Paulino Ungos III

Lawyer | Law Professor | Author

Tag: company-designated physician

  • Regardless of the Cause of Repatriation

    Reynaldo entered into a three-month employment contract to work as an oiler with Maritime Management Services (Maritime Management), through its agent, Southeast Asia Shipping Corp. (SEASCORP). Before deployment, he underwent his pre-employment medical examination and was certified to be fit for sea duty. On January 30, 2010, Reynaldo boarded the M/V BP Pioneer.

    Reynaldo narrated that on March 29, 2010, he was carrying spare parts needed for his repair of the ship’s generators when the ship swayed due to big waves. This caused him to bend and nearly fall to his knees.

    Reynaldo claimed that he soon felt excruciating pain in his scrotal/inguinal area, including pain and numbness in his left leg to his foot. Despite this, he continued to carry the parts and repaired the generator until he was relieved by another oiler. After his duty, Reynaldo went to his cabin and took a pain reliever. He then went to the ship’s clinic to have himself checked by the doctor on board. In the Report of Illness by the ship’s doctor, the latter diagnosed Reynaldo to have epididymorchitis and advised him to rest until further observation since it may just be due to tiredness. The doctor also ruled out hernia and trauma.

    On May 19, 2010, Reynaldo visited the ship’s doctor and informed the latter that he still feels pain during prolonged standing or while walking, with numbness of his lower extremity. However, the doctor concluded that this was normal considering his age and just advised to take pain relievers.

    Upon the expiration of his contract on May 25, 2010, Reynaldo disembarked the vessel at the port of Takoradi, Ghana and was repatriated back to the Philippines. Believing that the pain in his scrotal/inguinal area was normal and, as the doctor had advised, Reynaldo took a complete rest for about a month.

    Eventually, SEASCORP called him for possible deployment. He was sent to Merita Diagnostic Clinic (Merita), the company-accredited clinic, for his pre-employment medical examination.

    During his examination, Reynaldo informed the doctor about the injury sustained while on board the M/V BP Pioneer. Thus, the doctor asked him to get an x-ray of his scrotal/inguinal area and lumbar spine.

    On July 30, 2010, Reynaldo also underwent Magnetic Resonance Imaging (MRI) of the Lumbo-Sacral Spine. It was found that Reynaldo had spondylolisthesis, among others.

    On August 26, 2010, Reynaldo consulted two doctors who advised him to have surgery for his spondylolisthesis. Reynaldo found the procedure costly.

    Reynaldo approached SEASCORP to request for financial assistance. However, his request was denied.

    Reynaldo thus filed a complaint against his employer before the National Labor Relations Commission and claimed for permanent total disability benefits, moral and exemplary damages, and attorney’s fees.

    The Office of the Labor Arbiter found that Reynaldo suffered an injury while performing his duties as an oiler. Being a work-related injury, it held that it must be compensable.

    On the other hand, the said Office found that the mandatory three-day reporting requirement for a post-employment examination under the Philippine Overseas Employment Administration Standard Employment Contract (POEA SEC) did not apply in the case of Reynaldo because he was repatriated not because of a medical condition but due to the expiration of his contract.

    The Office of the Labor Arbiter thus ruled in favor of Reynaldo and required the employer to pay Reynaldo his permanent total disability compensation plus attorney’s fees.

    The National Labor Relations Commission reversed and set aside the Decision of the Office of the Labor Arbiter and dismissed Reynaldo’s complaint for lack of merit.

    According to the Commission, the injury suffered by Reynaldo that was reflected on record was the discomfort on his scrotal and inguinal area. His assertion that he suffered an injury while on board and felt pain on his left leg to his foot was unsupported by evidence.

    The Commission added that a seafarer who claims to be medically infirm must be examined by the company-designated physician within three days from repatriation. The failure of Reynaldo to report within the mandatory period without justifiable cause resulted in the forfeiture of his right to claim compensation and disability benefits under the POEA-SEC.

    The Court of Appeals denied Reynaldo’s petition in view of his failure to comply with the mandatory reporting requirement under the POEA-SEC. Such failure resulted in the forfeiture of his right to claim compensation and benefits.

    Reynaldo elevated his case to the Supreme Court.

    Was Reynaldo entitled to permanent total disability benefits?

    The Supreme Court ruled in the negative.

    The Court reiterated settled jurisprudence that in order to claim compensability under the POEA-SEC, it is required that the seafarer must have:

    • suffered a work-related illness or injury during the term of his contract; and
    • submitted himself to a mandatory post-employment medical examination within three (3) working days upon his arrival.

    The purpose of the three-day mandatory reporting requirement is to enable the company-designated physician to ascertain if the seafarer’s injury or illness is work-related. After that period, there would be difficulty in ascertaining the real cause of the illness. To ignore the rule would set a precedent with negative repercussions because it would open the floodgates to a limitless number of seafarers claiming disability benefits. It would certainly be unfair to the employer who would have difficulty determining the cause of a claimant’s illness considering the passage of time. In such a case, the employers would have no protection against unrelated disability claims.

    In the present case, the Court found that Reynaldo was repatriated due to the expiration of his contract. The Court stated that regardless of the cause of his repatriation, he was required to submit himself to a post-employment medical examination by the company-designated physician within three working days upon his return in order to ascertain if he was really suffering from a work-related injury or illness. Reynaldo may only be excused from such requirement if he was physically incapacitated to do so. The Court stressed that this was not Reynaldo’s situation.

    The Court equally found that Reynaldo complained of pain in the scrotal/inguinal area while on board which is why the initial diagnosis by the ship doctor was epididymorchitis.

    On the other hand, the Court noted that aside from his bare assertion, Reynaldo proffered no evidence establishing that he felt pain or numbness on his lower extremities while on board or that the ship doctor concluded that he contracted spondylolisthesis. According to the Court, it was only in July 2010, or after his repatriation, that the said findings were made by a doctor, which was well-beyond the three-day mandatory reporting period.

    The Court stated that while it commiserated with Reynaldo’s plight, non-compliance with the requirements set forth in the POEA-SEC had rendered it difficult to ascertain if his injury or illness was work-related.

    The Court accordingly denied Reynaldo’s claim for permanent total disability benefits.

    Further reading:

    • Cabatan v. Southeast Asia Shipping Corp., G.R. No. 219495, February 28, 2022.

  • A Mere Finding that the Illness is Not Work-Related is Not Automatically a Valid Medical Assessment

    In Starocean Manning Philippines, Inc. v. Saturnino,1G.R. No. 252659, December 2, 2020. the Supreme Court stressed that sufficient basis must support the assessment of the company-designated physician:

    Regardless of who the doctor is and his or her relation to the parties, the overriding consideration should be that the medical conclusions are based on (a) the symptoms and findings collated with medically acceptable diagnostic tools and methods, (b) reasonable professional inferences anchored on prevailing scientific findings expected to be known to the physician given his or her level of expertise, and (c) the submitted medical findings or synopsis, supported by plain English annotations that will allow the Labor Arbiter and the National Labor Relations Commission to make the proper evaluation.2Orient Hope Agencies, Inc. v. Jara, G.R. No. 204307, June 6, 2018.

    If the company-designated physician failed to provide a final and definite medical assessment within the required periods, the seafarer’s condition shall be, by operation of law, characterized as total and permanent.3Ampo-on v. Reinier Pacific International Shipping, Inc., G.R. No. 240614, June 10, 2019.

    Here, the employer failed to adduce evidence supporting the assessment that the seafarer’s illness was not work-related. For the Court, such unsupported finding of non-work-relatedness is an invalid medical assessment.

    The seafarer was accordingly ruled to be entitled to total and permanent disability benefits by operation of law. The Court further applied Section 20(A)(7) of the 2010 POEA-SEC, which requires that such benefits be separate and distinct from, and be in addition to whatever benefits which the seafarer is entitled to under Philippine laws such as from the Social Security System, Overseas Workers Welfare Administration, Employees’ Compensation Commission, Philippine Health Insurance Corporation, and Home Development Mutual Fund.

    Further reading:

    • Starocean Manning Philippines, Inc. v. Saturnino, G.R. No. 252659, December 2, 2020.

  • Foreign Doctor Who Provided Urgent Care — a Company-Designated Physician?

    On 7 August 2015, the seafarer entered into a 9-month employment contract with Beks Gemi Isletmeciligi Ve Ticaret A.S. through its agent, Status Maritime Corporation, to work as a fitter.

    Before boarding the vessel, the seafarer underwent a pre-employment medical examination and was declared fit to work.

    On 25 March 2016, the seafarer’s shoulder snapped and was dislocated while he was allegedly lifting a heavy object. He was repatriated and recommended for surgical repair after being diagnosed with recurrent left shoulder dislocation.

    Immediately after repatriation, the seafarer reported to Status Maritime, which referred him to the company-designated physician. Although the company-designated physician initially recommended that the seafarer undergo an MRI, Status Maritime disapproved of the procedure and rejected the seafarer’s sickness allowance claim.

    The seafarer then consulted his personal doctor. After undergoing an MRI, the seafarer was diagnosed with “Rotator cuff tear (Supraspinatus), left shoulder.” Said personal doctor declared him permanently disabled and “unfit to work” as a seafarer.

    On 16 June 2016, the seafarer filed a complaint for permanent total disability benefits before the Office of the Labor Arbiter.

    The Office of the Labor Arbiter found that when the seafarer underwent pre-employment medical examination, he misrepresented that he was not suffering from any illness. However, when he was diagnosed abroad, he admitted to a certain Dr. Selvarajah that it was already his third time to sustain a left shoulder dislocation and that two episodes occurred before he boarded the vessel.

    The Office of the Labor Arbiter added that even if the seafarer did not conceal his medical history, he still could not claim disability benefits because his injury was not work-related. While his condition manifested onboard, the seafarer failed to show the connection of his injury to the nature of his work as a fitter. For his failure to present substantial evidence that his work condition caused or aggravated his injury, the seafarer was accordingly denied his claim for disability benefits.

    When the case reached the Supreme Court, the seafarer asserted the following:

    • No diagnosis was made by a company-designated physician. Dr. Selvarajah, a foreign doctor, was not a company-designated physician and, therefore, not qualified to make conclusive findings. The failure of a company-designated physician to give a definite medical finding after the period set under the POEA Standard Employment Contract renders his disability permanent and total.
    • He did not willfully conceal his medical condition during his pre-employment medical examination. He merely forgot to disclose his medical history and, being a layman without medical background, thought there was no need to disclose this information.
    • There was a presumption of fitness which was uncontroverted by evidence.
    • His medical condition should have been detected during the pre-employment medical examination because it was an apparent and external injury. Status Maritime was estopped because it had all the opportunity to screen him for the injury.

    Did Status Maritime comply with its obligation to refer the seafarer to a company-designated physician?

    The requirement of a post-employment medical examination can be gleaned in the provisions of Section 20 (A) of the POEA Standard Employment Contract.1SECTION 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:

    1) The employer shall continue to pay the seafarer his wages during the time he is on board the ship;

    2) If the injury or illness requires medical and/or dental treatment in a foreign port, the employer shall be liable for the full cost of such medical, serious dental, surgical and hospital treatment as well as board and lodging until the seafarer is declared fit to work or to be repatriated. However, if after repatriation, the seafarer still requires medical attention arising from said injury or illness, he shall be so provided at cost to the employer until such time he is declared fit or the degree of his disability has been established by the company-designated physician.

    3) In addition to the above obligation of the employer to provide medical attention, the seafarer shall also receive sickness allowance from his employer in an amount equivalent to his basic wage computed from the time he signed off until he is declared fit to work or the degree of disability has been assessed by the company-designated physician. The period within which the seafarer shall be entitled to his sickness allowance shall not exceed 120 days. Payment of the sickness allowance shall be made on a regular basis, but not less than once a month.

    The seafarer shall be entitled to reimbursement of the cost of medicines prescribed by the company-designated physician. In case treatment of the seafarer is on an out-patient basis as determined by the company-designated physician, the company shall approve the appropriate mode of transportation and accommodation. The reasonable cost of actual traveling expenses and/or accommodation shall be paid subject to liquidation and submission of official receipts and/or proof of expenses.

    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. In the course of the treatment, the seafarer shall also report regularly to the company-designated physician specifically on the dates as prescribed by the company-designated physician and agreed to by the seafarer. 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.

    4) Those illnesses not listed in Section 32 of this Contract are disputably presumed as work-related.

    Jurisprudence teaches that the conduct of the post-employment medical examination is a reciprocal obligation shared by the seafarer and the employer. The seafarer is obliged to submit to an examination within 3 working days from his or her arrival, and the employer is correspondingly obliged to conduct a meaningful and timely examination of the seafarer.2Ebuenga v. Southfield Agencies, Inc., G.R. No. 208396, March 14, 2018.

    This post-employment medical examination is primarily conducted by the company-designated physician.3Orient Hope Agencies, Inc. v. Jara, G.R. No. 204307 , June 6, 2018. However, to be reliable, the assessment or findings of the company-designated physician must be “complete and definite to give the proper disability benefits to seafarers.” When the employer refuses to comply with its obligation to have the seafarer examined, the seafarer may rely on the medical findings of his or her chosen doctor.4Ebuenga v. Southfield Agencies, Inc., G.R. No. 208396, March 14, 2018. Between a non-existent medical assessment of a company-designated physician and the medical assessment of the seafarer’s doctor of choice, the latter evidently stands.5Dionio v. ND Shipping Agency and Allied Services, Inc., G.R. No. 231096, August 15, 2018.

    In the present case, the Supreme Court found that the seafarer went to Status Maritime immediately after arriving in the Philippines. However, when he requested a medical diagnosis of his condition, Status Maritime refused to subject him to a post-employment medical examination. This compelled the seafarer to go to a doctor of his choice. As noted above, this personal doctor declared him permanently disabled and “unfit to work” as a seafarer.

    On the other hand, the Court ruled that Dr. Selvarajah’s diagnosis could not be considered as that rendered by a company-designated physician. This is because a strict reading of the POEA Standard Employment Contract requires that the company-designated physician be the one to diagnose the seafarer upon repatriation.

    The Court further stated that even if the rules were to be applied liberally, the assessment of Dr. Selvarajah could not be considered thorough, final, and definitive, as it was merely for the seafarer’s urgent medical care. In Dr. Selvarajah’s medical report, there was no showing that he conducted tests to arrive at a proper diagnosis. In fact, he even recommended for the seafarer to undergo further tests to determine the extent of the injury. Furthermore, Dr. Selverajah’s report explicitly stated that it was not meant for any medicolegal proceedings, that it should not be used as a reference in any court hearing and that it does not support any compensation claim. The provisional nature of Dr. Selvarajah’s diagnosis was further supported by his act of recommending that the seafarer see an orthopedic surgeon for further assessment.

    The Court thus ruled that when there is no post-employment medical examination by a company-designated physician, the evaluation of the seafarer’s personal doctor is considered by law as binding between the parties. The refusal of Status Maritime to submit the seafarer to a medical examination was a contravention of its responsibility under the POEA Standard Employment Contract. Thus, the Court upheld the permanent disability rating of the seafarer’s personal doctor.

    Was the seafarer qualified to claim disability benefits?

    Despite the conclusion of his personal doctor, the Supreme Court declared that the seafarer was disqualified from claiming disability benefits on the ground of fraudulent concealment.

    Section 20 (E) of the POEA Standard Employment Contract states that “[a] seafarer who knowingly conceals a pre-existing illness or condition” is disqualified from claiming compensation and benefits.6The provision reads:

    SECTION 20. Compensation and Benefits. — x x x

    E. A seafarer who knowingly conceals a pre-existing illness or condition in the Pre-Employment Medical Examination (PEME) shall be liable for misrepresentation and shall be disqualified from any compensation and benefits. This is likewise a just cause for termination of employment and imposition of appropriate administrative sanctions. (Emphasis supplied)

    In the present case, the Court found that the seafarer knowingly concealed his history of shoulder dislocation. According to the Court, the seafarer had two instances of left shoulder dislocation prior to his employment — once in June 2015 and another in July 2015. Knowing that he had this recurring condition, the seafarer should have disclosed this fact during his pre-employment medical examination. This non-disclosure was apparent in his medical certificate, wherein he answered “no” to the question “Is applicant suffering from any medical condition likely to be aggravated by service at sea or to render the seafarer unfit for service. . .?”

    The Court further stated that the seafarer could not bank on the fact that he was cleared during the pre-employment medical examination. Jurisprudence dictates that this examination is not exploratory in nature and employers are not burdened to discover any and all pre-existing medical condition of the seafarer during its conduct. Pre-employment medical examinations are only summary examinations. They only determine whether seafarers are fit to work and does not reflect a comprehensive, in-depth description of the health of an applicant. This is precisely why Section 20 (E) mandates the seafarer to disclose his or her medical history during the pre-employment medical examination.7Status Maritime Corp. v. Spouses Delalamon, G.R. No. 198097, July 30, 2014, 740 PHIL 175-200; Philman Marine Agency, Inc. v. Cabanban, G.R. No. 186509, July 29, 2013, 715 PHIL 454-483

    According to the Court, intentional concealment of a pre-existing illness or injury is a ground for disqualification for compensation and benefits under the POEA Standard Employment Contract. While the laws give ample protection to our seafarers, this protection does not condone fraud and dishonesty.

    In the present case, the seafarer could not feign ignorance and downplay the concealment of his medical condition. The seafarer knew that he had a recurring shoulder dislocation and never denied this fact. Hence, his disability claim was not granted.

    Further reading:

    • Clemente v. Status Maritime Corp., G.R. No. 238933, July 1, 2020.