Final and Definitive Medical Assessments are Crucial for Seafarers’ Disability Claims

Razonable v. Maersk-Filipinas Crewing, Inc., G.R. No. 241674, June 10, 2020

Imagine the life of a seafarer, spending months at sea, only to suffer an injury that could change their life forever. For Zaldy C. Razonable, this became a harsh reality when he injured his back aboard the M/V Maren Maersk. His case against Maersk-Filipinas Crewing, Inc. and A.P. Moller A/S sheds light on the critical importance of timely and definitive medical assessments for seafarers claiming disability benefits. The Supreme Court’s ruling in this case not only resolved Razonable’s claim but also set a precedent for how such claims should be handled under Philippine law.

The central question in Razonable’s case was whether he was entitled to total and permanent disability benefits. After suffering a back injury while working, Razonable was assessed by company-designated physicians who provided conflicting reports. The Supreme Court found these assessments lacking, leading to a ruling in favor of Razonable, highlighting the legal standards governing disability claims for seafarers.

Understanding the Legal Framework for Seafarers’ Disability Claims

The legal landscape for seafarers’ disability claims is governed by the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC), which outlines the procedures and timelines for medical assessments. According to Section 20(A) of the POEA-SEC, the company-designated physician must issue a final medical assessment within 120 days from the seafarer’s repatriation, or extend this period to 240 days if justified by the need for further treatment.

Key terms to understand include:

• Total and Permanent Disability: A condition where the seafarer is unable to resume their job or any other gainful employment due to the injury or illness.
• Company-Designated Physician: A doctor appointed by the employer to assess the seafarer’s medical condition and disability grading.

The POEA-SEC stipulates that if the company-designated physician fails to issue a final and definitive assessment within the prescribed period, the seafarer’s disability is deemed total and permanent. This was illustrated in the case of Jebsens Maritime, Inc. v. Mirasol, where the Court emphasized the necessity of a clear and conclusive medical assessment.

The Journey of Zaldy C. Razonable’s Case

Zaldy C. Razonable signed a contract with A.P. Moller through Maersk-Filipinas Crewing, Inc. to work as an Ordinary Seaman on the M/V Maren Maersk. On May 6, 2015, he injured his back while carrying a heavy ripper motor. Diagnosed with a prolapsed lumbar disc, Razonable underwent surgery and was assessed by company-designated physicians upon his return to the Philippines.

The medical reports issued by these physicians were contradictory. One report required Razonable to return for further evaluation, while another stated he was unfit for work but assigned a partial disability grade. This inconsistency led Razonable to seek a second opinion, which declared him permanently unfit for sea duties.

When the company failed to initiate the third doctor referral process as required by law, Razonable filed a complaint with the National Conciliation and Mediation Board (NCMB), which initially ruled in his favor. However, the Court of Appeals (CA) reversed this decision, limiting Razonable’s benefits to partial disability.

The Supreme Court’s review of the case focused on the validity of the medical assessments. The Court noted:

“Noteworthy is the fact that, despite the issuance of a purportedly ‘final disability grading’ in the Disability Report, Razonable was still required to return almost a month later for ‘re-evaluation with results’ in the Medical Report issued on the same day. Taking these two documents together, the medical assessment was clearly not a final one because it still required further action on the part of the company-designated physicians.”

The Court further highlighted the contradiction in the disability report:

“While it indicated the supposed disability grading of Razonable, it likewise stated that he was unfit for work. This cannot be deemed as a valid and definite medical assessment.”

Ultimately, the Supreme Court ruled in favor of Razonable, awarding him total and permanent disability benefits of US$60,000.00 plus attorney’s fees, reversing the CA’s decision.

Practical Implications and Key Lessons

This ruling underscores the importance of timely and definitive medical assessments for seafarers. Employers must ensure that their designated physicians adhere to the POEA-SEC’s requirements, or risk being liable for total and permanent disability benefits. For seafarers, understanding their rights and the legal standards governing disability claims is crucial.

Key lessons include:

• Timeliness and Clarity: Medical assessments must be issued within the prescribed periods and must be clear and definitive.
• Right to a Second Opinion: Seafarers have the right to seek a second medical opinion if they disagree with the company-designated physician’s assessment.
• Legal Recourse: If the company fails to follow legal procedures, seafarers can seek recourse through the NCMB and the courts.

For businesses in the maritime industry, this case serves as a reminder to review and ensure compliance with the POEA-SEC and related regulations to avoid costly legal battles.

Frequently Asked Questions

What is the POEA-SEC?

The Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC) is a standardized contract that outlines the rights and obligations of Filipino seafarers and their employers, including provisions for disability benefits.

How long does the company have to issue a medical assessment?

The company-designated physician must issue a final medical assessment within 120 days from the seafarer’s repatriation, extendable to 240 days if further treatment is required.

What happens if the medical assessment is not final and definitive?

If the assessment is not final and definitive within the prescribed period, the seafarer’s disability is considered total and permanent, entitling them to higher benefits.

Can a seafarer seek a second medical opinion?

Yes, seafarers have the right to seek a second medical opinion if they disagree with the company-designated physician’s assessment.

What should seafarers do if their employer does not follow the legal process?

Seafarers can file a complaint with the National Conciliation and Mediation Board (NCMB) and seek legal advice to enforce their rights.

How can ASG Law help with seafarers’ disability claims?

ASG Law specializes in maritime law and can provide expert guidance and representation for seafarers seeking disability benefits. Contact us or email hello@asglawpartners.com to schedule a consultation.