Credibility of findings of company doctors

The findings of the  company-designated physician  do not always  bind the courts in determining the merits of compensation cases filed Filipino  seafarers.  

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

In the recent case of Magsaysay vs. Oliver Buenaventura ( G.R. No. 195878. January 10, 2018),   the seafarer  met an accident wherein  a mooring winch crushed his right hand. As a result, he suffered a fracture of the right first metacarpal bone and open fracture of the right second metacarpal  bone, which required  emergency  surgical procedures  both done in Japan and  he was later  medically repatriated. After six months, the company doctor declared him fit to work after undergoing conservative management, continuous rehabilitation physiotheraphy, and occupational therapy. He filed a case for disability benefits.

The Supreme Court denied the claims  for disability benefits of the seafarer as it stressed that  failure to refer the conflicting findings between the company-designated physician and the seafarer's physician of choice grants the former's medical opinion more weight and probative value  over the latter.

Nevertheless, the Supreme Court noted that it does not mean that the judicial bodies  should adopt it hook, line and sinker as it may be set aside if it is shown that the diagnosis of the company-designated physician  is attended with clear bias, has no scientific basis or are not supported by the medical records of the seafarer. 

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The Court also pointed out in a case 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).

Definitive assessment of a seafarer's disability

A seafarer is considered as  suffering permanent total disability if the medical statement of the company doctor  is  devoid of any definitive declaration as to the seafarer's  capacity  to return to work or at least a categorical and final degree of disability.

For the courts and labor tribunals, determining whether a seafarer's fitness to work despite suffering an alleged partial injury generally requires resort to the assessment and certification issued within the 120/240-day period by the company-designated physician. Through such certification, a seafarer's fitness to resume work or the degree of disability can be known, unless challenged by the seafarer through a second opinion secured by virtue of his right under the POEA-Standard Employment Contract. Such certification must be a definite assessment of the seafarer's fitness to work or permanent disability.  

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. (REYNALDO SUNIT,  vs. OSM MARITIME SERVICES, INC.  February 27, 2017G.R. No. 223035

Jurisprudence is replete with cases bearing similar pronouncements.

In Fil-Star Maritime Corporation v. Rosete (G.R. No. 192686, November 23, 2011), the Court concluded that the company-designated doctor's certification issued within the prescribed periods must be a definite assessment of the seafarer's fitness to work or disability:

As stated in Oriental Shipmanagement Co., Inc. v. Bastol, (G.R. No. 186289 June 29, 2010)

the company-designated doctor must declare the seafarer  fit to work or assess the degree of his permanent disability. Without which, the characterization of a seafarer's condition as permanent and total will ensue because the ability to return to one's accustomed work before the applicable periods elapse cannot be shown.

In Kestrel Shipping Co., Inc. v. Munar,  (G.R. No. 198501, January 30, 2013, 689 SCRA 795), the Supreme Court  underscored  that the assessment of the company-designated physician of the seafarer's fitness to work or permanent disability within the period of 120 or 240 days must be definite, viz: "Moreover, the company-designated physician is expected to arrive at a definite assessment of the seafarer's fitness to work or permanent disability within the period of 120 or 240 days. That should he fail to do so and the seafarer's medical condition remains unresolved, the seafarer shall be deemed totally and permanently disabled. (emphasis supplied)"

There is no "definitive assessment" where the company-designated physician noted that seafarer's wound was still open and that he was to continue his medications  (Carcedo v. Maine Marine Philippines, Inc G.R. No. 203804, April 15, 2015) If he fails to do so and the seafarer’s medical condition remains unresolved, the latter shall be deemed totally and permanently disabled.(Fil-Pride Shipping Company, Inc. v. Balasta,  G.R. No. 193047, March 3, 2014, 717 SCRA 624, 626) 

Such principle is more apparent in  event that  the seafarer  has remained unemployed as a seafarer for more than 240 days from the time of his repatriation  or he was unable to perform the same physical activities he used to perform prior to his injury.  ( Belchem Phils./UPL  vs. Eduardo  Zafra G.R. No. 204845               June 15, 2015) 

The 120/240 day rule on seafarer's disability cases

The number of days under medication is a significant element in determining the disability benefits of  a seafarer who was a medically repatriated.  

The  seafarer's standard employment contract of the Philippine Overseas Employment Administration (POEA)    enumerates under Section 20(A)(3) the three classes of benefits the seafarers are entitled to if the illness or injury is considered as work connected:

  (a)     sickness allowance not to exceed 120 days of  basic wage.

 (b)     medical expenses until such time he is declared fit or the degree of his disability has been    established by the company-designated physician.

  (c)     compensation in accordance with the    schedule of benefits governed by the rates and the rules        of compensation. 

In many instances, the period within which the company-designated physician  issues a final medical assessment on the seafarer's disability grading is a contentious factor  in the determination of compensation due to the seafarer. 

The  Supreme Court  laid down (Elburg Shipmgt.  Phils vs. Ernesto Quiogue, G.R. No. 211882, July 29, 2015)     the following guidelines that shall govern seafarers' claims for permanent and total disability benefits:

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.

Under the prevailing doctrine on disability claims of Filipino seafarers. when the company-designated physician makes an assessment of the seafarer’s disability rating within the period of 120 days from medical repatriation, such assessment becomes final. 

The additional 120 days (or a total of 240 days) from repatriation is given to the company-designated physician to provide further treatment to the seafarer and, “thereafter, make a declaration as to the nature of the latter’s disability.”


Failure to obtain any gainful employment for more than 120 days after his medical repatriation, or inability to continue his work as a seaman for the same period does not mean that a seafarer’s disability should be considered permanent and total.

The  Supreme Court further clarified that for the company-designated physician to avail of the extended 240-day period, he must first perform some significant act to justify an extension (e.g., that the illness still requires medical attendance beyond the initial 120 days but not to exceed 240 days); otherwise, the seafarer's disability shall be conclusively presumed to be permanent and total. (Jebsens Maritime, et.al. v. Florvin Rapiz (G.R. No. 218871. January 11, 2017)

A seafarer is considered as  suffering permanent total disability if the medical statement of the company doctor  is  devoid of any definitive declaration as to the seafarer's  capacity  to return to work or at least a categorical and final degree of disability.

There is no "definitive assessment" where the company-designated physician noted that seafarer's wound was still open and that he was to continue his medications  (Carcedo v. Maine Marine Philippines, Inc G.R. No. 203804, April 15, 2015) If he fails to do so and the seafarer’s medical condition remains unresolved, the latter shall be deemed totally and permanently disabled.(Fil-Pride Shipping Company, Inc. v. Balasta,  G.R. No. 193047, March 3, 2014, 717 SCRA 624, 626) 

Such principle is more apparent in  event that  the seafarer  has remained unemployed as a seafarer for more than 240 days from the time of his repatriation  or he was unable to perform the same physical activities he used to perform prior to his injury.  ( Belchem Phils./UPL  vs. Eduardo  Zafra G.R. No. 204845               June 15, 2015) 

A total disability does not require that the employee be completely disabled, or totally paralyzed. What is necessary is that the injury must be such that the employee cannot pursue his or her usual work and earn from it.   (Fil-Star Maritime Corp., et.al. vs. Hanziel Rosete, G.R. No. 192686, November 23, 2011), Permanent disability is the inability of the worker to perform his job , regardless of whether or not he loses the use of any part of his body. (Philimare, Inc./Marlow Navigation Co., Ltd.,  vs. Benedicto Suganob, G.R. No. 168753, July 9, 2008,  )

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Third doctor opinion rule in seafarer's compensation claims

In the event of disagreement on the services of the third doctor, the seafarer has the right to institute a complaint  for disability benefits directly before the National Labor Relations Commission (NLRC)  or the National Conciliation and Mediation Board (NCMB)

This is the ruling of the Supreme Court in  the recent case of Reynaldo Sunit vs. OSM (G.R. No. 2230, February 27, 2017) . The language of the POEA-Standard Employment Contract (SEC)  is clear in that both the seafarer and the employer must mutually agree to seek the opinion of a third doctor. In many instances, the  NLRC/ NCMB and appeal courts dismiss the compensation claims of seafarers for alleged “non-compliance” with the third doctor opinion rule.

During his employment, the seafarer  fell from the vessel's tank approximately 4.5 meters high and suffered a broken right femur. He was diagnosed to have suffered "Fractured, Right Femur; SIP Intramedullary Nailing, Right Femur." The seafarer was repatriated on October 6, 2012. After undergoing medical treatment, the company-designated doctor issued an interim Grade 10 disability on January 13, 2013. The seafarer  was then issued with a final Grade 10 disability by the company-designated doctor on February 15, 2013. Prior to the February 15, 2013 assessment, the seafarer  consulted the opinion of a second doctor, Dr. Garduce, who recommended a Grade 3 disability.

Both parties then consulted a third doctor to assess the seafarer's degree of disability, who assessed seafarer with a Grade 9 partial disability on February 17, 2014, 499 days from his repatriation. In addition to the partial disability grading, Dr. Bathan likewise assessed the seafarer  as unfit to work and recommended him to undergo further rehabilitation.

The parties do not dispute that seafarer's injury was work-related and that he is entitled to disability compensation. The disagreement, however, lies on the degree of disability and amount of benefits that petitioner is entitled.

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.

The Supreme Court recapitulated the procedural requisites under the rules and established jurisprudence where the parties opt to resort to the opinion of a third doctor:

First, according to the POEA-SEC  and as established by Vergara,26 when a seafarer sustains a work-related illness or injury while on board the vessel, his fitness or unfitness for work shall be determined by the company­ designated physician.

Second, if the seafarer disagrees with the findings of the company doctor, then he has the right to engage the services of a doctor of his choice. If the second doctor appointed by the seafarer disagrees with the findings of the company doctor, and the company likewise disagrees with the findings of the second doctor, then a third doctor may be agreed jointly between the employer and the seafarer, whose decision shall be final and binding on both of them.

It must be emphasized that the language of the POEA-SEC is clear in that both the seafarer and the employer must mutually agree to seek the opinion of a third doctor. In the event of disagreement on the services of the third doctor, the seafarer has the right to institute a complaint with the LA or NLRC.

Third, despite the binding effect of the third doctor's assessment, a dissatisfied party may institute a complaint with the LA to contest the same on the ground of evident partiality, corruption of the  third  doctor,  fraud, other undue means,lack of basis to support the assessment, or being contrary to law or settled jurisprudence.

Permanent disability is defined as the inability of a worker to perform his job for more than 120 days (or 240 days, as the case may be), regardless of whether or not he loses the use of any part of his body. Total disability, meanwhile, means the disablement of an employee to earn wages in the same kind of 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 attainments could do.

As the seafarer  was actually unable to work even after the expiration of the 240-day period and there was no final and conclusive disability assessment made by the third doctor on his medical condition, it would be inconsistent to declare him as merely permanently and partially disabled. It should be stressed that a total disability does not require that the employee be completely disabled, or totally paralyzed.  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

The imbalanced legal battle on seafarers claims

“Aanhin pa ang damo kung patay na ang kabayo.”  Never mind if the seafarer dies before he receives compensation. Through legislative fiat, ANGKLA partylist is  throwing off-balance  the already imbalanced legal battle on seafarers claims. 

ANGKLA  has consistently  used  the phrase “ balancing  the interest of the seafarer and the company”  when it filed the   proposed  bill (House Bill No.  5430)  that aimed to delay the execution of the monetary judgment award  issued by the National Labor Relations Commission (NLRC) and the National Conciliation and Mediation Board (NCMB)   in favor of a  seafarer. It  is the twin bill of the new law, the so-called “Seafarers’ Protection Act”.

Every labor dispute is a David and Goliath battle as  it  involves two opposing parties:  the worker on one side and the management on the other, for  monetary claims for  disability and death benefits, illegal dismissal as well as unpaid or underpayment of salaries and wages. 

 By placing   the proceeds  in escrow until such time the finality of the decision issued by the appropriate appellate court (Supreme Court or Court of Appeals), in the end, the “balance of scale” will tilt more to capital as this  will protect the business interest of the manning agencies and their principal rather than the seafarers themselves.

  

In order to discourage seafarers in pursuing legal actions against the companies when it authored the new law , the Seafarers’ Protection Act,  , ANGKLA deliberately and  sweepingly   depicted   seafarers’ lawyers as “unscrupulous” in an attempt to deflect the real issues why cases are being filed.  They blamed the lawyers , most of them  they described as “ambulance chasers” , who  go to lengths to push seafarers to file labor cases against their foreign employers, claiming for benefits even beyond the claims they are actually entitled to.

In essence, ANGKLA echoed  the employer’s phrase “ benefits even beyond the claims they are actually entitled ”  to sanitize the problematic  legal battle for seafarer’s compensation.

Valid claims,  employers  argue, necessarily must  follow what the POEA contract dictates: a contract  that contains terms and conditions formulated more favorable to his employer and is littered with ambiguous provisions, generalizations, technicalities that he does not understand.

Away from his family and working on board vessels sailing non-stop for weeks or months the world’s oceans, he is mentally and emotionally stressed. Constantly exposed to fluctuating temperatures caused by variant weather changes of extreme hot and cold as the ships cross ocean boundaries, not to mention harsh weather conditions, the risks of his getting killed, injured or ill are high.

Under  the 1996 POEA Standard Employment Contract (SEC),  for disability or death to be compensable,  it was sufficient that the seafarer suffered injury or illness during the term of his employment.  The cause of illness or death is immaterial.

However, through the lobbying of the principals and their  manning agencies, the restrictive clause “work-related”  was added under Section 20 (B) of the 2000 POEA SEC to limit their liabilities.   The 2000 POEA SEC defined "work-related injury" as "injury(ies) resulting in disability or death arising out of and in the course of employment" and "work-related illness" as "any sickness resulting to disability or death as a result of an occupational disease listed under Section 32-A of the contract”.  Being included in the list is not enough, since  all of the following conditions must be satisfied: (a) the seafarer’s   work must involve the risks described; (b) the disease was contracted as a result of the seafarer's exposure to the described risks; (c). the disease was contracted within a period of exposure and under such other factors necessary to contract it;  and (d) there was no notorious negligence on the part of the seafarer.  These same definitions were reiterated in the 2010 POEA SEC.

Two elements must concur for an injury or illness to be compensable. First, that the injury or illness must be work-related; and second, that the work-related injury or illness must have existed during the term of the seafarer's employment contract. The first requirement  appeared in the 2000 and 2010 POEA SEC but is  absent in the 1996 version.

Through such restrictive provisions of the POEA SEC, claims for disability compensation  became a legal battleground, especially in instances   when seafarers do not  receive full compensation that are legally entitled to have. Such emergence of cases is attributable to the fact that  the seafarer’s  employer does not hesitate to harness its immense resources to limit its liability.

In denying, if not limiting,  the seafarer’s claims, the employer usually raise the misleading argument that the POEA mandated that disability can only be assessed by the company-designated physician based on the disability grading system considering that the latter had the time and the opportunity to constantly monitor the health and physical condition of the seafarer. However, the Supreme Court stressed that their  medical assessment “is not the alpha and the omega of the seafarer's claim for permanent and total disability.” (Elburg Shipmanagement Phils. vs. Quiogue, Jr,  G.R.No.211882 July 29, 2015). The problem can be partly attributed to the Supreme Court's observation on the  proliferation of obviously biased company doctor whose “findings cannot be taken as gospel truth” and  “are palpably self-serving  and certainly could not be considered independent” as their  "loyalty rests completely upon the company they serve" (UPL/HAL  vs  . Beseril, 487 SCRA 249).  Thus, the POEA contract does not preclude the seafarer from getting a second opinion as to his condition for purposes of claiming disability benefits.

In reality, the grading system assessment under the POEA Contract is not  reflective of the benefits that should be given to the seafarer. There are medical conditions that are classified as partial disability (between Grade 2 to 14) but in essence should have been considered as total permanent (Grade 1).  Employers will never hire a seafarer who suffered complete loss of the sense of hearing on both ears (Grade 3), loss of speech due to injury to the vocal cord (Grade 9),   total loss of a leg or amputation at or above the knee (Grade 3),    paralysis of one upper extremity (Grade3) , or  loss of one foot at ankle joint or above (Grade 6),   loss of   ten  fingers of both hands (Grade 3)  or amputation between wrist and elbow joint (Grade 5), or total blindness of one  eye and fifty percent (50%) loss of vision of the other eye will never be employed due to visual impairments. (Grade 5).  Fit-To Work certifications are given even to seafarers who are still not cured or in essence can no longer be employed such as those who suffered from heart attacks, aneurism or stroke.

From the business point of view, it will be risky for the employers  to let the seafarer be re-employed since the harsh working environment might only aggravate his fragile condition and in the end expose the company to more serious insurance liabilities.

Thus, Supreme Court's consistently  ruled  that  "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. Disability need not render the seafarer absolutely helpless or feeble to be compensable; it means disablement of an employee 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.  (Valenzona vs. Fair Shipping Corporation, 659 SCRA 642)  

The word “unscrupulous” should likewise be applied to the employers and their people who  harness  their  immense resources to limit  their  liability. In many instances, the seafarer signs Receipt and Quitclaim documents thereby releasing his employers from all claims, demands and causes of action without even understanding their contents. Oftentimes, he is misled into accepting an ex-gratia, miniscule amount, in the guise that his condition is either not work-connected, or for any other reason for which he does not comprehend.

Unless their definition of “valid claims” is changed, through the deletion of the “work-related” clause, and  through the reversion to the  old  1996 POEA Contract , the denials of seafarers’ claims will continue. The compensation scheme should be less restrictive and more realistic, Otherwise, their only recourse is to seek legal assistance from lawyers of their own choosing. Conversely speaking, give the seafarers what they should  receive, and employers will not be hounded by legal cases.  

In essence, such reversion to the 1996 POEA Contract was partially done in the implementation of the Compulsory Insurance Coverage under the Migrant Workers and Overseas Filipinos Act of 1995” or Republic Act 8042 as amended by Republic Acts 9422 and 10022. The seafarer or his beneficiaries  will automatically be given, among others,  the benefits (US$15,000.00 if accidental death, US$10,000.00 if natural death, US$7,500.00 if total permanent disability) with or without fault on the part of the seafarer, as long as the basis of such  claim occurred during the effectivity of the POEA Contract.

And expectedly, ANGKLA will not  pursue the total deletion of the “work related clause” since this will run counter to the business interest of the employers.

In fact, ANGKLA filed  House Bill  No. 5430 aimed to amend the labor code that will have significant impact on labor claims governing the immediately “final and executory” nature of decisions issued by NLRC/NCMB.   The seafarer   will wait for longer years before they receive the award by the NLRC/NCMB,  ANGKLA proposes that the proceeds of execution shall be deposited in an escrow account to ensure the restitution of monetary awards in case the appropriate appellate court annuls or partially or totally reverses the monetary judgment.

Labor litigation takes years before it reaches the supreme court. In most cases, the elevation of the records alone from the NLRC/NCMB to the Court of Appeals or Supreme Court will take several years. The proceedings in the appellate court will entail further delay. ANGKLA justifies the Escrow bill to ensure that the seafarer will still receive the award in the future in the event that the manning agency close down. However, ANGKLA disregarded the fact that  in cases of seafarers with medical conditions, some incur huge debts to sustain their medication while others die before the decision by the Supreme Court is released forcing the seafarers into accepting an ex-gratia, miniscule amount  Companies have the legal remedies to recover the amount, but one cannot reclaim the life of the deceased claimant.

It is election time again. Be critical of the real colors.