THE SEAFARER must be formally informed of the final and definite assessment of his medical condition by the company-designated physician within the 120/240-day period, otherwise he will be entitled to total permanent disability benefits.
The Supreme Court reprimanded employers in their practice of deliberately concealing or delaying to divulge to the seafarers written or verbal information on the real status of their medical benefits, prompting them to file the necessary cases. It is only during the hearings that the written documents usually surface, often as attachments in pleadings.
In the case of Pelagio vs Philippine Transmarine Corp. (G.R. No. 231773, March 11, 2019), the Supreme Court awarded total permanent disability benefits to the seafarer who suffered with lumbar problems as the employers did not explain the reasons for their failure to present the company doctor’s medical report at the earliest opportunity.
It was only after the NLRC rendered an unfavorable decision that the same was presented in their Motion for Reconsideration. The belated submission of said document without any explanation casts doubt on its credibility especially since it does not appear to be newly discovered evidence. Belated submission of evidence may be allowed only if the delay in its presentation is sufficiently justified, the evidence adduced is undeniably material to the cause of a party, and the subject evidence should sufficiently prove the allegations sought to be established. The Court ruled that the document does not fall within the said rule.
The guidelines that govern seafarers’ claims for permanent and total disability benefits were outlined in the case of Jebsens Maritime, Inc. vs Rapiz (G.R. No. 218871, Jan. 11, 2017).
First, 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.
Second, 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.
Third, 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.
Lastly, 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 company-designated physician is required to issue a final and definite assessment of the seafarer’s disability rating within the aforesaid 120/240-day period; otherwise, the opinions of the company and the independent physicians are rendered irrelevant because the seafarer is already conclusively presumed to be suffering from a permanent and total disability, and thus, is entitled to the benefits under the contract.
In disability compensation, it is not the injury which is compensated, but rather it is the incapacity to work resulting in the impairment of one’s earning capacity. Permanent total disability means disablement to earn wages in the same kind of work, or work of similar nature that he was trained for or accustomed to perform, or any kind of work which a person of his mentality and attainment could do. It does not mean absolute helplessness.
Probability and not the ultimate degree of certainty is the test of proof. The precise medical causation of the illness is not significant, as long as the illness supervened in the course of employment and is reasonably shown to have been either precipitated or aggravated by work condition.
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Atty. Dennis Gorecho heads the seafarers’ division of the Sapalo Velez Bundang Bulilan law offices. For comments, email info@sapalovelez.com, or call 09175025808 or 09088665786./PN
