Key Takeaway: The Importance of Timely and Definitive Medical Assessments for Seafarers’ Disability Claims

Raul D. Bitco v. Cross World Marine Services, Inc., et al., G.R. No. 239190, February 10, 2021

Imagine a seafarer, far from home, who suffers a debilitating injury while on duty. The physical toll is immense, but so too is the uncertainty about their future. This is the reality faced by many seafarers, like Raul D. Bitco, whose case before the Philippine Supreme Court highlights the critical importance of timely and definitive medical assessments in determining disability benefits. At the heart of Bitco’s case was the question: Can a seafarer be deemed permanently and totally disabled if the company-designated physician fails to provide a final assessment within the legally mandated period?

Raul D. Bitco, an Ordinary Seaman, suffered a back injury while working on a vessel. Despite undergoing treatment, his condition did not improve, leading to a dispute over his disability benefits. The central issue was whether Bitco’s inability to work for over 240 days without a final medical assessment from the company-designated physician constituted permanent and total disability.

Legal Context: Understanding Disability Benefits for Seafarers

Under Philippine law, seafarers are entitled to disability benefits governed by the Labor Code, their employment contract, and the Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC). The POEA-SEC, applicable to Bitco’s case, stipulates that the company-designated physician must assess the seafarer’s fitness or degree of disability within 120 days from repatriation. If further treatment is required, this period can extend up to 240 days.

Key Provisions:

“The company-designated physician must issue a final medical assessment on the seafarer’s disability grading within a period of 120 days from the time the seafarer reported to him… If the company-designated physician fails to give his assessment within the period of 120 days, without any justifiable reason, then the seafarer’s disability becomes permanent and total.” – Elburg Shipmanagement Phils., Inc. v. Quiogue

Permanent disability means the inability to work for more than 120 or 240 days, regardless of whether the seafarer loses the use of any part of their body. Total disability refers to the inability to perform the usual work, not requiring complete helplessness. These distinctions are crucial in determining the seafarer’s entitlement to benefits.

Consider a seafarer who suffers a hand injury. If the injury prevents them from performing their duties for over 240 days without a final assessment, they may be deemed permanently and totally disabled, even if they can still use their hand for other tasks.

Case Breakdown: The Journey of Raul D. Bitco

Raul D. Bitco’s journey began when he felt a snap in his lower back while lifting supplies on duty in February 2015. Despite initial treatment, his condition worsened, leading to his repatriation to the Philippines in July 2015. Bitco underwent extensive treatment, including physical therapy and epidural steroid injections, but his condition did not significantly improve.

In December 2015, the company-designated physician assessed Bitco with a partial disability Grade 8 but did not definitively state whether he could return to work. This lack of a final assessment became central to Bitco’s claim for permanent and total disability benefits.

The case proceeded through various stages:

1. Labor Arbiter: Found merit in Bitco’s claim for total and permanent disability, awarding him USD 60,000.00 in benefits.
2. National Labor Relations Commission (NLRC): Affirmed the Labor Arbiter’s decision, emphasizing the permissive nature of the third-doctor referral under the POEA-SEC.
3. Court of Appeals (CA): Reversed the NLRC’s decision, ruling that the company-designated physician’s assessment should prevail due to Bitco’s failure to seek a third doctor’s opinion.
4. Supreme Court: Reversed the CA’s decision, reinstating the Labor Arbiter’s award. The Court emphasized the absence of a final assessment within the 240-day period.

The Supreme Court’s reasoning was clear:

“Without a valid, final, and definitive assessment from the company-designated physician, respondent’s temporary and total disability, by operation of law, became permanent and total.” – Raul D. Bitco v. Cross World Marine Services, Inc., et al.

The Court also clarified that the third-doctor rule is mandatory only if the company-designated physician issues a final assessment within the mandated period.

Practical Implications: Navigating Disability Claims

This ruling has significant implications for seafarers and employers alike. Seafarers must be vigilant in ensuring that their medical assessments are timely and definitive. If the company-designated physician fails to provide a final assessment within the 120 or 240-day period, seafarers may be entitled to permanent and total disability benefits.

For employers, this case underscores the importance of ensuring that their medical professionals adhere to the legal timelines and provide clear, final assessments. Failure to do so can result in substantial financial liabilities.

Key Lessons:

• Seafarers should document their medical treatment and any delays in assessment.
• Employers must ensure that their designated physicians provide timely and definitive assessments.
• Both parties should be aware of the legal timelines and their implications on disability claims.

Frequently Asked Questions

What is the difference between permanent and total disability?

Permanent disability refers to the inability to work for over 120 or 240 days, while total disability means the inability to perform one’s usual work, regardless of complete helplessness.

How long does the company-designated physician have to assess a seafarer’s disability?

The physician must provide a final assessment within 120 days from repatriation, extendable to 240 days if further treatment is required.

What happens if the company-designated physician fails to provide a final assessment within the mandated period?

If no final assessment is provided within 240 days, the seafarer’s disability becomes permanent and total by operation of law.

Is referral to a third doctor mandatory in all cases?

Referral to a third doctor is mandatory only if the company-designated physician issues a final assessment within the mandated period.

What should seafarers do if they believe their disability assessment is incorrect?

Seafarers should consult their own physician and, if necessary, request a third doctor’s opinion to challenge the company-designated physician’s assessment.

ASG Law specializes in maritime and labor law. Contact us or email hello@asglawpartners.com to schedule a consultation.