A.M. No. RTJ-07-2069 - Espina and Madarang Co. vs. Indar

On October 12, 2005, INC Shipmanagement Incorporated (now INC Navigation Co. Philippines, Inc.), on behalf of its foreign principal Interorient Shipping Co., Ltd., hired Benjamin Rosales as Chief Cook for the vessel M/V Franklin Strait under a POEA Standard Employment Contract (POEA-SEC).
The contract provided for a fixed ten-month engagement with a monthly salary of US$550.00, where Rosales was primarily tasked with food preparation, cooking, and maintaining the cleanliness of the working area.

In February 2006, while on board, Rosales experienced severe chest pain, breathing difficulties, and numbness in his left arm.
On February 13, 2006, at Mount Sinai Medical Center in Miami, Florida, he underwent a coronary angiogram and an angioplasty in the left anterior artery, procedures which were provided by the company at its own expense, following which he was declared unfit to work and advised to continue treatment in the Philippines.

Upon repatriation on February 20, 2006, Rosales was confined at the Manila Medical Center where the company-designated physician, Dr. Nicomedes G. Cruz, examined him and diagnosed him with acute myocardial infarction, coronary artery disease, hypertension, and diabetes mellitus.
On April 7, 2006, Rosales consulted Dr. Paterno Dizon, Jr. at Cardinal Santos Medical Center; after further diagnosis revealing severe coronary stenosis, he underwent coronary artery bypass graft surgery at the Philippine Heart Center.

On October 10, 2006, Dr. Cruz provided a partial permanent disability assessment rating Rosales as Grade 7 (moderate residuals of disorder), reflecting some marked improvement in his condition.
Conversely, on November 9, 2006, Dr. Efren R. Vicaldo, a cardiologist at the Philippine Heart Center, rendered a second opinion finding persistent hypertensive cardiovascular and coronary artery diseases, classifying Rosales as permanently totally disabled (Grade 1) and unfit to work as a seaman, thus attributing his illness as work-related.

Relying on Dr. Vicaldo’s favorable finding, Rosales claimed permanent total disability benefits from INC, which were denied by the company.
Following the denial, on December 7, 2006, Rosales filed a complaint before the National Labor Relations Commission (NLRC), seeking disability benefits, illness allowance, reimbursement of medical expenses, damages, and attorney’s fees based on his claim and the POEA-SEC terms.

In a June 26, 2007 decision, the Labor Arbiter (LA) ruled in favor of Rosales, awarding him US$60,000.00 as permanent total disability benefits along with attorney’s fees, noting his inability to work for more than 120 days post-repatriation.
The NLRC initially affirmed the LA’s decision in a January 4, 2008 resolution but later reversed it, limiting the award to a partial disability benefit amounting to approximately US$20,900.00 based on Dr. Cruz’s Grade 7 assessment.

Rosales challenged the NLRC’s reversal by filing a petition for certiorari under Rule 65 before the Court of Appeals (CA), arguing that the NLRC gravely abused its discretion by favoring the company-designated physician’s assessment over his private physician’s finding.
On December 6, 2010, the CA reinstated the LA’s decision, emphasizing that Rosales had been incapacitated for more than 120 days and that his two major heart surgeries underscored the severity of his condition. The CA also noted the issue of conflicting medical assessments but sided with the notion that prolonged incapacity was sufficient to deem him permanently disabled.

The case highlights the mandatory referral process provided by Section 20(B)(3) of the POEA-SEC, which requires that conflicting medical assessments between the company-designated physician and a private physician be resolved by a third doctor, whose decision is final and binding.
Rosales’s failure to request the third-doctor referral immediately, as mandated by the contract, became a crucial point of contention in upholding the binding nature of the company-designated physician’s assessment.

Whether or not Rosales is entitled to full (permanent total) disability benefits given that he was unable to work for more than 120 days, taking into consideration the differing medical assessments.
Whether the Court of Appeals erred in finding grave abuse of discretion on the part of the NLRC by favoring the findings of Rosales’s private physician over those of the company-designated physician, particularly in light of the contractual provisions set forth in the POEA-SEC.