Seafarer has the duty to signify his intent to refer the conflict between the findings of the company-designated physician and that of his own doctor to a third doctor. Failure to do so, the findings of the company-designated physician shall prevail.
Thus, the CA held in the following case:
Julleza vs. Orient Line Philippines, Inc.
G.R. No. 225190, July 29, 2019
Third doctor; disability; CBA provision on third doctor; Failure of the seafarer to signify intent to resort to third doctor the findings of company-designated physician should prevail
Petitioner Efren J. Julleza (Julleza) was employed by Respondents Orient Lines Philippines, Inc. Orient Navigation Corporation, and Macario Dela Peña (Orient Lines, et al.) as a bosun on board MV Orient Phoenix.
After undergoing the required pre-employment medical examination (PEME), he was certified as fit for sea duty and hence, signed a contract for a period of nine (9) months. The aforesaid employment was covered by the IBF-JSU/PSU-IMMAJ Collective Bargaining Agreement (CBA).
Julleza allegedly slipped while cleaning the cargo hold under bad weather condition. AB Rolen Magalona wanted to bring him to the hospital for medical attention; however, the ship master advised Julleza to just wait a while until his extended contract ends on 25 December 2012 and thereafter have his medical check up. In the meantime, Julleza was given medication to alleviate the pain on his lower back.
Upon his return to the Philippines, Julleza went to the company-designated physician on 27 December 2012. Several tests and therapy sessions were done until 21 February 2013 when the company-designated physician certified that Julleza was suffering from bilateral nephrolithiasis and lumbar spondylosis. They likewise informed Orient Lines, et al. in a letter dated 23 April 2013 that the disability grading of Julleza is Grade 8, i.e. loss of 2/3 lifting power of the trunk.
On 04 May 2013, Julleza consulted his independent physician, Dr. Rogelio Catapang, Jr.; and on 07 May 2013, he filed a complaint for illness allowance, disability benefits, reimbursement of medical expenses and damages. In his Medical Report dated 29 June 2013, Dr. Catapang stated that Julleza is unfit for further strenuous duties.
Disputing the claim, Orient Lines, et al. countered that the bilateral nephrolithiasis suffered by Julleza is not work related as certified by the company-designated physician; rather, it is caused by a combination of genetic predisposition, diet and water intake. Meanwhile, the lumbar spondylosis was classified as Grade 8 disability only.
Orient Lines, et al. likewise contended that the illness or injury did not result from an accident, as there was no confirmation or validation of such incident except only the self-serving statements of Julleza and his peer, AB Magalona. Consequently, Julleza is not entitled to the disability compensation granted under Paragraphs 28.1 and 28.4, Article 28 of the CBA.
The Labor Arbiter (LA) ruled in favor of Julleza.
The LA ruled that Julleza figured in an accident, which caused his lumbar spondylosis. The LA found that Julleza’s medical problem had not been resolved following the Grade 8 disability rating of the company-designated physician and the findings of his independent doctor which showed that it was impossible for Julleza to be gainfully employed as a bosun. Given this, the LA ruled that Julleza was entitled to permanent total disability benefits following the IBF-JSU/AMOSUP-IMMAJ Collective Bargaining Agreement (CBA).
Thus, the LA held Orient Lines, et al. liable to pay, jointly and severally Julleza the amount of US$90,882.00, representing the latter’s permanent total disability benefits plus US$9,088.20 or ten percent (10%) of the total award, as and by way of attorney’s fees.
Aggrieved, Orient Lines, et al. appealed to the NLRC.
The NLRC affirmed the ruling of the LA and dismissed the appeal.
The NLRC found that Orient Lines, et al. failed to refute the fact that Julleza slipped while he and AB Rolen M. Magalonga (AB Magalonga) were washing the cargo hold, thus Julleza is entitled to benefits under the CBA for having met an accident while on board the ship.
The CA reversed the NLRC.
In reversing the NLRC, the CA ruled that the company-designated physician has determined the final suggested disability grading of Julleza, which was Grade 8 due to loss of 2/3 lifting power of the trunk. The CA ruled that the company-designated physician acknowledged that Julleza suffered from partial permanent disability.
The CA also ruled that the failure to consult a third doctor, which is part of the conflict-resolution procedure, ties the hands of the Court and therefore the certification of the company-designated physician must be upheld. The CA also ruled that a review of the records revealed that Julleza may have not met an accident which would place him under the coverage of the CBA for compensation arising from an accident while on board the ship.
From the records, Julleza only complained of lower back pain, and his only support for his claim of accident was the unnotarized typewritten account of a certain AB Magalonga, which was not submitted to the ship master or to Orient Lines, et al..
Julleza filed a motion for reconsideration but this was denied by the CA. Hence, the Petition before the SC.
Whether or not the CBA providing that third doctor should be nominated in case of conflict of findings between company-designated physician and private physician shall govern
Whether or not the seafarer has the duty to signify the intent to refer to the third doctor in case of conflicting findings of company-designated physician and the private physician
Whether or not the CBA that covers benefits only arising from accident still applies where the injury does not arise therefrom
Whether or not the PEOA-SEC applies where the CBA is not applicable
The SC denied the petition.
The SC held that the CA acted correctly in reversing the NLRC and the LA. Given the conflict between the findings of the two doctors, the provision of the CBA regarding the resolution of such conflict applies.
The CBA provides that the disability suffered by the seafarer shall be determined by a doctor appointed by the Company. If a doctor appointed by or on behalf of the seafarer disagrees with the assessment, a third doctor may be nominated jointly between the Company and the Union and the decision of this doctor shall be final and binding on both parties.
In Gargallo vs. Dahle Seafront Crewing (Manila), Inc., the Court ruled that the seafarer is required to comply with the conflict-resolution procedure, which was the same under the 2010 Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC) and the CBA.
Further, with regard to the procedure for referral to a third doctor, jurisprudence has set that it is the duty of the seafarer to signify his intent to refer the conflict between the findings of the company-designated physician and that of his own doctor to a third doctor. After notice from the seafarer, the company must then commence the process of choosing the third doctor
Here, after receipt of his own doctor’s medical report, Julleza did not show any proof that he sent the· medical report to Orient Lines, et al. and signify to Orient Lines, et al. that he would like to refer the conflicting medical findings to a third doctor. The CA was therefore correct that absent compliance with the conflict-resolution procedure, the findings of the company-designated physician that Julleza has a Grade 8 disability rating should prevail over that of the seafarer’s doctor.
The CBA only covers disabilities arising from accidents. In fact, in Fil-Star Maritime Corp. v. Rosete, the Court ruled that Article 28 of the ITF-JSU/AMOSUP CBA, which also covers Julleza, is limited to injuries arising from accidents. The Court likewise ruled in Island Overseas Transport Corp. vs. Beja, which involved the same clause 28.1, that it only covers injuries resulting from accidents. And since the seafarer’s knee injury was not proven to have been the result of an accident, his disability benefits should be based on the POEA-SEC and not the CBA.
Following the foregoing, and given that Julleza’s injury did not arise from an accident, the provisions under the POEA-SEC applies to Julleza.