The Supreme Court has clarified the process for seafarers claiming disability benefits, particularly regarding the necessity of seeking a third medical opinion. The Court emphasized that the seafarer bears the responsibility to secure this third opinion if they disagree with the company-designated physician’s assessment. Failure to do so can weaken their claim for disability benefits, especially when the company doctor has already declared them fit to work. This ruling underscores the importance of adhering to the procedures outlined in the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC) to ensure a fair and objective assessment of a seafarer’s medical condition.

When a Seafarer’s Fitness is Questioned: Navigating Conflicting Medical Opinions

Emilio Conag, a bosun’s mate, sought disability benefits after experiencing back pain while working on a vessel managed by Scanmar Maritime Services. Upon repatriation, company doctors declared him fit to work, but Conag later consulted his own doctor who deemed him unfit. The Labor Arbiter (LA) initially favored Conag, but the National Labor Relations Commission (NLRC) reversed, citing Conag’s failure to obtain a third medical opinion as required by the POEA-SEC. The Court of Appeals (CA) sided with the LA, prompting Scanmar to elevate the case to the Supreme Court. The core legal question revolves around who carries the burden of securing a third medical opinion when there’s disagreement on a seafarer’s fitness to work and whether Conag presented sufficient evidence to overturn the company-designated physician’s assessment.

The Supreme Court, in examining the case, reiterated the established principle that while it is not a trier of facts in Rule 45 petitions, it may delve into factual issues when the findings of the NLRC and LA conflict. The Court emphasized that the right to disability benefits for seafarers is governed by the Labor Code, POEA-SEC, and any applicable Collective Bargaining Agreements (CBAs). In this context, the Court referred to the landmark case of Vergara v. Hammonia Maritime Services, Inc., et al., which detailed the process a seafarer must undertake to claim disability benefits.

According to the Vergara ruling, a seafarer must report to the company-designated physician within three days of arrival for diagnosis and treatment. During this period, not exceeding 120 days (extendable to 240 days under certain conditions), the seafarer is considered temporarily totally disabled and entitled to basic wage. The company may declare the seafarer fit to work, or acknowledge a permanent disability, based on the POEA-SEC and Philippine laws. If the seafarer disagrees with the company physician’s assessment, the POEA-SEC provides a mechanism for resolving the conflict.

The Court noted Conag’s failure to comply with Section 20-B(3) of the POEA-SEC, which stipulates the process for resolving conflicting medical opinions. Specifically, it states that if a seafarer consults his own doctor and disagrees with the company-designated physician’s assessment, the seafarer has the duty to secure the opinion of a third doctor. This third doctor is jointly selected by the seafarer and the employer, and their opinion is considered final and binding. Here, Conag obtained his doctor’s assessment only after the company doctors declared him fit to work and after he had already filed a complaint with the Labor Arbiter.

“[U]nder Section 20-B(3) of the POEA-SEC, the duty to secure the opinion of a third doctor belongs to the employee asking for disability benefits.”

The Court also found Conag’s claim lacking in factual medical basis. While Conag presented a medical certificate from his doctor, Dr. Jacinto, the Court noted the certificate’s deficiencies. Dr. Jacinto’s assessment lacked details of the treatments administered, the dates of consultation, and the specific diagnostic tests conducted. The certificate appeared to be a pro-forma document filled in by hand, raising doubts about its reliability. The Court contrasted this with the detailed assessment by the company-designated physicians, who conducted thorough examinations and laboratory tests.

Furthermore, the Court pointed out discrepancies in Conag’s account of his injury. While he claimed to have suffered a spinal injury due to heavy lifting, the ship’s logbook contained no record of any accident involving Conag. His medical repatriation form indicated he was sent home due to kidney problems. The Court also questioned the causal link between Conag’s diagnosed “Mild Lumbar Levoconvex Scoliosis and Spondylosis” and his work as a bosun’s mate, especially since the company-designated physician, Dr. Chuasuan, reported that Conag was free from pain and had regained full range of trunk movement. The “Negative Straight Leg Raising Test” further indicated against lumbar disk herniation.

The Supreme Court, therefore, concluded that Conag failed to provide sufficient evidence to prove his entitlement to disability benefits. His failure to comply with the POEA-SEC’s requirement of obtaining a third medical opinion and the lack of a solid medical basis for his claim led the Court to reverse the CA’s decision and reinstate the NLRC’s ruling, dismissing Conag’s complaint.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer, Conag, was entitled to disability benefits despite the company-designated physician declaring him fit to work and his failure to obtain a third medical opinion as required by the POEA-SEC.
What is the significance of Section 20-B(3) of the POEA-SEC?	Section 20-B(3) outlines the procedure for resolving conflicting medical opinions between the company-designated physician and the seafarer’s chosen doctor. It places the responsibility on the seafarer to secure the opinion of a third, mutually agreed-upon doctor.
Who bears the burden of proof in disability claims?	The seafarer bears the burden of proving that they are entitled to disability benefits. This includes providing sufficient medical evidence to support their claim and complying with the procedural requirements of the POEA-SEC.
What happens if a seafarer doesn’t get a third medical opinion?	Failure to obtain a third medical opinion, when there is disagreement between the company doctor and the seafarer’s doctor, can weaken the seafarer’s claim. The assessment of the company-designated physician may prevail if unchallenged by a third opinion.
What weight do the company doctor’s findings carry?	The findings of the company-designated physician are given significant weight, especially if they are well-documented and based on thorough examinations and tests. The seafarer must present strong evidence to rebut these findings.
How does this ruling affect future seafarer disability claims?	This ruling reinforces the importance of following the POEA-SEC procedures, especially the third-doctor rule. Seafarers must proactively seek a third opinion if they disagree with the company doctor to strengthen their claim.
What kind of medical evidence is considered sufficient?	Sufficient medical evidence includes detailed medical reports, diagnostic test results, treatment records, and a clear explanation of the seafarer’s condition and its impact on their ability to work.
Can a seafarer file a disability claim even after being declared fit to work?	Yes, but the seafarer must present compelling evidence that their condition deteriorated after being declared fit to work or that the initial assessment was incorrect. They must also follow the POEA-SEC procedures for disputing the assessment.
What if the company refuses to agree on a third doctor?	If the company unreasonably refuses to agree on a third doctor, the seafarer should document this refusal and may proceed with their claim based on the available medical evidence. This refusal can be seen as undermining the fairness of the process.

This case highlights the importance of adhering to the established procedures for claiming disability benefits as a seafarer. It underscores the need for seafarers to actively participate in resolving medical disputes and to provide solid medical evidence to support their claims. By understanding their rights and responsibilities under the POEA-SEC, seafarers can better protect their interests and ensure a fair assessment of their medical condition.

For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.

Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: SCANMAR MARITIME SERVICES, INC. vs. EMILIO CONAG, G.R. No. 212382, April 06, 2016