Physician's findings in maritime disability claim

In a maritime disability claim, the issue that often arises is the conflicting findings between the company-designated physician and the seafarer’s chosen physician.

Section 20(B)(3) of the POEA-SEC provides that if a doctor appointed by the seafarer disagrees with the assessment of the company-designated doctor, a third doctor may be agreed jointly between the employer and the seafarer, and the third doctor’s decision shall be final and binding on both parties.

In several cases, the Supreme Court upheld the findings of the company-designated physician due to the non-referral by the seafarer to a third doctor. In Philippine Hammonia Ship Agency v. Dumadag (G.R. No. 194362, 26 June 2013), the Supreme Court considered the filing of the complaint by the seafarer as a breach of his contractual obligation to have the conflicting assessments of his disability referred to a third doctor for a binding opinion. The case of Formerly INC Shipmanagement v. Rosales (G.R. No. 195832, 1 October 2014) was categorical in stating that non-referral to a third physician, whose decision shall be considered as final and binding, constitutes a breach of the POEA-SEC.

The more practical consideration in favoring the medical findings of the company-designated physician was explained in Dalusong v. Eagle Clarc, Shipping (G.R. No. 204233, 3 September 2014), thus:

As the Court aptly stated in Philman Marine Agency, Inc. (now DOHLE-PHILMAN Manning Agency, Inc.) v. Cabanban, “the doctor who have had a personal knowledge of the actual medical condition, having closely, meticulously and regularly monitored and actually treated the seafarer’s illness, is more qualified to assess the seafarer’s disability.” Based on the Disability Report of petitioner’s doctor, it appears that he only conducted a physical examination on petitioner before issuing his final diagnosis and disability rating on petitioner’s condition. Clearly, the findings of the company-designated doctor, who, with his team of specialists which included an orthopedic surgeon and a physical therapist, periodically treated petitioner for months and monitored his condition, deserve greater evidentiary weight than the single medical report of petitioner’s doctor, who appeared to have examined petitioner only once.

Following jurisprudence, the Court of Appeals correctly upheld the fit-to-work order issued by the company-designated physician. After the certification on the fitness for sea duties was issued by the company-designated physician, petitioner sought a second opinion from a private doctor. When the private doctor opined that petitioner was unfit to work, petitioner wasted no time in filing the instant complaint. Verily, he did not bother to seek the opinion of a third person as mandated by the POEA-SEC. Furthermore, the private doctor had only examined petitioner once while the company-designated physician had monitored petitioner’s medical condition for several months. As aptly observed by the Court of Appeals:

It also bears to note that petitioners extended medical assistance to private respondent from the time he arrived in the Philippines up to the time he was declared fit to resume his sea duties. The records show that petitioners referred him to the company-designated physician, Dr. Susannah Ong-Salvador of SHIP where he was diagnosed by the clinic’s ophthalmologists. On February 23, 2006, private respondent underwent an operation on his right eye at UST Hospital and was later admitted therein for further management under the care of SHIP’s specialists. On March 17, 2006, private respondent again underwent a second operation on his left eye at UST Hospital and was admitted therein for three days. Private respondent’s progress was also continuously evaluated and monitored by SHIP’s ophthalmologists as shown by the Medical Progress Reports they issued.

In all, the company-designated physician acquired a more detailed knowledge and familiarity of private respondent’s injury and could very well accurately evaluate the latter’s degree of disability. The evaluations made by the company-designated physician were never disputed. Even their competence has not been challenged. Besides, as between the company-designated doctor who has all the medical records of private respondent during the duration of his treatment and as against the latter’s private doctor who examined for a day as an outpatient, the former’s finding must prevail.

In OSG Shipmanagement v. Pellazar (G.R. No. 198367, 6 August 2014), the Supreme Court ruled that the company designated physician’s findings, although not binding on the Court, generally prevails over other medical findings. Thus:

By recognizing that a disagreement between the company-designated physicians and the physician chosen by the seafarer may exist, the POEA-SEC itself impliedly recognizes the seafarer’s right to request a second medical opinion from a physician of his own choice. That the seafarer should not be prevented from seeking an independent medical opinion proceeds from the theory that a company-designated physician, naturally, may downplay the compensation due to the seafarer because that is what the employer, after all, expects of him. Accordingly, the Court observed that labor tribunals and the courts are not bound by the medical findings of the company-designated physician and that the inherent merits of its medical findings will be weighed and duly considered.

However, even on this context, the NLRC’s ruling awarding Pellazar disability benefits based on the Grade 10 rating of Drs. De Guzman and Banaga can fully withstand a Rule 65 challenge since the Grade 10 rating had ample basis in the extensive evaluation and treatment of Pellazar by these two company doctors, including an orthopedic specialist and a physiatrist.

In stark contrast, Dr. Sabado, Pellazar’s chosen physician, examined him only once and could have treated him for a few hours only, considering as the petitioners point out, that Pellazar came all the way from Antipolo, where he resides, to Dagupan City, where Dr. Sabado is practicing his profession. It is as if, the petitioners aver, Pellazar sought out Dr. Sabado in Dagupan City for a favorable certification.

While Dr. Sabado’s diagnosis was consistent with that of the company-designated physicians (which centered on the injury in Pellazar’s 5th right finger and the resulting loss of grasping power of said fifth finger), Dr. Sabado certified Pellazar to be permanently unfit for sea service. Notwithstanding Dr. Sabado’s unfit-to-work certification (which the LA relied upon in ruling in Pellazar’s favor), the NLRC gave more credence to the Grade 10 disability rating of Pellazar than the assessment of Dr. Sabado.

The NLRC’s mere disagreement with the LA, however, does not give rise to grave abuse of discretion, unless the NLRC’s contrary conclusion had no basis in fact and law. In the present case, the NLRC ruling was actually based on the extensive evaluation and treatment of Pellazar’s medical condition by the company doctors. Under a Rule 65 petition, the CA does not determine which of the conflicting findings or assessment should be preferred; but rather, whether in deciding to uphold one over the other, the NLRC exceeded the bounds of its jurisdiction or committed grave abuse of discretion. The CA’s finding in this regard finds no support in its decision because of its misplaced reliance on the 120-day period, as earlier discussed.