PERMANENT AND TOTAL DISABILITY OF THE SEAFARER IS PRESUMED IN THE ABSENCE OF FINAL AND DEFINITE ASSESSMENT OF DISABILITY

In the absence of a final and definite disability assessment of the company-designated physician, Pelagio is conclusively presumed to be suffering from a permanent and total disability, and thus, is entitled to the benefits corresponding thereto.

Thus, the SC held as follows:

Pelagio vs. Philippine Transmarine Carriers, Inc., et al.
G.R. No. 231773, March 11, 2019

Permanent Total Disability; Interim assessment; Final and definite assessment; 120-day rule; 240-day rule

Facts:

Respondent Philippine Transmarine Carriers, Inc. (PTCI) for and on behalf of its foreign principal, Norwegian Crew Management A/S, hired Pelagio as a Motorman on board the vessel M/V Drive Mahone. After being declared fit for employment, Pelagio boarded M/V Drive Mahone.

Thereafter, Pelagio experienced difficulty in breathing and some pains on his nape, lower back, and joints while at work. Pelagio was then referred to a port doctor in Said, Egypt where he was diagnosed with “Myositis”11 and declared unfit to work.

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On March 2, 2010, Pelagio was repatriated back to the Philippines for further medical treatment, and thereafter, promptly sought the medical attention of the company-designated physician, Dr. Roberto Lim, at Metropolitan Medical Center.

After a series of medical and laboratory examinations, including chest x-ray, pulmonary function tests, electroencephalogram, and other related physical examinations, Pelagio was finally diagnosed with Carpal Tunnel Syndrome, Bilateral L5-S 1 Radiculopathy, Mild Degenerative Changes, and Lumbosacral Spine15 with an interim assessment of a Grade 11 disability rating -“slight loss oflifting power of the trunk.”

On August 18, 2010, Pelagio sought a second opinion from a private orthopedic surgery physician, Dr. Manuel Fidel M. Magtira (Dr. Magtira), who assessed him with a Grade 8 disability – moderate rigidity or two-thirds loss of motion or lifting power of the trunk-and declared him “permanently UNFIT TO WORK in any capacity at his previous occupation.”

Pelagio then sought to avail of permanent total disability benefits from Respondents PTCI, Carlos Salinas, and Norwegian Crew Management A/S (PTCI, et al.), to no avail. Hence, he filed a claim for permanent total disability benefits, reimbursement of medical expenses, illness allowance, damages, and attorney’s fees before the NLRC. Essentially, Pelagio contends that his inability to· work for more than 120 days from repatriation entitles him to permanent total disability benefits.

For their part, PTCI, et al. countered that Pelagio is not entitled to permanent total disability benefits, considering that the independent physician, Dr. Magtira, merely assessed him with a Grade 8 impediment. In this relation, PTCI, et al. likewise claimed that on August 5, 2010, the company-designated physician assessed Pelagio with a Grade 11 disability -slight loss of lifting power of the trunk (August 5, 2010 Medical Report). In view of the conflicting findings of the company-designated and the independent physicians, PTCI, et al. suggested that they seek a third mutually-appointed doctor to comply with the provisions of the POEA Standard Employment Contract, but Pelagio refused. Finally, PTCI, et al. averred that they offered Pelagio the amount of US$13,437.00, the corresponding benefit to a Grade 11 impediment pursuant to the CBA, but he rejected such offer.

LA Ruling:

The LA found Pelagio to be suffering from a permanent partial disability.

The LA ruled that Pelagio’s mere inability to work for 120 days from his repatriation did not ipso facto mean that he is suffering from a permanent total disability, especially in view of the disability assessments given by both the company-designated and the independent physicians. On this note, the LA gave weight to the findings of the company-designated physician that Pelagio was suffering from a Grade J 1 impediment, and thus, must only be awarded disability benefits corresponding thereto.

Dissatisfied, Pelagio appealed to the NLRC

NLRC Ruling:

The NLRC reversed and set aside the LA ruling, and accordingly, awarded Pelagio the amounts of US$70,000.00 representing permanent total disability benefits and US$7,000.00 as attorney’s fees, or a total of US$77,000.00, at their peso equivalent at the time of actual payment.

The NLRC found that in the absence of the purported August 5, 2010 Medical Report in the case records, there is nothing that would support PTCI, et al.’s claim that the company-designated physician indeed issued Pelagio a final disability rating of Grade 11. Thus, the NLRC deemed that there was no final assessment made on Pelagio.

In view thereof, the NLRC ruled that Pelagio’ s disability went beyond 240 days without a declaration that he is fit to resume work or an assessment of disability rating, and as such, he is already entitled to permanent total disability benefits as stated under the CBA.

PTCI, et al. filed a motion for reconsideration, attaching thereto a copy of the August 5, 2010 Medical Report. However, the same was denied. Aggrieved, PTCI, et al. filed a petition for certiorari before the CA.

CA Ruling:

The CA annulled the NLRC ruling and reinstated that of the LA.

It opined that the company-designated physician indeed gave Pelagio a disability rating of Grade 11 within 240 days from his repatriation, as evinced by the July 27, 2010 Medical Report which was later on affirmed by the August 5, 2010 Medical Report. Hence, the CA concluded that the company-designated physician’s findings should prevail considering that he extensively examined and treated Pelagio’s medical condition. Dissatisfied, Pelagio moved for reconsideration, but was denied.

Hence, the petition before the SC.

Issue/s:

Whether or not a medical report within the 120-day period that expressly provides that the findings are interim constitutes final and definite assessment that would establish partial disability only

Whether or not a medical report within the 240-day period that expressly provides for “potential disability grading” constitutes final and definite assessment partial disability only

SC Ruling:

The SC found the petition meritorious.

In Jebsens Maritime, Inc. vs. Rapiz, the Court explained that a seafarer’s failure to obtain any gainful employment for more than 120 days after his medical repatriation does not ipso facto deem his disability to be permanent and total as the company designated physician may be given an additional 120 days, or a total of 240 days from such repatriation, to give the seafarer further treatment, and thereafter, make a declaration as to the nature of the latter’s disability. It was then clarified, however, that for the company-designated physician to avail of the extended 240-day period, he must first perform some significant act to justify an extension (e.g., that the illness still requires medical attendance beyond the initial 120 days but not to exceed 240 days); otherwise, the seafarer’s disability shall be conclusively presumed to be permanent and total.

If the company-designated physician still fails to give his assessment within the extended period of 240 days, then the seafarer’s disability); becomes permanent and total, regardless of any justification.

Otherwise stated, the company-designated physician is required to issue a final and definite assessment of the seafarer’~ disability rating within the aforesaid 120/240-day period;45 otherwise, the opinions of the company-designated and the independent physicians are rendered irrelevant because the seafarer is already conclusively presumed to be suffering from a permanent and total disability, and thus, is entitled to the benefits corresponding thereto.

The CA’s finding that the company-designated physician gave Pelagio a disability rating is largely based on the July 27, 2010 Medical Report which was seconded by the August 5, 2010 Medical Report, which PTCI, et al. claim to contain the company-designated physician’s final disability grading of Pelagio’s condition.

However, a more circumspect review of these documents show that these do not constitute the final and definite assessment required by law, considering that: (a) the July 27, 2010 Medical Report expressly provided that the findings therein are only interim; whereas (b) the August 5, 2010 Medical Report only provided for a “potential disability grading.”

Besides, even assuming arguendo that the August 5, 2010 Medical Report indeed contains Pelagio’s final disability grading as posited by PTCI, et al., it must be noted that the same was belatedly adduced in evidence when it was attached to PTCI, et al.’s motion for reconsideration before the NLRC, even if it appears to be readily available. Case law instructs that “while strict compliance to technical rules is not required in labor cases, liberal policy should still be pursuant to equitable principles of law.

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In this regard, belated submission of evidence may be allowed only if the delay in its presentation is sufficiently justified; the evidence adduced is undeniably material to the cause of a party; and the subject evidence should sufficiently prove the allegations sought to be established.” Here, PTCI, et al. did not explain the reasons for their failure to present the August 5, 2010 Medical Report at the earliest opportunity, and it was only after the NLRC rendered an unfavorable decision that the same was presented. Verily, PTCI, et al.’s belated submission thereof without any explanation casts doubt on its credibility especially since it does not appear to be a newly discovered evidence.

In the absence of a final and definite disability assessment of the company-designated physician, Pelagio is conclusively presumed to be suffering from a permanent and total disability, and thus, is entitled to the benefits corresponding thereto.