The Importance of a Definite Medical Assessment in Seafarer Disability Claims

Multinational Ship Management, Inc./Singa Ship Agencies, Pte. Ltd., and Alvin Hiteroza v. Lolet B. Briones, G.R. No. 239793, January 27, 2020

Imagine working tirelessly on a ship, far from home, when sudden pain disrupts your life. For seafarers like Lolet Briones, the promise of disability benefits can be a lifeline. But what happens when the medical assessments that determine these benefits are unclear or contested? This was the central question in the case of Multinational Ship Management, Inc. versus Lolet Briones, where the Supreme Court of the Philippines had to navigate the murky waters of medical assessments and disability benefits under the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC).

In this case, Briones, a cabin stewardess, suffered from back pain during her tour of duty. Despite undergoing treatment, her condition did not improve, leading to a dispute over her entitlement to total and permanent disability benefits. The case traversed through various courts, ultimately reaching the Supreme Court, which had to decide whether Briones was entitled to these benefits despite not following the third-doctor referral provision in the POEA-SEC.

Legal Context: Understanding Disability Benefits for Seafarers

Seafarers, like many overseas Filipino workers, are governed by specific employment contracts that outline their rights and obligations. The POEA-SEC, in particular, sets forth the conditions under which a seafarer can claim disability benefits. A crucial aspect of this contract is Section 20(A)(3), which mandates the referral to a third doctor if there is a disagreement between the company-designated physician and the seafarer’s personal doctor regarding the seafarer’s fitness to work or degree of disability.

The term “disability” in this context refers to the inability of the seafarer to perform their usual duties due to illness or injury sustained during their employment. The POEA-SEC distinguishes between temporary and permanent disability, with the latter being considered total if it lasts continuously for more than 120 days. This distinction is vital because it directly impacts the type and amount of benefits a seafarer can claim.

Consider, for example, a seafarer who suffers a hand injury. If the company-designated doctor deems the injury temporary and expects recovery within 120 days, but the seafarer’s personal doctor believes the injury is permanent, the seafarer can request a third doctor’s assessment to resolve the dispute. This process ensures fairness and clarity in determining the seafarer’s eligibility for benefits.

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. The third doctor’s decision shall be final and binding on both parties.”

Case Breakdown: The Journey of Lolet Briones

Lolet Briones’ ordeal began when she experienced back pain while assisting with luggage on her ship. Despite receiving treatment, her condition worsened, leading to her repatriation to the Philippines for further medical care. Upon her return, she was treated by the company-designated physician, Dr. Keith Adrian Celino, who eventually declared her condition resolved. However, Briones sought a second opinion from Dr. Manuel Fidel Magtira, who assessed her as permanently unfit for her previous duties.

The dispute escalated through the legal system. The Labor Arbiter initially ruled in Briones’ favor, granting her total and permanent disability benefits based on Dr. Magtira’s assessment. However, the National Labor Relations Commission (NLRC) reversed this decision, emphasizing the mandatory nature of the third-doctor referral and upholding Dr. Celino’s findings.

Briones appealed to the Court of Appeals (CA), which reinstated the Labor Arbiter’s decision, except for the award of sickness allowance. The CA noted that Dr. Celino’s report lacked a definite assessment of Briones’ fitness to work, thus giving more weight to Dr. Magtira’s detailed findings.

The Supreme Court, in its review, focused on the clarity and definitiveness of the medical assessments. The Court stated, “A perusal of the Medical Report issued by Dr. Celino, the company-designated physician, would reveal that it failed to state a definite assessment of Briones’ fitness or unfitness to work, or to give a disability rating of her injury.” This lack of clarity led the Court to affirm the CA’s decision, emphasizing that “What is crucial is whether the employee who suffers from disability could still perform his work notwithstanding the disability he incurred.”

The procedural steps in this case highlight the importance of following the POEA-SEC’s conflict-resolution procedure:

• Initial assessment by the company-designated physician
• Seafarer’s right to seek a second medical opinion
• Mandatory referral to a third doctor if assessments differ
• Judicial review if the third-doctor referral is not followed

Practical Implications: Navigating Disability Claims

This ruling underscores the importance of clear and definitive medical assessments in seafarer disability claims. Employers must ensure that their designated physicians provide comprehensive and unambiguous reports on a seafarer’s fitness to work. Seafarers, on the other hand, should be aware of their right to seek a second opinion and the mandatory nature of the third-doctor referral if assessments differ.

For businesses, this case serves as a reminder to comply with the POEA-SEC’s provisions to avoid protracted legal battles. For seafarers, understanding these procedures can be crucial in securing rightful benefits.

Key Lessons:

• Ensure medical assessments are clear and definitive.
• Follow the POEA-SEC’s mandatory third-doctor referral process when assessments differ.
• Seafarers should document their medical condition and treatments thoroughly.

Frequently Asked Questions

What is the POEA Standard Employment Contract?

The POEA-SEC is a standardized contract that governs the employment of Filipino seafarers on ocean-going vessels, outlining their rights, duties, and benefits.

What happens if a seafarer disagrees with the company-designated physician’s assessment?

The seafarer can seek a second medical opinion. If the assessments differ, the POEA-SEC mandates a referral to a third doctor, whose decision is final and binding.

Is the third-doctor referral mandatory?

Yes, the Supreme Court has ruled that the referral to a third doctor is a mandatory procedure under the POEA-SEC.

What if the company-designated physician’s assessment is unclear?

An unclear assessment can lead to the seafarer being deemed totally and permanently disabled if it fails to provide a definite evaluation of their fitness to work.

How can seafarers ensure they receive rightful disability benefits?

Seafarers should document their medical condition and treatments thoroughly, seek a second medical opinion if necessary, and follow the mandatory third-doctor referral process if assessments differ.

ASG Law specializes in labor and employment law, particularly in cases involving seafarers. Contact us or email hello@asglawpartners.com to schedule a consultation.