The Supreme Court ruled that a seafarer who abandons treatment with a company-designated physician forfeits the right to claim permanent total disability benefits. While entitled to temporary total disability benefits during treatment, failure to complete medical assessments, as required by the POEA-SEC, prevents a finding of permanent disability. This decision emphasizes the seafarer’s duty to comply with prescribed medical treatments and follow-up evaluations to properly assess their condition for disability claims.
When a Seafarer’s Recovery Journey Stalls: Examining Abandonment of Treatment in Disability Claims
This case, Solpia Marine and Ship Management, Inc. v. Michael V. Postrano, revolves around a seafarer’s claim for permanent total disability benefits after sustaining injuries on board a vessel. The central legal question is whether the seafarer, Postrano, is entitled to such benefits when he discontinued treatment with the company-designated physician, thereby preventing a final assessment of his condition. This scenario highlights the tension between a seafarer’s right to claim disability and their obligation to follow prescribed medical procedures.
Postrano, an able seaman, suffered injuries to his hands while working on a ship managed by Solpia Marine. Upon repatriation, he underwent medical examination and physical therapy. The company-designated physician advised him to continue therapy and return for follow-up. However, Postrano ceased attending these sessions and instead consulted an independent physician who assessed him with a Grade 9 disability. This divergence in medical assessment lies at the heart of the dispute.
The Labor Arbiter (LA) initially dismissed Postrano’s claim, a decision later affirmed by the National Labor Relations Commission (NLRC). Both tribunals found that Postrano prematurely sought an independent medical opinion before completing his treatment with the company-designated physician, violating the POEA Standard Employment Contract (SEC). However, the Court of Appeals (CA) reversed these rulings, awarding Postrano permanent total disability benefits, citing the company-designated physician’s failure to provide a definitive impediment rating.
The Supreme Court, in this instance, sided with the employer, Solpia Marine, underscoring the importance of adhering to the medical procedures outlined in the POEA-SEC. The Court emphasized that Postrano’s abandonment of treatment prevented the company-designated physician from accurately assessing his condition and issuing a final disability grading. Without this assessment, the claim for permanent total disability could not be substantiated.
The legal framework governing seafarer disability claims is primarily rooted in the Labor Code, the Amended Rules on Employees’ Compensation (AREC), and the POEA-SEC. Article 192(c)(1) of the Labor Code addresses permanent disability:
Art. 192. Permanent disability. x x x x
C. The following disabilities shall be deemed total and permanent:
The POEA-SEC outlines the obligations of both the employer and the seafarer in cases of injury or illness. Section 20(A)(3) of the POEA-SEC details the process for medical examination and assessment:
Sec. 20. COMPENSATION AND BENEFITS
A. COMPENSATION AND BENEFITS FOR INJURY OR ILLNESS
x x x x
3. In addition to the above obligation of the employer to provide medical attention, the seafarer shall also receive sickness allowance from his employer in an amount equivalent to his basic wage computed from the time he signed off until he is declared fit to work or the degree of disability has been assessed by the company-designated physician. The period within which the seafarer shall be entitled to his sickness allowance shall not exceed 120 days. Payment of the sickness allowance shall be made on a regular basis, but not less than once a month.
x x x x
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. x x x 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.
The Court emphasized that the seafarer’s failure to comply with the mandatory reporting requirement and to complete the prescribed treatment resulted in the forfeiture of his right to claim disability benefits. It is crucial for seafarers to understand that their cooperation in the medical assessment process is not merely a procedural formality but a substantive requirement for a successful disability claim.
The Court, however, recognized that Postrano was entitled to income benefits for the period of his temporary total disability, which extended beyond the initial 120-day period but remained within the 240-day limit. This highlights that even when permanent disability is not established, seafarers are still entitled to compensation for the duration of their treatment and temporary incapacity. The court stated:
While We deny Postrano’s claim for permanent total disability benefits, We note that Postrano is entitled to the income benefit for temporary total disability benefits during the period of his treatment, although exceeding beyond the 120 day-period but within the 240 day period, as his condition required further treatment. Hence, We deem it proper to award income benefit equivalent to 218 days.
This decision carries significant implications for seafarers and employers alike. It reinforces the importance of adhering to the medical protocols outlined in the POEA-SEC. Seafarers must understand their responsibility to complete the prescribed treatment and assessment process to substantiate their disability claims. Employers, on the other hand, must ensure that seafarers receive appropriate medical attention and that the assessment process is conducted fairly and transparently.
The Court also cited Splash Philippines, Inc., et al. v. Ruizo, emphasizing that refusal to complete medical treatment negates the payment of disability benefits. This underscores the principle that disability benefits are not automatically granted but are contingent on the seafarer’s active participation in the medical evaluation and treatment process. In sum, the Supreme Court’s decision in Solpia Marine serves as a reminder of the mutual obligations of seafarers and employers in ensuring a fair and equitable resolution of disability claims.
FAQs
| What was the key issue in this case? | The key issue was whether a seafarer is entitled to permanent total disability benefits when he abandoned treatment with the company-designated physician, preventing a final assessment of his condition. |
| What is the POEA-SEC? | The POEA-SEC is the Philippine Overseas Employment Administration Standard Employment Contract, which governs the terms and conditions of employment for Filipino seafarers. It outlines the rights and responsibilities of both the seafarer and the employer, including provisions for medical care and disability compensation. |
| What is the role of the company-designated physician? | The company-designated physician is the doctor appointed by the employer to assess the seafarer’s medical condition and determine the degree of disability, if any. Their assessment is crucial in determining the seafarer’s entitlement to disability benefits. |
| What happens if a seafarer disagrees with the company-designated physician’s assessment? | If a seafarer disagrees with the company-designated physician’s assessment, they can consult an independent physician. If the opinions differ, 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 does it mean to abandon treatment? | Abandoning treatment, in this context, means that the seafarer failed to continue with the prescribed medical treatment and follow-up evaluations with the company-designated physician. This prevents the physician from making a final assessment of the seafarer’s condition. |
| What is temporary total disability? | Temporary total disability refers to a period when the seafarer is unable to perform their usual work due to injury or illness. During this time, they are entitled to sickness allowance and medical benefits as provided by the POEA-SEC. |
| What is permanent total disability? | Permanent total disability refers to a condition where the seafarer is unable to return to their previous work or any gainful employment due to the severity of their injury or illness. This entitles them to disability benefits. |
| What benefits is a seafarer entitled to during treatment? | During treatment, a seafarer is entitled to sickness allowance equivalent to their basic wage, as well as medical and transportation expenses. The sickness allowance is typically paid for a maximum of 120 days, but may be extended up to 240 days if further treatment is required. |
In conclusion, the Supreme Court’s decision underscores the critical importance of seafarers actively participating in their prescribed medical treatment and assessment process. Abandonment of treatment can result in the forfeiture of disability benefits. However, entitlement to temporary disability benefits will be awarded as appropriate.
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: SOLPIA MARINE AND SHIP MANAGEMENT, INC. VS. MICHAEL V. POSTRANO, G.R. No. 232275, July 23, 2018
Leave a Reply