In cases involving seafarers’ disability benefits, the Supreme Court emphasizes the importance of adhering to the prescribed periods for medical assessment. The Court ruled that a seafarer’s claim for total and permanent disability benefits was premature because it was filed before the expiration of the 240-day period allowed for the company-designated physician to issue a final assessment. While the seafarer was ultimately entitled to a partial disability rating based on the physician’s eventual assessment, the initial claim for full benefits was denied due to the premature filing. This case underscores the need for seafarers to allow the full assessment period before pursuing legal action.

Did He Wait Long Enough? Examining Seafarer’s Premature Disability Claim

The case of Ruel L. Guadalquiver v. Sea Power Shipping Enterprise, Inc. (G.R. No. 226200, August 5, 2019) revolves around a seafarer’s claim for disability benefits and whether he prematurely filed his claim. After experiencing back pain while working on a vessel, Guadalquiver was medically repatriated and attended to by a company-designated doctor, Dr. Gonzales. During his treatment, Guadalquiver also consulted his own physician, Dr. Magtira, who declared him unfit to work. Claiming his condition didn’t improve, Guadalquiver filed a complaint for permanent and total disability benefits before the company-designated doctor could issue a final assessment.

The Labor Arbiter (LA) ruled in favor of Guadalquiver, ordering the respondents to pay permanent and total disability benefits. The LA reasoned that the opinion of the seafarer’s personal doctor outweighed that of the company-designated physician. Additionally, the LA considered Guadalquiver’s inability to find work for more than 120 days as equivalent to permanent and total disability. This decision was affirmed by the National Labor Relations Commission (NLRC), leading the respondents to file a petition for certiorari with the Court of Appeals (CA).

The Court of Appeals reversed the NLRC decision, emphasizing that Guadalquiver was obligated to complete his medical treatment until the company-designated doctor made a final declaration. The CA noted that at the time the case was filed, the company-designated physician had not yet determined the extent of his disability. Moreover, the CA found that Guadalquiver failed to report back for scheduled treatment sessions, hindering the assessment process. Although the seafarer had the right to seek medical opinion from his chosen doctor, it had to be undertaken on the presumption that there was already a certification given by the company-designated physician.

The Supreme Court, in its decision, addressed the question of when a seafarer is deemed permanently and totally disabled. The Court referred to the landmark case of Vergara vs. Hammonio Maritime Services, Inc., which established a framework for determining disability benefits. The Vergara ruling sets a 120-day period from repatriation during which the employer must assess the seafarer’s fitness to work or determine the degree of disability. The 120-day period may be extended to a maximum of 240 days if the seafarer requires further medical attention.

According to the established jurisprudence, a seafarer is considered permanently and totally disabled under the following conditions: when the company-designated doctor makes such a declaration within the 120 or 240-day period; or after 240 days have passed without any declaration from the company-designated physician. The Supreme Court also referenced Scanmar Maritime Services, Inc. vs. Hernandez, Jr., which outlined several instances when a seafarer could pursue a case for full disability benefits. These instances include failure of the company-designated physician to issue a declaration; lapse of 240 days without certification; conflicting opinions between the company doctor and the seafarer’s doctor; and disagreement on the disability grading.

Applying these principles to the case, the Supreme Court found that the CA did not err in ruling that the NLRC had committed grave abuse of discretion. The Court emphasized that Guadalquiver filed his disability case on March 31, 2014, which was only 193 days after his repatriation on September 19, 2013. This was still within the 240-day period allowed for the company-designated doctor to issue an assessment on Guadalquiver’s condition. Since the 240-day period had not yet lapsed, and the company-designated doctor had not yet issued a definitive assessment, Guadalquiver’s cause of action had not yet accrued, making the filing of the suit premature.

The Supreme Court also addressed the issue of the medical opinion provided by Guadalquiver’s personal doctor. While acknowledging a seafarer’s right to seek a second opinion, the Court clarified that such an opinion is relevant only when the company-designated doctor has already issued a definite declaration on the seafarer’s condition. Since there was no certification from the company-designated doctor at the time Guadalquiver filed his claim, the assessment made by his personal doctor could not be given credence.

The Court also addressed Guadalquiver’s contention that he was entitled to full disability benefits because the company-designated doctor failed to provide an assessment within the initial 120-day period. Citing Oriental Shipmanagement Co., Inc. vs. Ocangas, the Court clarified that the 240-day rule, as elucidated in Vergara, applies to cases filed after October 6, 2008. This means that even if the initial 120-day period had passed without an assessment, the company-designated doctor still had up to 240 days to make a determination, and the seafarer was not automatically entitled to full disability benefits.

Despite the premature filing of the case and the denial of full disability benefits, the Supreme Court affirmed the CA’s decision to award Guadalquiver a Grade 11 disability rating. The Court recognized that the company-designated doctor had indeed made such a diagnosis within the allowable 240-day period, and neither party had refuted this finding. The award of partial disability benefits demonstrates the Court’s recognition of the seafarer’s condition and entitlement to some form of compensation, even though his initial claim for full benefits was deemed premature.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer, Guadalquiver, prematurely filed his claim for permanent and total disability benefits before the expiration of the 240-day period for the company-designated doctor to issue a final assessment.
What is the significance of the 240-day rule?	The 240-day rule, established in Vergara vs. Hammonio Maritime Services, Inc., is the maximum period allowed for the company-designated physician to assess a seafarer’s condition and issue a final declaration on their fitness to work or degree of disability.
Can a seafarer seek a second medical opinion?	Yes, a seafarer has the right to seek a second medical opinion from a doctor of their choice. However, this right can be properly exercised when the company-designated doctor has already issued a definite declaration on the seafarer’s medical condition.
What happens if the company-designated doctor fails to issue an assessment within 240 days?	If the company-designated doctor fails to issue an assessment within the 240-day period, the seafarer may be considered permanently and totally disabled, entitling them to disability benefits, per the POEA-SEC.
What constitutes medical abandonment?	Medical abandonment occurs when a seafarer fails to comply with the prescribed medical treatments or fails to report to the company-designated doctor for regular check-ups and assessments without justifiable reason, potentially affecting their claim for benefits.
What factors did the court consider?	The court considered the timing of the filing of the disability claim relative to the 240-day period, the absence of a final assessment from the company-designated physician, and whether the seafarer adhered to the prescribed medical treatments and check-ups.
Why was the seafarer’s claim for full benefits denied?	The claim for full benefits was denied because it was filed prematurely, before the 240-day period had lapsed and before the company-designated doctor had issued a final assessment.
What benefits was the seafarer ultimately entitled to?	Despite the premature filing, the seafarer was entitled to a Grade 11 disability rating, as determined by the company-designated doctor within the specified period of 240 days.

This case highlights the critical importance of adhering to the procedural requirements and timelines outlined in the POEA-SEC and relevant jurisprudence when pursuing disability claims. Seafarers must ensure that they allow the company-designated physician the full 240-day period to conduct a thorough assessment and issue a final declaration before initiating legal action. Prematurely filed claims may be dismissed, potentially delaying or jeopardizing the seafarer’s ability to receive the benefits they are entitled to.

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: Ruel L. Guadalquiver v. Sea Power Shipping Enterprise, Inc., G.R. No. 226200, August 05, 2019