COMPANY-DESIGNATED PHYSICIAN ASSESSMENT DOES NOT AUTOMATICALLY BECOME CONCLUSIVE AND BINDING ON THE COURT

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Company-designated physician must come up with an assessment as to his fitness or unfitness to work before the expiration of the 120-day or 240-day periods. Alternatively put, absent a certification from the company-designated physician, the seafarer had nothing to contest and the law steps in to conclusively characterize his disability as total and permanent.

Multinational Ship Management, Inc.vs. Briones

G.R. No. 239793. January 27, 2020 [Date Uploaded: 08/19/2020]

Third doctor; Final and definitive assessment; Permanent and total disability

Facts:

Petitioner Multinational Ship Management Inc. (MSMI) is a corporation duly established and existing under the laws of the Philippines and duly licensed to do business as a manning agency with petitioner Alvin Hiteroza (Hiteroza) as its President/General Manager. Petitioner Singa Ship Agencies PTE. LTD. is MSMI’s foreign principal for the vessel M/V Viking Mimir ((collectively, petitioners are referred to in this digest as MSM, et al.)).

On March 25, 2015, MSMI and respondent Lolet Briones (Briones) entered into an employment contract whereby the latter was hired as Cabin Stewardess in the vessel Viking Mimir for a period of eight (8) months with a basic salary of US$980.00. The employment contract incorporated the POEA’s “Standard Terms and Conditions Governing the Employment of Filipino Seafarers On-Board Ocean-Going Vessels.

After undergoing a series of medical tests or routine Pre-Employment Medical Examination (PEME), Briones was declared fit for duty. Thereafter, she boarded her vessel of assignment and commenced her work as Cabin Stewardess.

While on board the vessel and in the course of her tour of duty, Briones experienced back pains. She alleged that she assisted in the unloading of luggage of departing passengers and in retrieving boxes of mattresses and bedsheets from the laundry section to the state rooms. She felt pain in her back while in the middle of replacing the mattresses. When the pain did not subside the following day, she went to see the ship’s doctor and was given pain relievers. She was allowed to continue her work, but the pain persistedand became unbearable after almost two (2) weeks of continuous duty.

When the vessel arrived in Hungary, Briones was sent to a hospital. She was diagnosed to have lower back pain and muscle strain and was prescribed pain relievers. She rejoined the vessel and went back to her normal routine, but her back pain worsened. She was again disembarked when the vessel arrived in Passau, Germany. After undergoing X-ray and MRI on her back, she was suspected to have lumbar spine problem. She was prescribed with medicines to alleviate the pain and was advised to have a thorough check-up. As the vessel had to leave the port, she was not able to undergo further check-up.

When the vessel arrived in Austria, she was sent to the hospital. She was found to have serious back pain and was advised to be repatriated and undergo physiotherapy. Briones was finally repatriated on September 24, 2015 and she was immediately referred by MSMI to the Ship to Shore Medical Center under the care of the company-designated physician, Dr. Keith Adrian Celino (Dr. Celino). She underwent her various laboratory examinations the results of which revealed that she was suffering from back pain and Lumbago. She was advised to undergo physical therapy sessions and to continue her medications.

Despite treatment and therapy, Briones claimed that she was not able to recover from her back pain. She requested for MRI on her back and upper portion of her body and MRI on her thoracic portion. Her request on the latter MRI, however, was denied. In a follow-up report, Briones was noted to have tenderness on the lumbar area. She was advised to undergo MRI of the lumbosacral area. She made several follow up consults with the company-designated doctor to monitor her medical progress.

On December 1, 2015, the company-designated doctor cleared Briones from the cause of her repatriation and declared that her Lumbago was resolved. MSMI alleged that it unconditionally shouldered all of Briones’ medical expenses and seasonably paid her sick wages.

Briones claimed that the company doctors discontinued her treatment despite of her failure to recover and plea to the company to continue the medical treatment. This constrained her to consult an orthopedic specialist, Dr. Manuel Fidel Magtira (Dr. Magtira), from the Department of Orthopedic Surgery & Traumatology of the Armed Forces of the Philippines Medical Center. Upon advice of Dr. Magtira, she underwent MRI on her thorax and lumbar spine.

Dr. Magtira prescribed Briones pain relievers, but after more than one (1) month of treatment, Dr. Magtira issued a Certification dated March 10, 2016 stating, among others, that Briones is “permanently UNFIT in any capacity to resume her sea duties as a Sea woman.” When MSMI failed to pay Briones the required benefits, the latter filed a labor complaint for total and permanent disability benefits, sickness allowance, medical benefits, damages and attorney’s fees.

LA Ruling:

The Labor Arbiter (LA) rendered a Decision! granting Briones’ claims for total permanent disability and sick wage benefits, damages and attorney’s fees.

In resolving the labor complaint in favor of Briones, the Labor Arbiter reasoned out that the disabilityprovision in the POEA Standard Employment Contract (POEA-SEC) recognizes the seafarer’s right to seek a second medical opinion and prerogative to consult a physician of his choice.

The Labor Arbiter opined that while the POEA SEC provides for the designation of a third doctor in case of difference between the company-designated doctor’s assessment and that of the seafarer’s doctor of choice, the provision, however, is merely directory and not mandatory. The fact that Briones initiated the complaint for permanent disability benefit based on her personal doctor’s findings is sufficient notice to MSMI to exercise the option to refer the same to a third doctor.

Finally, the Labor Arbiter viewed Dr. Magtira’s Medical Report more complete and exhaustive than the certification issued by the company-designated doctor, which was merely concerned with the examination of the complaint for purposes of diagnosis and treatment rather than a determination of Briones’ fitness to resume her work as a seafarer

NLRC Ruling:

On appeal, the NLRC reversed and set aside the Labor Arbiter’s decision.

In its Decision, the NLRC pointed out that the ruling in Maersk Filipinas Crewing, Inc., et al. vs. Mesina,’s wherein it was ruled that referral to a third doctor opinion is merely directory and not mandatory, was superseded by the ruling in INC. Shipmanagement Incorporated (now INC. Navigation Co. Philippines, Inc.), et al., vs. Rosales, and reiterated in the subsequent case of Silagan vs. Southfield Agencies, Inc., et al., which described the nature of the referra. to a third party doctor opinion as a mandatory procedure.

It, thus, ruled that the failure of Briones to comply with the mandatory procedure makes her complaint susceptible to dismissal for being premature. In contrast to the Labor Arbiter’s findings, the NLRC upheld the company-designated physician’s findings as against Dr. Magtira’s unfit to work certification. It took note of the medical treatment provided by the company-designated physician after her repatriation on September 24, 2015, and the MRI and series of physical therapy sessions undertaken by Briones until December 1, 2015, when her Lumbago was declared to have been resolved. This was after the result of the MRI was found to be unremarkable and the physical exercises required from Briones were done without complaints from her.

Thus, the NLRC concluded that Dr. Magtira’s medical opinion, which was arrived at only after a single consultation, cannot override the assessment of the company-designated physician who had treated and monitored Briones’ condition for months.

Aggrieved, Briones elevated the Decision of the NLRC to the Court of Appeals (CA) via Petition for Certiorari under Rule 65 of the Rules of Court.

CA Ruling:

The CA granted the petition and nullified the decision of the NLRC, except with respect to the award of sickness allowance in favor of Briones.

The CA held that while the seafarer’s non-compliance with the conflict-resolution procedure results in the affirmance of the fit-to-work certification of the company-designated physician, the seafarer’s compliance with such procedure, however, presupposes that the company-designated physician came up with an assessment of one’s fitness or unfitness to work before the expiration of the 120-day or 240-day periods and that the certification must be a definite assessment of the seafarer’s fitness to work or permanentdisability.

According to the CA, the Medical Report dated December 1, 2015 issued by Dr. Celino, the company-designated physician, failed to make a categorical or definite assessment/declaration on Briones’ fitness to work for sea duty, or a disability rating. The appellate court noted that the Medical Report dated March 10, 2016 issued by Briones personal physician, Dr. Magtira, confirmed that Briones was continuously suffering from back pain.

It considered Dr. Magtira’s detailed explanation on Briones’ injury and result of the MRI of the Thoraco-Lumbar Spine (Non-Contrast) dated February 4, 2016. Thus, as between the findings of Dr. Celino and Dr. Magtira, the CA accorded more weight to the assessment of the latter, who opined that Briones does not have the physical capacity to return to the type of work she was performing at the time of her injury. Accordingly, the CA granted the claims of Briones for payment of total and permanent disability benefits; sickness allowance and attorney’s fees, but denied the award of actual and exemplary damages for lack of sufficient factual and legal basis.

After their motion for reconsideration was denied by the CA, MSMI, et al. filed the present petition before the Supreme Court (SC).

Issue/s:

Whether or not non-compliance with the third doctor requirement automatically makes the diagnosis of the company designated conclusive and binding on the courts

SC Ruling:

The SC denied the petition.

Non-compliance with the third doctor referral does not automatically make the diagnosis of the company designated physician conclusive and binding on the courts.

The Court has previously held that, “if the findings of the company-designated physician are clearly biased in favor of the employer, then courts may give greater weight to the findings of the seafarer’s personal physician. Clear bias on the part of the company-designated physician may be shown if there is no scientific relation between the diagnosis and the symptoms felt by the seafarer, or if the final assessment of the company-designated physician is not supported by the medical records of the seafarer.”

In Kestrel Shipping Co., Inc., et al., vs. Munar, it was held that “a seafarer’s compliance with such procedure presupposes that the company-designated physician came up with an assessment as to his fitness or unfitness to work before the expiration of the 120-day or 240-day periods. Alternatively put, absent a certification from the company-designated physician, the seafarer had nothing to contest and the law steps in to conclusively characterize his disability as total and permanent.

In the present case, both the Labor Arbiter and the CA gave more weight to the diagnosis of Dr. Magtira, who stated in his Medical Report. On the other hand, the NLRC upheld Dr. Celino’s medical report.

A perusal of the Medical Report issued by Dr. Celino, the company designated physician, would reveal that it failed to state a definite assessment of Briones’ fitness or unfitness to work, or to give a disability rating of her injury. As it is, the report lacked substantiation on the medical condition of Briones concerning her fitness to return to the type of work she was performing at the time of her injury. What was clear in the medical report is that Briones has not fully recovered from her injury as she “was advised to continue home exercises and that pain is foreseen to improve with time” and that she has to undergo“Physical Therapy Sessions.” With such statements, Dr. Celino, in effect, admits that the pain experienced by Briones is still subsisting and that it is thru the passage of time that it was expected to improve.

On the other hand, the Medical Report issued by Dr. Magtira gave an explanation on the nature, cause, effects, and possible treatment of the injury sustained by Briones. Unlike Dr. Celino’s medical report which merely describes the MRI of the Lumbosacral spine as “unremarkable”, Dr. Magtira’s report on the MRI of the Thoraco-Lumbar Spine (Non-Contrast) conducted on Briones, contained the following impression: “L4-L5: Mild bilateral neural foramina! narrowing due to disc bulge; L5-S1: Mild bilateral neural foraminal narrowing due to disc bulge and facet hypertrophy; Facet arthrosis and ligamentum flavum hypertrophy; Mild lumbar curvature to the right may be positional versus mild lumbar dextroscoliosis, Small non-specific pelvic fluid; Small uterine myomas.”

Consistent with the result of the said MRI, Dr. Magtira explained that, “The significance of this posterior bulge of the degenerated disc is that this is the area where the nerves run that supply the extremities. This patient has been complaining of back pain. The vast majority of patients responded well to non-surgical treatment though. Probably the most important of which is time, that is to say, that no matter what is done, most cases of acute back and neck pain slowly resolve if given enough time to get better.” He adds that, “If a long term and more permanent result are desired however, she should refrain from activities producing torsional stress on the back and those that require repetitive bending and lifting. Things Ms. Briones is expected to do as a Sea woman.”

Prescinding from the foregoing, the SC, thus, found Dr. Magtira’s assessment as exhaustive and more reflective of the medical condition of Briones especially so since both medical reports acknowledged the passage of time as a key factor in resolving the back pain experienced by Briones. A total disability does not require that the employee be completely disabled, or totally paralyzed. What is necessary is that the injury must be such that the employee cannot pursue his or her usual work and earn from it. On the other hand, a total disability is considered permanent if it lasts continuously for more than 120 days. What is crucial is whether the employee who suffers from disability could still perform his work notwithstanding the disability he incurred.