Seafarer's Right to Disability Benefits: The Indefinite Assessment and the Third Doctor Rule

The Supreme Court recently clarified the rules on seafarer disability claims, specifically when a company-designated physician's assessment is delayed or indefinite. In Solpia Marine and Ship Management, Inc. v. Postrano (G.R. No. 232275, July 23, 2018), the Court ruled that a seafarer who abandons his medical treatment cannot later claim permanent total disability benefits, even if the company physician failed to issue a final assessment within the 120-day period.

This decision is crucial for seafarers and their families because it defines the boundaries between temporary and permanent disability, and explains what happens when the "third doctor rule" is invoked.

The Facts of the Case

Michael Postrano was an able seaman on board MV Daebo IBT under a 10-month contract approved by the Philippine Overseas Employment Administration (POEA). In December 2012, he fractured his right hand and suffered an open wound on his left hand while arranging a ladder. He was treated in Indonesia and Korea, then repatriated to the Philippines on January 1, 2013.

Upon arrival, Postrano was referred to the company-designated physician, who prescribed medication and later advised physical therapy. Postrano completed 10 sessions and returned for a follow-up on March 14, 2013. The physician advised him to continue therapy and return again. Instead, Postrano continued therapy on his own but failed to return to the company-designated physician. He later consulted an independent physician who gave him a Grade 9 disability rating, and he filed a claim for permanent total disability benefits.

The Issue

The central question was whether Postrano was entitled to permanent total disability benefits despite his failure to complete his treatment with the company-designated physician.

The Supreme Court's Ruling

The Supreme Court ruled in favor of the employer, reversing the Court of Appeals. The Court held that Postrano's claim for permanent total disability benefits must fail because he committed "medical abandonment."

The Court explained that when Postrano reported on March 14, 2013, only 72 days had passed since his treatment began. At that point, he was only suffering from temporary total disability because the 120-day period had not yet lapsed. The company-designated physician's advice to continue therapy indicated that his condition was improving and that a final assessment would depend on the outcome of those sessions.

The Court emphasized that the failure of the company-designated physician to give a definitive assessment does not automatically mean the seafarer is permanently and totally disabled. Without a final assessment, and where the seafarer is at fault for the absence of that assessment, the seafarer is deemed to be suffering only from temporary total disability.

The 120/240-Day Rule

The Court applied the standard rule under the Labor Code and the Amended Rules on Employees' Compensation: a disability is total and permanent if the employee is unable to perform any gainful occupation for a continuous period exceeding 120 days, except as otherwise provided. The rules extend this to 240 days if the injury or sickness still requires medical attendance beyond 120 days.

In this case, because Postrano's treatment was ongoing and he was improving, the Court awarded him income benefit for 218 days — from his repatriation on January 1, 2013 until August 7, 2013, when he completed his last sanctioned physical therapy session. This was within the 240-day period and reflected his temporary total disability.

The Third Doctor Rule

The Court also touched on the "third doctor rule" under the POEA Standard Employment Contract. This rule provides that if the seafarer's doctor disagrees with the company-designated physician's assessment, a third doctor may be jointly agreed upon, and that third doctor's decision is final and binding.

However, the Court noted that this rule presupposes that there is a company-designated physician's assessment to disagree with. In Postrano's case, there was no final assessment because he abandoned his treatment. The third doctor rule cannot be used to manufacture a disability rating when the seafarer's own actions prevented the company physician from completing his evaluation.

Practical Takeaways

• Do not abandon medical treatment. A seafarer who fails to return to the company-designated physician as instructed risks losing the right to claim permanent disability benefits.
• The 120-day rule is not automatic. The lapse of 120 days without a final assessment does not automatically convert a temporary disability into a permanent one, especially if the seafarer is at fault for the delay.
• The third doctor rule requires a prior assessment. The rule only applies when there is a company-designated physician's assessment that the seafarer's doctor disagrees with.
• Keep records of all medical sessions. Documentation of physical therapy sessions and follow-up appointments can support a claim for temporary disability income benefits.
• Temporary total disability benefits may still be awarded. Even when a permanent disability claim fails, a seafarer may be entitled to income benefits for the period of treatment, up to 240 days.

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