The Importance of Timely and Definitive Medical Assessments for Seafarers’ Disability Claims

United Philippine Lines, Inc. and/or Holland America Line Westours, Inc. and/or Jose Geronimo Consunji v. Juanito P. Alkuino, Jr., G.R. No. 245960, July 14, 2021

Imagine a seafarer, miles away from home, suddenly facing a debilitating injury that threatens their livelihood. This is not just a hypothetical scenario but the reality for many Filipino seafarers who rely on their health and ability to work at sea. The case of Juanito P. Alkuino, Jr. against United Philippine Lines, Inc. (UPLI) and its foreign principal, Holland America Line Westours, Inc., sheds light on the critical issue of disability benefits for seafarers, particularly the importance of timely and definitive medical assessments.

In this case, Alkuino, an Assistant Stage Manager aboard the vessel “Westerdam,” suffered back injuries that led to a dispute over his entitlement to permanent and total disability benefits. The central legal question was whether his disability should be classified as permanent and total or partial and permanent, and the role of the company-designated physician’s assessment in determining this.

The Legal Framework Governing Seafarers’ Disability Benefits

The rights of seafarers to disability benefits are enshrined in various legal instruments, including the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC) and the Collective Bargaining Agreement (CBA) between the seafarer’s union and the employer. These documents outline the conditions under which a seafarer may be entitled to disability benefits, the assessment process, and the compensation amounts.

Under the POEA-SEC, a seafarer’s disability is considered permanent and total if the company-designated physician fails to issue a final medical assessment within the 120 or 240-day treatment period. The CBA, in this case, the HAL AMOSUP CBA, specifies that the seafarer’s disability compensation is calculated based on the POEA’s schedule of disability or impediment, using the assessment of the company-designated physician.

Key terms such as “permanent total disability” and “permanent partial disability” are crucial. Permanent total disability means the seafarer can no longer work in the same or similar capacity they were trained for, whereas permanent partial disability refers to a condition that does not completely prevent the seafarer from working in their trained capacity.

Consider a seafarer who suffers a hand injury. If the injury prevents them from performing any seafaring work, it might be deemed permanent total disability. However, if they can still perform their duties with some limitations, it could be classified as permanent partial disability.

The Journey of Juanito P. Alkuino, Jr.

Juanito P. Alkuino, Jr. was hired by UPLI as an Assistant Stage Manager for Holland America Line Westours, Inc. in November 2014. His role involved assisting the manager, supervising, and organizing the stage for performances aboard the vessel. In March 2015, Alkuino began experiencing severe back pain after moving equipment, which worsened over time, leading to his repatriation for medical reasons in April 2015.

Upon returning to the Philippines, Alkuino was placed under the care of the company-designated physician, who diagnosed him with disc degeneration and recommended surgery. Alkuino, however, refused surgery and opted for physical therapy. After completing his therapy sessions, the physician assessed him as having a permanent partial disability with a Grade 8 impediment, which was issued within the 120-day period.

Alkuino, unsatisfied with this assessment, sought a second opinion from his doctor of choice, who declared him permanently and totally disabled. This led to a dispute over the validity of the assessments, which eventually reached the Supreme Court.

The Supreme Court emphasized the importance of the company-designated physician’s assessment, stating, “The company-designated physician issued a final medical assessment within the reglementary period of 120 days.” The Court further noted, “The assessment of the company-designated physician prevails over the assessment of respondent’s doctor of choice,” due to the physician’s prolonged opportunity to observe and treat the seafarer.

The procedural journey involved Alkuino filing a complaint with the National Conciliation Mediation Board-Panel of Voluntary Arbitrators (NCMB-PVA), which initially ruled in his favor for permanent total disability benefits. The Court of Appeals upheld this ruling but absolved the company president, Jose Geronimo Consunji, from liability. The Supreme Court, however, modified the decision, ruling that Alkuino was entitled to partial and permanent disability benefits based on the company-designated physician’s assessment.

Implications for Seafarers and Employers

This ruling has significant implications for seafarers and their employers. For seafarers, it underscores the importance of cooperating with the company-designated physician and the potential impact of refusing recommended treatments on their disability claims. For employers, it highlights the necessity of ensuring that their designated physicians provide timely and definitive assessments to avoid disputes over disability benefits.

Key Lessons:

• Seafarers should seek a second medical opinion if they disagree with the company-designated physician’s assessment but must be prepared for the company’s assessment to hold more weight in legal proceedings.
• Employers must ensure that their designated physicians adhere to the 120 or 240-day assessment periods to prevent automatic classification of disabilities as permanent and total.
• Understanding the specific terms of the CBA and POEA-SEC is crucial for both parties in navigating disability claims.

Frequently Asked Questions

What is the difference between permanent total and permanent partial disability?

Permanent total disability means a seafarer can no longer work in their trained capacity, while permanent partial disability means they can still work but with some limitations.

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

The physician must issue a final assessment within 120 days, extendable to 240 days if further treatment is needed.

What happens if the company-designated physician fails to issue an assessment within the specified period?

If no assessment is issued within 120 or 240 days, the seafarer’s disability is deemed permanent and total.

Can a seafarer refuse recommended surgery and still claim disability benefits?

Yes, but refusing recommended treatments may impact the assessment of the disability’s severity and the corresponding benefits.

How are disability benefits calculated for seafarers?

Disability benefits are calculated based on the POEA’s schedule of disability or impediment, using the assessment of the company-designated physician and the CBA’s specified compensation basis.

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