Monday, January 6, 2020

Final and definite disability assessments on seafarer’s benefits




A  final and definite disability assessment is necessary in order to truly reflect  the true extent of the sickness or  injuries of the seafarer and his or her capacity to resume work as such.

Otherwise, the corresponding disability benefits awarded might not be commensurate with the prolonged effects of the injuries suffered.

This was the principle on  seafarer’s disability benefits cases  reiterated  by the Supreme Court   in the recent case of Jerry Talaugon vs. BSM  Crew Services/ Schulte  Shipmgt. ( GR. No. 227934 September 4, 2019)

The company  employed the seafarer  as an oiler.

The seafarer was medically repatriated after he was hospitalized in Saudi Arabia and  was diagnosed with "Renal Colic Lumbago post Zoster Neuralgia."  

Upon his arrival in the Philippines, he was seen by a company designated doctor  wherein he was  diagnosed with "Hyperthesia, Ruled out Hansen's Disease, L4- L5 Disc Protrusion, Disc  Dessication"  and later on with a tumor in his spinal cord.  

After undergoing surgery and physical therapy, he went back to, yet, another company-designated doctor .  The  latter observed that he was still suffering lower back pain probably due to his lumbar spondylosis who then declared that his  illness  was  not work related. Said doctor, nonetheless, offered to give him a disability grading of 11.

The company­ designated physician made an assessment on seafarer's illness within the 120-day period, specifically a  rating of  Grade 11 on May 15, 2014 or 117th day since he was evaluated and had been undergoing continuous medical treatment.

The Supreme Court, however,  did not consider  said assessment as final and definite within the ambit of the existing jurisprudence.

Section 20(B) of POEA-SEC  provides that it is the primary responsibility of a company-designated physician to determine the disability grading  or  fitness  to  work  of  seafarers.

 To  be  conclusive,  however, company-designated physicians' medical assessments or reports must be complete and definite.

The guidelines that govern seafarers' claims for permanent and total disability benefits was outlined  in the case of  Elhurg Shipmanagement Phils., Inc. v. Quiogue, Jr (G.R. No. 211882, July 29, 2015):

First, the company-designated doctor 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;

Second,  if the company-designated doctor fails to give his assessment within the period of 120 days, without any justifiable reason, then the seafarer's disability becomes permanent and total;

Third, if the company-designated doctor 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

Lastly, if the company-designated doctor  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

 Two (2) requisites must concur for a determination of a seafarer's condition: 1) an assessment must be issued within the 120/240 window, and 2) the assessment must be final and definitive.

The  Medical Report dated May 15, 2014 contained the following observations: "the prognosis of returning to (his) sea duties is guarded" and "If patient is entitled to a disability, his suggested  disability  grading  is Grade 11 - slight rigidity or 1/3 loss of motion of lifting power of the trunk."

The Supreme Court pointed out that this  is hardly the "definite and conclusive assessment of the seafarer's disability or fitness to return to work" required by law from the company­ designated doctor.

For there was nothing on record showing that the company designated doctor explained in detail the  progress  of seafarer's treatment and the  approximate period needed for him to fully recover.

The assessment will not be considered definitive if  the seafarer will  continue to require medical treatments thereafter.

Consequently, without a final and definitive assessment from the company­ designated doctor  on the seafarer's disability,  the Supreme Court stressed that the   same  is  deemed permanent and total by operation of law.

In disability compensation, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairment of one's earning capacity.  Permanent total disability means disablement  to earn wages in the same kind of work, or work of similar nature that he was trained for or accustomed to perform, or any kind of work which a person of his  mentality and attainment could do. It does not mean absolute helplessness.

Atty. Gorecho heads the seafarers’ division of the Sapalo Velez Bundang Bulilan  law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786

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