Seafarer Disability Benefits: Why Final Medical Assessments Matter

The Supreme Court recently reminded seafarers that claiming permanent total disability benefits requires patience and procedure. In Mabalot v. Maersk-Filipinas Crewing, Inc. (G.R. No. 224344, September 13, 2021), the Court denied a seafarer's claim for full disability benefits because he filed his complaint prematurely—before the company-designated physician could issue a final medical assessment. The case clarifies when a seafarer may properly claim permanent total disability and why the 120-day and 240-day rules under the POEA-SEC matter.

The Facts of the Case

Edgardo Mabalot was deployed as an Able Seaman by Maersk-Filipinas Crewing, Inc. in March 2011. In July 2011, he complained of pain in his left shoulder. He was medically repatriated on October 15, 2011, and referred to the company-designated physician, Dr. Natalio Alegre II.

Dr. Alegre diagnosed Mabalot with "Frozen Shoulder" and recommended arthroscopic surgery. Mabalot opted for a second opinion instead and continued physical therapy. On February 2, 2012—110 days after repatriation—Dr. Alegre issued a Grade 11 interim disability assessment, noting Mabalot's limited arm movement and recommending continued therapy and a follow-up check-up on February 10, 2012.

On March 5, 2012, Mabalot consulted his own doctor, Dr. Manuel Jacinto Jr., who declared him permanently and totally disabled. On the same day—142 days after repatriation—Mabalot filed a complaint for permanent total disability benefits.

The Issue

The central question was whether Mabalot was entitled to permanent total disability benefits despite the company-designated physician having issued only an interim assessment within the 120-day period.

The Ruling: No Permanent Total Disability

The Supreme Court denied Mabalot's petition. The Court held that the Grade 11 rating issued on February 2, 2012 was merely interim, not final and definite. Because Dr. Alegre still recommended continued physical therapy and a follow-up check-up, Mabalot remained under treatment, which justified extending the assessment period from 120 days to a maximum of 240 days.

The Court explained that a final, conclusive, and definite medical assessment must clearly state the seafarer's fitness to work or his exact disability rating, without any further condition or treatment. An interim assessment does not suffice.

The 120-Day and 240-Day Rules

The Court reiterated the rules from Jebsens Maritime, Inc. v. Mirasol:

1. The company-designated physician must issue a final medical assessment within 120 days from the seafarer's report.
2. If no assessment is issued within 120 days without justifiable reason, the disability becomes permanent and total.
3. If no assessment is issued within 120 days with sufficient justification (e.g., further treatment needed), the period extends to 240 days.
4. If no assessment is issued within 240 days, the disability becomes permanent and total regardless of justification.

In this case, Mabalot filed his complaint on the 142nd day—within the extended 240-day period. The company-designated physician still had time to issue a final assessment. The complaint was therefore prematurely filed.

The Role of the Seafarer's Own Doctor

The Court also addressed Mabalot's reliance on Dr. Jacinto's medical certificate. While a seafarer may seek a second opinion, this right is premised on the company-designated physician having already issued a definite assessment that the seafarer disagrees with. Since no final assessment existed yet, Mabalot could not rely on his own doctor's declaration.

Practical Takeaways

• Wait for the final assessment. Filing a disability claim before the company-designated physician issues a final, definite assessment—or before the 240-day period lapses—may result in denial for prematurity.
• Interim assessments are not final. A medical report that recommends continued treatment or follow-up check-ups is not a final disability grading.
• The 120-day period can extend to 240 days. If the seafarer needs further medical attention, the period for the company doctor to assess extends, provided there is sufficient justification.
• A seafarer's own doctor cannot substitute for the company doctor's assessment. The second-opinion right arises only after the company-designated physician has issued a definite assessment.
• When in doubt, consult a lawyer. The rules on seafarer disability are technical, and timing is critical.

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