In a seafarer’s disability claim, the Supreme Court has clarified the importance of adhering to the procedures outlined in the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC). Specifically, the Court emphasized that without a third-doctor consultation to challenge the company-designated physician’s assessment, and absent any evidence casting doubt on that assessment, the company doctor’s findings will generally prevail. This ruling underscores the need for seafarers to follow established protocols for resolving medical disputes in disability claims.

Navigating Seafarer’s Rights: When Does a Back Injury Qualify for Full Disability?

This case revolves around Teody D. Asuncion, a GP1 Motorman who sustained a back injury while working on a vessel. After being repatriated and examined by a company-designated physician, he was given a Disability Grade 8, indicating a moderate rigidity of the trunk. Disagreeing with this assessment, Asuncion sought a second opinion from his own doctor, who declared him unfit for sea duty. The core legal question is whether Asuncion is entitled to total and permanent disability benefits, despite the company doctor’s partial disability assessment, especially given his failure to seek a third, independent medical opinion.

The factual background of the case begins with Asuncion’s employment by MST Marine Services. During his nine-month contract, he fell and injured his back. Upon returning to the Philippines, the company-designated physician, Dr. Cruz, initially diagnosed him with lumbosacral strain. Despite various tests, Asuncion continued to experience pain. Eventually, Dr. Cruz assessed him with a Disability Grade 8. However, Asuncion later consulted Dr. Escutin, who diagnosed him with a more severe condition and deemed him unfit for sea duty.

The Labor Arbiter (LA) initially ruled in favor of Asuncion, awarding him total and permanent disability benefits. This decision was upheld by the National Labor Relations Commission (NLRC). The petitioners then appealed to the Court of Appeals (CA), which also affirmed the LA’s ruling, emphasizing Asuncion’s inability to work for more than 120 days. However, the Supreme Court disagreed with the CA’s reasoning.

The Supreme Court referenced a critical point from Vergara v. Hammonia Maritime Services, Inc., et al.: a temporary total disability becomes permanent either when the company-designated physician makes that declaration within the allowed period or when the maximum 240-day medical treatment period expires without a declaration of fitness or permanent disability. This highlights that the mere passage of time does not automatically qualify a disability as total and permanent.

Furthermore, the Court emphasized that permanent disability benefits are determined by the disability grading under Section 32 of the POEA-SEC. In Scanmar Maritime Services, Inc., et al. v. Emilio Conag, the Court stated:

[F]or work-related illnesses acquired by seafarers from the time the 2010 amendment to the POEA-SEC took effect, the declaration of disability should no longer be based on the number of days the seafarer was treated or paid his sickness allowance, but rather on the disability grading he received, whether from the company-designated physician or from the third independent physician, if the medical findings of the physician chosen by the seafarer conflicts with that of the company-designated doctor.

Building on this principle, the Court reiterated the importance of the third-doctor consultation process. While a seafarer can seek a second opinion, any conflicting conclusions must be resolved through a jointly appointed third physician. Without this third opinion and without any evidence to discredit the company doctor’s assessment, the latter’s findings should prevail.

The Court observed that the third-doctor referral provision in the POEA-SEC is often neglected, which is unfortunate because this process is intended to settle disability claims efficiently at the parties’ level. In line with this, the Court cited Philippine Hammonia Ship Agency, Inc., et al. v. Dumadag, emphasizing the importance of following this procedure.

The Court found that Asuncion failed to follow this procedure. He did not seek a third-doctor consultation, nor did he provide any justification for bypassing it. Furthermore, he filed his complaint before even consulting his own physician, rendering his claim premature. At the time he filed his complaint, there was no medical basis supporting his claim at all.

The Court also addressed the CA’s rejection of the company-designated physician’s assessment. The Court found this reasoning flawed, as Dr. Cruz monitored Asuncion’s condition throughout his treatment and based his assessment on objective scientific procedures, which Asuncion failed to successfully challenge.

Adding to this, the Court noted that Asuncion’s own physician, Dr. Escutin, did not provide a disability grading. While Dr. Escutin declared Asuncion permanently disabled, he also recommended further diagnostic tests, which undermines the finality of his diagnosis. The court found Dr. Escutin’s conclusions to be less reliable than those of the company-designated physician under these circumstances.

Despite ruling against Asuncion on the merits of his disability claim, the Supreme Court upheld the conditional settlement of the judgment award. The Court considered the agreement made by Asuncion. This agreement, specifically the statement that Asuncion had no further claims and would not file any future suits, was deemed inequitable to the employee.

The Supreme Court has previously stated that a conditional settlement of a judgment award can operate as a final satisfaction. In Career Philippines Ship Management, Inc. v. Madjus, the Court explained that the settlement became final due to terms prejudicial to the employee. This was further clarified in Philippine Transmarine Carriers, Inc. v. Legaspi, where the Court allowed the return of excess payment only because the agreement was fair to both parties.

Ultimately, the Supreme Court denied the petition, affirming the CA’s decision, but on the grounds of the conditional settlement rather than the disability assessment. Despite Asuncion’s failure to follow the proper procedures for contesting the company-designated physician’s assessment, he was allowed to keep the previously awarded settlement due to the inequitable nature of the agreement he had signed.

FAQs

What was the key issue in this case?	The key issue was whether a seafarer was entitled to total and permanent disability benefits despite a partial disability assessment by the company-designated physician and failure to seek a third medical opinion.
What is the role of the company-designated physician?	The company-designated physician is responsible for assessing the seafarer’s medical condition and providing a disability grading, which is crucial in determining the benefits the seafarer is entitled to.
What is the significance of the third-doctor consultation?	The third-doctor consultation is a critical step in resolving disputes between the company-designated physician and the seafarer’s chosen physician, providing an impartial assessment. It is a mandatory step under the POEA-SEC.
What happens if a seafarer fails to seek a third-doctor opinion?	If a seafarer fails to seek a third-doctor opinion without valid justification, the assessment of the company-designated physician will generally prevail.
How is disability grading determined under the POEA-SEC?	Disability grading is determined based on the schedule of benefits outlined in Section 32 of the POEA-SEC, which assigns specific grades to various medical conditions and disabilities.
What constitutes total and permanent disability for a seafarer?	Total and permanent disability for a seafarer means the inability to perform their usual sea duties for more than 120 days, although this determination is primarily based on the disability grading assigned by the company-designated physician or a third doctor.
Can a seafarer consult their own physician?	Yes, a seafarer can consult their own physician, but any conflicting findings must be resolved through a third, independent physician jointly selected by the employer and the seafarer.
What is the impact of a conditional settlement agreement?	A conditional settlement agreement can operate as a final satisfaction of a judgment, especially if the terms are fair to both parties. However, terms that are prejudicial or inequitable to the employee may be viewed negatively by the Court.
Why was the seafarer allowed to keep the settlement in this case?	Despite the ruling against his disability claim, the seafarer was allowed to keep the settlement because of the inequitable terms of the agreement he signed, which the Court deemed prejudicial to his rights.

This case serves as a reminder of the importance of following the procedures outlined in the POEA-SEC when pursuing disability claims. While seafarers have the right to seek medical opinions and contest assessments, adhering to the established protocols, particularly the third-doctor consultation, is crucial for a successful claim. Additionally, it highlights the need for caution when entering settlement agreements to ensure terms are equitable to both parties.

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: MST Marine Services vs. Asuncion, G.R. No. 211335, March 27, 2017