Medical findings re disability benefits

The relations between the parties and the procedure that is followed in case of a conflict in medical findings during claims for disability benefits is governed by the Standard Terms and Conditions Governing the Employment of Filipino Seafarers On-Board Ocean-Going Vessels (also known as POEA Standard Employment Contract [POEA-SEC]) under POEA Memorandum Circular No. 9, dated June 14, 2000. It states:

Section 20. Compensation and Benefits

x x x x

B. Compensation And Benefits For Injury Or Illness.

The liabilities of the employer when the seafarer suffers work-related injury or illness during the term of his contract are as follows:

1. The employer shall continue to pay the seafarer his wages during time he is on board the vessel;

2. If the injury or illness requires medical and/or dental treatment in a foreign port, the employer shall be liable for the full cost of such medical, serious dental, surgical and hospital treatment as well as board and lodging until the seafarer is declared fit to work or to repatriate.

However, if after repatriation, the seafarer still requires medical attention arising from said injury or illness, he shall be so provided at cost to the employer until such time he is declared lit or the degree of his disability has been established by the company-designated physician.

3. Upon sign-off from the vessel for medical treatment, the seafarer I is entitled to sickness allowance equivalent to his basic wage until he is declared fit to work or the degree of permanent disability has been assessed by the company-designated physician but in no case shall this period exceed one hundred twenty (120) days.

For this purpose, the seafarer shall submit himself to a post-employment medical examination by a company-designated physician within three working days upon his return except when he is physically incapacitated to do so, in which case, a written notice to the agency within the same period is deemed as compliance. Failure of the seafarer to comply with the mandatory reporting requirement shall result in his forfeiture of the right to claim the above benefits.

If a doctor appointed by the seafarer disagrees with the assessment, a third doctor may be agreed jointly between the Employer and the seafarer. The third doctor's decision shall be final and binding on both parties.

Under the above provision, it is the findings and evaluations of the company-designated physician which should form the basis of the seafarer's disability claim.[1] It is this physician who is entrusted with the task of assessing a seafarer's disability and there is a procedure to be followed to contest his findings.[2] But the assessment of the company-designated physician is not final, binding or conclusive on anyone, including the seafarer, the labor tribunals, or the courts, since the seafarer may seek a second opinion and consult a doctor of his choice regarding his ailment or injury.[3] If the physician chosen by the seafarer disagrees with the assessment of the company-designated physician, the company and the seafarer may agree jointly to refer the latter to a third doctor whose decision shall be final and binding on them.

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[1] Andrada v. Agemar Manning Agency Inc., supra note 46, at 598.

[2] C.F. Sharp Crew Management, Inc. v. Took, G.R. No. 193679, July 18, 2012, 677 SCRA 296, 316.

[3] Wallem Maritime Services Inc. v. Tanawan, G.R. No. 160444, August 29, 2012, 679 SCRA 255, 267.