In Hartman Crew Phils. v. Acabado, the Supreme Court addressed the rights of seafarers to disability benefits, emphasizing the importance of timely and definitive medical assessments by company-designated physicians. The Court ruled that if a company-designated physician fails to provide a final disability assessment within the 120 or 240-day period, the seafarer’s disability is conclusively presumed to be permanent and total, entitling them to maximum benefits. This ruling underscores the stringent requirements placed on employers to ensure prompt and accurate medical evaluations, protecting the rights of seafarers injured or who become ill while on duty.

Navigating the High Seas of Healthcare: When a Seafarer’s Claim Sails or Sinks on Timely Medical Assessments

Randy Acabado, a Wiper employed by Hartman Crew Philippines and Sea Giant Shipmanagement Ltd., suffered knee injuries while working aboard a vessel. Upon repatriation, he was examined by a company-designated physician, Dr. Alegre, who initially assessed a Grade 10 disability. However, Acabado sought additional medical opinions that suggested a more severe condition. The central legal question arose when the company-designated physician failed to issue a final and definitive disability assessment within the prescribed 120 or 240-day period stipulated under the POEA-SEC. This failure triggered a dispute over Acabado’s entitlement to total and permanent disability benefits.

The case hinges on the interpretation and application of the 120/240-day rule, crucial in determining a seafarer’s eligibility for disability benefits. The entitlement to disability benefits for seafarers is governed by the Labor Code, its Implementing Rules and Regulations (IRR), the POEA-SEC, and established jurisprudence. The POEA-SEC outlines specific procedures and timelines for assessing a seafarer’s disability, emphasizing the role of the company-designated physician in providing a timely and accurate medical evaluation. This framework aims to protect seafarers from potential exploitation while ensuring fair compensation for work-related injuries or illnesses.

The Supreme Court, in line with previous rulings, reiterated the importance of adhering to the prescribed timelines for medical assessments. The Court referenced the Elburg Shipmanagement Phils., Inc., et al. v. Quiogue ruling, which clearly defines the obligations of the company-designated physician. The Elburg ruling stipulates that:

The company-designated physician must issue a final medical assessment on the seafarer’s disability grading within a period of 120 days from the time the seafarer reported to him.

If the physician fails to provide an assessment within this period, the seafarer’s disability becomes permanent and total. However, if there is a justifiable reason for the delay, such as the need for further medical treatment, the period may be extended to 240 days. The employer bears the burden of proving that the extension is justified. Even within the extended period, failure to provide a final assessment results in the seafarer’s disability being deemed permanent and total, regardless of any justification.

The court emphasized that the company-designated physician’s assessment must be final and definitive, clearly stating the seafarer’s disability grading. An interim assessment, where further treatment or rehabilitation is required, does not meet the legal standard. The absence of a definitive declaration regarding the seafarer’s capacity to return to work, or a categorical degree of disability, renders the assessment insufficient.

In this case, the petitioners argued that Dr. Alegre’s assessment on January 16, 2016, corresponded to a Grade 10 disability. However, the Court scrutinized the medical reports and found that they lacked the finality required by law. The reports indicated that Acabado was still undergoing physical therapy and advised to return for follow-up appointments, therefore showing a non-definitive rating.

The implications of failing to issue a final assessment within the prescribed period are significant. As the court highlighted, the referral to a third doctor, as outlined in Section 20(A)(3) of the 2010 POEA-SEC, is contingent upon the company-designated physician providing a valid, final, and definite assessment within the 120/240-day period. Without this initial assessment, the seafarer is not obligated to seek a third opinion and is considered permanently disabled by operation of law. This legal principle protects seafarers from undue delays and ensures that they receive timely compensation for their disabilities.

Building on this principle, the Supreme Court found that Hartman Crew Phils. and Sea Giant Shipmanagement Ltd. failed to demonstrate that Dr. Alegre provided a final and definitive medical assessment within the allowable timeframe. Consequently, Acabado’s disability was deemed permanent and total upon the lapse of the 240-day period. The Court upheld the CA’s decision to award Acabado US$60,000.00 in permanent total disability benefits. This ruling reinforces the importance of strict compliance with the POEA-SEC regulations and the timelines set forth for medical assessments.

Furthermore, the Supreme Court affirmed the award of attorney’s fees to Acabado. Article 2208 of the Civil Code justifies the award of attorney’s fees when a party is compelled to litigate to protect their interests. In this case, Acabado was forced to pursue legal action to secure his disability benefits, making the award of attorney’s fees appropriate. This aspect of the ruling serves as a reminder that employers who fail to meet their obligations may be liable for additional costs incurred by the seafarer in pursuing their rightful claims.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer was entitled to permanent total disability benefits due to the failure of the company-designated physician to issue a final and definitive medical assessment within the prescribed 120 or 240-day period.
What is the 120/240-day rule?	The 120/240-day rule refers to the period within which a company-designated physician must issue a final and definitive assessment of a seafarer’s disability. The initial period is 120 days, which can be extended to 240 days if there is a justifiable reason for the delay.
What happens if the company-designated physician fails to issue an assessment within the 120/240-day period?	If the company-designated physician fails to issue a final assessment within the 120/240-day period, the seafarer’s disability is conclusively presumed to be permanent and total, entitling them to disability benefits.
What constitutes a final and definitive assessment?	A final and definitive assessment must clearly state the seafarer’s disability grading and their capacity to return to work. Interim assessments or recommendations for continued treatment do not meet this requirement.
Is the seafarer required to seek a third doctor’s opinion if the company-designated physician fails to issue a timely assessment?	No, the seafarer is not required to seek a third doctor’s opinion if the company-designated physician fails to issue a final assessment within the 120/240-day period. The seafarer is considered permanently disabled by operation of law.
What is the basis for awarding attorney’s fees in this case?	Attorney’s fees are awarded because the seafarer was compelled to litigate to protect their interests and secure their disability benefits, as justified under Article 2208 of the Civil Code.
What is the significance of the Elburg ruling in this case?	The Elburg ruling provides a clear framework for the obligations of the company-designated physician and the consequences of failing to meet the prescribed timelines for medical assessments.
What type of disability benefits was the seafarer awarded in this case?	The seafarer was awarded US$60,000.00 in permanent total disability benefits, reflecting the maximum compensation available under the POEA-SEC for total and permanent disability.

The Hartman Crew Phils. v. Acabado case serves as a critical reminder of the importance of strict adherence to the POEA-SEC regulations regarding medical assessments for seafarers. Employers must ensure that company-designated physicians provide timely and definitive evaluations to avoid potential liability for permanent total disability benefits. The ruling reinforces the protection afforded to seafarers, recognizing their vulnerability and the need for fair compensation when work-related injuries or illnesses occur.

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: Hartman Crew Phils. v. Acabado, G.R. No. 249567, September 29, 2021