. BSM CREW SERVICE CENTRE PHILS., G.R. No. 195978, August 19, 2015