Medical Abandonment in Seafarer Disability Claims: A Critical Factor

G.R. No. 244724, October 23, 2023

Imagine a seafarer injured at sea, undergoing treatment, and then suddenly stopping, failing to attend scheduled medical re-evaluations. This scenario highlights the concept of ‘medical abandonment’ and its significant impact on disability claims under Philippine law. The Supreme Court, in the case of Roque T. Tabaosares v. Barko International, Inc., clarified the duties of seafarers undergoing medical treatment and the consequences of failing to comply with the prescribed medical regime. This case serves as a crucial reminder for both seafarers and employers regarding their responsibilities in disability claims.

The Legal Framework for Seafarer Disability Claims

Seafarer disability claims in the Philippines are governed by a combination of laws, contracts, and medical findings. Key legal bases include Articles 197 to 199 of the Labor Code, as amended, and Section 2(a), Rule X of the Amended Rules on Employee Compensation. Contractual frameworks are established through the Philippine Overseas Employment Administration – Standard Employment Contract (POEA-SEC), collective bargaining agreements (CBAs), if any, and individual employment agreements.

The POEA-SEC, being a labor contract imbued with public interest, is liberally construed in favor of the seafarer. However, the Supreme Court has consistently held that this principle must be balanced with the need for fairness and adherence to established rules and procedures. The rights of management are also respected, and the courts do not favor labor when the employee is at fault.

A critical aspect of these claims is the role of the company-designated physician. The Supreme Court has set clear guidelines on the timelines for medical assessments. In Elburg Shipmanagement Phils., Inc. v. Quiogue, Jr., the Court summarized these rules:

1. 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;
2. If the company-designated physician fails to give his assessment within the period of 120 days, without any justifiable reason, then the seafarer’s disability becomes permanent and total;
3. If the company-designated physician fails to give his assessment within the period of 120 days with a sufficient justification (e.g. seafarer required further medical treatment or seafarer was uncooperative), then the period of diagnosis and treatment shall be extended to 240 days. The employer has the burden to prove that the company-designated physician has sufficient justification to extend the period; and
4. If the company-designated physician still fails to give his assessment within the extended period of 240 days, then the seafarer’s disability becomes permanent and total, regardless of any justification.

The 240-day rule is significant because it allows for a more comprehensive evaluation of the seafarer’s condition, especially when further treatment or rehabilitation is needed. However, this extension hinges on the seafarer’s cooperation and adherence to the prescribed medical treatment.

The Tabaosares Case: A Story of Missed Opportunities

Roque T. Tabaosares, a No. 1 oiler, sustained an injury on board a vessel. He was medically repatriated and underwent treatment with a company-designated physician. After initial treatment, he was given an interim disability assessment of Grade 11. He completed several physical therapy sessions, but ultimately, he failed to attend a scheduled re-evaluation, despite the company’s offer to shoulder his travel expenses. As the Court noted:

[H]e, however, failed to heed, despite the company shouldering his plane ticket, and refused to take its calls. Thus, the Court finds petitioner guilty of medical abandonment.

Tabaosares then sought the opinion of his own physician, who declared him unfit to work. However, because he failed to complete his treatment with the company-designated physician, the Supreme Court ruled against his claim for total and permanent disability benefits. The Court emphasized that:

[I]t is but the seafarer’s duty to comply with the medical treatment as provided by the company-designated physician; otherwise, a sick or injured seafarer who abandons his or her treatment stands to forfeit his or her right to claim disability benefits.

Here’s a breakdown of the key procedural steps:

• Tabaosares was injured on March 24, 2014 and repatriated on March 28, 2014.
• He underwent treatment with the company-designated physician, including multiple physical therapy sessions.
• On July 8, 2014, the company-designated physician gave an interim disability assessment of Grade 11.
• He failed to attend a scheduled re-evaluation on November 18, 2014, despite the company’s efforts to facilitate his attendance.
• He then consulted his own physician and filed a claim for total and permanent disability benefits.

The Court ultimately denied Tabaosares’ claim for total and permanent disability, finding him guilty of medical abandonment. He was, however, entitled to sickness benefit and medical allowance including the differential sickness allowance that was offered during the grievance meeting.

Practical Implications: Responsibilities and Rights

This ruling underscores the importance of seafarers actively participating in their medical treatment and adhering to the directives of the company-designated physician. Failure to do so can have severe consequences on their disability claims. This case also highlights the need for clear communication and documentation throughout the treatment process. It is not enough that the seafarer failed to attend the check-up; the company must also provide evidence of proper notification.

Here are key lessons from this case:

• Complete Medical Treatment: Seafarers must diligently attend all scheduled medical appointments and comply with the prescribed treatment plan.
• Communicate Concerns: If a seafarer has concerns about the treatment or faces challenges in attending appointments, they should communicate these concerns to the company promptly.
• Document Everything: Keep detailed records of all medical appointments, treatments, and communications with the company and medical professionals.

Hypothetical Example: A seafarer is required to undergo physical therapy in Manila but lives in a remote province. If the seafarer fails to attend his treatment due to financial constraint, he must inform the company and request support. Should he fail to do this, that will be considered medical abandonment. If the seafarer properly requested support, the company is duty-bound to reimburse the costs. In both situation, the seafarer must provide proof of expenses.

Frequently Asked Questions

Q: What is considered medical abandonment?
A: Medical abandonment occurs when a seafarer fails to complete their medical treatment as prescribed by the company-designated physician, preventing a final assessment of their condition.

Q: What are the consequences of medical abandonment?
A: A seafarer who abandons their medical treatment may forfeit their right to claim disability benefits.

Q: What is the 120/240-day rule?
A: The company-designated physician has 120 days to issue a final medical assessment. This period can be extended to 240 days if justified by the need for further treatment.

Q: Can a seafarer consult their own doctor?
A: Yes, a seafarer has the right to seek a second opinion, but this right is best exercised after the company-designated physician has issued a definite declaration of their condition.

Q: What should a seafarer do if they have difficulty attending medical appointments?
A: Communicate the challenges to the company and request assistance. Document all communications and efforts to comply with the treatment plan.

Q: What happens if the company-designated physician fails to give an assessment within 240 days?
A: If, without justifiable reason, the company-designated physician fails to provide an assessment within the extended 240-day period, the seafarer’s disability is deemed permanent and total.

Q: Is financial incapacity a valid excuse for not attending check-ups?
A: While it can be, it must be supported by clear and convincing evidence, especially if the company has been providing sickness allowance.

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