On 22 August 2012, the seafarer entered into a 7-month employment contract with WSM Ltd., through its agent, WSBM, Inc., to work as a third engineer on board the vessel M/V NOCC Puebla. On 5 September 2012, the seafarer boarded the said vessel.
The seafarer alleged that sometime in March 2013, he felt pain on his back while conducting maintenance works. He said that the pain was so severe that he fell on his knees. He added that although he was given pain relievers, he was advised to be medically repatriated for further examination.
The seafarer was repatriated on 28 March 2013 and was seen by the company-designated physician. He was diagnosed to have S/P Laminotomy, L4 Bilateral Interspinous Process Decompression Coflex. He was advised to regularly consult with the specialists for the monitoring of his condition. He also underwent out-patient rehabilitation sessions at the Metropolitan Medical Center.
On 9 July 2013, the company-designated physician issued a letter addressed to a co-specialist, stating that the seafarer’s prognosis was guarded and that the latter had already reached his maximum medical improvement. Consequently, the company-designated physician gave the seafarer a disability grading of 8 or 2/3 loss of lifting power of the trunk. Despite this, the company-designated physician still advised the seafarer to continue with his medications and rehabilitation. The seafarer was also directed to see the co-specialist sometime in May 2014.
On 5 June 2014, the seafarer independently consulted his personal doctor. On 21 July 2014, said personal doctor issued a Medical Certificate, stating that the seafarer’s disability was total and the cause of injury was work-related/work-aggravated, thus, declaring the seafarer unfit to go back to work as a seafarer. This prompted the seafarer to file a complaint for total and permanent disability benefits against his employer.
In denying liability for total and permanent disability benefits, the employer countered that the seafarer’s condition was merely brought about by the recurrence of his lumbar problem from his previous employment, for which he had already claimed total and permanent disability benefits from his previous employer.
Can the seafarer be granted his claim of total and permanent disability benefits?
Yes.
The Court emphasized the requirement of a final and definite disability assessment within the 120-day or 240-day period.1
As to the extent of compensability, the entitlement of an overseas seafarer to disability benefits is governed by the law, the employment contract, and the medical findings in accordance with the rules.
By law, the seafarer’s disability benefits claim is governed by Articles 191 to 193, Chapter VI of the Labor Code, in relation to Rule X, Section 2 of the Implementing Rules and Regulations (IRR) of the Labor Code. Article 192 (c) (1) of the Labor Code provides:
Art. 192. Permanent total disability. x x x
C. The following disabilities shall be deemed total and permanent:
(1) Temporary total disability lasting continuously for more than one hundred twenty days, except as otherwise provided in the Rules;
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Rule VII, Section 2 (b) of the Amended Rules on Employees’ Compensation also provides:
(b) A disability is total and permanent if as a result of the injury or sickness the employee is unable to perform any gainful occupation for a continuous period exceeding 120 days, except as otherwise provided for in Rule X of these Rules.
The exception to the 120-day rule repeatedly cited above is Rule X of the Implementing Rules and Regulations (IRR) of Book IV of the Labor Code, specifically Section 2 thereof which states:
Section 2. Period of entitlement. — (a) The income benefit shall be paid beginning on the first day of such disability. If caused by an injury or sickness it 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 from onset of disability in which case benefit for temporary total disability shall be paid. However, the System may declare the total and permanent status at any time after 120 days of continuous temporary total disability as may be warranted by the degree of actual loss or impairment of physical or mental functions as determined by the System.
By contract, it is governed by the employment contract which the seafarer and his employer/local manning agency executes prior to employment, and the applicable POEA-SEC that is deemed incorporated in the employment contract. In this case, the parties executed the contract of employment on August 22, 2012, thus, the 2010 POEA-SEC is applicable. Relevant provision of Section 20 (A) thereof provides:
SECTION 20. COMPENSATION AND BENEFITS —
A COMPENSATION AND BENEFITS FOR INJURY OR ILLNESS
The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:
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6 In case of permanent total or partial disability of the seafarer caused by either injury or illness the seafarer shall be compensated in accordance with the schedule of benefits enumerated in Section 32 of his Contract. Computation of his benefits arising from an illness or disease shall be governed by the rates and the rules of compensation applicable at the time the illness or disease was contracted.
The disability shall be based solely on the disability gradings provided under Section 32 of this Contract, and shall not be measured or determined by the number of days a seafarer is under treatment or the number of days in which sickness allowance is paid.
By the medical findings, the assessment of the company-designated doctor generally prevails, unless the seafarer disputes such assessment by exercising his right to a second opinion by consulting a physician of his choice, in which case, the medical report issued by the latter shall also be evaluated by the labor tribunal and the court, based on its inherent merit. In case off disagreement in the findings of the company-designated doctor and the seafarer’s personal doctor, the parties may agree to jointly refer the matter to a third doctor whose decision shall be final and binding on them.
The Court had the occasion to summarize the rules above-cited regarding the company-designated physician’s duty to issue a final medical assessment on the seafarer’s disability grading to determine the extent of compensation:
1 The company-designated physician must issue a final medical assessment on the seafarer’s disability grading within a period of 120 days from the time the seafarer reported to him;
2 If the company-designated physician fails to give his assessment within the period of 120 days, without any justifiable reason, then the seafarer’s disability becomes permanent and total;
3 If the company-designated physician fails to give his assessment within the period of 120 days with a sufficient justification (e.g., seafarer required further medical treatment or seafarer was uncooperative), then the period of diagnosis and treatment shall be extended to 240 days. The employer has the burden to prove that the company-designated physician has sufficient justification to extend the period; and
4 If the company-designated physician still fails to give his assessment within the extended period of 240 days, then the seafarer’s disability becomes permanent and total, regardless of any justification.
According to the Court, such kind of assessment is neccessary under the rules to truly reflect the true extent of the sickness or injuries of the seafarer and his capacity to resume to work as such.2Pastor v. Bibby Shipping Philippines, Inc., G.R. No. 238842, November 19, 2018 Otherwise, the corresponding disability benefits awarded might not be commensurate with the prolonged effects of the injuries suffered.3Sunit v. OSM Maritime Services, Inc., G.R. No. 223035, February 27, 2017, 806 PHIL 505-524
In the present case, the Court found that although the company-designated physician subjected the seafarer to a series of medications and rehabilitation, he failed to give any definite disability assessment.
The Court pointed out that the Grade 8 disability rating given by the company-designated physician could not be considered as the complete, definite, and final medical assessment contemplated by the rules, as such assessment was merely addressed to another specialist, who still advised the seafarer to continue with his medications and rehabilitation. The Court further found that:
- Up to May 2014, the seafarer was still ordered to see the said specialist for re-evaluation
- The seafarer’s treatment lasted for over a year, evidencing that his condition remained unresolved.
- The company-designated physician’s prognosis on the seafarer’s condition was guarded in that the outcome of his illness was in doubt.
The Court added that the employer could not rely on Section 20 (A) (6) of the 2010 POEA-SEC which states that “[t]he disability shall be based solely on the disability gradings provided under Section 32 of this contract, and shall not be measured or determined by the number of days a seafarer is under treatment or the number of days in which sickness allowance is paid.” According to the Court, before the disability gradings under Section 32 should be considered, the disability ratings should be properly established and contained in a valid and timely medical report of a company-designated physician or the third doctor agreed upon by the parties. In other words, the periods prescribed by the rules should still be complied with. Thus, the foremost consideration of the courts should be to determine whether the medical assessment or report of the company-designated physician was complete and appropriately issued; otherwise, the medical report shall be set aside and the disability grading contained therein cannot be seriously appreciated.4Olidana v. Jebsens Maritime, Inc., G.R. No. 215313, October 21, 2015, 772 PHIL 234-251 The Court reiterated that no final and complete assessment was given in this case.
The Supreme Court ruled that with this failure of the company-designated physician to issue a complete, definite, and final medical assessment, the seafarer’s disability, under legal contemplation, is deemed total and permanent.5Pastor v. Bibby Shipping Philippines, Inc., G.R. No. 238842, November 19, 2018
Further reading:
- Wilhelmsen Smith Bell Manning, Inc. v. Villaflor, G.R. No. 225425, January 29, 2020.
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