In a dispute over disability benefits for a Filipino seafarer, the Supreme Court clarified the mandatory procedure for resolving conflicting medical assessments. The Court held that failure to seek a third opinion, when the company-designated physician’s assessment is contested, constitutes a breach of the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC), rendering the company doctor’s findings final and binding. However, the Court also ruled that even with this breach, the seafarer is still entitled to compensation based on the company-designated physician’s disability grading, preventing a complete dismissal of the claim and ensuring the seafarer receives appropriate benefits for the assessed injury. This decision balances adherence to contractual procedures with the seafarer’s right to receive fair compensation for work-related injuries.

When Conflicting Medical Opinions at Sea Lead to a Legal Showdown

The case of Geminiano S. Murillo v. Philippine Transmarine Carriers, Inc. revolves around a seafarer’s claim for disability benefits following an injury sustained while working aboard a vessel. Murillo, an able seaman, injured his knees while securing a lifeboat. Upon repatriation, he was examined by a company-designated physician who assessed his disability as “Grade 10 x 2 – stretching leg or ligaments of a knee.” Disagreeing with this assessment, Murillo consulted his own physician, who declared him permanently unfit for sea duties. This conflict in medical opinions triggered a legal battle that ultimately reached the Supreme Court, focusing on the mandatory procedure for resolving such disputes under the POEA-SEC.

At the heart of the matter is Section 20(B)(3) of the POEA-SEC, which outlines the process for handling injury or illness claims. This section mandates that a seafarer undergo a post-employment medical examination by a company-designated physician within three working days of repatriation. It also stipulates that:

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 of Appeals initially ruled that Murillo’s complaint should have been dismissed because he failed to seek a third opinion to resolve the conflicting medical assessments. The Supreme Court, however, took a more nuanced approach, affirming the mandatory nature of the third-doctor referral but also recognizing the seafarer’s right to compensation based on the company-designated physician’s assessment. The Supreme Court leaned on the principle established in Andrada vs. Agemar Manning Agency, Inc., which emphasized the POEA-SEC as the governing framework for seafarer employment and disability claims. The court has consistently held that the company-designated physician’s assessment is not automatically final, binding, or conclusive and that the seafarer has the right to seek a second opinion.

Building on this principle, the Supreme Court highlighted the importance of adhering to the prescribed procedure for resolving conflicting medical opinions. In Philippine Hammonia Ship Agency, Inc. vs. Dumagdag, the Court clarified that while a seafarer has the right to seek a second opinion, they cannot preempt the mandatory procedure outlined in Section 20 of the POEA-SEC. The correct approach, according to the Court, is to refer the conflicting opinions to a third doctor for a final determination. Failure to do so constitutes a breach of the POEA-SEC, as further emphasized in Formerly INC Shipmanagement, Inc. vs. Rosales, where the Court stated unequivocally that the referral to a third doctor is mandatory.

The Supreme Court, in the present case, underscored that the company can insist on its disability rating unless the seafarer expresses disagreement and requests a referral to a third doctor. The decision in Silagan vs. Southfield Agencies, Inc. reiterates the mandatory nature of this procedure, reinforcing the principle that the company-designated doctor’s assessment prevails unless the seafarer actively seeks a third opinion. In Murillo’s case, the Supreme Court found that he had indeed failed to comply with this mandatory procedure. As a consequence, the Court acknowledged that the company-designated physician’s assessment should be considered final and binding.

However, the Supreme Court also identified a critical error in the Court of Appeals’ decision. By dismissing Murillo’s complaint entirely, the appellate court effectively denied him any disability benefits, contradicting its own finding that the company-designated physician’s assessment was more credible. The Supreme Court emphasized that the company-designated physician had, in fact, assessed Murillo’s condition and assigned a disability grading. Therefore, the Court held that Murillo was entitled to compensation based on that assessment.

To rectify this error, the Supreme Court turned to Section 32 of the POEA-SEC, which provides a schedule of disability allowances. The Court noted that “stretching leg of the ligaments of a knee resulting in instability of the joint” corresponds to a Grade 10 disability, entitling the seafarer to 20.15% of US$50,000.00. Since both of Murillo’s knees were affected, the Court doubled the amount, awarding him a total of US$20,150.00. This decision underscores the importance of adhering to the POEA-SEC procedures while also ensuring that seafarers receive fair compensation for work-related injuries, even when they fail to follow the mandatory third-doctor referral process. This approach contrasts with a strict, formalistic interpretation of the POEA-SEC, which could leave injured seafarers without any recourse.

FAQs

What was the key issue in this case?	The central issue was whether a seafarer who failed to seek a third medical opinion, as required by the POEA-SEC, was entitled to disability benefits. The case also examined the extent to which the assessment of the company-designated physician is binding.
What is the POEA-SEC?	The Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) is a standard contract that governs the employment of Filipino seafarers on board ocean-going vessels, outlining their rights and obligations. It includes provisions for compensation and benefits in case of injury or illness.
What is the role of the company-designated physician?	The company-designated physician is responsible for assessing the seafarer’s medical condition upon repatriation. Their assessment is initially considered the primary basis for determining disability benefits, but it is not automatically final.
What happens if the seafarer disagrees with the company-designated physician’s assessment?	If the seafarer disagrees, they can consult their own physician for a second opinion. If the two opinions conflict, the POEA-SEC mandates that both parties jointly agree on a third doctor whose decision will be final and binding.
Is the referral to a third doctor mandatory?	Yes, according to the Supreme Court, the referral to a third doctor is a mandatory procedure under the POEA-SEC. Failure to comply with this requirement can affect the seafarer’s claim for disability benefits.
What was the Court’s ruling on the seafarer’s failure to seek a third opinion?	The Court ruled that the seafarer’s failure to seek a third opinion constituted a breach of the POEA-SEC, making the company-designated physician’s assessment final and binding. However, it did not result in a complete dismissal of the claim.
Was the seafarer entitled to any compensation in this case?	Yes, despite the breach of the POEA-SEC, the Court awarded the seafarer compensation based on the disability grading provided by the company-designated physician. The Court determined that a complete dismissal of the case was not appropriate.
How was the amount of compensation determined?	The Court referred to Section 32 of the POEA-SEC, which provides a schedule of disability allowances. Based on the company-designated physician’s assessment of the seafarer’s knee injury, the Court calculated the corresponding disability benefit.
What is the practical implication of this ruling for seafarers?	This ruling clarifies the importance of following the mandatory third-doctor referral process under the POEA-SEC when disputing a company doctor’s assessment. It also ensures that seafarers receive appropriate compensation for work-related injuries, even if procedural requirements are not strictly followed.

In conclusion, the Murillo case underscores the critical importance of adhering to the procedural requirements outlined in the POEA-SEC for resolving disputes over seafarer disability claims. While the failure to follow these procedures, such as the mandatory referral to a third doctor, can have significant consequences, the Supreme Court’s decision also demonstrates a commitment to ensuring that seafarers receive fair compensation for work-related injuries based on the assessments made by company-designated physicians. This ruling balances the need for procedural compliance with the protection of seafarers’ rights.

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: GEMINIANO S. MURILLO, VS. PHILIPPINE TRANSMARINE CARRIERS, INC., G.R. No. 221199, August 15, 2018