Third Doctor’s Opinion is Key in Philippine Seafarer Disability Claims

TEODORO B. BUNAYOG, PETITIONER, VS. FOSCON SHIPMANAGEMENT, INC., /GREEN MARITIME CO., LTD., /EVELYN M. DEFENSOR, RESPONDENTS. G.R. No. 253480, April 25, 2023

Imagine a Filipino seafarer, far from home, falling ill and facing an uncertain future. The process of claiming disability benefits can be a daunting legal maze. A recent Supreme Court decision clarifies the crucial role of a third doctor’s opinion in resolving disputes between seafarers and their employers regarding disability claims. This case offers vital guidance for navigating the often-complex world of maritime employment contracts and medical assessments.

Understanding the POEA-SEC and Disability Claims

When a Filipino seafarer is hired to work on an international vessel, their employment is governed by the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC). This contract outlines the rights and responsibilities of both the seafarer and the employer, particularly concerning work-related illnesses or injuries.

A key aspect of the POEA-SEC is the process for determining disability benefits. If a seafarer becomes ill or injured during their employment, they are entitled to medical care and, potentially, disability compensation. However, disagreements often arise regarding the extent of the disability and the corresponding benefits.

Section 20(A) of the 2010 POEA-SEC is central to these disputes. It states that the seafarer must undergo a post-employment medical examination by a company-designated physician within three days of repatriation. If the seafarer disagrees with the company doctor’s assessment, they can seek a second opinion. Critically, if these opinions conflict, “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.”

This “third doctor rule” is designed to provide an impartial resolution to medical disputes. It ensures that a neutral expert can assess the seafarer’s condition and determine the appropriate level of disability compensation.

For example, imagine a seafarer develops a back injury while working on a ship. The company doctor declares him fit for light duty, but his personal doctor believes he is totally disabled. In this scenario, the third doctor rule would be invoked to resolve the conflicting opinions.

The Bunayog Case: A Seafarer’s Journey

Teodoro Bunayog, a chief cook on the vessel MIT Morning Breeze, experienced cough, fever, and breathing difficulties while at sea. He was diagnosed with pneumonia and repatriated to the Philippines. After treatment, the company-designated physician declared him fit to work. Dissatisfied, Bunayog consulted his own doctor, who deemed him unfit for sea duty due to pleural effusion.

Bunayog, through counsel, wrote to his employer requesting another medical examination to confirm his disability. The employer failed to respond. This led Bunayog to file a complaint for total and permanent disability benefits.

The case wound its way through the labor tribunals:

• The Labor Arbiter (LA) dismissed the complaint, favoring the company doctor’s assessment.
• The National Labor Relations Commission (NLRC) affirmed the LA’s decision.
• The Court of Appeals (CA) also sided with the employer, dismissing Bunayog’s petition.

Finally, the case reached the Supreme Court. The central issue was whether Bunayog was entitled to disability benefits, given the conflicting medical opinions and the employer’s failure to respond to his request for a third doctor.

The Supreme Court acknowledged the importance of the third doctor rule, stating, “This provision clearly gives the parties the opportunity to settle, without the aid of the labor tribunals and/or the courts, the conflicting medical findings of the company-designated physician and the seafarer’s physician of choice through the findings of a third doctor, mutually agreed upon by the parties.”

However, the Court ultimately ruled against Bunayog, finding that his doctor’s medical report lacked sufficient scientific basis. Despite the employer’s failure to respond to Bunayog’s request, the Court determined that the company doctor’s assessment was more credible based on the medical evidence presented.

Key Takeaways and Practical Advice

The Bunayog case underscores the importance of following the procedures outlined in the POEA-SEC when pursuing disability claims. It also highlights the need for seafarers to obtain thorough and well-supported medical opinions from their chosen physicians.

Here are some key lessons from this case:

• Request a Third Doctor: If you disagree with the company doctor’s assessment, promptly request a referral to a third doctor.
• Document Everything: Keep detailed records of all medical examinations, treatments, and communications with your employer.
• Obtain a Strong Medical Report: Ensure that your doctor’s report is comprehensive, scientifically sound, and supported by medical records.
• Comply with Deadlines: Adhere to all deadlines and reporting requirements outlined in the POEA-SEC.

The Supreme Court laid down specific guidelines for future cases involving third-party doctor referrals:

1. A seafarer who receives a contrary medical finding from his or her doctor must send to the employer, within a reasonable period of time, a written request or demand to refer the conflicting medical findings of the company designated physician and the seafarer’s doctor of choice to a third doctor.
2. The written request must be accompanied by, or at the very least, must indicate the contents of the medical report or medical abstract from his or her doctor, to be considered a valid request.
3. In case of a valid written request from the seafarer for a third doctor referral, the employer must, within 10 days from receipt of the written request or demand, send a written reply stating that the procedure shall be initiated by the employer.

Frequently Asked Questions

Q: What happens if the company refuses to acknowledge my request for a third doctor?

A: The Supreme Court now considers this a violation of the POEA-SEC. You can then file a complaint against your employer.

Q: What if I can’t afford a second medical opinion?

A: Document your financial constraints and explore options for pro bono legal assistance.

Q: How long do I have to file a disability claim?

A: The prescriptive period for filing a claim is generally three years from the date of repatriation.

Q: What evidence do I need to support my claim?

A: You’ll need medical records, employment contracts, and any other documents that demonstrate your illness or injury and its connection to your work.

Q: What if the third doctor’s opinion is unfavorable to me?

A: The third doctor’s opinion is generally binding. However, you may be able to challenge it if you can demonstrate bias or lack of scientific basis.

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