The Importance of Clear Medical Assessments and Compliance with Contractual Provisions in Seafarer Disability Claims

Nicasio M. Dagasdas v. Trans Global Maritime Agency, Inc., G.R. No. 248445 and G.R. No. 248488, May 12, 2021

Imagine a seafarer, far from home, battling a debilitating illness that threatens his career and livelihood. This is the reality for many seafarers who face the challenge of obtaining disability benefits when their health fails. The case of Nicasio M. Dagasdas against Trans Global Maritime Agency, Inc. sheds light on the critical issues surrounding disability claims for seafarers, particularly the importance of medical assessments and adherence to contractual obligations. In this case, Dagasdas, a seafarer, was diagnosed with pulmonary tuberculosis and sought compensation under the terms of his employment contract. The central question was whether he was entitled to disability benefits and under which contractual provisions.

Legal Context: Navigating Seafarer Disability Claims

Seafarer disability claims are governed by a complex interplay of laws, regulations, and contractual agreements. The Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) sets the minimum standards for seafarer employment, including provisions for disability benefits. Additionally, collective bargaining agreements (CBAs) may offer more favorable terms, as was the case with the AMOSUP/ITF TCCC NON-IBF CBA applicable to Dagasdas.

Key to these claims is the medical assessment process. The POEA-SEC and CBAs typically outline procedures for determining disability, often involving assessments by company-designated physicians and, in cases of disagreement, the possibility of consulting a third doctor. The Supreme Court has emphasized that the findings of the company-designated physician generally prevail, but this can be challenged if the assessment is biased or unsupported by medical records.

The relevant provision from the POEA-SEC states: “If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the employer and the seafarer.” Similarly, the CBA specifies: “If a doctor appointed by the seafarer and his Union disagrees with the assessment, a third doctor may be agreed jointly between the Employer and the Seafarer and his Union, and the third doctor’s decision shall be final and binding on both parties.”

Case Breakdown: The Journey of Nicasio M. Dagasdas

Nicasio M. Dagasdas was employed by Trans Global Maritime Agency, Inc. as a pumpman on the vessel Ridgebury Pride. In January 2016, he experienced severe health issues, including shortness of breath and chest pain, which led to his repatriation to the Philippines. Upon his return, he was diagnosed with pulmonary tuberculosis and underwent treatment.

Despite completing his treatment, the company-designated physician declared Dagasdas fit to work in August 2016. However, Dagasdas sought a second opinion from his doctor of choice, who found that his condition had not fully healed and declared him permanently disabled due to chronic obstructive pulmonary disease secondary to tuberculosis.

When Dagasdas attempted to claim disability benefits, Trans Global refused to settle, leading to arbitration proceedings. The Office of the Voluntary Arbitrator (OVA) initially awarded Dagasdas benefits under the CBA, but the Court of Appeals (CA) modified this to align with the POEA-SEC. The Supreme Court ultimately sided with Dagasdas, emphasizing the lack of supporting medical records for the company’s fit-to-work certification and the failure to refer the case to a third doctor.

Key quotes from the Supreme Court’s reasoning include:

“The submission to a third doctor is not the sole duty of the seafarer; it must be jointly agreed upon by the employer and the seafarer.”

“If the findings of the company-designated physician are biased in favor of the employer, then labor tribunals and courts may give greater weight to the findings of the seafarer’s personal physician.”

The procedural steps involved in this case were:

• Dagasdas filed a claim through the Single-Entry Approach (SEnA) and a Notice to Arbitrate.
• The OVA awarded disability benefits based on the CBA, but the CA modified this to the POEA-SEC standard.
• The Supreme Court reviewed the case, focusing on the medical assessments and the third doctor provision.

Practical Implications: Lessons for Seafarers and Employers

This ruling underscores the importance of thorough and unbiased medical assessments in seafarer disability claims. Employers must ensure that their designated physicians provide assessments supported by comprehensive medical records. Seafarers, on the other hand, should be aware of their rights to seek a second opinion and the importance of the third doctor provision in resolving disputes.

Key Lessons:

• Ensure that medical assessments are supported by detailed records to avoid disputes.
• Both parties should actively engage in the process of appointing a third doctor if assessments differ.
• Seafarers should document all medical consultations and treatments to support their claims.

Frequently Asked Questions

What is the role of the company-designated physician in seafarer disability claims?

The company-designated physician’s role is to assess the seafarer’s medical condition and determine the degree of disability. Their findings generally prevail unless challenged by the seafarer’s own doctor.

What happens if there is a disagreement between the company doctor and the seafarer’s doctor?

If there is a disagreement, the seafarer and employer can jointly agree to consult a third doctor, whose decision will be final and binding.

Can a seafarer claim disability benefits if declared fit to work by the company?

Yes, if the seafarer’s own doctor disagrees and the case is not referred to a third doctor, the seafarer can still claim benefits based on their doctor’s assessment.

What are the key provisions in the POEA-SEC regarding disability benefits?

The POEA-SEC provides for disability benefits based on the degree of disability assessed by the company-designated physician, with provisions for a third doctor in case of disagreement.

How can a seafarer ensure they receive fair compensation for disability?

Seafarers should keep detailed medical records, seek a second opinion if necessary, and ensure that the third doctor provision is utilized if assessments differ.

What are the implications of this ruling for future seafarer disability claims?

This ruling emphasizes the need for clear and supported medical assessments and adherence to contractual provisions, which may lead to more rigorous documentation and processes in future claims.

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