The Supreme Court ruled that a seafarer forfeits the right to claim disability benefits under the POEA-SEC if they fail to submit to a post-employment medical examination by a company-designated physician within three working days of repatriation. This requirement is crucial for determining if an illness is work-related and ensures fairness to the employer. The Court emphasized that while the POEA-SEC should be liberally construed in favor of seafarers, it cannot sanction claims where there is a failure to substantially establish compensability and comply with mandatory reporting.

When a Seafarer’s Delayed Report Jeopardizes Disability Benefits: The Malicdem Case

Jose Aspiras Malicdem, a Chief Engineer, filed a complaint for disability benefits against Asia Bulk Transport Phils., Inc. (ABTPI) and related entities, claiming his hypertension and glaucoma were work-related. Malicdem argued that his working conditions on board the vessel aggravated his conditions. The Labor Arbiter (LA) dismissed the complaint, a decision affirmed by the National Labor Relations Commission (NLRC) and the Court of Appeals (CA). The central legal question revolved around whether Malicdem’s failure to comply with the mandatory post-repatriation medical examination period would result in the forfeiture of his claims, and whether he could provide sufficient evidence that his hypertension and glaucoma are work related.

The Supreme Court emphasized the importance of adhering to Section 20(A)(3) of the Amended Standard Terms and Conditions Governing the Overseas Employment of Filipino Seafarers on-Board Ocean-Going Ships (2010 POEA-SEC). This provision requires seafarers seeking disability benefits to submit to a post-employment medical examination by a company-designated physician within three working days from repatriation. According to the Court, two elements must concur for disability to be compensable: first, the injury or illness must be work-related; and second, the work-related injury or illness must have existed during the term of the seafarer’s employment contract. A ‘work-related illness’ is defined as any sickness resulting from an occupational disease listed under Section 32-A of the POEA-SEC contract, with the conditions set therein satisfied. For diseases not listed, it must be shown that they are work-related and the conditions for compensability are met.

The court highlighted the mandatory nature of the three-day reporting requirement, quoting Section 20(A)(3) of the POEA-SEC:

For this purpose, the seafarer shall submit himself to a post­ employment medical examination by a company-designated physician within three working days upon his return except when he is physically incapacitated to do so, in which case, a written notice to the agency within the same period is deemed as compliance. In the course of the treatment, the seafarer shall also report regularly to the company-designated physician specifically on the dates as prescribed by the company-designated physician and agreed to by the seafarer. Failure of the seafarer to comply with the mandatory reporting requirement shall result in his forfeiture of the right to claim the above benefits.

The Court referred to jurisprudence, specifically Coastal Safeway Marine Services, Inc. v Esguerra, emphasizing that failure to comply with this mandatory reporting requirement without justifiable cause results in forfeiture of the right to claim compensation and disability benefits under the POEA-SEC. It stated, “For the seaman’s claim to prosper, however, it is mandatory that he should be examined by a company-designated physician within three days from his repatriation. Failure to comply with this mandatory reporting requirement without justifiable cause shall result in forfeiture of the right to claim the compensation and disability benefits provided under the POEA-SEC.”

The rationale for the three-day mandatory requirement was explained in Jebsens Maritime, Inc. and/or Alliance Marine Services, Ltd. v. Undag:

x x x The rationale behind the rule can easily be divined. Within three days from repatriation, it would be fairly easier for a physician to determine if the illness was work-related or not. After that period, there would be difficulty in ascertaining the real cause of the illness.

To ignore the rule would set a precedent with negative repercussions because it would open the floodgates to a limitless number of seafarers claiming disability benefits. It would certainly be unfair to the employer who would have difficulty determining the cause of a claimant’s illness considering the passage of time. In such a case, the employers would have no protection against unrelated disability claims.

In Malicdem’s case, the Court found that he failed to report to ABTPI within three working days for a post-employment medical examination, and that no exceptions applied. He was therefore deemed to have forfeited his right to claim disability benefits. Even if the court had excused Malicdem’s failure to comply with the reporting requirement, his petition would still fail because he could not substantially prove that his illnesses were compensable.

The Supreme Court clarified how illnesses are treated under the 2010 POEA-SEC. While Section 20(A)(4) creates a disputable presumption that illnesses not listed as occupational diseases are work-related, this does not automatically grant compensation. The claimant must still prove by substantial evidence that their work conditions caused or increased the risk of contracting the disease. The seafarer needs to satisfy all of the conditions for compensability under Section 32(A) of the 2000 POEA-SEC, which include demonstrating that the seafarer’s work involved the risks described, the disease was contracted as a result of exposure to those risks, the disease was contracted within a period of exposure, and there was no notorious negligence on the part of the seafarer.

The Court concurred with the labor tribunals and the CA in finding that Malicdem failed to prove that his hypertension and glaucoma were compensable. He didn’t provide enough evidence that his hypertension was caused or aggravated by his work conditions, and the opinion of his private doctor didn’t connect the hypertension to his work. Similarly, he presented no medical history or physician’s report to substantiate a reasonable connection between his work and his glaucoma. The Court also noted that a company-designated physician’s report stated that Malicdem’s glaucoma was not work-related.

The importance of the company-designated physician’s assessment was also highlighted, stating that it is the company-designated physician who is entrusted with the task of assessing a seafarer’s illness for claiming disability benefits. It also gives more weight to the company-designated physicians’ findings over those of a private physician, as the former devoted more attention and time in observing and treating the claimant’s condition.

FAQs

What was the key issue in this case?	The key issue was whether the seafarer’s failure to comply with the mandatory three-day reporting requirement under the POEA-SEC would forfeit his disability claims.
What does the POEA-SEC require regarding medical examinations?	The POEA-SEC requires a seafarer to submit to a post-employment medical examination by a company-designated physician within three working days of repatriation to claim disability benefits.
What happens if a seafarer doesn’t comply with the three-day rule?	Failure to comply with the mandatory reporting requirement without justifiable cause results in forfeiture of the right to claim compensation and disability benefits under the POEA-SEC.
Are there exceptions to the three-day reporting requirement?	Yes, exceptions exist if the seafarer is physically incapacitated or if the employer refuses to submit the seafarer to a medical examination.
What kind of evidence is needed to prove a disease is work-related?	Substantial evidence is needed, meaning that the claimant must prove by substantial evidence that their work conditions caused or increased the risk of contracting the disease.
What if a disease isn’t listed as an occupational disease?	Even if a disease isn’t listed, it can still be compensable if the seafarer proves it’s work-related and satisfies the conditions for compensability under Section 32(A) of the 2000 POEA-SEC.
What role does the company-designated physician play?	The company-designated physician is entrusted with the task of assessing a seafarer’s illness for purposes of claiming disability benefits, and their findings often carry significant weight.
Can a seafarer rely solely on their own doctor’s opinion?	While a seafarer can consult their own doctor, the company-designated physician’s assessment is given more weight, especially if the seafarer failed to report for examination within three days.
What if a seafarer’s contract already expired when they were repatriated?	Repatriation after an expired contract can weaken a seafarer’s claim that their ailment was aggravated by working conditions during their employment.

The Supreme Court’s decision underscores the importance of seafarers adhering to the procedural requirements outlined in the POEA-SEC to successfully claim disability benefits. While the law aims to protect seafarers, it also necessitates compliance with established rules to ensure fairness and prevent unwarranted claims.

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: JOSE ASPIRAS MALICDEM v. ASIA BULK TRANSPORT PHILS., INC., G.R. No. 224753, June 19, 2019