Seafarers’ Right to Timely and Definitive Medical Assessments for Disability Benefits

Adex R. Macahilas v. BSM Crew Service Centre Phils., Inc., et al., G.R. No. 237130, July 01, 2020

Imagine a seafarer, miles away from home, battling not just the waves but also a sudden illness that could change their life forever. This is the reality for many who work at sea, where the line between a job and a life-altering event can be thin. In the case of Adex R. Macahilas, a Filipino seafarer, the Supreme Court of the Philippines had to navigate through the murky waters of employment contracts, medical assessments, and disability benefits to determine his rightful compensation. This case brings to light the critical issue of how seafarers’ health conditions are assessed and compensated, especially when it comes to permanent and total disability benefits.

Macahilas, employed as a third engineer on the APL Canada, suffered from acute appendicitis while on duty. Despite undergoing surgery and subsequent treatments, the company-designated physician’s failure to provide a timely and definitive assessment of his condition led to a dispute over his eligibility for disability benefits. The central legal question was whether Macahilas was entitled to permanent and total disability benefits due to the delay in his medical assessment.

Legal Context

The legal framework governing seafarers’ rights in the Philippines is primarily anchored in the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC). This contract outlines the conditions under which a seafarer’s illness or injury is compensable. According to Section 20(A) of the POEA-SEC, for an illness to be compensable, it must be work-related and occur during the term of the employment contract.

Furthermore, Section 32-A of the POEA-SEC lists specific occupational diseases that are presumed to be work-related. However, illnesses not listed, like appendicitis in Macahilas’s case, are subject to a disputable presumption of work-relatedness. This means that while there is a presumption that the illness is connected to the seafarer’s work, it must be substantiated with reasonable proof of a causal link between the illness and the work environment.

The term “permanent and total disability” is defined by the Labor Code of the Philippines, which states that a disability is considered permanent and total if it renders the employee unable to perform any gainful occupation for a continuous period exceeding 120 days. This definition is crucial in determining the extent of benefits a seafarer is entitled to.

In practical terms, if a seafarer’s injury or illness prevents them from resuming their job, and the company-designated physician fails to issue a final assessment within the prescribed 120/240-day period, the seafarer may be deemed to have a permanent and total disability, entitling them to full disability benefits.

Case Breakdown

Adex Macahilas’s journey began when he signed an employment contract with BSM Crew Service Centre Phils., Inc. to work as a third engineer on the APL Canada. His role involved strenuous work in the engine room, where he was exposed to harmful chemicals and fumes. On December 29, 2013, Macahilas experienced severe abdominal pain, leading to his diagnosis with acute appendicitis. After undergoing an appendectomy in Mexico, complications arose, including an infection and later, an incisional hernia.

Upon his medical repatriation to the Philippines, the company-designated physician assessed that his appendicitis was not work-related. However, Macahilas continued to receive treatment, and over a year later, he was declared fit to work. Despite this, his personal physician deemed him unfit to resume work as a seafarer, leading Macahilas to file a claim for permanent and total disability benefits.

The case traversed through various levels of the Philippine judicial system. Initially, the Labor Arbiter and the National Labor Relations Commission (NLRC) ruled in favor of Macahilas, awarding him permanent and total disability benefits. However, the Court of Appeals reversed this decision, stating that Macahilas failed to prove the work-relatedness of his illness.

The Supreme Court, upon review, emphasized the importance of timely and definitive medical assessments. The Court stated, “A final, conclusive and definite assessment must clearly state whether the seafarer is fit to work or the exact disability rating, or whether such illness is work-related, and without any further condition or treatment.” The Court found that the company-designated physician’s assessment was issued beyond the 240-day mandated period, leading to the conclusion that Macahilas’s disability was permanent and total.

The Supreme Court’s ruling highlighted the procedural steps involved in assessing a seafarer’s disability:

• The company-designated physician must issue a final medical assessment within 120 days from the seafarer’s repatriation.
• If no assessment is provided within this period, the disability is considered permanent and total unless there is a valid justification for the delay.
• If the assessment is delayed beyond 240 days, regardless of any justification, the disability is deemed permanent and total.

Practical Implications

This ruling has significant implications for seafarers and their employers. It underscores the importance of adhering to the mandated timelines for medical assessments, ensuring that seafarers receive timely and fair compensation for their disabilities. Employers must be diligent in monitoring and facilitating the medical assessments of their seafarers to avoid legal disputes and potential liabilities.

For seafarers, this case serves as a reminder to document their health conditions meticulously and seek independent medical opinions if they believe the company’s assessment is inadequate or untimely. It also highlights the need for seafarers to be aware of their rights under the POEA-SEC and the Labor Code.

Key Lessons:

• Seafarers should ensure that their medical conditions are assessed within the prescribed periods to avoid delays in receiving disability benefits.
• Employers must comply with the legal requirements for timely medical assessments to prevent automatic classification of disabilities as permanent and total.
• Both parties should maintain clear communication and documentation regarding the seafarer’s health and treatment progress.

Frequently Asked Questions

What is considered a work-related illness for seafarers under Philippine law?

An illness is considered work-related if it is listed as an occupational disease in the POEA-SEC or if there is a reasonable connection between the seafarer’s work and the illness, even if it is not listed.

How long does a company-designated physician have to issue a final medical assessment?

The physician must issue a final assessment within 120 days from the seafarer’s repatriation, extendable to 240 days if justified by the need for further treatment.

What happens if the medical assessment is delayed beyond the 240-day period?

If the assessment is not issued within 240 days, the seafarer’s disability is automatically considered permanent and total, entitling them to full disability 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 to protect their rights to disability benefits?

Seafarers should document their medical conditions, keep records of their treatments, and be aware of the timelines for medical assessments. They should also seek legal advice if they believe their rights are being violated.

ASG Law specializes in labor and employment law for seafarers. Contact us or email hello@asglawpartners.com to schedule a consultation.