ASG Law

Tag: Second Opinion

  • Navigating Seafarer Disability Rights: Understanding Consent and Compensation in Maritime Law

    Seafarers Retain Right to Consent to Medical Procedures Despite Employer Obligations

    Roberto F. Rodelas, Jr. v. MST Marine Services (Phils.), Inc., G.R. No. 244423, November 04, 2020

    Imagine a seafarer, far from home, facing a medical dilemma that could impact their livelihood. Roberto Rodelas, Jr., a Chief Cook aboard MV Sparta, found himself in this predicament when he suffered from a back injury that led to a contentious legal battle over his disability benefits. The central issue in his case was whether his refusal to undergo a recommended surgery disqualified him from receiving compensation. This case sheds light on the rights of seafarers to consent to medical treatments and the obligations of employers under Philippine maritime law.

    Roberto Rodelas, Jr. was diagnosed with a herniated disc and other conditions after experiencing pain on duty. His employer, MST Marine Services, offered him a disability rating and compensation, but Rodelas sought a second opinion that declared him permanently unfit for sea duty. The Supreme Court’s decision in this case provides critical insights into the legal framework governing seafarer disability claims and the importance of informed consent.

    Legal Context: Understanding Seafarer Rights and Employer Obligations

    In the Philippines, the rights of seafarers and the obligations of their employers are primarily governed by the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) and the Labor Code. These legal instruments outline the responsibilities of employers to provide medical treatment and compensation for work-related injuries or illnesses.

    The POEA-SEC stipulates that employers must provide medical treatment until the seafarer is declared fit to work or the degree of disability is assessed. It also allows seafarers to seek a second medical opinion if they disagree with the company-designated physician’s assessment. The concept of informed consent is crucial here, as it empowers seafarers to make decisions about their medical treatment based on full understanding and personal choice.

    Section 20.D of the POEA-SEC states that no compensation shall be payable for injuries resulting from the seafarer’s willful or criminal act or intentional breach of duties. However, the employer must prove that such an act directly caused the injury or disability. This provision is often at the heart of disputes over disability benefits.

    For example, if a seafarer suffers a back injury while lifting heavy cargo, the employer is obligated to provide medical treatment and assess the disability within a specified period. If the seafarer refuses a recommended surgery, the employer cannot automatically deny benefits without proving that the refusal directly worsened the condition.

    Case Breakdown: The Journey of Roberto Rodelas, Jr.

    Roberto Rodelas, Jr., a Chief Cook, was hired by MST Marine Services to work aboard MV Sparta. On May 6, 2014, he experienced severe back pain and was diagnosed with a herniated disc and other conditions. After being repatriated to the Philippines, he underwent medical examinations and treatments, but remained undecided about undergoing spine surgery.

    On September 6, 2014, MST Marine sought a disability assessment from their designated physician, who assigned Rodelas a Grade 11 disability rating. Despite this, Rodelas sought a second opinion from Dr. Renato Runas, who declared him permanently unfit for sea duty due to his condition’s impact on his job.

    The procedural journey of this case involved multiple levels of adjudication. Initially, the Panel of Voluntary Arbitrators awarded Rodelas permanent total disability benefits, citing his inability to return to sea duties. However, the Court of Appeals modified this to permanent partial disability benefits, arguing that Rodelas’ refusal to undergo surgery prevented a final assessment.

    The Supreme Court’s decision reversed the Court of Appeals, reinstating the award of permanent total disability benefits. The Court emphasized that Rodelas retained the right to consent to medical procedures and that his refusal did not disqualify him from benefits. Key quotes from the decision include:

    “A seafarer does not lose the right to consent to the prescribed medical treatments of a company-designated physician.”

    “Respondent is now estopped from assailing the finality of its assessment.”

    The Court also noted the procedural steps that affected the outcome:

    • Rodelas underwent multiple medical examinations and treatments.
    • He sought a second medical opinion after being informed of his disability rating.
    • The employer failed to refer Rodelas to a third doctor as requested.

    Practical Implications: Navigating Disability Claims and Employer Responsibilities

    This ruling has significant implications for seafarers and maritime employers. Seafarers are now more empowered to make informed decisions about their medical treatments without fear of losing their disability benefits. Employers must respect these decisions and cannot use a seafarer’s refusal to undergo surgery as a basis to deny compensation without clear evidence of direct causation.

    For businesses in the maritime sector, this case underscores the importance of clear communication and documentation in handling disability claims. Employers should ensure that they follow the procedures outlined in the POEA-SEC, including the right of seafarers to seek second opinions and the obligation to refer to a third doctor if necessary.

    Key Lessons:

    • Seafarers have the right to consent to or refuse medical treatments recommended by company-designated physicians.
    • Employers must provide evidence that a seafarer’s refusal to undergo treatment directly caused the disability to deny benefits.
    • Seeking a second medical opinion is a crucial right that can influence the outcome of disability claims.

    Frequently Asked Questions

    What is the significance of informed consent for seafarers?

    Informed consent allows seafarers to make decisions about their medical treatments based on full understanding and personal choice, ensuring their autonomy and rights are respected.

    Can an employer deny disability benefits if a seafarer refuses surgery?

    An employer cannot automatically deny benefits based on refusal of surgery unless they can prove that the refusal directly caused the disability or was a willful breach of duties.

    What should a seafarer do if they disagree with the company-designated physician’s assessment?

    Seafarers have the right to seek a second medical opinion and, if necessary, request a referral to a third doctor jointly agreed upon by both parties.

    How long does an employer have to assess a seafarer’s disability?

    The company-designated physician has up to 120 days to assess the disability, extendable to 240 days if further treatment is needed.

    What are the potential consequences for employers who do not follow the POEA-SEC procedures?

    Employers risk legal action and may be required to pay higher disability benefits if they fail to follow the procedures, including respecting the seafarer’s right to a second opinion and third doctor referral.

    ASG Law specializes in maritime law and seafarer rights. Contact us or email hello@asglawpartners.com to schedule a consultation and ensure your rights are protected.

  • Seafarer’s Disability: Upholding the Right to a Second Medical Opinion and Timely Disability Benefits

    The Supreme Court’s decision underscores the importance of protecting the rights of Filipino seafarers, especially concerning disability claims. It clarifies that a seafarer is entitled to seek a second medical opinion, even after being examined by a company-designated physician, to properly assess their condition and eligibility for disability benefits. This ruling ensures that seafarers receive fair compensation for work-related injuries and illnesses, acknowledging the risks they face at sea. If a company doctor fails to declare the seafarer fit to work within 120 days, they are entitled to total disability benefits.

    Navigating Conflicting Medical Opinions: Can a Seafarer Challenge the Company Doctor’s Assessment?

    Leopoldo Abante, a seafarer, sustained a back injury while working aboard the M/T Rathboyne. Upon repatriation, he was examined by a company-designated physician who, after initial treatment and surgery, eventually declared him fit to work. Dissatisfied with this assessment, Abante sought a second opinion from another doctor, who diagnosed him with a “failed back syndrome” and deemed him unfit for sea duty. This conflict in medical opinions led Abante to file a complaint for disability benefits, sparking a legal battle that reached the Supreme Court. The central legal question was whether Abante was bound by the company-designated physician’s assessment, or if he had the right to challenge it and claim disability benefits based on an independent medical evaluation.

    The Supreme Court sided with Abante, emphasizing the seafarer’s right to seek a second opinion. The Court grounded its decision on Section 20(B)(3) of the POEA Standard Employment Contract of 2000, which outlines the compensation and benefits for injury and illness suffered during the term of a seafarer’s contract. This provision states that:

    SECTION 20. COMPENSATION AND BENEFITS FOR INJURY AND ILLNESS

    The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:

    x x x x

    3. Upon sign-off from the vessel for medical treatment, the seafarer is entitled to sickness allowance equivalent to his basic wage until he is declared fit to work or the degree of permanent disability has been assessed by the company-designated physician but in no case shall this period exceed one hundred twenty (120) days.

    For this purpose, the seafarer shall submit himself to a post-employment medical examination by a company-designated physician within three working days upon his return except when he is physically incapacitated to do so, in which case, a written notice to the agency within the same period is deemed as compliance. Failure of the seafarer to comply with the mandatory reporting requirement shall result in his forfeiture of the right to claim the above benefits.

    If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the Employer and the seafarer. The third doctor’s decision shall be final and binding on both parties. (emphasis supplied)

    The Court clarified that this provision does not prevent a seafarer from seeking a second opinion to determine their condition for claiming disability benefits, citing the case of NYK-Fil Ship Management v. Talavera. The Court emphasized that while the company-designated physician initially assesses the seaman’s disability, the seafarer retains the right to consult a physician of their choice, reinforcing the seafarer’s prerogative to request a second opinion.

    The Supreme Court addressed the appellate court’s reliance on POEA Memo Circular No. 55, series of 1996, which does not contain a similar provision for a third doctor’s opinion. The Court cited Seagull Maritime Corporation v. Dee, where it applied the 2000 Circular even to a contract entered into in 1999, before the circular’s promulgation. The ruling underscores the Court’s commitment to protecting labor rights, especially in cases of disability or ailment. The Court firmly stated that doubts regarding the company-designated physician’s assessment should prompt a resort to other competent medical professionals. This ensures that the seafarer has the opportunity to assert their claim by proving the nature of their injury, which will then be used to determine the benefits rightfully accruing to them.

    The Court also noted that Dr. Lim’s medical findings were not significantly different from those of Dr. Caja’s. Despite Dr. Lim declaring Abante fit to resume sea duties, the diagnosis of “foraminal stenosis and central disc protrusion” remained six months post-surgery. The Court acknowledged that a company-designated physician might be more inclined to provide a positive assessment, which is why the POEA Standard Employment Contract allows seafarers to seek a second opinion. The Court emphasized the protective intent of the POEA standard employment contract for seamen, designed to benefit Filipino seamen working on ocean-going vessels, mandating that its provisions be construed and applied fairly, reasonably, and liberally in their favor.

    Referencing HFS Philippines v. Pilar, the Supreme Court affirmed the preference for independent medical opinions over those of company-designated physicians when discrepancies arise. The Court held that when evidence can be reasonably interpreted in two divergent ways, one prejudicial and the other favorable to the laborer, the balance must tilt in favor of the latter, in line with the principle of social justice. This principle underscores the judiciary’s role in protecting the rights and welfare of workers, especially when faced with conflicting interpretations of medical evidence.

    The Court addressed the issue of whether Abante could claim disability benefits, ruling affirmatively. Permanent disability is defined as the inability of a worker to perform their job for more than 120 days, irrespective of the loss of any body part. The Court determined that Abante’s entitlement to permanent disability benefits rested on his inability to work for more than 120 days. In Abante’s case, the Certificate of Fitness for Work was issued by Dr. Lim on February 20, 2001, over six months after his initial evaluation on July 24, 2000, and after his surgery on August 18, 2000. This delay of more than 120 days qualified Abante for permanent disability benefits.

    Evidence from Dr. Lim’s office revealed that Abante was seen by him thirteen times between July 24, 2000, and February 20, 2001. Excluding the final two reports, Dr. Lim consistently recommended continued physical rehabilitation and therapy, with clinic revisits for re-evaluation. This implied that Abante was not yet fit to work, further supporting his claim for disability benefits. Given a seafarer’s entitlement to permanent disability benefits when they cannot work for more than 120 days, the failure of the company-designated physician to declare Abante fit to work within that period entitled him to permanent total disability benefits of US$60,000.00, as per Sec. 30-A of the POEA Standard Employment Contract.

    The Court denied the claims for moral and exemplary damages due to the absence of bad faith or malice on KJGS’s part, noting that the company had covered all expenses related to Abante’s surgery and rehabilitation and consistently inquired about his condition. However, the claim for attorney’s fees was granted under Article 2208 of the New Civil Code, allowing recovery in actions for wages and indemnity under employer’s liability laws. The Court awarded attorney’s fees of ten percent (10%) of the monetary award, citing the need to protect the plaintiff’s interests after the respondent’s refusal to settle the claims, consistent with prevailing jurisprudence.

    FAQs

    What was the key issue in this case? The key issue was whether a seafarer is bound by the company-designated physician’s assessment of fitness to work or if they can seek a second opinion to claim disability benefits. The Supreme Court affirmed the seafarer’s right to a second opinion.
    What is the significance of the 120-day period? The 120-day period is crucial because if the company-designated physician fails to declare the seafarer fit to work within this time frame, the seafarer is entitled to permanent total disability benefits. This is regardless of any subsequent fitness declaration.
    What does the POEA Standard Employment Contract say about medical assessments? The POEA Standard Employment Contract mandates that seafarers undergo a post-employment medical examination by a company-designated physician. It also allows the seafarer to seek a second opinion if they disagree with the initial assessment.
    What happens if there are conflicting medical opinions? If there are conflicting opinions between the company-designated physician and the seafarer’s chosen doctor, the POEA contract suggests agreeing on a third, independent doctor whose decision will be final and binding.
    What benefits is a seafarer entitled to if deemed permanently disabled? A seafarer deemed permanently and totally disabled is entitled to disability benefits, which can include a lump-sum payment. In this case, the amount was US$60,000.00, as well as attorney’s fees to cover legal expenses.
    Why did the Court award attorney’s fees in this case? Attorney’s fees were awarded because the employer’s refusal to settle the claim compelled the seafarer to incur expenses to protect their interests. This is in line with Article 2208 of the New Civil Code.
    Can a seafarer claim moral and exemplary damages? Moral and exemplary damages are not automatically granted. They require concrete evidence of bad faith or malice on the part of the employer, which was not sufficiently demonstrated in this case.
    What if the employment contract was entered before POEA Memo Circular No. 9? Even if the employment contract predates POEA Memo Circular No. 9, the courts may still apply the 2000 Circular, especially concerning the seafarer’s right to seek a second medical opinion.

    In conclusion, the Supreme Court’s decision in the Abante case serves as a crucial reminder of the rights afforded to Filipino seafarers under the POEA Standard Employment Contract. It reinforces the importance of seeking independent medical evaluations and ensures that seafarers receive fair compensation for work-related disabilities.

    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: Leopoldo Abante vs. KJGS Fleet Management Manila, G.R. No. 182430, December 04, 2009