GUIDELINES GOVERNING SEAFARERS’ CLAIMS FOR PERMANENT AND TOTAL DISABILITY BENEFITS

In the case of Jebsens’ Maritime Inc., et al. vs. Florvin G. Rapiz (G.R. No. 218871, 11 January 2017), the Supreme Court reiterated the guidelines governing seafarers’ claims for permanent and total disability benefits:

 

  1. The company-designated physician must issue a final medical assessment on the seafarer’s disability grading within a period of 120 days from the time the seafarer reported to him;
  2. If the company-designated physician fails to give his assessment within the period of 120 days, without any justifiable reason, then the seafarer’s disability becomes permanent and total;
  3. If the company designated physician fails to give his assessment within the period of 120 days with a sufficient justification (e.g. seafarer required further medical treatment or seafarer was uncooperative), then the period of diagnosis and treatment shall be extended to 240 days. The employer has the burden to prove that the company-designated physician has sufficient justification to extend the period; and
  4. 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.

 

The High Court, in the case of Reynaldo Y. Sunit vs. OSM Maritime Services, et al. (G.R. No. 223035, 27 February 2017), added the following guidelines:

 

  1. If the seafarer disagrees with company-designated physician’s final medical assessment on the seafarer’s disability grading within a period of 120 days or 240 days extended period from the time the seafarer reported to him, the seafarer has the right to engage the services of a doctor of his choice. If the second doctor appointed by the seafarer disagrees with the findings of the company-designated physician, and the company likewise disagrees with the findings of the seafarer’s hired doctor, then a third doctor may be jointly appointed by the employer and the seafarer, whose decision shall be final and binding on both of them;
  2. The third doctor, appointed jointly by the company and the seafarer, is not required to give his medical assessment within the 120/240 day period for assessing the degree of disability of the seafarer. However, similar to what is required of a company-designated physician, the third-party physician must likewise arrive at a “definite and conclusive assessment of the seafarer’s disability or fitness to return to work before his or her opinion can be valid and binding between the parties.”; and
  3. Despite the binding effect of the third doctor’s assessment, a dissatisfied party may institute a complaint with the Labor Arbiter to contest the same on the ground of evident partiality, corruption of the third doctor, fraud, other undue means, lack of basis to support the assessment, or being contrary to law or settled jurisprudence.

 

The Supreme Court, in the same case, likewise held that, “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.”

 

The High Court finally held, in the said Sunit case, that:

 

“In determining whether a disability is total or partial, what is crucial is whether the employee who suffered from disability could still perform his work notwithstanding the disability he met.  A permanent partial disability presupposes a seafarer’s fitness to resume sea duties before the end of the 120/240-day medical treatment period despite the injuries sustained, and works on the premise that such partial injuries did not disable a seafarer to earn wages in the same kind of work or similar nature for which he was trained.(Belchem Philippines Inc. vs. Zafra Jr., G.R. No. 204845, 15 June 2015, citing Fil-Star Maritime Corp. vs. Rosete, G.R. No. 192686, 23 November 2011)”

 

“ . . .  In disability compensation, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairments of one’s earning capacity.(Eyana vs. Tansmarine Carriers, Inc., et al., G.R. No. 193468, 28 January 2015)”