DISABILITY COMPLAINT FILED BEFORE THE EXPIRATION OF THE 240-DAY PERIOD WHEN THE SEAFARER WAS STILL UNDER TREATMENT LACKS CAUSE OF ACTION

Disability case filed with only 193 days had lapsed, which is again, within the above-cited 240-day period and where there were remaining days for the company-designated doctor to issue his assessment renders the filing premature.

Guadalquiver vs. Sea Power Shipping Enterprise, Inc.,
G.R. No. 226200, August 5, 2019

120-day rule; 240-day rule; Kerstel Doctrine; Medical abandonment; Premature filing

Facts:

Under a nine-month contract (with three-month extension), Respondent Sea Power Shipping Enterprise, Inc. (Sea Power), in behalf of its principal, Mississauga Enterprises, Inc. (Mississauga), collectively referred to in this digest as Sea Power, et al., employed Guadalquiver Ruel Guadalquiver (Guadalquiver) as Able Seaman to work aboard the vessel M/V Dimi.

After passing his pre-employment medical examination, Guadalquiver boarded the vessel which was later extended. Guadalquiver alleged that his work involved strenuous manual work of pushing, pulling, lifting and/or carrying heavy objects. He narrated that in November 2012, after lifting a heavy jar of paint on the vessel, he felt a “click” followed by pain on his lower back. He initially ignored the incident but the pain persisted. He later consulted a  doctor in Egypt who diagnosed him with osteoarthritis.

On September 19, 2013, Guadalquiver was medically repatriated and immediately went to the company-designated doctor, Dr. Jose Emmanuel E. Gonzales (Dr. Gonzales). On October 7, 2013, Dr. Gonzales reported that after undergoing an MRI, Guadalquiver was diagnosed with lumbo-sacral muscle strain but there was no indication that surgery was needed.

Consequently, Dr. Gonzales advised Guadalquiver to undergo physical therapy. While Guadalquiver was still undergoing therapy, Dr. Gonzales noted the great improvement in Guadalquiver’s pain relief Because of this progress, he assured Guadalquiver that he could be given a fit-to-work certification after six sessions of physical therapy. However, notwithstanding the assurance, Guadalquiver unjustifiably failed to report back to the company-designated physician.

Resultantly, in his Medical Repot, Dr. Gonzales declared that Guadalquiver abandoned his treatment as he failed to return for his follow-up physical therapy. He also gave Guadalquiver his final diagnosis of “Lumbo Sacral Muscle Strain with Myositis SIP Physical Therapy.

Meanwhile, Guadalquiver admitted having consulted his physician-of-choice, Dr. Manuel Fidel M. Magtira (Dr. Magtira), because his condition did not improve. He also declared that Dr. Magtira already declared him unfit to work at his previous occupation. According to Guadalquiver, he sought payment of disability benefits from his employer but to no avail.

Thus, on March 31, 2014, he filed a Complaint for permanent and total disability benefits and reimbursement of medical expenses against Sea Power, et al.

Thereafter, Dr. Gonzales specified that he last treated Guadalquiver on February 28, 2014; he required Guadalquiver to report back on March 11, 2014 for his physical therapy session but the latter did not return for his follow-up treatment. Because of this, Dr. Gonzales gave him his final disability grade of “Grade 11 –  Slight rigidity or one third (1/3) loss of motion or lifting power of the trunk.”

Guadalquiver asserted that from his repatriation on September 19, 2013 until the filing of his complaint on March 31, 2014, more than 120 days had lapsed without him regaining his fitness to work as a seafarer. He also refuted that he committed medical abandonment contending that there was no evidence to prove that his disability was because he absconded his treatment. He added that his personal doctor already declared him unfit to work as seafarer which made him entitled to full disability benefits.

Sea Power, et al., on their end, countered that Guadalquiver was still on his 188^th day of medical treatment with the company-designated doctor when he filed this suit. They averred that on April 9, 2014, the company-designated physician issued his final disability assessment based on Guadalquiver’s last physical examination. They insisted that the final assessment was given within the 240-day period as required by law.

Moreover, Sea Power, et al. contended that Guadalquiver committed medical abandonment when he did not return for his physical therapy session with the company-designated doctor. They also maintained that Guadalquiver was not entitled to permanent and total disability benefits because the company-designated doctor only found him to have suffered from Grade 11 disability.

LA Ruling:

The Labor Arbiter (LA) ordered Sea Power, et al. to pay jointly and severally permanent and total disability benefits (US$60,000.00) as well as attorney’s foes equivalent to 10% of the total monetary award in favor of Guadalquiver.

The LA ruled that the opinion of the company-designated physician could not outweigh the categorical declaration of Guadalquiver’s personal doctor, who certified as to his permanent unfitness. The LA further noted that more than 120 days had lapsed from the time Guadalquiver was repatriated yet there was no indication that he had gained employment as seafarer.

According to the LA, Guadalquiver’s inability to find work for more than 120 days already amounted to permanent and total disability.

NLRC Ruling:

On appeal, the NLRC affirmed in toto the LA Decision.

With the denial of their motion for reconsideration, Sea Power, et al. filed a petition for certiorari with the CA.

CA Ruling:

The CA reversed and set aside the NLRC Decision and Resolution and, accordingly, ordered Sea Power and Missisauga to jointly and severally pay Guadalquiver income benefit for 202 days and partial disability benefit.

The CA stressed that Guadalquiver was duty-bound to complete his medical treatment until the company-designated doctor declares him fit to work or his disability was duly assessed. It underscored that at the time Guadalquiver filed this case, the company-designated physician had not yet determined the extent of his disability and it remained undisputed that Guadalquiver failed to report back for his already scheduled treatment.

In addition, the CA ruled that Guadalquiver had no cause of action when he filed this suit emphasizing that while a  seafarer has a  right to seek medical opinion from his chosen doctor, it must be undertaken on tile presumption that there was already a  certification given by the company-designated physician. Since no such certification was given here, then the filing of the case was premature.

The CA decreed that Guadalquiver was entitled to sickness allowance or income benefit for the period from his repatriation until the date that the company-designated doctor issued his assessment on his condition. It further ruled that Guadalquiver is entitled to Grade 11 disability benefits considering that Sea Power, et al. themselves acknowledged that the company-designated doctor made such assessment on Guadalquiver.

Issue/s:

Whether or not a claim for disability filed within the 240-day period and still being under treatment is premature

Whether or not cause of action accrued before the justified 240-day period has expired

Whether or not the opinion given by the private physician prior to the expiration of the 240-day period vested cause of action to the seafarer

SC Ruling:

Citing Vergara vs. Hammonia Maritime Services, Inc., the Supreme Court (SC) has elucidated in Scanmar Maritime Services, Inc. vs. Hernandez, that the period of 120 days from repatriation is  the duration within which the employer is to determine the fitness of the seafarer to work or to asce1iain the degree of his disability.

In such case where the seafarer remains in need of, medical attention, the 120-day period may be extended to a maximum period of 240 days within which the company-designated doctor must make a definite declaration on the fitness to work or the degree of the disability of the seafarer. A seafarer is thus considered permanently and totally disabled when so declared by the company-designated doctor within the period of 120 or 240 days, as the case may be; or after the lapse of 240 days without any declaration being issued by the company-designated physician.

The SC found that the CA did not err in ruling that the NLRC committed grave abuse of discretion in affirming the LA Decision awarding permanent and total disability benefits to Guadalquiver.

From his repatriation on September 19, 2013, Guadalquiver had been under the care of the company-designated doctor, who regularly monitored and issued reports on Guadalquiver’s condition. However, after his physical therapy session on February 28, 2014, Guadalquiver simply did not return for his treatment. At that time, Guadalquiver was on the 162nd day of treatment, and the company-designated doctor has not yet issued his definite declaration on Guadalquiver’s condition for the apparent reason that Guadalquiver was still under treatment and the maximum period of 240 days to issue the certification had not yet lapsed.

When Guadalquiver filed his disability case on March 31, 2014, only 193 days had lapsed, which is again, within the above-cited 240-day period. This only means that there were remaining days for the company-designated doctor to issue his assessment on Guadalquiver’s condition. However, without waiting for such declaration and/or the lapse of the 240-day period, Guadalquiver prematurely filed this suit even if his cause of action had not yet accrued.

Guadalquiver’s cause of action had not yet accrued considering that the 240-day period had not yet lapsed and the company-designated d0ctor still had a remaining period within which to give his definitive assessment on the medical condition or the fitness of Guadalquiver to return to work. In fact, prior to the filing of the case, petition was under the close monitoring of the company-designated physician and the latter even assured him that after completing six physical therapy sessions, he would be given fit-to-work certification. However, petition simply did not report back to the company-designated doctor and already filed this case against Sea Power, et al..

Moreover, the opinion of Guadalquiver’s personal doctor cannot be given credence since, it did not give Guadalquiver the necessary cause of action he lacked when he filed the complaint. Indeed, while a seafarer has the right to seek the opinion of other doctors, such right may be availed of on the presumption that the company-designated doctor had already issued a definite declaration on the condition of the seafarer, and the seafarer finds it  disagreeable. Given the lack of certification from the company-designated doctor, Guadalquiver cannot rely on the assessment made by his own doctor.

In Oriental Shipmanagement Co., Inc. vs. Ocangas, the Court pointed out its ruling in Kestrel Shipping Co., Inc. vs. Munar where it, in turn, clarified that if the seafarer filed his or her case for disability benefits before October 6, 2008 (the date the Court promulgated its ruling in Vergara), the 120-day rule shall apply. However, if the case was filed after October 6, 2008, as in this case, the 240-day rule elucidated in Vergara and discussed above must be considered.

In this case, while Guadalquiver properly reported to the company-designated doctor upon his repatriation, he nevertheless did not continue his treatment despite the clear instruction of the company-designated doctor for him to continue to do so. During this time, it is evident that Guadalquiver needed further medical attention and the maximum period of 240 days had not yet lapsed. Hence. Guadalquiver cannot invoke that simply because 120 days had passed, he was already entitled to full disability benefits. As mentioned, the Court itself made it dear in Kestrel that the 240-day rule must be observed in deciding disability benefits cases filed after its ruling in Vergara.

Similar to the finding of the CA, the Court decrees that Guadalquiver is nevertheless entitled to Grade 11 disability rating, as determined by the company-designated doctor within the specified period of 240 days. The Court gives weight to this finding as neither party refuted that the company-designated doctor indeed made such diagnosis within the allowable period for him to do so.