The company doctor’s incomplete and doubtful assessment in disability benefits cases
A seafarer has no obligation to secure the second opinion of his personal doctor if the company doctor issued an incomplete and doubtful assessment.
The Supreme Court reiterated in the case of Joemar Bacabac vs. NYK-Fil Ship Management (G.R. No. 228550 July 28, 2021) the need for the company physician’s assessment to be complete and definite for the purpose of ascertaining the degree of the seafarer’s disability benefits.
The seafarer in said case suffered abdominal pain and symptoms while he was on board the vessel. He was then medically repatriated and was diagnosed with Severe Acute Cholangitis two days after disembarkation.
The respondents denied liability on the disability benefits as that they argued that the seafarer’s illness is not compensable as the company physician declared it not work-related.
The Court then ruled that the seafarer’s medical condition is disputably presumed as work-related although not listed as an occupational disease because the illness manifested or was discovered during the term of his contract.
It becomes incumbent upon the respondents to prove otherwise.
What the POEA contract requires is for the company physician to justify the assessment using the medical findings he had gathered during his treatment of the seafarer.
The company physician’s assessment must be complete and definite for the purpose of ascertaining the degree of the seafarer’s disability benefits.
The assessment must truly reflect the extent of the sickness or injuries of the seafarer and his or his capacity to resume work as such. A bare claim that the illness is not work-related, or that the seafarer is fit for sea duties is insufficient.
The Court will not hesitate to strike down an incomplete, and doubtful medical report of the company physician and disregard the improvidently issued assessment.
The Court said in this case that the company doctor’s medical report is inadequate to overcome the presumption. The company doctor’s report only indicated the diagnosis for Severe Acute Cholangitis or the inflammation or swelling of the bile duct.
Cholangitis is a type of liver disease. When the bile ducts get inflamed, the bile can back up into the liver and this can lead to liver damage.
Acute Cholangitis happens suddenly and can be caused by bacterial infection, gallstones, blockages, and tumor.
There are also environmental causes like infections, smoking and exposure to chemicals.
The seafarer’s Severe Acute Cholangitis suggests that he did not respond well to the initial medical treatment and have organ dysfunction in at least one of the following organs/systems: cardiovascular, nervous system, respiratory system, renal system, and hepatic system.
The Court, however, is at a loss on the cause, gravity, and extent of the seafarer’s ailment.
The medical report did not contain any explanation how the company physician arrived at his conclusion that the illness was not work related. There is no other document submitted to support such finding.
Worse, the company doctor made such report only two days after the seafarer was medically repatriated. The Court also noted the seafarer’s continued hospital confinement for one whole month after such declaration.
As the company physician’s medical evaluation of the seafarer fell short of the parameters provided by law and jurisprudence, the seafarer is deemed totally and permanently disabled as of the date of the expiration of the 120-day period counted from his repatriation.
There could no longer be any issue on whether hisillness is work related or not. Thus, the seafarer properly filed his complaint for payment of permanent and total disability benefits against the respondents after the expiration of the 120-day period from his repatriation.
The Court also stressed that the seafarer has no obligation to secure the opinion of his own doctor. A seafarer’s compliance with such procedure presupposes that the company physician came up with a valid assessment as to his fitness or unfitness to work before the expiration of the 120-day or 240-day periods.
Absent a valid certification from the company physician, the seafarer had nothing to contest and the law steps in to conclusively consider his disability as total and permanent.
(Atty. Dennis R. Gorecho heads the seafarers’ division of the Sapalo Velez Bundang Bulilan law offices. For comments, email [email protected], or call 09175025808 or 09088665786)
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