This case clarifies the crucial role of a company-designated physician’s assessment in seafarers’ disability claims under Philippine law. The Supreme Court ruled that the assessment of the company-designated physician prevails unless proven to be tainted with bad faith or bias. It also reiterated the established procedure for resolving conflicting medical opinions, emphasizing the importance of seeking a third, mutually agreed-upon doctor to provide a final and binding assessment. This ensures a fair and objective evaluation of a seafarer’s condition in determining eligibility for disability benefits.
海上の苦難：船員の健康診断は誰の手に委ねられるのか？
The case of Bahia Shipping Services, Inc. v. Crisante C. Constantino revolves around a seafarer, Constantino, who claimed disability benefits after experiencing back pain while working on a vessel. He argued that his chosen physician’s assessment of permanent partial disability should supersede the company-designated physician’s declaration of fitness to work. The central legal question is whether the company-designated physician’s assessment is binding and, if not, what procedure should be followed to resolve conflicting medical opinions. The Supreme Court’s decision sheds light on the weight given to medical assessments in seafarer disability claims under the POEA-SEC.
The POEA-SEC serves as the governing law for employment relationships between Filipino seafarers and their employers. This contract sets forth the terms and conditions that both parties must strictly adhere to. Section 20(B)(3) of the POEA-SEC clearly specifies that the company-designated physician is responsible for determining a seafarer’s fitness to work or the degree of disability following a work-related injury or illness. This provision emphasizes the initial authority granted to the company-designated physician in assessing the seafarer’s medical condition. Therefore, any claim for disability benefits must, in its starting point, consider this physician’s evaluation.
Building on this principle, the Supreme Court underscored that the company-designated physician’s assessment is not absolute and can be challenged. The POEA-SEC provides a mechanism for resolving disagreements between the company-designated physician and the seafarer’s chosen physician. Specifically, if the seafarer’s doctor disagrees with the company doctor’s assessment, the parties can jointly agree on a third, independent doctor whose decision will be final and binding. This process ensures that the seafarer has the opportunity to challenge the initial assessment and seek a more objective evaluation of their condition.
This approach contrasts with the Court of Appeals’ (CA) stance, which favored the assessment of Constantino’s chosen physician, Dr. Almeda. The CA deemed Dr. Almeda’s report more credible because he specialized in occupational medicine and orthopedics. However, the Supreme Court overturned this decision, emphasizing that Dr. Almeda examined Constantino only once and primarily interpreted the findings of the company-accredited doctors. On the other hand, the team of doctors designated by the company, including Dr. Lim, examined and treated Constantino twelve times for a period of almost six months and, each time they treated him, they issued a report of Constantino’s medical condition. Given these considerations, the Supreme Court placed greater weight on the thorough and continuous monitoring provided by the company’s medical team.
Herein lies the significance of the timeline and scope of medical evaluation. One time big time assessments are simply not enough. This is not to say they hold no bearing but consistent reports over a substantial amount of time allows a more complete view. Absent of bad faith, assessments like these are difficult to overturn.
The Court also emphasized the importance of adhering to the established procedure for resolving medical disagreements. The seafarer, Constantino, should have actively requested that the conflicting assessments between his doctor and the company-designated physician be referred to a third, independent doctor for a final and binding opinion. Since Constantino failed to make such a request, the employer-company cannot be expected to respond. Because he did not request this action, the first assessment of the company-designated physician stood.
“If a doctor appointed by the seafarer disagrees with the assessment (of the company-designated physician), 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.”
The absence of bad faith or self-serving motives on the part of the company-designated physician further strengthens the validity of their assessment. In this case, the Supreme Court found no evidence to suggest that the company doctors acted in bad faith or that their reports were intended to avoid liability. In fact, the company paid for Constantino to have many tests and sessions with their doctors and rehabilitation experts. Without such proof, the Court upheld the principle that the company-designated physician’s assessment should be given due weight and deference. In turn, his company should act in a consistent manner and this gives him the high level of integrity that is expected and needed for fair claims.
In light of these considerations, the Supreme Court also addressed the Certificate of Fitness for Work executed by Constantino. The Court clarified that the certificate should not be viewed as a quitclaim to be regarded with disfavor. Instead, it signified Constantino’s concurrence with the company-designated physician’s assessment that he was fit to work. This certificate supports the conclusion that Constantino did not have a compensable disability claim. Because the Supreme Court agreed with his fitness assessment from the designated company physician, he could no longer assert the fitness assessment from the personal doctor he was seeing.
Ultimately, the Supreme Court’s decision in this case reinforces the importance of adhering to the provisions of the POEA-SEC in resolving seafarer disability claims. It underscores the crucial role of the company-designated physician’s assessment, while also recognizing the seafarer’s right to seek a second opinion and challenge the initial assessment through the established procedure. The need to call upon a mutually agreeable third opinion if a different medical decision comes from the seafarer’s personal physician becomes apparent. Failure to abide by such an action may be cause for a negative judgement when and if this claim ends up in court.
FAQs
| What was the key issue in this case? |
The key issue was whether the company-designated physician’s assessment of a seafarer’s fitness to work should prevail over the assessment of the seafarer’s chosen physician in a disability claim. |
| What is the POEA-SEC? |
The POEA-SEC stands for the Philippine Overseas Employment Administration-Standard Employment Contract, which governs the employment relationship between Filipino seafarers and their employers. |
| What is the role of the company-designated physician? |
Under the POEA-SEC, the company-designated physician is responsible for assessing a seafarer’s fitness to work or the degree of disability following a work-related injury or illness. |
| What happens if the seafarer’s doctor disagrees with the company doctor’s assessment? |
The POEA-SEC provides a procedure for resolving disagreements: the parties can jointly agree on a third, independent doctor whose decision will be final and binding. |
| Did the seafarer in this case follow the correct procedure? |
No, the seafarer did not actively request that the conflicting assessments be referred to a third, independent doctor for a final and binding opinion. |
| What was the significance of the Certificate of Fitness for Work in this case? |
The Certificate of Fitness for Work, executed by the seafarer, signified his concurrence with the company-designated physician’s assessment that he was fit to work. |
| What did the Supreme Court ultimately decide? |
The Supreme Court ruled in favor of the company, upholding the company-designated physician’s assessment and dismissing the seafarer’s claim for disability benefits. |
| What should a seafarer do if they disagree with a company doctor’s assessment? |
A seafarer should actively request that the conflicting assessments be referred to a third, independent doctor jointly agreed upon by both parties, as provided by the POEA-SEC. |
This decision highlights the importance of following the procedures outlined in the POEA-SEC for resolving seafarer disability claims. It provides guidance for seafarers, employers, and medical professionals on the proper steps to take when medical opinions differ. By adhering to these guidelines, all parties can ensure a fair and objective assessment of a seafarer’s condition.
For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.
Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: Bahia Shipping Services, Inc. v. Constantino, G.R. No. 180343, July 09, 2014
