The Importance of Timely Medical Assessments in Determining Total and Permanent Disability

Seacrest Maritime Management, Inc., Nordis Tankers Marine A/S, and Redentor Anaya v. Samuel B. Bernarte, G.R. No. 239221, April 28, 2021

Imagine a seafarer, miles away from home, struck by an injury that leaves him unable to work. The stakes are high, not just for his livelihood but for the companies that employ him. This is the reality for many in the maritime industry, where the timely assessment of injuries can mean the difference between a swift return to work or a life-altering disability claim. In the case of Samuel B. Bernarte, a seafarer who suffered a severe back injury, the Supreme Court of the Philippines had to navigate the complex waters of disability benefits and the responsibilities of employers under the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC). The central question was whether Bernarte was entitled to total and permanent disability benefits due to the company-designated physician’s failure to issue a timely medical assessment.

Legal Context: Navigating the Seas of Disability Law

The legal framework governing seafarers’ disability benefits in the Philippines is primarily outlined in the POEA-SEC, a contract that sets the minimum standards for seafarers’ employment. Under Section 20(A) of the 2010 POEA-SEC, when a seafarer suffers a work-related injury or illness, the company-designated physician must assess the seafarer’s fitness or degree of disability within 120 days from repatriation. This period can be extended to 240 days if justified by the seafarer’s medical condition.

Total and permanent disability, as defined by Article 192(c)(1) of the Labor Code, occurs when a temporary total disability lasts continuously for more than 120 days, except as otherwise provided in the rules. These rules, specifically Section 2, Rule X of the Amended Rules on Employees’ Compensation, allow for an extension to 240 days if the injury or sickness still requires medical attention beyond the initial 120-day period.

The POEA-SEC’s schedule of disability/impediment categorizes disabilities into grades, with Grade 1 being equivalent to total and permanent disability, warranting a benefit of US$60,000.00. However, the interplay between the POEA-SEC and collective bargaining agreements (CBAs) can complicate matters, especially when the CBA specifies different conditions for disability benefits, such as those resulting from accidents.

Case Breakdown: The Voyage of Samuel B. Bernarte

Samuel B. Bernarte’s journey began when he was hired by Seacrest Maritime Management, Inc. and Nordis Tankers Marine A/S as an Able Seaman aboard the MT Clipper Karen. On September 6, 2013, while performing his duties, Bernarte was allegedly hit by a metal hatch, leading to severe back pain. This injury, diagnosed as lumbar disc prolapse, necessitated his repatriation to the Philippines for further medical evaluation.

Upon his return, Bernarte was examined by the company-designated physician, Dr. Natalia Alegre, who initially assessed his condition on January 18, 2014, 121 days after repatriation. Dr. Alegre recommended surgery but noted that Bernarte’s condition was unresponsive to physical therapy. Five days later, Dr. Alegre issued a final assessment, declaring that Bernarte had reached maximum medical cure and assigning him a Disability Grade 8, despite Bernarte’s refusal of the recommended surgery.

Bernarte, believing his injury constituted total and permanent disability, filed a complaint with the Labor Arbiter (LA). The LA ruled in his favor, granting him total and permanent disability benefits based on the CBA, which provided for 100% compensation for seafarers declared permanently unfit for sea duty, even if assessed with less than 50% disability.

The National Labor Relations Commission (NLRC) affirmed the LA’s decision, but the Court of Appeals (CA) modified it, ruling that Bernarte’s benefits should be based on the POEA-SEC rather than the CBA, as his injury was not proven to result from an accident. The Supreme Court upheld the CA’s ruling, emphasizing the company-designated physician’s failure to issue a timely assessment within the mandated 120-day period.

The Court’s reasoning was clear: “Considering that the 120-day period expired on January 17, 2014 without Dr. Alegre having issued a final and definite assessment of respondent’s fitness to work or permanent disability, and without giving any justification for the extension of the 120-day period to 240 days, while respondent remained unfit for work and his medical condition remained unresolved, the latter is deemed totally and permanently disabled by operation of law.”

The Court also noted that Bernarte’s injury, though work-related, did not result from an accident but rather from the normal performance of his duties, specifically lifting heavy objects. This distinction was crucial, as the CBA’s provisions on disability benefits were limited to injuries resulting from accidents.

Practical Implications: Charting a Course Forward

This ruling underscores the critical importance of timely medical assessments in seafarers’ disability claims. Employers and their designated physicians must adhere strictly to the 120-day assessment period, or justify any extension to 240 days, to avoid automatic classification of a seafarer’s disability as total and permanent.

For seafarers, this case highlights the need to document and contest any delays or inadequate assessments by company-designated physicians. It also emphasizes the importance of understanding the specific provisions of their employment contracts and CBAs, as these can significantly impact their entitlement to benefits.

Key Lessons:

• Employers must ensure that company-designated physicians issue timely and justified assessments of seafarers’ disabilities.
• Seafarers should be aware of their rights under both the POEA-SEC and any applicable CBAs, particularly regarding the conditions for total and permanent disability benefits.
• Documentation and evidence of the cause and nature of injuries are crucial in disability claims, especially when distinguishing between work-related injuries and those resulting from accidents.

Frequently Asked Questions

What is the significance of the 120-day period in seafarers’ disability claims?

The 120-day period is critical as it is the timeframe within which the company-designated physician must assess a seafarer’s fitness to work or degree of disability. If no assessment is made within this period, the seafarer may be deemed totally and permanently disabled by operation of law.

Can the 120-day assessment period be extended?

Yes, the period can be extended to 240 days if justified by the seafarer’s medical condition, but the company-designated physician must provide a valid reason for the extension.

What is the difference between the POEA-SEC and a Collective Bargaining Agreement (CBA) in terms of disability benefits?

The POEA-SEC sets the minimum standards for seafarers’ employment, including disability benefits, while a CBA may provide additional or different conditions for benefits, such as those specifically related to accidents.

How can a seafarer prove that their injury resulted from an accident?

Seafarers must provide substantial evidence, such as medical reports, witness statements, or incident reports, to demonstrate that their injury was caused by an unforeseen event rather than the normal performance of their duties.

What should seafarers do if they believe their disability has been misassessed?

Seafarers should consult an independent physician and, if necessary, file a complaint with the appropriate labor tribunal to contest the company-designated physician’s assessment.

ASG Law specializes in labor and employment law, particularly in cases involving seafarers’ rights and disability benefits. Contact us or email hello@asglawpartners.com to schedule a consultation.