DISABILITY GRADING RENDERED BY COMPANY-DESIGNATED PHYSICIAN WITHIN THE 240-DAY RULE BINDS THE COURT IF THE SEAFARER FAILS TO QUESTION THROUGH THE POEA-SEC PROCEDURE

Disability grading and assessment by the company-designated physician rendered within the specified period binds the Court as the seafarer never questioned such diagnosis in accordance with the procedure set forth under the POEA-SEC nor contested the company-designated physician’s competence.

Oriental Shipmanagement Co., Inc. vs. William David P. Ocangas
G.R. No. 226766, September 27, 2017

Facts:

Respondent William David P. Ocangas was hired by petitioner MOL Tankship Management (Europe) Ltd. as a Pumpman through its local manning agency in the Philippines, Petitioner Oriental Shipmanagement Co., Inc.

While on duty, Ocangas suffered a broken spine and felt extreme pain on his lower back and numbness on his lower extremities, as a result of him having to lift the cover of the ballast pump manually, which he is then preparing for inspection and maintenance. He was then advised to rest and given pain relievers.

Ocangas’s condition did not improve despite medical attention. Thus, Ocangas was recommended to be repatriated to obtain further medical treatment.

Upon his repatriation on September 4, 2012, Ocangas immediately reported to Oriental Shipmanagement Co., Inc., which then referred him to the company’s accredited physician at the Marine Medical Services of the Metropolitan Medical Center. After a series of tests, Ocangas was found to be suffering from “Central Disc Protrusions L4-L5 and L5-Sl, ·and Minimal Osteophytes, Lumbar vertebrae.” Ocangas then underwent a series of treatments supervised by company-designated physicians.

On January 23, 2013, Ocangas was declared by Dr. William Chuasuan, a company-designated and accredited physician, to have reached the maximum medical cure with Grade 11 disability impediment for 1 /3 loss of lifting power and per the Philippine Overseas Employment Agency Standard Employment Contract (POEA-SEC) Schedule of Benefits, entitled to US$ 7,465 .

On January 24, 2013, Ocangas filed a Complaint against Oriental Shipmanagement, et al. for recovery of permanent total disability benefits, refund of medical expenses, sickness allowance, and claim for damages.

On March 25, 2013, Ocangas sought the medical opinion of Dr. Marcelino Cadag, orthopedic surgeon of the Loyola International Multi Specialty Clinics. Dr. Cadag recommended that the Ocangas undergo further therapy and diagnosed him to be suffering from “Herniated Nucleus Pulposus L4-L5, L5-Sl with Nerve Root Compression; Lumbar Spondylosis,” and as such no longer fit for sea duty or for any work aboard seafaring vessel given his medical condition.

LA Ruling:

The LA rendered his Decision granting the Complaint.

The LA held that contrary to the allegation of the Oriental Shipmanagement, et al., the company-designated physician does not have the exclusive prerogative in the determination and assessment of the illness and/or injury of the seafarer. As such, the findings of the company-designated physician should not be taken as the only primary consideration, especially where there is a contrary opinion as in the instant case.

The LA ruled that the Ocangas was rendered unfit to work as seaman for more than 120 days, by itself, already constitutes permanent total disability and entitles the latter to US$ 100,000.00 pursuant to their collective bargaining agreement (CBA).

Oriental Shipmanagement, et al. appealed the Decision of the LA to the NLRC, asserting that while they admit liability for Ocangas’s disability, the latter is entitled only to benefits corresponding to permanent partial disability (Grade 11) as determined by the company-designated physician.

NLRC Ruling:

The NLRC rendered its Decision granting the appeal, and accordingly reversed and set aside the Decision of the LA.

The NLRC initially dismissed the case stating that at the time the complaint was filed only Grade 11 disability finding was obtained. Furthermore, the NLRC claimed that even if it considers the medical certificate issued by the Ocangas’s doctor, it is still bound to uphold the Grade 11 disability assessment of the company-designated physician, as the latter is in a far better position to assess the Ocangas who has been under his care and treatment from the time of the latter was repatriated on September 4, 2012 until January 23, 2012 when the assessment was issued.

Ocangas filed motion for reconsideration of the said Decision but the same was denied by the NLRC.

CA Ruling:

The CA granted the petition for certiorari filed by the Ocangas.

The CA held that the primordial consideration in determining whether the disability is total and permanent rests on evidence establishing that the seafarer’s continuous inability to work due to a work-related illness is for a period of more than 120 days.

Moreover, the CA declared that the NLRC erred in relying fully with the company-designated physician’s assessment, as it is settled that the latter’s findings are not binding on the labor tribunals and the courts.

Oriental Shipmanagement, et al. sought a reconsideration but the CA denied the same.

Issue/s:

Whether or not there is permanent and total disability even in the absence of the findings of the private physician of the seafarer at the time of the filing of the complaint.

Whether or not the Grade 11 disability rating is proper if rendered after 141 days from the time the seafarer was repatriated if the case was filed January 2013.

Whether or not the Crystal Shipping doctrine still applies in a 2013 case.

Whether or not the disability grading of the company-designated physician within the 240-day period binds the Court in the absence of the second opinion by the seafarer’s private physician

SC Ruling:

The SC found merit in the petition.

The CA, in ruling that the Ocangas suffered permanent total disability relied primarily on the cases of Crystal Shipping, Inc. v. Natividad, Philimare, Inc. v. Suganob, Micronesia Resources v. Cantomayor; and United Philippine Lines, Inc. and/or Holland America Line, Inc. v. Beseril. The last three cases were decided within the purview of the doctrine laid down in Crystal Shipping that permanent and total disability consists mainly in the inability of the seafarer to perform his customary work for more than 120 days.

As elucidated in the case of Splash Philippines Inc., et al. v. Ruizo, the ruling in Crystal Shipping has already been modified in that the doctrine laid down therein cannot simply be lifted and applied as a general rule for all cases in all contexts.

The Court clarified and delineated in Kestrel Shipping Co. Inc. v. Munar, that if the complaint for maritime disability compensation was filed prior to October 6, 2008, the 120-day rule enunciated in Crystal Shipping applies. However, if such complaint was filed from October 6, 2008 onwards, as in the case at bar where the Complaint was filed by the Ocangas .on January 24, 2013, the 240-day rule provided in the case of Splash Philippines, Inc. and clarified in the case of Vergara v. Hammonia Atfaritime Services Inc., applies.

Insofar as cases covered by the 240-day rule, the Court has repeatedly emphasized that the detennination of the rights of seafarers to compensation for disability benefits depends not solely on the provisions of the POEA-SEC but likewise by the parties’ contractual obligations set forth under their CBA, the attendant medical findings, and relevant Philippine laws and rules.

Pertinent to the entitlement of a seafarer to permanent and total disability benefits, Section 20(A) of the POEA-SEC provides in part that the disability shall be based solely on the disability gradings provided under Section 32 of their Contract.

The provisions of the POEA-SEC notwithstanding, in light of the definition provided for under Article 192 of the Labor Code as well as that under Rule X, Section 243 of the Amended Rules on Employees Compensation, the Court clarified in Alpha Shipmanagement Corporation v. Calo, that apart from illnesses that are classified as Grade 1 under the POEA-SEC, an illness may be considered as permanent and total, among others, if the temporary total disability lasts continuously for more than one hundred twenty days, except as otherwise provided for in the Rules.

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Harmonizing the provisions of the POEA-SEC, Labor Code, and the Rules on Employee Compensation, the Court referred to its discussion in the case of Vergara v. Hammonia Maritime Services, Inc. that the seafarer, upon sign-off from his vessel, must report to the company-designated physician within three (3) days from arrival for diagnosis and treatment. For the duration of the treatment but in no case to exceed 120 days, the seaman is on temporary total disability as he is totally unable to work. He receives his basic wage during this period until he is declared fit to work or his temporary disability is acknowledged by the company to be permanent, either partially or totally, as his condition is defined under the POEA Standard Employment Contract and by applicable Philippine laws. If the 120 days initial period is exceeded and no such declaration is made because the seafarer requires further medical attention, then the temporary total disability period may be extended up to a maximum of 240 days, subject to the right of the employer to declare within this period that a permanent partial or total disability already exists. The seaman may of course also be declared fit to work at any time such declaration is justified by his medical condition.

Upon repatriation, the seafarer is regarded to be on temporary total disability, which then becomes permanent when a) it so declared by the company-designated physician; or b) when 120 days has elapsed from the onset of disability and there is no need for further medical treatment, and the company-designated physician fails to make a declaration either of fitness or permanent partial or total disability; or c) when even after the 120-day period further medical attention becomes necessary and continues after the maximum 240-day medical treatment period without any declaration of fitness or permanent disability.

Simply stated, a seafarer is conclusively presumed to be totally and permanently disabled when the company-designated physician fails to make a declaration regarding the seafarer’s fitness or status of disability within the specified 120 or 240-day periods. “On the other hand, if the company-designated physician declares the seaman fit to work within the said periods, such declaration should be respected unless the physician chosen by the seaman and the doctor selected by both the seaman and his employer declare otherwise.

In this case, Ocangas was diagnosed within the 240-day period of treatment, as only 141 days has lapsed. The SC declared that it is bound by the Grade 11 disability grading and assessment by the company-designated physician rendered within the specified period, as Ocangas never questioned such diagnosis in accordance with the procedure set forth under the POEA-SEC nor contested the company-designated physician’s competence.

Here, instead of expressing his disagreement to the findings of the company-designated physician, the Ocangas filed a Complaint for permanent total disability benefits, without any corresponding medical certificate in support thereof but that of the Grade 11 disability assessment by the company-designated physician. In fact, it took Ocangas two (2) months after the filing of the Complaint before he submitted himself for examination by a physician of his choice, who then issued a permanent and total disability (Grade 1) rating.

Compelling the Court to consider the opinion rendered by Ocangas’s physician of choice, submitted two (2) months after the filing of the complaint, would undermine the right of the Oriental Shipmanagement, et al. to refute the findings and avail of the option to jointly refer with the Ocangas the disputed diagnosis to a third doctor of the parties’ choice, as agreed upon by the parties under the POEA-SEC.

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