Tag: POEA-SEC

Upholding Seafarer Rights: Employer’s Duty to Provide Clear Disability Assessment

The Supreme Court ruled that a seafarer is entitled to total and permanent disability benefits when the company-designated physician fails to provide a final and definite disability assessment within the prescribed period. This decision reinforces the protection afforded to seafarers under Philippine law, ensuring they receive due compensation for work-related illnesses. It emphasizes the employer’s responsibility to provide a comprehensive medical assessment, without which the seafarer’s disability is legally presumed to be total and permanent, thus entitling them to appropriate benefits.

When Silence Speaks Volumes: The Case of Delayed Disability Assessment for Seafarers

In the case of Rodelio R. Onia v. Leonis Navigation Company, Inc., the central question revolved around a seafarer’s entitlement to disability benefits following a stroke suffered while on duty. Rodelio Onia, an oiler on board the vessel MV Navios Koyo, experienced a stroke and was subsequently diagnosed with cerebrovascular infarct, hypertensive cardiovascular disease, and diabetes mellitus. After being medically repatriated, Onia sought disability benefits, but his claim was contested by Leonis Navigation Company, Inc. and World Maritime Co. Ltd., who argued that his illness was not work-related and that he had concealed pre-existing conditions during his pre-employment medical examination (PEME). This case highlights the crucial importance of timely and conclusive disability assessments in maritime employment.

The central point of contention was whether Onia’s failure to disclose his hypertensive cardiovascular disease and diabetes mellitus during his PEME disqualified him from receiving disability benefits. The Court emphasized that concealment, as defined under Section 20 (E) of the 2010 POEA-SEC, applies only when a seafarer knowingly withholds information about an illness that cannot be diagnosed during the PEME. Here, since hypertension and diabetes mellitus are detectable through routine tests, the Court found that Onia’s condition was not a concealed pre-existing illness within the meaning of the POEA-SEC. The fact that the company-accredited physician prescribed maintenance medicines for these conditions further indicated that the company was aware of his health status from the outset.

Building on this principle, the Court examined whether Onia’s illnesses were work-related and compensable. Under Section 20 (A) of the 2010 POEA-SEC, employers are liable for disability benefits when a seafarer suffers a work-related injury or illness during their contract. A work-related illness is defined as any sickness resulting from an occupational disease listed under Section 32-A of the same contract. Since Onia’s diagnoses – cerebrovascular infarct, hypertensive cardiovascular disease, and diabetes mellitus – are listed as occupational diseases under Section 32-A, they are presumed to be work-related.

Section 32-A of the 2010 POEA-SEC explicitly lists “Cerebrovascular events” and “End Organ Damage Resulting from Uncontrolled Hypertension” as occupational diseases. For cerebrovascular events to be compensable, the 2010 POEA-SEC outlines specific conditions that must be met:

12. CEREBROVASCULAR EVENTS

All of the following conditions must be met:

If the heart disease was known to have been present during employment, there must be proof that an acute exacerbation was clearly precipitated by an unusual strain by reasons of the nature of his work.

The strain of work that brings about an acute attack must be [of] sufficient severity and must be followed within 24 hours by the clinical signs of a cardiac insult to constitute causal relationship.

If a person who was apparently asymptomatic before being subjected to strain at work showed signs and symptoms of cardiac injury during the performance of his work and such symptoms and signs persisted, it is reasonable to claim a causal relationship.

If a person is a known hypertensive or diabetic, he should show compliance with prescribed maintenance and doctor-recommended lifestyle changes. The employer shall provide a workplace conducive for such compliance in accordance with Section 1 (A) paragraph 5.

In [sic] a patient not known to have hypertension or diabetes, as indicated on his last PEME[.]

Similarly, for hypertension to be deemed compensable, the guidelines are as follows:

Impairment of function of the organs such as kidneys, heart, eyes and brain under the following conditions considered compensable:

If a person is a known hypertensive or diabetic, he should show compliance with prescribed maintenance medications and doctor-recommended lifestyle changes. The employer shall provide a workplace conducive for such compliance in accordance with Section 1 (A) paragraph.

In [sic] a patient not known to have hypertension has the following on his last PEME: normal BP, normal CXR and ECG/treadmill.

The Court found that Onia’s work as an oiler, which involved maintaining ship engine parts and working in extreme temperatures with exposure to engine fumes and chemicals, contributed to his condition. The fact that Onia experienced stroke symptoms while performing his duties further solidified the connection between his work and his illnesses. This aligns with established jurisprudence, which states that a pre-existing illness does not bar compensation if it is aggravated by working conditions.

A crucial aspect of this case is the failure of the company-designated physician to issue a final and definite assessment of Onia’s disability within the prescribed 120 to 240-day period. The Court reiterated that a valid disability assessment must be complete and definite, including a clear disability rating. In the absence of such an assessment, the law presumes the disability to be total and permanent. The medical report provided by the company-designated physician merely described the risk factors and etiology of Onia’s illnesses without providing a final assessment of his disability or fitness to work. Thus, the Court concluded that Onia’s disability was total and permanent by operation of law, entitling him to disability benefits.

The Court clarified the timeline and obligations regarding disability assessments, stating that the employer is obligated to refer the seafarer to a company-designated physician who must provide a final and definite assessment within 120 days, extendable to 240 days if further treatment is needed. Because the company-designated physician failed to make a final assessment within this period, the Supreme Court favored the seafarer’s claim.

While the Court awarded Onia total and permanent disability benefits amounting to US$60,000.00, it denied his claim for moral and exemplary damages due to the lack of evidence showing bad faith or malice on the part of the respondents. However, the Court granted attorney’s fees equivalent to ten percent (10%) of the total award, recognizing that Onia was compelled to litigate to protect his valid claim. The monetary awards were also subjected to a legal interest of six percent (6%) per annum from the finality of the decision until full payment, as mandated by prevailing jurisprudence.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer, Rodelio Onia, was entitled to total and permanent disability benefits after suffering a stroke while employed, considering his pre-existing conditions and the lack of a final disability assessment from the company-designated physician.
What is the significance of the PEME in this case?	The Pre-Employment Medical Examination (PEME) is significant because it determines if a seafarer has pre-existing illnesses. In this case, the Court found that the seafarer’s conditions were detectable during the PEME, negating the company’s claim of concealment.
What constitutes concealment of a pre-existing illness?	Concealment, under the POEA-SEC, occurs when a seafarer knowingly fails to disclose an illness that cannot be diagnosed during the PEME. The illness must be undetectable through standard medical procedures during the examination.
What makes an illness work-related under the POEA-SEC?	Under the POEA-SEC, an illness is work-related if it is listed as an occupational disease under Section 32-A or if the seafarer’s working conditions significantly contributed to the development or aggravation of the illness.
What is the responsibility of the company-designated physician?	The company-designated physician must provide a final and definite assessment of the seafarer’s disability within 120 days of repatriation, which can be extended to 240 days if further medical treatment is required. This assessment must include a clear disability rating.
What happens if the company-designated physician fails to provide a final assessment?	If the company-designated physician fails to provide a final and definite assessment within the prescribed period, the seafarer’s disability is presumed to be total and permanent by operation of law, entitling them to disability benefits.
What disability benefits is the seafarer entitled to in this case?	The seafarer, Rodelio Onia, was entitled to US$60,000.00 in total and permanent disability benefits, as well as attorney’s fees equivalent to 10% of the total award.
Why were moral and exemplary damages denied in this case?	Moral and exemplary damages were denied because there was no sufficient evidence to prove that the respondents acted in bad faith or with malice in denying the seafarer’s claim for disability benefits.
What is the legal interest imposed on the monetary awards?	A legal interest of six percent (6%) per annum was imposed on the monetary awards from the finality of the decision until full payment, in accordance with prevailing jurisprudence.

This ruling underscores the importance of adhering to the procedural requirements outlined in the POEA-SEC to protect the rights of Filipino seafarers. The decision reinforces the principle that employers must ensure timely and thorough medical assessments are conducted and that seafarers are not unjustly denied benefits due to technicalities or delayed medical evaluations.

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: Rodelio R. Onia vs. Leonis Navigation Company, Inc., G.R. No. 256878, February 14, 2022

February 14, 2022

Diabetes and Hypertension: Establishing Work-Relatedness for Seafarer Disability Claims

The Supreme Court ruled that a seafarer’s illnesses, specifically diabetes mellitus and hypertension, are not automatically compensable as permanent total disability benefits. To be entitled to compensation, a seafarer must prove that the illness is work-related and existed during the term of their employment contract. The Court emphasized the importance of medical findings from company-designated physicians and the seafarer’s obligation to follow the conflict-resolution procedure outlined in the POEA-SEC when disputing medical assessments. This decision clarifies the burden of proof for seafarers claiming disability benefits due to illnesses that are not inherently occupational diseases.

Sailing Through Sickness: When Do Seafarer Ailments Warrant Disability?

The case of BW Shipping Philippines, Inc. v. Mario H. Ong revolves around a seafarer’s claim for permanent total disability benefits due to diabetes mellitus and hypertension. Mario H. Ong, employed by BW Shipping, sought compensation after being diagnosed with these conditions while working on board a vessel. The central legal question is whether Ong adequately demonstrated that his illnesses were work-related, thus entitling him to disability benefits under the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC).

The entitlement of an overseas seafarer to disability benefits is governed by the POEA-SEC, which is deemed incorporated into their employment contract. To be entitled to compensation, the seafarer must satisfy two conditions under Section 20(B), paragraph 6 of the 2000 POEA-SEC. First, the injury or illness must be work-related. Second, it must have existed during the term of the seafarer’s employment contract. In this case, the Court scrutinized whether Ong’s diabetes and hypertension met these criteria.

The Court emphasized that diabetes mellitus is not an occupational disease under Section 32-A of the POEA-SEC.

“Diabetes mellitus is a metabolic and a familial disease to which one is pre-disposed by reason of heredity, obesity or old age. It does not indicate work-relatedness and, by its nature, is more the result of poor lifestyle choices and health habits for which disability benefits are improper.”

This means that the mere diagnosis of diabetes does not automatically warrant disability benefits; the seafarer must prove a significant connection between the illness and their work conditions.

While essential hypertension is recognized as an occupational disease under Section 32A of the POEA-SEC, the Court clarified that not all cases of hypertension qualify for disability benefits. The POEA-SEC requires an element of gravity, specifically that hypertension must impair the function of body organs such as the kidneys, heart, eyes, and brain, resulting in permanent disability. The seafarer must provide real and substantial evidence of this impairment, not merely apparent symptoms.

The Supreme Court found that Ong failed to adequately demonstrate how his work responsibilities led to the acquisition of diabetes and hypertension, and how these conditions are correlated. Furthermore, Ong did not substantiate that his hypertension was severe enough to render him permanently and totally disabled from performing his duties as a seafarer. The Court noted that after Ong’s repatriation, he was promptly attended to by company-designated physicians, underwent a series of checkups and tests, and was provided with the necessary medication and treatment.

On October 2, 2008, just 104 days after Ong’s repatriation, the company-designated physician certified him as fit to resume sea duties. Interestingly, Ong did not immediately contest this finding. Instead, he waited over three months before consulting his own physician. The Court emphasized that the medical certificate from Ong’s personal physician, issued on January 12, 2009, lacked sufficient factual and medical support. The Court contrasted this with the thorough medical attention provided by the company-designated physicians, whose diagnoses were supported by laboratory tests showing normal results.

The Court underscored the significance of compliance with prescribed maintenance medications and lifestyle changes for seafarers with hypertension and/or diabetes. Even with these conditions, a seafarer can remain employed if the illnesses are controlled. The company-designated physicians initially validated Ong’s conditions but, after treatment and medication, found him fit to work, demonstrating the possibility of managing these illnesses effectively.

The Court also rejected Ong’s argument that his inability to work as a seafarer for more than 120 days from repatriation should automatically qualify his disability as permanent and total. The extent of a seafarer’s disability is determined not solely by the number of days unable to work, but by the disability grading provided by the doctor based on the resulting incapacity to work and earn wages.

Ultimately, the Court found that Ong did not comply with his obligation under Section 20(A)(3) of the POEA-SEC, which outlines the procedure for challenging the assessment of the company-designated physician. This provision requires the seafarer to disclose any conflicting medical assessments to the company and to signify an intention to resolve the disagreement by referral to a third doctor jointly agreed upon by the parties, whose decision would be final. Ong failed to follow this conflict-resolution procedure, leading the Court to uphold the diagnosis of the company-designated physician.

The Supreme Court, in this case, emphasized that the medical findings, evaluated in relation to the requirements of pertinent law and contract, did not support Ong’s claim for permanent total disability benefits.

FAQs

What was the key issue in this case?	The key issue was whether a seafarer’s diabetes mellitus and hypertension were work-related and severe enough to warrant permanent total disability benefits under the POEA-SEC.
What does the POEA-SEC require for disability claims?	The POEA-SEC requires that the illness or injury be work-related and exist during the term of the seafarer’s employment contract to be compensable.
Is diabetes mellitus considered an occupational disease under the POEA-SEC?	No, diabetes mellitus is not considered an occupational disease under Section 32-A of the POEA-SEC, requiring the seafarer to prove a work connection.
What about hypertension? Is that an occupational disease?	Yes, essential hypertension is recognized as an occupational disease, but it must be of such nature as indicative of impairment of the function of body organs, resulting in permanent disability.
What is the role of the company-designated physician in disability claims?	The medical assessment of the company-designated physician is given significant weight, especially if supported by laboratory tests and thorough medical attention.
What is the procedure for disputing the company-designated physician’s assessment?	The seafarer must disclose conflicting medical assessments and signify an intention to resolve the disagreement by referral to a third doctor jointly agreed upon by the parties.
What happens if the seafarer fails to follow the conflict-resolution procedure?	If the seafarer fails to follow the conflict-resolution procedure, the diagnosis of the company-designated physician will be upheld.
Does being unable to work for more than 120 days automatically qualify a seafarer for disability benefits?	No, the extent of disability is determined by the disability grading provided by the doctor, based on the resulting incapacity to work and earn wages, not solely by the number of days unable to work.
Can a seafarer with hypertension or diabetes still be employed?	Yes, a seafarer can still be employed if the conditions are controlled by compliance with prescribed maintenance medications and lifestyle changes.

This case serves as a reminder to seafarers of the importance of documenting their working conditions and any potential health risks they may encounter. It also emphasizes the need to follow the proper procedures for disputing medical assessments to ensure their rights are protected under the POEA-SEC.

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: BW SHIPPING PHILIPPINES, INC. vs. ONG, G.R. No. 202177, November 17, 2021

November 17, 2021

Seafarer’s Rights: Defining ‘Maximum Medical Improvement’ in Disability Claims

In the case of Ruthgar T. Parce v. Magsaysay Maritime Corporation, the Supreme Court clarified the standards for determining a seafarer’s entitlement to disability benefits, emphasizing the necessity of a clear and definitive medical assessment from the company-designated physician. The court ruled that a declaration of ‘maximum medical improvement’ alone does not equate to a fitness-to-work assessment. The ruling reinforces the importance of providing seafarers with proper medical assessments and protecting their rights to claim disability benefits when their ability to work at sea is compromised, ensuring fair treatment and adherence to contractual obligations under the POEA-SEC guidelines.

When Does ‘Maximum Medical Improvement’ Mean Fit to Work? A Seafarer’s Fight for Disability Benefits

Ruthgar T. Parce, a seasoned seafarer, had been employed by Magsaysay Maritime Agency, Inc. since 1992. In 2014, he was working as a Senior Electrical Fitter aboard the vessel ‘Golden Princess’ when he injured his left shoulder while lifting heavy objects. Despite initial treatment and pain management, the pain persisted, leading to his repatriation to the Philippines. Upon his return, Parce underwent treatment with Shiphealth, Inc., the company-designated physician. After several therapy sessions, he was informed that he had reached ‘maximum medical cure,’ and no further treatment would be provided.

However, Shiphealth issued a Final Medical Report indicating a diagnosis of rotator cuff tendinitis but without a clear declaration of Parce’s fitness to return to sea duties. A subsequent Memorandum from Princess Cruises considered Parce fit without restrictions based on this report. Still experiencing pain, Parce consulted another physician, Dr. Manuel Fidel Magtira, who declared him permanently unfit for sea duties. This divergence in medical opinions led Parce to request a referral to a third doctor, which Magsaysay denied. Consequently, Parce filed a complaint seeking disability benefits, arguing that the company-designated physician’s report was incomplete and did not accurately reflect his condition.

The Labor Arbiter ruled in favor of Parce, awarding him full disability benefits and attorney’s fees, a decision affirmed by the National Labor Relations Commission (NLRC). The NLRC emphasized that the company-designated physician’s report did not contain a definite assessment of Parce’s fitness for work, and the failure to provide such an assessment within the prescribed period rendered Parce’s disability total and permanent by operation of law. Magsaysay appealed to the Court of Appeals (CA), which reversed the labor tribunals’ decisions, citing Parce’s failure to immediately protest the medical assessment and a perceived delay in filing his complaint. This divergence in rulings set the stage for the Supreme Court’s intervention to clarify the requirements for determining a seafarer’s disability benefits.

The Supreme Court, in its analysis, emphasized that a seafarer’s entitlement to disability benefits is governed by Philippine laws, particularly Articles 191 to 193 of the Labor Code, and the provisions of the POEA-SEC, which are integrated into every seafarer’s employment contract. The Court highlighted Section 20(A)(3) of the 2010 POEA-SEC, which mandates that a seafarer must submit to a post-employment medical examination by a company-designated physician within three working days of their return. This section also outlines the process for resolving disagreements in medical assessments through a third doctor’s opinion. The Supreme Court stressed the importance of a complete and timely medical report from the company-designated physician in determining disability gradings, citing the Chan v. Magsaysay Maritime Inc. case to reinforce this requirement.

The Court found that the medical report issued by Magsaysay’s company-designated physician fell short of the requirements for a complete and definite assessment. The term ‘maximum medical improvement’ used in the report was deemed insufficient to indicate fitness for sea duty. The Supreme Court clarified that such a term merely suggests that the patient’s treatment has ended but does not equate to a declaration of fitness. Furthermore, the Court noted that Parce was not provided with a copy of the final medical report, which is essential for the seafarer to properly contest and evaluate the medical assessment, as stipulated in the POEA-SEC. This failure to provide a conclusive and definite assessment from the company-designated physician relieved Parce of the burden to initiate a referral to a third doctor, as his disability became permanent by operation of law. In the Salas v. Transmed Manila Corporation, et al. case, it was clearly stated that

The responsibility of the company-designated physician to arrive at a definite assessment within the prescribed period necessitates that the perceived disability rating has been properly established and inscribed in a valid and timely medical report. To be conclusive and to give proper disability benefits to the seafarer, this assessment must be complete and definite; otherwise, the medical report shall be set aside and the disability grading contained therein shall be ignored.

The Supreme Court underscored the importance of providing seafarers with a copy of their final medical report. Quoting Section 20 of the POEA-SEC, the court reiterated that, ‘When requested, the seafarer shall be furnished a copy of all pertinent medical reports or any records at no cost to the seafarer.’ Citing Gere v. Anglo-Eastern Crew Management Phils., Inc., the Court emphasized that denying a seafarer the opportunity to evaluate their medical assessment invalidates the report. In light of these considerations, the Supreme Court reversed the Court of Appeals’ decision, reinstating the NLRC’s ruling that Magsaysay Maritime Corporation and Princess Cruises Ltd. were jointly and severally liable to pay Ruthgar T. Parce permanent disability benefits.

The Court affirmed the award of attorney’s fees, finding it justified under Article 2208 of the New Civil Code, as Parce was compelled to litigate to pursue his disability benefits. However, the claims for moral and exemplary damages were denied due to a lack of substantial evidence showing that Magsaysay and Princess Cruises acted with malice or bad faith. The Supreme Court’s decision clarified the interpretation of ‘maximum medical improvement’ in seafarer disability claims, underscoring the necessity of a clear, definite, and communicated assessment of fitness to work from the company-designated physician.

FAQs

What was the key issue in this case?	The key issue was whether the medical report issued by the company-designated physician, indicating “maximum medical improvement” without a clear statement of fitness to work, was sufficient to deny the seafarer’s claim for disability benefits.
What does “maximum medical improvement” mean?	“Maximum medical improvement” means that the seafarer has reached the point where further medical treatment will not significantly improve their condition, but it does not necessarily mean they are fit to return to work.
What is the role of the company-designated physician?	The company-designated physician is responsible for providing a complete and definite assessment of the seafarer’s medical condition, including a clear statement of fitness to work or a disability rating.
What happens if the seafarer disagrees with the company doctor?	If the seafarer disagrees with the company doctor’s assessment, they can consult their own physician, and if there is still disagreement, a third, independent doctor can be jointly chosen to provide a final and binding opinion.
What is the POEA-SEC?	The POEA-SEC (Philippine Overseas Employment Administration-Standard Employment Contract) is a standard employment contract that governs the rights and obligations of Filipino seafarers and their employers.
What is the significance of Section 20(A)(3) of the POEA-SEC?	Section 20(A)(3) of the POEA-SEC outlines the procedures and timelines for medical examinations and assessments of seafarers who suffer work-related injuries or illnesses, including the process for resolving disputes in medical opinions.
Can a seafarer claim disability benefits even without a third doctor’s opinion?	Yes, if the company-designated physician fails to provide a complete and definite assessment of the seafarer’s fitness to work within the prescribed period, the seafarer’s disability may be considered permanent by operation of law, entitling them to benefits without needing a third doctor.
What did the Supreme Court rule regarding attorney’s fees in this case?	The Supreme Court affirmed the award of attorney’s fees to the seafarer, as he was compelled to litigate to pursue his rightful disability benefits.

This case highlights the importance of clear and definitive medical assessments for seafarers seeking disability benefits. The Supreme Court’s ruling reinforces the obligation of employers to ensure that company-designated physicians provide comprehensive reports and that seafarers are informed of their medical status, ultimately protecting the rights of Filipino seafarers under the POEA-SEC.

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: Ruthgar T. Parce v. Magsaysay Maritime Corporation, G.R. No. 241309, November 11, 2021

November 11, 2021

Mental Health and Seafarer’s Rights: Understanding Work-Related Illness Compensation

In Efraim Daut Darroca, Jr. v. Century Maritime Agencies, Inc., the Supreme Court addressed the compensability of a seafarer’s mental illness, specifically major depression with psychotic features. The Court denied Darroca’s claim for disability benefits, holding that he failed to sufficiently prove that his illness was work-related. This decision clarifies the burden of proof for seafarers claiming disability benefits due to mental health conditions and emphasizes the importance of establishing a clear link between their work environment and their illness. The ruling also highlights the legal standards and evidentiary requirements necessary to successfully claim compensation for work-related illnesses under the POEA-SEC.

Navigating the Storm: Did Seafarer’s Depression Arise from the High Seas?

Efraim Daut Darroca, Jr., a seafarer with years of experience, sought disability benefits after being diagnosed with major depression with psychotic features. He claimed his condition arose from his work environment on board the vessel MT “Dynasty.” Century Maritime Agencies, Inc., his employer, contested the claim, arguing the illness was not work-related. The case wound its way through labor tribunals and appellate courts, ultimately reaching the Supreme Court. The central legal question was whether Darroca successfully proved a causal connection between his work as a seafarer and his mental illness, entitling him to disability benefits under the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC).

The Supreme Court began its analysis by reiterating that, under the POEA-SEC, an illness must be work-related and must have existed during the term of the seafarer’s employment contract to be compensable. The Court emphasized that it is not enough to simply show the seafarer is disabled; there must be a direct link between the job and the illness. The POEA-SEC defines a work-related illness as “any sickness as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.” For illnesses not specifically listed, a disputable presumption arises in favor of the seafarer, suggesting the illness is work-related. However, this presumption only extends to work-relatedness, not to the overall compensability of the illness.

Building on this principle, the Court clarified that even with the presumption of work-relatedness, a seafarer must still meet the conditions for compensability outlined in Section 32-A of the POEA-SEC. This section stipulates that, for an occupational disease to be compensable, the seafarer’s work must involve described risks, the disease must result from exposure to those risks, the disease must be contracted within a specific period of exposure, and there must be no notorious negligence on the part of the seafarer. This means seafarers must present substantial evidence to support their claim, even when their illness is not specifically listed as an occupational disease.

In Darroca’s case, the Supreme Court found he failed to provide sufficient evidence to establish that his major depression with psychotic features was work-related. The Court noted that Darroca did not adequately describe his specific duties on board the MT “Dynasty” or demonstrate how his work environment contributed to his condition. His statement about experiencing dizziness from chemical fumes was considered too general to establish a causal link. The court stated that:

…aside from his bare statement that he worked as an able seaman on board MT “Dynasty,” records are bereft of any showing what his specific duties were. Moreover, his general assertion of experiencing “dizziness when he smells the fumes of chemicals he was working on” is insufficient to conclude that his work brought about or increased the risk of his depression.

The Court also pointed to an affidavit signed by Darroca, stating that he was employed under fair working conditions and did not experience maltreatment or traumatic incidents onboard. This affidavit further weakened his claim that his work environment contributed to his mental illness. The Supreme Court agreed with the lower courts that Darroca had not met the burden of proving a causal connection between his work and his illness, thus negating his claim for disability benefits. While the legal presumption initially favored Darroca, the employer successfully presented evidence to overturn it.

Furthermore, the Supreme Court addressed the Court of Appeals’ statement that mental diseases must result from a traumatic head injury to be compensable. The Court clarified that this is not always the case. Mental illnesses like schizophrenia can be compensable if proven to be work-related. Citing Leonis Navigation Co., Inc. v. Obrero, the Court noted that a seafarer’s work environment can increase the risk of developing or triggering mental disorders. Additionally, in Career Philippines Shipmanagement, Inc. v. Godinez, the Court recognized that traumatic head injuries, under Section 32 of the POEA-SEC, can include mental or emotional damage, not just physical damage. The court stated that:

…”traumatic head injury” does not only involve physical damage but mental or emotional damage as well.

This clarification underscores the evolving understanding of compensable illnesses to include mental health conditions, provided they meet the necessary criteria for work-relatedness. However, the court reiterated that the seafarer bears the responsibility of demonstrating that his work conditions caused or aggravated his mental illness. The Court ultimately concluded that the lower courts did not err in denying Darroca’s claim. The lack of sufficient evidence linking his work environment to his mental illness was the determining factor in the denial of his claim. The Court emphasized the importance of providing concrete evidence of work-related risks and exposures when claiming disability benefits for mental health conditions. This case also underscores the challenges seafarers face in proving the work-relatedness of mental illnesses, which often require detailed documentation of job duties, working conditions, and medical evidence.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer, Efraim Daut Darroca, Jr., sufficiently proved that his major depression with psychotic features was work-related, entitling him to disability benefits under the POEA-SEC. The court ultimately decided he did not provide enough evidence.
What is the POEA-SEC?	The Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) sets the terms and conditions of employment for Filipino seafarers. It outlines the rights and obligations of both the seafarer and the employer, including provisions for disability benefits.
What does it mean for an illness to be “work-related” under the POEA-SEC?	Under the POEA-SEC, a work-related illness is any sickness resulting from an occupational disease listed in the contract, or any illness caused or aggravated by the seafarer’s working conditions. It must be proven that the job duties contributed to the development or worsening of the illness.
What is the significance of the disputable presumption in favor of the seafarer?	The disputable presumption means that illnesses not listed as occupational diseases are presumed to be work-related, shifting the burden of proof to the employer to demonstrate otherwise. However, the seafarer must still prove the conditions for compensability.
What kind of evidence is needed to prove a mental illness is work-related for a seafarer?	Seafarers need to provide detailed evidence of their job duties, working conditions, and medical records linking their illness to their work environment. Affidavits from coworkers or supervisors can also bolster their claim.
Can mental or emotional damage be considered a “traumatic head injury” under the POEA-SEC?	Yes, the Supreme Court has clarified that “traumatic head injury” under the POEA-SEC is not limited to physical damage but can include mental or emotional damage resulting from work-related stress or incidents. This means that the injury doesn’t necessarily have to be physical.
What happens if there is a conflict between the company-designated physician and the seafarer’s personal doctor?	Under the POEA-SEC, if there is a disagreement between the company-designated physician and the seafarer’s doctor, the seafarer can consult a third, independent doctor to resolve the conflict. The third doctor’s opinion is considered binding.
What is the role of the company-designated physician in disability claims?	The company-designated physician is responsible for examining the seafarer and determining the nature and extent of their illness or injury. Their assessment is crucial in determining whether the seafarer is entitled to disability benefits.

This case serves as a crucial reminder for seafarers to meticulously document their working conditions and any health issues that arise during their employment. Understanding the legal requirements for claiming disability benefits, particularly for mental health conditions, is essential for protecting their rights. Future cases may further refine the evidentiary standards for proving the work-relatedness of mental illnesses in the maritime industry.

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: EFRAIM DAUT DARROCA, JR. VS. CENTURY MARITIME AGENCIES, INC., G.R. No. 234392, November 10, 2021

November 10, 2021

The 240-Day Rule: Protecting Seafarers’ Rights to Full Disability Benefits in the Philippines

The Supreme Court has clarified the application of the 240-day rule in determining seafarers’ entitlement to permanent and total disability benefits. The Court held that a seafarer is not automatically entitled to permanent and total disability benefits simply because the company-designated physician exceeded the 120-day period for medical assessment. The extension to 240 days is permissible if justified by the need for further medical treatment, but failure to provide such justification within the initial 120 days can result in the seafarer’s disability being deemed permanent and total. This decision underscores the importance of timely and well-supported medical assessments in safeguarding seafarers’ rights.

When a Back Injury at Sea Leads to a Dispute Over Disability: Rodriguez vs. Philippine Transmarine Carriers

This case revolves around Edgar Rodriguez, a seafarer who sustained a back injury while working on board a vessel. The central legal question is whether Rodriguez is entitled to permanent and total disability benefits, given the differing medical assessments provided by the company-designated physician and his personal doctor. This issue is further complicated by the timeline of medical evaluations and the applicability of the 120/240-day rule in Philippine maritime law. The Supreme Court’s decision clarifies the obligations of employers and the rights of seafarers in disability claims.

The facts show that Rodriguez, employed as an ordinary seaman, suffered a back injury in June 2012 while lifting heavy loads on the MV Thorscape. Upon reaching Taiwan, he was diagnosed with Hepatomegaly; L5 Spondylosis with Lumbar Spondylosis and repatriated. He was then referred to Dr. Robert Lim, the company-designated physician, who, after a series of examinations, diagnosed him with several conditions, including Antral Gastritis; H. Pylori Infection; Non-Specific Hepatic Nodule; L2-S1 Disc Protrusion and incidental finding of Specific Colitis; Cholecystitis. Despite recommendations for surgery, Rodriguez opted for conservative treatment. Dr. Lim initially issued an interim disability assessment and later a final assessment of Grade 8 disability. Dissatisfied, Rodriguez consulted Dr. Cesar Garcia, his personal orthopedic surgeon, who declared him permanently unfit for sea duty with a Grade 1 disability, equivalent to permanent total disability.

A critical aspect of this case is the application of the 2010 POEA-SEC, which governs the employment terms of Filipino seafarers. This contract specifies the obligations of the employer regarding medical attention and disability benefits. The 2010 POEA-SEC, along with the Labor Code, provides the legal framework for determining the extent of Rodriguez’s entitlement to compensation. The interplay between these regulations and the timeline of medical assessments forms the crux of the legal analysis. Specifically, the case underscores the importance of the company-designated physician’s role in providing a timely and well-supported assessment.

The Labor Arbiter initially ruled in favor of Rodriguez, awarding him permanent and total disability benefits. The LA reasoned that Dr. Lim’s final assessment was issued beyond the 120-day period from Rodriguez’s repatriation, thus classifying the disability as Grade 1. The National Labor Relations Commission (NLRC) affirmed this decision, albeit deleting the award for moral damages. However, the Court of Appeals reversed the NLRC’s ruling, holding that the assessment was made within the allowable 240-day period and upholding Dr. Lim’s Grade 8 disability assessment. The Court of Appeals emphasized that temporary total disability becomes permanent only when declared by the company physician within the allowed periods or upon the expiration of the 240-day period without a declaration of fitness to work or permanent disability.

The Supreme Court, in its decision, delved into the intricacies of the 120/240-day rule, clarifying its application in seafarer disability claims. The Court cited Article 192(c)(1) of the Labor Code, which defines permanent total disability, and Rule X, Section 2 of the IRR, which implements Book IV of the Labor Code, providing the income benefit shall not be paid longer than 120 consecutive days except where such injury or sickness still requires medical attendance beyond 120 days but not to exceed 240 days. These provisions, in conjunction with Section 20(A) of the 2010 POEA-SEC, outline the employer’s obligations regarding medical attention and sickness allowance. A crucial element of the case is the interpretation of the 2010 POEA-SEC, which specifies the obligations of the employer to provide medical attention and sickness allowance.

The Court emphasized the landmark case of Vergara v. Hammonia Maritime Services, Inc., which harmonized the provisions of the POEA-SEC, the Labor Code, and its IRR. The Vergara ruling established that the seafarer must report to the company-designated physician within three days of arrival for diagnosis and treatment. The seafarer is considered temporarily and totally disabled for up to 120 days, receiving basic wage during this period. If further medical attention is required beyond 120 days, the period may be extended to a maximum of 240 days, during which the employer may declare a permanent partial or total disability. It’s a balancing act, ensuring the seafarer receives adequate care while providing employers with a reasonable timeframe for assessment.

The Court distinguished between cases filed before and after October 6, 2008, the date of the Vergara decision. For complaints filed after this date, the 240-day rule applies, allowing for an extension of the medical evaluation period. However, this extension is not automatic. A claim for permanent and total disability benefits may prosper after the initial 120-day period if the company-designated physician fails to declare within this period that the seafarer requires further medical attention. This requirement ensures that seafarers are not left in limbo indefinitely, awaiting a medical assessment. The Supreme Court underscores that a lack of timely justification for extending the treatment period can lead to the disability being classified as permanent and total.

The Court also addressed scenarios where the failure to issue a timely medical assessment is due to the seafarer’s fault, such as refusal of medical treatment. In such cases, a claim for permanent and total disability benefit may be denied. The Court cited cases like Splash Phils., Inc. v. Ruizo, where the seafarer cut short his sessions with the doctor and missed an important medical procedure. Similarly, in New Filipino Maritime Agencies, Inc. v. Despabeladeras, the seafarer failed to complete his treatment, preventing the company-designated physician from making a proper assessment. These cases illustrate that seafarers have a responsibility to cooperate with medical treatment to avail themselves of disability benefits.

Furthermore, the Supreme Court highlighted the mandatory nature of seeking a third doctor’s opinion in case of conflicting medical assessments. Section 20(A) of the 2010 POEA-SEC stipulates that if the seafarer’s appointed doctor disagrees with the company-designated physician’s assessment, a third doctor, jointly agreed upon, should provide a final and binding decision. In the absence of a third doctor’s opinion, the medical assessment of the company-designated physician should prevail. This provision aims to resolve disputes fairly and efficiently, ensuring that both parties have an opportunity to present their case.

Applying these principles to Rodriguez’s case, the Court found that Dr. Lim’s final medical assessment was justifiably issued within 240 days from the time Rodriguez first reported to him. The Court noted that Dr. Lim’s interim assessment provided sufficient justification for extending the medical treatment beyond 120 days, citing Rodriguez’s persistent back problems and the need for further evaluation. Additionally, Rodriguez failed to seek a third doctor’s opinion despite the conflicting assessments from Dr. Lim and Dr. Garcia. Consequently, the Court upheld Dr. Lim’s assessment of Grade 8 disability, entitling Rodriguez only to partial and permanent disability benefits.

The Supreme Court’s decision reinforces the importance of adhering to the procedural requirements outlined in the POEA-SEC and related regulations. Seafarers must comply with the mandatory reporting requirements and cooperate with medical treatment. Employers, on the other hand, must ensure that company-designated physicians provide timely and well-supported medical assessments, justifying any extension of the treatment period beyond 120 days. The mandatory third-party opinion serves as a crucial mechanism for resolving conflicting assessments and ensuring fair outcomes for both parties. These procedural safeguards are essential for protecting the rights of seafarers and promoting transparency in disability claims.

FAQs

What was the key issue in this case?	The central issue was whether the seafarer, Edgar Rodriguez, was entitled to permanent and total disability benefits or only partial disability benefits based on conflicting medical assessments and the application of the 120/240-day rule. The Supreme Court ultimately ruled that Rodriguez was only entitled to partial disability benefits.
What is the 120/240-day rule?	The 120/240-day rule refers to the period within which a company-designated physician must provide a final medical assessment of a seafarer’s disability. The initial period is 120 days, which can be extended to a maximum of 240 days if further medical treatment is required and justified.
When does the 120-day period begin?	The 120-day period begins from the time the seafarer reports to the company-designated physician for post-employment medical examination. This initial report must occur within three working days upon the seafarer’s return, except when physically incapacitated.
What happens if the company doctor exceeds the 120-day period?	If the company-designated physician exceeds the 120-day period without a justifiable reason or without declaring the need for further treatment, the seafarer’s disability may be considered permanent and total. However, if an extension is justified, the period can be extended up to 240 days.
Is a seafarer automatically entitled to total disability after 120 days?	No, a seafarer is not automatically entitled to total disability benefits after 120 days. The medical evaluation period can be extended to 240 days if the seafarer requires further medical attention, as determined and justified by the company-designated physician.
What should a seafarer do if their doctor disagrees with the company doctor?	If the seafarer’s personal doctor disagrees with the assessment of the company-designated physician, the POEA-SEC mandates that a third doctor, jointly agreed upon by both parties, should be consulted. The third doctor’s decision will be final and binding.
What is the effect of failing to consult a third doctor?	Failing to consult a third doctor in case of conflicting medical assessments means that the assessment of the company-designated physician will prevail. This is because the company doctor’s assessment is considered more credible due to the extended period of medical attendance and diagnosis.
What is the seafarer’s responsibility during the medical assessment period?	The seafarer has a responsibility to comply with the mandatory reporting requirements, attend medical appointments, and cooperate with the prescribed medical treatment. Failure to do so may result in the forfeiture of the right to claim disability benefits.
Can a seafarer claim disability benefits even before the end of the 240-day period?	Generally, no. A seafarer’s disability claim will not ripen into a cause of action for total and permanent disability until the 240-day period has lapsed or the company-designated physician has issued a final assessment, unless the failure to do so is without justifiable reason.

This case highlights the importance of understanding the nuances of maritime law, particularly the rules governing disability claims for seafarers. The Supreme Court’s decision provides valuable guidance on the application of the 120/240-day rule and the obligations of both employers and seafarers in ensuring fair and timely resolution of disability claims.

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: Dolores Gallevo Rodriguez vs. Philippine Transmarine Carriers, Inc., G.R. No. 218311, October 11, 2021

October 11, 2021

Seafarer’s Rights: Work-Related Illness and the Burden of Proof in Disability Claims

In a significant ruling, the Supreme Court has affirmed the rights of seafarers to disability benefits when illnesses are contracted during their employment. This decision clarifies the burden of proof in establishing work-relatedness, especially when the illness is not explicitly listed as an occupational disease. The court emphasized that a disputable presumption exists in favor of the seafarer, requiring employers to provide a sufficient basis to refute the connection between the illness and the working conditions. This ruling offers crucial protection for seafarers, ensuring they receive just compensation for health issues arising from their service.

When a Laundryman’s Illness Unravels the Presumption of Work-Relatedness

Wero Jocosol Grona, a laundryman on the M/V Queen Elizabeth, suffered a bout of fever and flu-like symptoms during his employment. After being treated in Mexico, Grona was diagnosed with ruptured diverticulitis. Upon repatriation to the Philippines, the company-designated physician declared his condition as non-work-related, leading to the denial of disability benefits. The central legal question emerged: Is diverticulitis a work-related illness entitling Grona to compensation, and what evidence is sufficient to overcome the presumption in favor of the seafarer?

The Supreme Court began its analysis by recognizing that while diverticulitis is not specifically listed as an occupational disease under Section 32 of the 2010 POEA-SEC, it falls under the broader category of “Abdomen – Severe residuals of impairment of intra-abdominal organs which requires regular aid and attendance that will unable worker to seek any gainful employment.” This classification corresponds to a Grade 1 disability, indicating total and permanent disablement. Common sense dictates that the residuals of the impairment of Grona’s intra-abdominal organs are severe. The respondents recognized such severity when it enumerated the long list of ailments and the numerous procedures that Grona underwent after he was assessed with infection of the abdominal cavity in Mexico and eventually diagnosed with diverticulitis upon repatriation in the Philippines.

Building on this, the Court invoked Section 20(A)(4) of the 2010 POEA-SEC, which provides a disputable presumption of work-relation for illnesses not listed in Section 32. This presumption arises when a seafarer suffers an illness or injury during the term of their contract. The burden then shifts to the employer to prove that the illness is not work-related. As the Court explained in Ventis Maritime Corporation v. Salenga:

The disputable presumption of work-relatedness provided in paragraph 4 above arises only if or when the seafarer suffers from an illness or injury during the term of the contract and the resulting disability is not listed in Section 32 of the POEA-SEC. That paragraph 4 above provides for a disputable presumption because the injury or illness is suffered while working at the vessel. Thus, or stated differently, it is only when the illness or injury manifests itself during the voyage and the resulting disability is not listed in Section 32 of the POEA-SEC will the disputable presumption kick in. This is a reasonable reading inasmuch as, at the time the illness or injury manifests itself, the seafarer is in the vessel, that is, under the direct supervision and control of the employer, through the ship captain.

Therefore, the Court emphasized that the statutory presumption stands unless refuted by the employer. The employer can only overcome this presumption of work-relation if there is a sufficient basis to support the assessment that the seafarer’s illness was not work-related. The mere finding that the illness is not work-related is not automatically a valid medical assessment.

The Court found the respondents’ assessment lacking. The medical assessment merely defined diverticulitis but failed to provide a reasonable professional inference as to how Grona contracted the condition. While acknowledging the numerous procedures Grona underwent, the respondents did not present results from diagnostic tools demonstrating that Grona was exposed to the causes of diverticulitis (low fiber diet, constipation, and obesity) without any relation to his work as a laundryman.

The Court also noted the contradiction in the company-designated physicians’ statements. Dr. Olalia issued a medical certificate stating that diverticulitis refers to inflammation associated with diverticulosis, which cannot be acquired from dietary provisions. In light of these inconsistencies, the Court concluded that there was no sufficient medical assessment of non-work relation, thus failing to overturn the presumption of work-relation in favor of Grona.

The Court also addressed the respondents’ argument that Grona did not prove a causal connection between his illness and nature of work. The Court clarified that the general conditions enumerated under Section 32-A of the 2010 POEA-SEC are used to prove work-relation only when the illness is suffered after the term of the contract. Because Grona suffered his illness during the term of the contract, these conditions did not apply.

The Supreme Court then discussed the importance of a final and definitive medical assessment. The company-designated physician has 120 days, extendable to 240 days, from the seafarer’s repatriation to issue this assessment. Without a final and definitive medical assessment from the company-designated physician within the 120-days or 240-day extended period, the law steps in to consider the seafarer’s disability as total and permanent. Here, while the company-designated physicians issued a medical certificate stating that diverticulitis is not work-related, such medical assessment of non-work relation is not sufficient. Because the medical assessment was premature and far from being final since additional assessments may still be made up to November 7, 2015, or the expiration of the 240-day extended period, Grona is entitled to total and permanent disability benefits by operation of law.

Lastly, the Court addressed the opinion of a third doctor. While the 2010 POEA-SEC provides that the third doctor’s decision shall be final and binding on both parties, there was no third doctor appointed by both parties whose decision would be binding on the parties. Hence, it is up to the labor tribunal and the courts to evaluate and weigh the merits of the medical reports of the company-designated doctor and the seafarer’s doctor. Moreover, Grona cannot be faulted for not complying with the third-doctor referral provision of the 2010 POEA-SEC. As already explained, there was no final and definitive disability grading issued within the 120-day or 240-extended period.

Despite recognizing the respondents’ efforts to provide medical assistance to Grona, the Court awarded him disability benefits, reimbursement of medical expenses, and attorney’s fees. The Court found no bad faith on the part of the respondents to justify the award for moral and exemplary damages.

FAQs

What was the key issue in this case?	The central issue was whether Grona’s diverticulitis was a work-related illness entitling him to disability benefits under the 2010 POEA-SEC. The Court also examined the sufficiency of evidence to overcome the presumption in favor of the seafarer.
What is the disputable presumption of work-relatedness?	Section 20(A)(4) of the 2010 POEA-SEC provides a disputable presumption that an illness suffered by a seafarer during their employment is work-related. This shifts the burden to the employer to prove otherwise.
What constitutes a sufficient medical assessment from the company-designated physician?	A sufficient assessment must be final and definitive, reflecting the true extent of the seafarer’s sickness or injuries. It must also be based on medically acceptable diagnostic tools and methods, and provide reasonable professional inferences.
What is the 120/240-day rule?	The company-designated physician has 120 days from the seafarer’s repatriation to issue a final and definitive disability assessment. This period may be extended to 240 days if the seafarer requires further medical attention.
What happens if the company-designated physician fails to issue a final assessment within the 120/240-day period?	If no final assessment is made within the prescribed period, the law considers the seafarer’s disability as total and permanent. This entitles the seafarer to disability benefits.
What is the role of a third doctor in disability claims?	If the seafarer’s doctor disagrees with the company-designated physician, a third doctor may be jointly agreed upon. The third doctor’s decision is final and binding on both parties.
When are the general conditions under Section 32-A of the 2010 POEA-SEC used?	The general conditions under Section 32-A of the 2010 POEA-SEC are used to prove work-relation only when the illness is suffered after the term of the contract. The seafarer’s work must involve the risks described, the disease was contracted as a result of the seafarer’s exposure to the described risks, the disease was contracted within a period of exposure and under such other factors necessary to contract it; and there was no notorious negligence on the part of the seafarer.
What benefits is a seafarer entitled to if their illness is deemed work-related?	A seafarer with a work-related illness is entitled to disability benefits, reimbursement of medical expenses, and attorney’s fees. The specific amount of disability benefits depends on the disability grade assigned.

This Supreme Court decision reinforces the protection afforded to seafarers under Philippine law, particularly in cases where the work-relatedness of an illness is disputed. By clarifying the burden of proof and emphasizing the importance of a thorough and well-supported medical assessment, the Court has ensured that seafarers receive the compensation they deserve for illnesses contracted during their service.

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: WERO JOCOSOL GRONA VS. SINGA SHIP MANAGEMENT PHILS. INC., G.R. No. 247532, October 06, 2021

October 6, 2021

The Unsigned Assessment: Seafarer Entitled to Disability Benefits Despite ‘Fitness’ Certification

In Avior Marine, Inc. v. Turreda, the Supreme Court affirmed that a seafarer, Arnaldo R. Turreda, was entitled to total and permanent disability benefits due to an incomplete and questionable medical assessment by the company-designated physician. The court emphasized the importance of a final, definitive, and scientifically supported disability assessment to protect seafarers’ rights, especially when their health conditions are uncertain. This ruling underscores the legal responsibility of employers to ensure thorough and unbiased medical evaluations, and to actively participate in resolving disputes regarding a seafarer’s fitness for duty.

Navigating Murky Waters: Can a Hasty ‘Fit to Work’ Certification Sink a Seafarer’s Disability Claim?

Arnaldo R. Turreda, a Chief Cook employed by Avior Marine, Inc., experienced severe headaches while aboard the vessel Water Phoenix. After being repatriated due to his condition, he underwent medical examinations by the company-designated physician. While initially diagnosed with several health issues, including hypertension and heart-related conditions, he was abruptly declared fit to work just three weeks later. Concerned about his persistent symptoms, Turreda sought a second opinion from his own doctor, who deemed him unfit for sea duty. This divergence in medical opinions led to a legal battle over Turreda’s entitlement to disability benefits, with the core question being whether the company-designated physician’s assessment was sufficient to deny his claim.

The Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC) governs the rights and obligations of seafarers and their employers. According to the POEA-SEC, a work-related illness is defined as “any sickness resulting to disability or death as a result of an occupational disease listed under Section 32-A of this Contract with the conditions set therein satisfied.” This definition highlights the importance of determining whether a seafarer’s illness is linked to their work environment and conditions.

Notably, the Supreme Court has previously recognized hypertensive cardiovascular disease as an occupational disease under certain circumstances, as elucidated in Bautista v. Elburg Shipmanagement Philippines, Inc., et al. The Court stipulated that for a seafarer to claim compensation for hypertensive cardiovascular disease, they must demonstrate that the disease was contracted under specific conditions, such as an acute exacerbation due to unusual strain from their work or the onset of symptoms during work performance. In this case, Avior Marine argued that Turreda’s illness was merely a simple migraine, not a work-related condition. However, the Court found compelling evidence suggesting otherwise.

The court noted that the prompt repatriation and subsequent medical tests conducted by the company-designated physician indicated a more serious underlying condition than a simple migraine. The fact that Turreda was prescribed medications for high blood pressure and underwent cardiac evaluations suggested that he was indeed suffering from hypertensive cardiovascular disease. Furthermore, the Court emphasized that Turreda had been declared fit for sea duty prior to his employment, implying that his cardiovascular issues arose during his time aboard the Water Phoenix. This aligns with the POEA-SEC provision recognizing a causal relationship between the disease and the seafarer’s job when symptoms manifest during employment.

“A party in whose favor the legal presumption exists may rely on and invoke such legal presumption to establish a fact in issue. The effect of a presumption upon the burden of proof is to create the need of presenting evidence to overcome the prima facie case created thereby which, if no contrary proof is offered, will prevail.”, Bautista v. Elburg Shipmanagement Philippines, Inc. et al. In disability claims, the POEA-SEC outlines a specific procedure for resolving disputes regarding medical assessments. If the seafarer’s doctor disagrees with the company-designated physician’s assessment, the parties may jointly agree to consult a third doctor, whose decision shall be final and binding. This process ensures an impartial resolution based on expert medical opinion.

The case of INC Navigation Co. Philippines, Inc., et al. v. Rosales, clarifies that the burden of initiating the third doctor provision lies with the company once the seafarer challenges the company doctor’s assessment. The Court emphasized that the company must actively respond by setting into motion the process of choosing a third doctor. In Ilustricino v. NYK-FIL Ship Management, Inc., et al., the Court further underscored the importance of the employer’s response to the seafarer’s request for a third-doctor referral. The court highlighted that the burden to refer the case to a third doctor shifts to the respondents upon being notified of the petitioner’s intent to dispute the company doctors’ findings.

In Turreda’s case, he notified Avior Marine of the conflicting medical assessments and requested a third-doctor referral, but the company failed to initiate the process. While Avior Marine argued that the request was made after the case had already been filed, the Court clarified that the POEA-SEC does not specify a timeframe for seeking a third opinion, allowing it even during labor tribunal proceedings. Since no third doctor was appointed, the Court proceeded to evaluate the medical reports, emphasizing the importance of a final, complete, and definitive disability assessment. To be conclusive, the medical assessment or report of the company-designated physician should be complete and definite to provide the appropriate disability benefits to seafarers.

The court found the company-designated physician’s assessment to be lacking in several respects. First, the physician issued a certificate of fitness to work just three weeks after advising Turreda to continue medication for high blood pressure and related conditions. Second, the assessment lacked supporting documentation, such as laboratory results and specialist reports. Third, the medical reports were unsigned, further casting doubt on their validity. Clear bias on the part of the company-designated physician may be shown if there is no scientific relation between the diagnosis and the symptoms felt by the seafarer, or if the final assessment of the company-designated physician is not supported by the medical records of the seafarer.

Because of the incomplete, questionable, and unsubstantiated nature of the company-designated physician’s assessment, the Supreme Court affirmed the lower courts’ decisions, holding that Turreda was entitled to total and permanent disability benefits. This case reinforces the importance of a thorough and unbiased medical evaluation in determining a seafarer’s fitness for duty and entitlement to disability benefits. The court emphasized that employers must ensure that medical assessments are complete, definitive, and supported by sufficient medical evidence.

FAQs

What was the key issue in this case?	The key issue was whether the company-designated physician’s assessment was sufficient to deny the seafarer’s claim for total and permanent disability benefits, considering the incomplete and questionable nature of the assessment.
What is a work-related illness under the POEA-SEC?	A work-related illness is any sickness resulting in disability or death as a result of an occupational disease listed under Section 32-A of the POEA-SEC, provided the conditions set therein are satisfied. This definition requires a clear link between the illness and the seafarer’s work.
Under what conditions is hypertensive cardiovascular disease considered an occupational disease for seafarers?	Hypertensive cardiovascular disease is considered an occupational disease if it was known to be present during employment and an acute exacerbation was clearly precipitated by the unusual strain of the seafarer’s work, the strain of work brought about an acute attack followed within 24 hours by clinical signs, or if a person was asymptomatic before work and showed signs during work.
What happens when the company-designated physician and the seafarer’s doctor disagree on the medical assessment?	The POEA-SEC provides that a third doctor may be agreed jointly between the Employer and the seafarer, and the third doctor’s decision shall be final and binding on both parties. The burden of initiating the third doctor provision lies with the company once the seafarer challenges the company doctor’s assessment.
What are the requirements for a valid disability assessment by the company-designated physician?	A valid disability assessment must be final, complete, and definitive, reflecting the true extent of the seafarer’s illness or injuries and their capacity to resume sea duties. It must also be supported by sufficient medical evidence and free from bias.
What happens if the company fails to initiate the process of choosing a third doctor?	If the company fails to initiate the process of choosing a third doctor after being notified of the disagreement, the assessment of the company-designated physician is not binding. The court will then evaluate the medical reports and evidence presented by both parties.
Why was the company-designated physician’s assessment in this case considered insufficient?	The assessment was considered insufficient because it was issued hastily, lacked supporting documentation, and was unsigned, raising concerns about its validity and completeness. The physician also certified Turreda as fit to work despite ongoing health issues and medication.
What is the significance of a seafarer being declared fit for duty during the pre-employment medical examination?	If a seafarer is declared fit for duty during the pre-employment medical examination, it creates a presumption that any subsequent illness developed during employment is work-related. The burden then shifts to the employer to prove otherwise.

This case demonstrates the Supreme Court’s commitment to protecting the rights of seafarers and ensuring fair and thorough medical evaluations in disability claims. The ruling emphasizes the importance of employers fulfilling their obligations under the POEA-SEC and acting in good faith when assessing a seafarer’s fitness for duty.

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: AVIOR MARINE, INC. VS. ARNALDO R. TURREDA, G.R. No. 250806, September 29, 2021

September 29, 2021

Seafarer’s Disability: The Imperative of Timely Medical Assessments in Maritime Employment

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

September 29, 2021

Understanding Seafarer Disability Benefits: The Importance of Final Medical Assessments
The Crucial Role of Final Medical Assessments in Determining Seafarer Disability Benefits

Edgardo I. Mabalot v. Maersk – Filipinas Crewing, Inc. and/or A.P. Moller A/S, G.R. No. 224344, September 13, 2021

Imagine a seafarer, far from home, who suffers an injury that could change his life forever. The journey to recovery is not just physical but also legal, as the outcome hinges on a medical assessment that determines his future. In the case of Edgardo I. Mabalot, this scenario played out in the Philippine Supreme Court, highlighting the complexities of seafarer disability benefits.

Edgardo Mabalot, an able seaman, was deployed on a vessel when he began experiencing shoulder pain. After medical repatriation and a series of assessments, he faced a legal battle over his disability benefits. The central question was whether he was entitled to permanent total disability benefits or only partial disability benefits based on the medical assessments he received.

Legal Context: Navigating Seafarer Disability Claims

Seafarers’ rights to disability benefits are governed by the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC). This contract outlines the procedures and timelines for medical assessments that determine a seafarer’s disability status. The key principle is that a final and conclusive medical assessment must be made within specific time frames to determine the seafarer’s fitness to work or the extent of their disability.

The POEA-SEC states that the company-designated physician must issue a final medical assessment within 120 days from the time the seafarer reports to them. If this period is exceeded without a final assessment, the disability may be considered permanent and total. However, if further treatment is required, this period can be extended to 240 days.

Understanding these timelines is crucial for seafarers and employers alike. For instance, if a seafarer is injured and requires ongoing treatment, the company-designated physician’s assessment could significantly impact their compensation. The term “final medical assessment” refers to a definitive statement on the seafarer’s fitness to work or disability rating, without any further conditions or treatments required.

Case Breakdown: Mabalot’s Journey Through the Legal System

Edgardo Mabalot’s story began when he was deployed as an able seaman on the “Maersk Stepnica” in March 2011. In July of that year, he started experiencing pain in his left shoulder, leading to a diagnosis of “Omarthritis” in Japan. Upon repatriation, he consulted Dr. Natalio G. Alegre II, the company-designated physician, who initially diagnosed him with a “Frozen Shoulder” and recommended further treatment.

On February 2, 2012, Dr. Alegre issued a Grade 11 interim disability assessment, advising Mabalot to continue physical therapy and consult a Rehabilitation Medicine Specialist. However, Mabalot sought a second opinion from Dr. Manuel C. Jacinto, Jr., who declared him unfit for work due to permanent total disability.

Mabalot then filed a complaint for permanent total disability benefits, which led to a series of legal proceedings. The Labor Arbiter initially awarded him Grade 11 disability benefits, but the National Labor Relations Commission (NLRC) overturned this decision, granting him permanent total disability benefits. The Court of Appeals (CA) reversed the NLRC’s decision, reinstating the Labor Arbiter’s ruling.

The Supreme Court upheld the CA’s decision, emphasizing that Dr. Alegre’s assessment was interim and not final. The Court noted, “The failure of Dr. Alegre to issue a complete and definite medical assessment within the 120-day period did not automatically render Mabalot’s disability as total and permanent.” Furthermore, the Court stated, “A final, conclusive, and definite medical assessment must clearly state the seafarer’s fitness to work or his exact disability rating.”

The procedural journey through the courts highlighted the importance of adhering to the POEA-SEC’s requirements for medical assessments. Mabalot’s case was ultimately decided based on the lack of a final assessment within the prescribed period, illustrating the critical role of timely and definitive medical evaluations.

Practical Implications: What Seafarers and Employers Should Know

This ruling underscores the importance of final medical assessments in seafarer disability claims. Seafarers must understand the timelines and requirements set by the POEA-SEC, ensuring they receive a final assessment within the specified periods. Employers, on the other hand, should ensure that their designated physicians provide thorough and timely assessments to avoid disputes over disability ratings.

For similar cases going forward, this ruling sets a precedent that interim assessments do not suffice for determining permanent disability benefits. Seafarers and their legal representatives should be prepared to challenge any delays in final assessments, while employers must ensure compliance with the POEA-SEC to avoid legal challenges.

Key Lessons:
- Seafarers should seek a final medical assessment within the 120-day period or the extended 240-day period if further treatment is necessary.
- Employers must ensure that their designated physicians issue complete and final assessments to avoid disputes over disability benefits.
- Understanding the procedural steps and timelines of the POEA-SEC is crucial for both seafarers and employers in navigating disability claims.
Frequently Asked Questions

What is a final medical assessment under the POEA-SEC?

A final medical assessment is a definitive statement by the company-designated physician on the seafarer’s fitness to work or their exact disability rating, without any further conditions or treatments required.

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

The company-designated physician must issue a final medical assessment within 120 days from the time the seafarer reports to them. This period can be extended to 240 days if further treatment is necessary.

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

If no final assessment is issued within 120 days without justification, the seafarer’s disability may be considered permanent and total. If the period is extended to 240 days and still no final assessment is issued, the disability is also considered permanent and total.

Can a seafarer seek a second opinion from another doctor?

Yes, a seafarer can seek a second opinion, but this right is typically exercised after the company-designated physician has issued a final assessment that the seafarer disagrees with.

What are the implications of this ruling for seafarers and employers?

This ruling emphasizes the importance of timely and definitive medical assessments. Seafarers must ensure they receive a final assessment within the specified periods, while employers must ensure their designated physicians comply with these requirements to avoid legal disputes.

ASG Law specializes in labor and employment law. Contact us or email hello@asglawpartners.com to schedule a consultation.
September 13, 2021

Seafarer Disability Claims: Proving Work-Related Illness Under Philippine Law

The Supreme Court has ruled that a seafarer’s illnesses, hypertension and diabetes, were not directly linked to their work conditions, thus denying a disability claim. The court emphasized the need for substantial evidence to prove a causal connection between the working environment and the illness, especially when the diseases are not listed as occupational under the POEA-SEC. This decision highlights the importance of providing concrete evidence and following the procedures outlined in the POEA-SEC for disability claims.

High Seas, High Stakes: When Do Seafarers’ Health Issues Warrant Compensation?

This case revolves around Manuel M. Cunanan, a seafarer who worked as an assistant carpenter for CF Sharp Crew Management Inc., deployed by Norwegian Cruise Lines. Cunanan’s employment contract was for ten months, beginning November 20, 2009. During his time aboard the vessel, he was diagnosed with elevated blood sugar and hypertension, leading to his medical repatriation in February 2010. After returning to the Philippines, he sought medical attention from both company-designated physicians and his own doctors, receiving conflicting assessments regarding his fitness to return to work. This discrepancy led to a legal battle over his entitlement to disability compensation.

The core legal question is whether Cunanan’s hypertension and diabetes were work-related and, therefore, compensable under the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC). The Labor Arbiter (LA) initially dismissed Cunanan’s complaint, but the National Labor Relations Commission (NLRC) reversed this decision, awarding him disability benefits and attorney’s fees. The Court of Appeals (CA) then dismissed the petitioners’ (CF Sharp Crew Management Inc. and Norwegian Cruise Lines Inc.) petition for certiorari due to procedural issues. The Supreme Court, however, took a different stance, focusing on the substantive merits of the case.

The Supreme Court began by addressing the procedural lapses noted by the Court of Appeals, emphasizing that rules of procedure should facilitate, not frustrate, justice. The court acknowledged that while the petitioners had initially failed to submit certified true copies of the NLRC decision, they had later rectified this by attaching certified xerox copies to their petition before the Supreme Court. Given the circumstances and the conflicting findings of the LA and the NLRC, the Supreme Court opted to relax the procedural rules and proceed to rule on the merits of the case.

Turning to the substantive issues, the Court emphasized that entitlement to disability benefits for seafarers is governed by Philippine law, the contract between the parties, and medical findings. The POEA-SEC defines a work-related illness as one resulting from an occupational disease listed under Section 32-A of the contract. Illnesses not listed are disputably presumed to be work-related, but this presumption does not automatically equate to compensability. The claimant must still present substantial evidence to prove that their work conditions caused or increased the risk of contracting the disease.

Cunanan was diagnosed with hypertension (Stage 1) and Type 2 diabetes mellitus, both controlled. Under the POEA-SEC, hypertension is considered an occupational disease only if it is primary or essential and causes impairment of body organs, resulting in permanent disability. The Court noted that Cunanan failed to provide documentary evidence to substantiate his claim of essential hypertension or prove that it had caused impairment of any vital organs. Diabetes, on the other hand, is not listed as an occupational disease under Section 32-A of the POEA-SEC. The Supreme Court cited C.F. Sharp Crew Management, Inc., et al. v. Santos, emphasizing that diabetes is often a metabolic and familial disease, resulting from lifestyle choices rather than work-related conditions.

The Court further highlighted the inconsistencies in Cunanan’s arguments regarding the cause of his illnesses. While he initially claimed an accident on board the vessel and exposure to hazardous materials, he later attributed his diabetes to a poor diet at sea. These unsubstantiated allegations failed to meet the required quantum of proof for compensability. Importantly, the Court pointed out that hypertension and diabetes do not automatically warrant disability benefits, especially if the seafarer demonstrates compliance with medication and lifestyle changes.

The company-designated physicians had declared Cunanan fit for work 184 days after his repatriation, and Cunanan had even signed a Certificate of Fitness for Work. The Supreme Court emphasized that a seafarer’s inability to work for more than 120 days does not automatically qualify them for permanent and total disability benefits. The initial 120-day treatment period can be extended to 240 days if justified, and the company-designated physician can declare the seafarer fit to work or assess the degree of permanent disability within this extended period. In this case, the company doctors issued the fit-for-work declaration before the 240-day period expired.

The Court also addressed the conflicting medical assessments from Cunanan’s personal doctors, noting that the POEA-SEC gives the company-designated physician the first opportunity to examine the seafarer and issue a medical assessment. If the seafarer disagrees with this assessment, the POEA-SEC provides a procedure for a third doctor to be jointly appointed by both parties. The third doctor’s decision is final and binding. Cunanan failed to follow this procedure. Because he failed to involve a third doctor, the assessment of the company-designated physician prevailed. The court has consistently ruled that the absence of a third doctor’s opinion means the company-designated physician’s assessment should be upheld.

Finally, the Supreme Court addressed the issue of Cunanan’s non-rehiring, clarifying that seafarers are contractual employees, and there was no obligation for the company to renew his contract. There was no concrete evidence that the non-rehiring was due to a permanent and total incapacity to work. Consequently, the court found that Cunanan’s claim for attorney’s fees must also fail. The Supreme Court emphasized that while it is committed to protecting the rights of laborers, it must also uphold the rights of employers when they are in the right. Justice must be dispensed based on established facts, applicable laws, and jurisprudence.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer’s hypertension and diabetes were work-related and thus compensable under the POEA-SEC. The court needed to determine if there was sufficient evidence to link these illnesses to the seafarer’s working conditions.
What is the POEA-SEC?	The POEA-SEC refers to the Philippine Overseas Employment Administration Standard Employment Contract. It sets the terms and conditions for the employment of Filipino seafarers on board ocean-going vessels, including provisions for disability compensation.
What is required to prove a work-related illness for seafarers?	To prove a work-related illness, the seafarer must show that the illness is either listed as an occupational disease in the POEA-SEC or provide substantial evidence that their working conditions caused or increased the risk of contracting the illness. The burden of proof lies on the seafarer.
What happens if the company-designated doctor and the seafarer’s doctor disagree?	If there’s disagreement between the company-designated doctor and the seafarer’s doctor, the POEA-SEC provides a procedure for both parties to jointly appoint a third doctor. This third doctor’s assessment becomes final and binding on both parties.
Why was the seafarer’s claim denied in this case?	The seafarer’s claim was denied because he failed to provide sufficient evidence to prove that his hypertension and diabetes were caused or aggravated by his work conditions. He also did not follow the third-doctor procedure outlined in the POEA-SEC.
Is hypertension always considered a work-related illness for seafarers?	No, hypertension is only considered a work-related illness if it is classified as primary or essential and causes impairment of body organs, resulting in permanent disability. Specific documentary evidence, like chest x-ray and ECG reports, is required to substantiate the claim.
What is the significance of the company-designated physician’s assessment?	The company-designated physician has the initial opportunity to assess the seafarer’s medical condition and issue a certification of fitness. Their assessment carries significant weight, especially if the seafarer fails to follow the third-doctor procedure when disagreeing with the assessment.
Does a seafarer’s inability to be rehired automatically qualify them for disability benefits?	No, a seafarer’s inability to be rehired does not automatically qualify them for disability benefits. Seafarers are contractual employees, and there is no guarantee of contract renewal. The seafarer must still prove that they are unable to work due to a work-related illness or injury.
What is the 120/240-day rule in seafarer disability cases?	The 120/240-day rule refers to the period during which a seafarer receives sickness allowance while undergoing medical treatment. The initial treatment period is 120 days, but it can be extended up to 240 days if the seafarer requires further medical attention.
What happens if a seafarer consults their own doctor while still under treatment by the company-designated physician?	Consulting their own doctor is permissible. However, in case of conflicting medical assessments, the seafarer must invoke Section 20 (B) (3) of the 2000 POEA-SEC regarding the joint appointment by the parties of a third doctor whose decision shall be final and binding on them.

This Supreme Court decision underscores the importance of providing concrete evidence and following proper procedures when claiming disability benefits as a seafarer. It reiterates that while the law leans towards protecting laborers, claims must be substantiated with credible proof. It serves as a reminder to both seafarers and employers of their rights and responsibilities under Philippine law.

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: CF SHARP CREW MANAGEMENT INC. v. CUNANAN, G.R. No. 210072, August 04, 2021

August 4, 2021

Tag: POEA-SEC

When Silence Speaks Volumes: The Case of Delayed Disability Assessment for Seafarers

FAQs

Sailing Through Sickness: When Do Seafarer Ailments Warrant Disability?

FAQs

When Does ‘Maximum Medical Improvement’ Mean Fit to Work? A Seafarer’s Fight for Disability Benefits

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Navigating the Storm: Did Seafarer’s Depression Arise from the High Seas?

FAQs

When a Back Injury at Sea Leads to a Dispute Over Disability: Rodriguez vs. Philippine Transmarine Carriers

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When a Laundryman’s Illness Unravels the Presumption of Work-Relatedness

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Navigating Murky Waters: Can a Hasty ‘Fit to Work’ Certification Sink a Seafarer’s Disability Claim?

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

FAQs

The Crucial Role of Final Medical Assessments in Determining Seafarer Disability Benefits

Edgardo I. Mabalot v. Maersk – Filipinas Crewing, Inc. and/or A.P. Moller A/S, G.R. No. 224344, September 13, 2021

Legal Context: Navigating Seafarer Disability Claims

Case Breakdown: Mabalot’s Journey Through the Legal System

Practical Implications: What Seafarers and Employers Should Know

Frequently Asked Questions

High Seas, High Stakes: When Do Seafarers’ Health Issues Warrant Compensation?

FAQs