Seafarers’ Disability Claims: Abandoning Treatment and the POEA-SEC Rules

The Supreme Court’s 2014 ruling in Splash Philippines, Inc. v. Ruizo (G.R. No. 193628) clarifies a crucial point for seafarers and their families: filing a disability claim does not hinge on how long a seafarer is unable to work. Instead, it depends on strict compliance with the procedures under the Philippine Overseas Employment Administration Standard Employment Contract (POEA-SEC). This case serves as a reminder that abandoning prescribed medical treatment can forfeit a claim for disability benefits.

The Case of a Chief Cook with a Kidney Ailment

Ronulfo Ruizo was a chief cook on the M/V Harutamou. In December 2005, he experienced pain and was diagnosed with a blocked right kidney. He was repatriated to the Philippines and referred to the company-designated physician, who recommended treatment, including a procedure called extracorporeal shockwave lithotripsy (ESWL). Ruizo underwent the first ESWL but failed to return for a follow-up procedure, which the company doctor believed was necessary.

While still under the company doctor’s care, Ruizo filed a complaint for disability benefits. He later consulted his own physician, who rated his disability at Grade VII (41.8%). The Labor Arbiter and the National Labor Relations Commission dismissed his claim, finding he had abandoned his treatment. The Court of Appeals, however, reversed this, awarding him permanent total disability benefits based on the “120-day rule”—the idea that being unable to work for more than 120 days automatically means permanent total disability.

The Supreme Court: The 120-Day Rule Is Not a Cure-All

The Supreme Court sided with the petitioners, setting aside the Court of Appeals’ decision. The Court clarified that the 120-day rule, often invoked in maritime cases, is not a rigid formula. Citing Vergara v. Hammonia Maritime Services, Inc., the Court stressed that a seafarer’s disability cannot be determined solely by the number of days he is unable to work. The assessment must be based on the seafarer’s contract, the POEA-SEC, and any applicable collective bargaining agreement (CBA).

The Court emphasized that under Section 20(B)3 of the POEA-SEC, the employer is liable only for a disability that has been assessed by the company-designated physician. If the seafarer’s own doctor disagrees, the dispute must be referred to a third doctor whose decision is final and binding.

The Consequences of Abandoning Treatment

The Court found that Ruizo’s failure to return for further treatment was the reason the company doctor could not issue a disability assessment. His explanation—that the doctor said he would forward an assessment—was contradicted by the doctor’s report. The Court noted that Ruizo filed his complaint while still under treatment and consulted his own doctor without informing the company, which suggested he was more interested in claiming benefits than in recovering.

Under Section 20(D) of the POEA-SEC, no compensation is payable if the disability results from a seafarer’s willful act or intentional breach of duties. The Court held that Ruizo’s refusal to undergo further treatment negated his claim. Furthermore, the Court noted that the POEA-SEC’s Schedule of Disability Compensation (Section 32) measures disability by gradings, not by the number of days of incapacity. Only a Grade 1 disability constitutes total and permanent disability.

The CBA Question

The Court also rejected the existence of a CBA covering Ruizo’s employment. The one-page excerpt he presented was unsigned and did not identify the employer. A later submission had a blank space for the employer’s name and was for a CBA that had already expired. The Court found no basis for the award of US$100,000.00 under a CBA whose existence was under serious question.

Practical Takeaways

• Follow the company doctor’s orders. A seafarer must complete prescribed treatment and follow-up appointments. Abandoning treatment can be seen as a willful act that bars a disability claim.
• The 120-day rule is not automatic. A seafarer is not automatically entitled to permanent total disability benefits just because he is unable to work for more than 120 days. The company-designated physician’s assessment is key.
• Use the third-doctor mechanism. If a seafarer disagrees with the company doctor’s assessment, the proper step is to seek a joint third-doctor evaluation, not to rely solely on a private physician’s opinion.
• Prove the CBA. A seafarer claiming benefits under a CBA must present clear and convincing evidence of its existence and coverage. An unsigned excerpt or an expired agreement will not suffice.
• Document everything. Keep records of all medical visits, treatments, and communications with the employer and the company-designated physician.

This article is general information and not legal advice. For your specific situation, consult a lawyer or ask ASG Legal AI.