PERMANENT AND TOTAL DISABILITY ARISES BY OPERATION OF LAW FOR LACK OF FINAL AND DEFINITIVE ASSESSMENT

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Permanent and total disability arises by operation of law for failure to satisfy the two requisites must concur for a determination of a seafarers medical condition: (1) an assessment must be issued within the 120/240 window, and (2) the assessment must be final and definitive.

Thus, the SC held in the following case:

Magadia vs. Elburg Shipmanagement Philippines, Inc.
G.R. No. 246497, December 5, 2019

Final and definitive assessment; Definite and conclusive assessment of the seafarer’s disability or fitness to return to work is required by law from the company-designated physician; Permanent and total disability;

Facts:

Respondents Elburg Shipmanagement Philippines, Inc. and Enterprises Shipping Agency SRL, (Elburg, et al.) hired petitioner Ramon Magadia as messman to work on board MV FD Honorable for a period of nine (9) months. While he was carrying a garbage bag to the ship’s upper deck, he fell from the stairway.

Magadia’s shoulder hit the steel railings and his body rammed against the floor. He was immediately administered first aid and brought to a hospital in Rio de Janeiro. He had an x-ray on his spine and pelvis and got diagnosed with “Herniated Nucleus Pulposus, Lumbosacral Vertebrae.”

On My 23, 2014, he got repatriated to Manila and reported to the company-designated physician for examination and treatment. After undergoing a magnetic resonance imaging (MRI) test, company-designated physician Dr. William Chuasuan, Jr. diagnosed him with “L4-L5 and L-5-S1 Disc Dessication;Left Forearm Contusion. He was recommended for physical therapy.

On September 24, 2014, the company-designated physician issued Magadia an initial disability grading of 11 after he found that his trunk was within functional range.” Further, after medical treatment, the company-designated physician issued a Medical Report that he already reached maximum medical treatment. If he is entitled to disability, his final disability grading is Grade 11 – loss of 1/3 lifting power of the trunk.

Magadia, thereafter, continued with his treatment and therapy. On January 6, 2015, the company-designated physician assessed his condition as resolved and stopped his treatment. His back pain, however, persisted. Thus, the next day, he sough the opinion of another physician, Dr. Misael Jonathan A. Ticman. Dr. Ticman found him to be suffering from permanent disability and that he is unfit to work as a seaman in any capacity. Consequently, he demanded from Elburg, et al. payment of full disability benefits, but to no avail.

On the part of Elburg, et al. the aver that Magadia was only entitled to partial permanent disability benefits equivalent to the company-designated physician’s assessment. That the company-designated physician’s assessment should be given more weight over his personal doctor since the latter failed to observe the proper procedure by referring the matter to a third doctor.

LA Ruling:

The Labor Arbiter (LA) granted Magadia’s claim for permanent and total disability benefits.

NLRC Ruling:

The National Labor Relations Commission (NLRC) modified the LA decision.

The NLRC declared Magadia as only entitled to partial disability benefits. Magadia sought a reconsideration but the same was denied.

Thus, Magadia went to the Court of Appeals (CA).

CA Ruling:

The CA affirmed the NLRC. Magadia’s motion for reconsideration was also denied.

Issue/s:

Whether or not a medical finding that fails to explain in detail the progress of seafarer’s treatment and the approximate period needed to fully recover is final and definitive

SC Ruling:

The Supreme Court (SC) granted the petition.

The SC held that based on the guidelines set out in the case of Orient Hope Agencies, Inc. vs. Jara, two requisites must concur for a determination of a seafarers medical condition: (1) an assessment must be issued within the 120/240 window, and (2) the assessment must be final and definitive.

Here, Magadia was repatriated on May 23, 2014. After undergoing medical treatment, the company-designated physician issued an interim Grade 11 disability on September 24, 2014. His back pain persisted which required him to continue with his medical treatment.

Per medical report, the company-designated physician issued Magadia a final disability grading of 11, 133 days since he got evaluated. Indeed, the diagnonsis was laid down within the extended period of 240 days. But the case does not stop here. The rules also require that the company-designated physician’s assessment on a seafarer’s illness be final and definitive.

Section 20 (B) of POEA-SEC provides that it is the primary responsibility of a company-designated physician to determine the disability grading or fitness to work of seafarers. To be conclusive, however, company-designated physician’s medical assessments or reports must be complete and definite. A final and definite disability assessment is necessary in order to truly reflect the true extent of the sickness or injuries of the seafarer and his or her capacity to resume work as such. Otherwise, the corresponding disability benefits awarded might not be commensurate with the prolonged effects of the injuries suffered.

Here, the Medical Report contained the following observations: “The specialist opines that the patient had already reached maximum medical treatment. If the patient is entitled to disability, his final disability grading is Grade 11 – loss of 1/3 lifting power of the trunk”

There was nothing on record showing that the company-designated physician explained in detail the progress of Magadia’s treatment and the approximate period needed for him to fully recover. Instead, the medical report stated that he suffered disability grading of 11 and that he had reached maximum medical care. Clearly, this is hardly the “definite and conclusive assessment of the seafarer’s disability or fitness to return to work” required by law from the company-designated physician because Magadia, in fact, returned to the company-designated physician and underwent further therapy which lasted for almost more than three (3) months.

Citing the case of Island Overseas Transport Corp. vs. Beja, the SC held that a month after his knee operation, the seafarer was given Grades 10 and 13 partial disability by the company-designated physician. It was considered as tentative assessment because he continued his physical therapy sessions which even went beyond 240 days. The company-designated physician did not explain how he arrived at the partial permanent disability assessment nor provided any justification for his conclusion.

Citing another case, Tamin vs. Magsaysay Maritime Corporation, the SC held that the company-designated physician in said case failed to give a definitive rating on disability because the seafarer still experienced recurring pain in his left hand and was required to undergo further therapy sessions whichextended beyond the 240 day window.

On the strength of these judicial dicta, the SC held that Magadia’s disability is deemed permanent and total by operation of law in the absence of final and definitive assessment from the company-designated physician.