Third Doctor's Opinion: A Seafarer's Duty to Resolve Conflicting Medical Assessments in Disability Claims

The Supreme Court has long protected the rights of Filipino seafarers, but it also expects them to follow the rules. In Career Phils. Shipmanagement, Inc. v. Tiquio (G.R. No. 241857, June 17, 2019), the Court reminded seafarers that when a company-designated physician and their own doctor disagree, the seafarer must invoke the third-doctor mechanism under the POEA-SEC. Failure to do so can result in the denial of a disability claim.

The Facts of the Case

John Frederick T. Tiquio was hired as an ordinary seaman under a nine-month contract. While on board the vessel, he suffered high fever, nausea, and vomiting. He was diagnosed with hyperthyroidism secondary to Graves' Disease and repatriated for treatment.

The company-designated physician treated Tiquio for a year and issued a medical certification stating he was unfit for work. However, the physician also declared the illness was "NOT Work Oriented," meaning it was not related to his duties.

Tiquio filed a complaint for total and permanent disability benefits. In his rejoinder, he attached a medical certificate from his own doctor, Dr. San Luis, who declared him permanently incapacitated and stated his illness was work-related. The certificate was obtained only three months after Tiquio filed his complaint.

The Issue

The central question was whether Tiquio was entitled to total and permanent disability benefits despite failing to comply with the conflict-resolution procedure under Section 20(A)(3) of the 2010 POEA-SEC.

The Ruling

The Supreme Court ruled in favor of the petitioners, reversing the Court of Appeals and reinstating the NLRC's dismissal of Tiquio's claim.

The Court held that when a seafarer's personal doctor disagrees with the company-designated physician's assessment, the parties must jointly appoint a third doctor whose decision shall be final and binding. This procedure is mandatory, not merely directory.

Tiquio filed his complaint without presenting any contrary medical opinion. He only submitted his doctor's certificate months later, and there was no evidence he consulted this doctor before filing the case. The Court found that his non-compliance with the mandated procedure militated against his claim, resulting in the affirmance of the company-designated physician's findings.

Proving Compensability

The Court also addressed the burden of proving that an illness is compensable under Section 32-A of the POEA-SEC. While work-relatedness is presumed for illnesses not listed as occupational diseases, the seafarer must still prove all four conditions for compensability:

1. The work must involve the risks described
2. The disease was contracted as a result of exposure to those risks
3. The disease was contracted within a period of exposure
4. There was no notorious negligence on the part of the seafarer

In this case, Tiquio failed to establish a causal connection between his duties as an ordinary seaman and his Graves' Disease. The company-designated physician, an endocrinologist, explained that the disease is an autoimmune disorder with known risk factors including genetics, age, weight, and smoking—none of which were shown to relate to his work. The seafarer's doctor, a neurologist, based his assessment on a single encounter and could not support his conclusions with medical literature.

Practical Takeaways

• Follow the third-doctor procedure. If a seafarer's personal doctor disagrees with the company-designated physician, the seafarer must request the joint appointment of a third doctor under Section 20(A)(3) of the POEA-SEC. Filing a complaint without doing so may be considered premature.

• Present contrary evidence promptly. A seafarer who claims to have consulted an independent doctor should present the medical certificate before filing a complaint, not months later.

• Prove work-relatedness with substantial evidence. A medical certificate alone may not suffice. Seafarers should present evidence showing how their specific duties and working conditions caused or aggravated their illness.

• Choose the right expert. The Court gave weight to the company-designated physician who was an endocrinologist—an expert on the disease—over the seafarer's doctor who was a neurologist with limited familiarity with the condition.

• Understand the burden of proof. Even when work-relatedness is presumed, the seafarer must still prove compliance with all conditions for compensability under Section 32-A of the POEA-SEC.

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