Title
Maersk-Filipinas Crewing, Inc. vs. Alferos
Case
G.R. No. 216795
Decision Date
Apr 1, 2019
Seafarer’s disability claim dismissed; SC ruled company-designated physician’s assessment controls, third-doctor procedure not followed, claim premature.
disability benefits
procedure
medical assessments
A

Case Summary (G.R. No. 216795)

Factual Background

The petitioners had employed respondent as an Able Seaman without interruption since 1995, redeploying him under successive contracts upon Physical Employment Medical Examination (PEME) results that consistently found him fit for work. For the last employment arrangement, the parties hired respondent on board M/S Laura Maersk on a contract beginning May 10, 2012 with a basic salary of US$585.00 per month for six months. After the completion of the contract, the parties mutually extended his services because no replacement was available for his position.

On December 20, 2012, respondent reported sudden pain in his lower back and abdomen while on duty, accompanied by difficulty and pain when urinating. He informed his superior officer, who brought him to the Dulsco Medical Clinic in Dubai. There, medical examination led to a diagnosis of “Dysuria, with loin pain and back pain.” He underwent treatment and was subsequently discharged to return to the vessel. Despite such treatment, his condition allegedly did not improve and instead worsened, prompting his medical repatriation and disembarkation on January 12, 2013.

Thereafter, the company-designated physicians, Dr. Karen Frances Hao-Quan and Dr. Robert D. Lim, referred respondent to a urologist. Their medical reports reflected continued urinary and back-related complaints, with urinalysis showing red blood cells, and imaging results including focal cortical calcification in the right kidney and Grade 1 prostate hypertrophy. Respondent was recommended to undergo a CT Stonogram, and later re-evaluation led to an impression of “Prostatitis rule out Urolithiasis.” In a subsequent report dated March 5, 2013, the company-designated physicians declared respondent fit to resume sea duties, concluding that the prostatitis had already resolved. Respondent was then required to sign a “Certificate of Fitness to Work” dated March 5, 2013, with the company-designated physician as witness.

Respondent did not accept that he was fit. Although he was made to sign the certificate of fitness, he still proceeded to submit himself for examination by another physician. The records showed that on March 19, 2013, he sought further evaluation and management at Supercare Medical Services by signing an “Agreement to Proceed with Further Evaluation and Management.” Based on the subsequent assessment, respondent was diagnosed with kidney stones and vertigo, and he was referred to St. Luke’s Medical Center where Dr. Jaime C. Balingit diagnosed nephrolithiasis. He was further referred to Dr. Manuel C. Jacinto, who issued a written medical assessment declaring respondent physically unfit to return to work as a seafarer, citing nephrolithiasis, diabetic nephropathy, osteoarthritis, lumbosacral spine radiculopathy, and benign positional vertigo.

After these developments, respondent filed a complaint with the Arbitration Office of the NLRC seeking, among others, permanent disability compensation, payment of sick wages for 120 days, moral and exemplary damages, attorney’s fees, and other benefits under law and the applicable agreement.

Labor Arbiter Proceedings

On September 16, 2013, Labor Arbiter Enrique Flores Jr. granted respondent’s claim. The labor arbiter ordered petitioners to pay respondent US$60,000.00 as permanent total disability benefits and attorney’s fees equivalent to ten percent of the total award.

NLRC Ruling

On appeal, the NLRC affirmed the labor arbiter’s award on April 30, 2014. The NLRC found that the company-designated physician had focused only on prostatitis while simultaneously ruling out urolithiasis, without addressing fully the earlier diagnoses and the broader set of ailments later identified by respondent. The NLRC also treated petitioners’ arguments concerning the scope of repatriation—namely that it resulted only from the dysuria, loin pain, and back pain—as evasion of issues related to other conditions such as nephrolithiasis and other ailments that respondent later asserted as disabling.

CA Decision on Certiorari

Petitioners then moved for certiorari before the CA (C.A.-G.R. SP No. 136293), contending that the NLRC had acted with grave abuse of discretion in affirming the award despite the company-designated physician’s declaration that respondent had been found fit to resume sea duties. Petitioners likewise argued that the NLRC improperly relied on the second physician’s findings contrary to the POEA-SEC requirement of a “third doctor” procedure when the company-designated and seafarer’s physicians conflict.

The CA, by decision dated November 10, 2014, dismissed the petition and upheld the NLRC. The CA reasoned that the labor arbiter and NLRC based their conclusions on substantial evidence, particularly the assessment following respondent’s PEME at Supercare, which allegedly revealed conditions rendering him unfit. The CA also concluded that the company-designated physician’s fit-to-work assessment did not reflect respondent’s true health state.

Issues Raised on Appeal

Before the Supreme Court, petitioners maintained that the CA erred in upholding the NLRC’s reliance on the second physician’s assessment and in disregarding Section 20-A(3) of the POEA-SEC, which required that, upon conflicting assessments, the parties jointly appoint a third physician, whose decision would be final and binding.

Supreme Court’s Ruling and Disposition

The Supreme Court granted the petition. It reversed and set aside the CA decision dated November 10, 2014 and dismissed respondent’s claim for disability benefits, sick wages, damages, and attorney’s fees for lack of factual and legal basis, without costs of suit.

Legal Basis and Reasoning

The Supreme Court held that the central issue was procedural and contractual: under the POEA-SEC, the assessment made by the company-designated physician is controlling for the determination of disability benefits. The Court reiterated that when a seafarer submits a claim based on the assessment of his chosen physician without first giving notice to the employer of the intent to submit the seafarer’s condition for evaluation by a third physician, the claim is premature and violative of the POEA-SEC.

The Court acknowledged that the POEA-SEC provides that when a seafarer suffers a work-related illness or injury aboard the vessel, the company-designated physician determines fitness or unfitness. If the seafarer’s nominated physician disagrees, the POEA-SEC allows the parties to agree on a third physician jointly and makes the third physician’s decision final and binding on both parties. In support of this controlling framework, the Court cited TSM Shipping Phils., Inc. v. Patino, holding that non-observance of the third-physician requirement results in the company-designated physician’s assessment prevailing.

The Court also examined the conditions under C.F Sharp Crew Management, Inc. v. Taok under which a seafarer may pursue disability benefits despite the company-designated physician’s declarations. Applying those conditions, the Court found no basis to treat respondent’s situation as falling within the enumerated exceptions. It emphasized that although respondent was not precluded from seeking a second medical opinion, compliance with the POEA-SEC’s procedure for resolving conflicting assessments required an affirmative step by the seafarer.

The Court further explained that the POEA-SEC requires the seafarer to initiate the third-physician process by signifying intent and serving notice to the employer, because the need for the third physician arises from the existence of a conflict that must be resolved through the POEA-SEC procedure. It held that the records did not show that the parties jointly sought the opinion of a third physician to determine the presence or absence of disability. It also held that respondent’s failure to give petitioners notice of his intent to submit his condition for assessment by a third physician negated the need for a third physician evaluation and rendered respondent’s claim premature.

The Court stressed that, absent such notice, the employer could not be expected to respond by setting into motion the selection of a third doctor. It held that the seafarer could not validly insist on a different assessment after the employer had relied on the company-designated physician’s findings, because the third physician—by the contract’s terms—must be jointly chosen to resolve the disputed medical situation. The Court described the duty to secure the opinion of the third doctor as belonging to the employee seeking benefits, citing Hernandez v. Magsaysay Maritime Corporation for the proposition that the duty to request the third-physician evaluation falls upon the seafarer and that the contract presupposes a valid final and definite company-designated assessment before the conflict-resolution mechanism may be invoked.

In the Court’s view, respondent’s non-compliance with the POEA-SEC procedure directly contravened the terms and conditions of his contract with petitioners. Such contravention disauthorized the making of the claim for benefits and led to the conclusion that the company-designated physician’s fit-to-work assessment became the controlling and reliable medical assessment. The Court also reasoned that the filing of respondent’s disability claim on the basis of his physician’s assessment was therefore bereft of legal and factual basis.

The Supreme Court likewise addressed the evidentiary weight as

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