In most seafarer cases for disability or death benefits claims, one of
the arguments often raised by the companies
or the insurance correspondents is that they are not liable to pay benefits by pointing to the medical reports of
the company-designated physician that the seafarer’s illness is not
work-connected, that he is fit to work or that the compensation is limited to a
lower amount based on a low disability grading.
They point out that the POEA
mandated that the seafarer’s disability
can only be assessed by the company-designated physician considering that the
latter had the time and the opportunity to constantly monitor the health and
physical condition of the seafarer.
This issue was discussed by the Supreme Court in the
recent 2015 case of Philippine
Transmarine Carriers, Inc. and Northern Marine Management Vs. Joselito A.
Cristino (G.R. No. 188638. December 9, 2015) wherein the Court
said that the medical opinion of the seafarer’s personal specialist doctor
deserves greater evidentiary weight as the company offered no other convincing
proof to substantiate their arguments. The company doctor and the seafarer’s
personal doctor differed on their opinion on the work-relatedness of the
seafarer’s illness, melanocytes or malignant
melanoma. The Court said that the seafarer’s own oncologist was actively
involved in his treatment and even performed surgical procedure on him as
opposed to the more basic medical management provided by the company’s
designated physician which were initially limited to the giving of oral
medication and wound dressing.
In various decisions, the Supreme
Court clearly pointed out that the findings and the disability grading of a
company-designated physician could be set aside by the Court in its
determination of disability compensation (Philippine Transmarine Carriers, Inc. vs.
NLRC, 353 SCRA 47). The Court noted that “their findings cannot be
taken as gospel truth” due to the proliferation of obviously biased company
doctors whose loyalty rests completely upon the company they serve and these
“are palpably self-serving and biased in favor of petitioners and certainly
could not be considered independent” (Wallem
vs.NLRC 318 SCRA 623, United Philippine Lines, Inc. and/or Holland
America Line, Inc., vs. Francisco D. Beseril, 487 SCRA 249). The
Court also considered the glaring apparent inconsistency in the company
doctor's medical report between the classification of claimant's disability and
the fact stated that said claimant had been unable to work for long period of
time, which condition makes his disability permanent and total (Crystal Shipping, Inc. vs. Natividad, 473
SCRA 559.)
In Seagull Maritime Corp. vs. Jaycee Dee
et al (520 SCRA 109) the highest tribunal explained that “courts
are called upon to be vigilant in their time-honored duty to protect labor,
especially in cases of disability or ailment. When applied to Filipino seamen,
the perilous nature of their work is considered in determining the proper
benefits to be awarded. These benefits, at the very least, should approximate
the risks they brave on board the vessel every single day. Accordingly,
if serious doubt exists on the company-designated physician's declaration of
the nature of a seafarer's injury and its corresponding impediment grade,
resort to prognosis of other competent medical professionals should be made. In
doing so, a seaman should be given the opportunity to assert his claim after
proving the nature of his injury. These evidences will in turn be used to
determine the benefits rightfully accruing to him. Nowhere in that case (German Marine Agencies,
Inc. did we hold that the company-designated physician's assessment of the
nature and extent of a seaman's disability is final and conclusive on the
employer company and the seafarer-claimant. While it is the company-designated
physician who must declare that the seaman suffered a permanent disability
during employment, it does not deprive the seafarer of his right to seek a
second opinion.”
In HFS Philippines
vs. Pilar (585 SCRA 315), the
findings of the independent physicians were given more credence than those of
the company-designated physicians, the Supreme Court held that “the bottomline
is this: the certification of the company-designated physician would defeat
respondent's claim while the opinion of the independent physicians would uphold
such claim. In such a situation, we adopt the findings favorable to respondent.
The law looks tenderly on the laborer. Where the evidence may be reasonably
interpreted in two divergent ways, one prejudicial and the other favorable to
him, the balance must be tilted in his favor consistent with the principle of
social justice.”
The POEA contract does not preclude the seafarer from getting a second
opinion as to his condition for purposes of claiming disability benefits. The
Supreme Court reiterated in the case of
Maersk
Filipinas Crewing Inc. vs. Mesina (697 SCRA 601) that "[w]hile it is the
company-designated physician who must declare that the seaman suffers a
permanent disability during employment, it does not deprive the seafarer of his
right to seek a second opinion," hence, the Contract "recognizes the
prerogative of the seafarer to request a second opinion and, for this purpose,
to consult a physician of his choice” (NYK-Fil
Ship Management vs. Talavera, 571 SCRA 183; Abante vs. KJGS Fleet Management
Manila, et al, 607 SCRA 734). The Court stressed that the company
physician's assessment does not evince irrefutable and conclusive weight in
assessing the compensability of an illness as the seafarer has the right to
seek a second opinion from his preferred physician. (Maunlad Transport, Inc. vs. Manigo Jr., G.R. No. 161416, June 13, 2008,
citing Crystal Shipping, Inc. vs. Natividad, Philippine Transmarine Carriers,
Inc. vs.NLRC, 525 SCRA 42, Cadornigara vs. NLRC, 538 SCRA 363.)
In the case of Magsaysay vs. Laurel (694 SCRA 225) the disability provisions
of the POEA-SEC recognize the right of a seafarer to seek a second medical
opinion and the prerogative to consult a physician of his choice. Therefore,
the provision should not be construed that it is only the company-designated
physician who could assess the condition and declare the disability of
seafarers. The provision does not serve as a limitation but rather a guarantee
of protection to overseas workers.
This principle is in line with the
Supreme Court rulings that strict rules of evidence are not applicable in
claims for compensation considering the probability and not the ultimate degree
of certainty is the ultimate test of proof in compensation proceedings (Barcenas vs. WCC 158 SCRA 314; NFD
International Manning Agents, Inc. vs. NLRC, 269 SCRA 486; Heirs of the late
R/O Reynaldo Aniban vs. NLRC, 282 SCRA 377).
No comments:
Post a Comment