EMPLOYER HAS THE OBLIGATION TO REFER TO THIRD DOCTOR THE CONFLICTING FINDINGS OF COMPANY-DESIGNATED PHYSICIAN AND PRIVATE PHYSICIAN IF THE SEAFARER HAS SIGNIFIED HIS INTENTION TO RESOLVE SUCH CONFLICT

Employer and seafarer may agree jointly to refer to a third doctor if a doctor appointed by the seafarer disagrees with the assessment of the company-designated physician.

Thus, the SC held in the following case as follows:

Abosta Shipmanagement Corporation, Panstar Shipping Co., Ltd., and/or Gaudencio Morales vs. Rodel D. Delos Reyes
G.R. No. 215111, June 20, 2018

Definition of total disability and permanent disability; Third doctor; The obligation of the employer to refer the matter to third doctor arises only when the seafarer signifies the intention to resolve the conflict by referral to third doctor

Facts:

Abosta Shipmanagement Corporation (Abosta) employed respondent Rodel D. Delos Reyes (Reyes) as a bosun on board the vessel MV Stellar Daisy for a period of nine months. Before boarding the vessel, Reyes underwent a Pre-Employment Medical Examination and was declared fit to work.

Thereafter, Reyes complained of pain in his groin while performing his duties. He received treatment in Korea and was diagnosed with Inguinal Hernia. On August 1, 2010, Reyes was repatriated and medically examined by the company-designated physician.

Upon recommendation of the company-designated physician, Reyes underwent right inginual herniorrhaphy with mesh imposition. He was discharged from the hospital and was paid two months sickness allowance. Later, he was declared fit to work by the company-designated physician.

Reyes consulted Dr. Li-Ann Lara-Orencia (Dr. Orencia), who found him to be permanently unfit to work and suffering from a Grade 1 disability. He filed a Complaint for Disability Benefits, Damages and Attorney’s fees.

LA Ruling:

The Labor Arbiter (LA) rendered a Decision dismissing the complaint for lack of merit.

The Labor Arbiter gave more credence to the medical assessment of the company-designated physician as it was based on several months of treatment as against the medical assessment of the independent physician, Dr. Orencia, which was issued almost a year after Reyes was repatriated. He appealed the dismissal of the complaint.

NLRC Ruling:

The National Labor Relations Commission (NLRC) issued a Decision affirming the dismissal of the Complaint since it found no error on the part of the Labor Arbiter in giving credence to the medical assessment of the company-designated physician.

The CA ruled that the assessment of the company-designated physician prevailed considering that Reyes failed to seek the opinion of a third doctor as provided in the Philippine Overseas Employment Administration (POEA) Standard Employment Contract (SEC). Reyes moved for reconsideration but the NLRC denied the same.

Unfazed, Reyes elevated the matter to the Court of Appeals (CA) via a Petition for Certiorari25 under Rule 65 of the Rules of Court.

CA Ruling:

The CA reversed and set aside the Decision and Resolution of the NLRC.

The CA found Reyes entitled to total and permanent disability compensation since his illness rendered him unfit to resume his duties as bosun, which requires physical exertion, lifting, and carrying heavy objects.

In arriving at such conclusion, the CA gave more credence to the medical assessment of Dr. Orencia that persons with such illness were advised to avoid lifting heavy objects as there was the possibility of the illness recurring. Thus, the CA ordered petitioners Abosta and Panstar (Abosta, et al.) to jointly and severally pay Reyes total and permanent disability benefits of US$60,000.00 plus ten percent (10%) of the amount as attorney’s fees.

Abosta, et al. sought reconsideration but the same was unavailing. Hence, the SC petition.

Issue/s:

Whether or not a total and permanent disability can be declared based on the conflicting findings of the company-designated physician and personal physician of the seafarer

Whether or not in the absence of the findings of third doctor the opinion of the private physician prevails

Whether or not the employer has the obligation to refer the matter to a third doctor in the absence of signified intention from the seafarer to resolve the conflicting findings of the physicians

SC Ruling:

The SC found merit in the petition.

In resolving, the SC defined total disability and permanent disability. According to the SC, there is total disability when employee is unable to earn wages in the same kind of work or work of similar nature that he or she was trained for, or accustomed to perform, or any kind of work which a person of his or her mentality and attainments could do. On the other hand, there is permanent disability when the worker is unable to perform his or her job for more than 120 days [or 240 days, as the case may be,] regardless of whether or not he loses the use of any part of his or her body.

The Labor Code of the Philippines 2018 Edition (re-numbered and updated)

In this case, Reyes was repatriated for medical treatment. Upon the advice of the company-designated physician, he underwent right inginual hemiorrhaphy with mesh imposition. Two months after his surgery or within the 120-day period, he was declared fit to work by the company-designated physician. The CA, however, rejected the fit-to-work assessment of the company-designated physician, and instead, declared him entitled to total and permanent disability benefits.

The CA reasoned that Reyes’ illness prevented him from pursuing his job as a bosun since, according to Dr. Orencia, there was a possibility that his illness might recur if he resumed his work lifting heavy objects. The CA also said that the failure of Abosta, et al. to reemploy Reyes as a bosun proved that, contrary to the declaration of the company-designated physician, Reyes was not fit to work.

The SC did not agree with the CA’s view holding that Section 20 (B) (3) of the 2000 POEA-SEC provides that upon sign-off from the vessel for medical treatment, the seafarer is entitled to sickness allowance equivalent to his basic wage until he is declared fit to work or the degree of permanent disability has been assessed by the company-designated physician but in no case shall it exceed one hundred twenty (120) days. 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.

Citing Marlow Navigation Philippines, Inc. vs. Osias, the SC declared that the referral to a third doctor is mandatory when: (1) there is a valid and timely assessment by the company-designated physician and (2) the appointed doctor of the seafarer refuted such assessment.

Further, citing the case of Carcedo, the SC held that to definitively clarify how a conflict situation should be handled, upon notification that the seafarer disagrees with the company doctor’s assessment based on the duly and fully disclosed contrary assessment from the seafarer’s own doctor, the seafarer shall then signify his intention to resolve the conflict by the referral of the conflicting assessments to a third doctor whose ruling, under the POEA-SEC, shall be final and binding on the parties. Upon notification, the company carries the burden of initiating the process for the referral to a third doctor commonly agreed between the parties.

In this case, Reyes, after consulting with Dr. Orencia, who happened to be the same doctor in Marlow, failed to refer the conflicting medical assessments to a third doctor. In fact, after consulting with Dr. Orencia, he immediately filed the instant complaint without first notifying Abosta, et al.

The SC ruled that for this reason alone, the CA should not have given any credence to the Medical Report of Dr. Orencia. The Court has consistently ruled that in case of conflicting medical assessments, referral to a third doctor is mandatory. In the absence of a third doctor’s opinion, it is the medical assessment of the company-designated physician that should prevail.

Finally, the SC held that the medical assessment of the company-designated physician is more reliable considering that it was based on the treatment and medical evaluation done on Reyes, which showed that the treatment or surgery undergone by him was successful, while Dr. Orencia’s medical assessment merely quoted the medical definition of hernia and some studies on the possibility of recurrence of the illness.

Under prevailing jurisprudence, the assessment of the company-designated physician is more credible for having been arrived at after months of medical attendance and diagnosis, compared with the assessment of a private physician done in one day on the basis of an examination or existing medical records.

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