TL;DR
The Supreme Court ruled that a seafarer’s disability claim was valid, despite the company doctor’s ‘fit-to-work’ assessment, because the company failed to initiate a third doctor referral process when medical opinions conflicted. The Court emphasized that the employer shares the responsibility to jointly agree on a third doctor and must support their physician’s assessment with medical records. This decision clarifies that employers cannot unilaterally rely on their doctor’s opinion if challenged by the seafarer, especially when their assessment lacks evidentiary support, ensuring fairer disability claim resolutions for seafarers.
Whose Diagnosis Prevails? Protecting Seafarers’ Rights in Disputed Disability Assessments
When a seafarer falls ill at sea, determining the extent of their disability and entitlement to compensation can become a battle of medical opinions. In the case of Dagasdas v. Trans Global Maritime Agency, Inc., the Supreme Court addressed this very issue, clarifying the responsibilities of both seafarers and employers in resolving conflicting medical assessments, particularly concerning the crucial ‘third doctor’ referral. The central legal question was: In a dispute over a seafarer’s fitness to work, who bears the responsibility to initiate the process of seeking a third, impartial medical opinion, and what evidentiary weight should be given to differing medical assessments?
Nicasio Dagasdas, a pumpman, contracted pulmonary tuberculosis while working on a vessel. Upon repatriation, the company-designated doctor initially treated him and eventually declared him fit to work. However, Dagasdas’ chosen physician diagnosed him with permanent disability due to chronic obstructive pulmonary disease secondary to his unresolved tuberculosis. When Dagasdas sought disability benefits, the company argued his claim was premature because he failed to initiate a third doctor referral to settle the conflicting medical opinions. The company insisted that the company-designated doctor’s assessment should prevail.
The Supreme Court disagreed with the company’s stance. The Court underscored that the obligation to pursue a third doctor referral is not solely on the seafarer. Both the POEA-SEC and the CBA stipulate that a third doctor may be jointly agreed upon by the employer and the seafarer. Citing previous jurisprudence, the Court reiterated that once a seafarer expresses disagreement with the company doctorâs assessment by presenting a contrary medical opinion, the burden shifts to the employer to initiate the process of selecting a third doctor.
In this case, Dagasdas, through the SEnA process, informed the company of the differing medical opinions and his intention to seek a third doctor. However, the company responded with a rejection of any disability benefit settlement, effectively refusing to engage in the third doctor referral process. The Supreme Court interpreted this response as a clear refusal by the company to participate in the jointly agreed-upon procedure. Therefore, the Court concluded that Dagasdas could not be faulted for the absence of a third doctorâs opinion.
Having established that the lack of a third doctor referral was not Dagasdasâ fault, the Court proceeded to evaluate the conflicting medical assessments. While generally, the company-designated physician’s findings are given more weight, this presumption is not absolute. The Court emphasized that the company doctor’s assessment must be credible and supported by medical reports and records. In Dagasdasâ case, the company-designated physician declared him fit to work without providing the underlying medical records, such as the CT scan and x-ray results that were supposed to be the basis of this certification.
Conversely, Dr. Donato-Tan, Dagasdas’ chosen physician, based her permanent disability assessment on a recent x-ray examination clearly indicating that Dagasdasâ pulmonary tuberculosis remained unresolved. Dr. Donato-Tan detailed how Dagasdas’ condition, now progressing to COPD, permanently hindered his ability to perform sea duties. Furthermore, the Court noted inconsistencies, such as the company’s refusal to redeploy Dagasdas despite the fit-to-work certification, and the companyâs failure to present the medical basis for their physician’s assessment. These factors led the Supreme Court to give greater weight to Dr. Donato-Tanâs findings.
Ultimately, the Supreme Court affirmed Dagasdas’ entitlement to permanent total disability benefits, but modified the compensation amount. While the Voluntary Arbitrator initially awarded benefits under the CBA (US$96,909.00), the Court of Appeals reduced it to the POEA-SEC rate (US$60,000.00). The Supreme Court reinstated the CBA rate, emphasizing the applicability of the CBA’s permanent medical unfitness clause given Dagasdas’ total and permanent disability, aligning with the principle that CBA provisions should be upheld when they provide superior benefits. The Court also awarded sickness allowance and attorney’s fees to Dagasdas.
FAQs
| What was the main point of contention in this case? | The disagreement centered on whether Mr. Dagasdas was permanently disabled and entitled to disability benefits, especially given the conflicting medical assessments from the company doctor and his personal physician. |
| Who is responsible for initiating the third doctor referral process? | The responsibility is shared. While the seafarer must indicate disagreement with the company doctor, the employer then has the burden to initiate the process of jointly selecting a third, impartial doctor. |
| What happens if the employer refuses to participate in the third doctor referral? | If the employer refuses to jointly agree on a third doctor, the seafarer is not penalized for the absence of a third doctor’s opinion, and the court will evaluate the existing medical evidence. |
| Which medical assessment is given more weight by the court? | While company-designated doctors’ assessments are generally considered, they must be supported by medical records. If unsupported or contradicted by credible evidence from the seafarer’s doctor, the court may give greater weight to the latter’s opinion. |
| What benefits was Mr. Dagasdas ultimately entitled to? | Mr. Dagasdas was entitled to permanent total disability benefits at the rate specified in the CBA (US$96,909.00), sickness allowance, and attorney’s fees. |
| What is the practical implication of this ruling for seafarers? | This ruling protects seafarers by ensuring employers cannot solely rely on potentially unsupported ‘fit-to-work’ certifications. It reinforces the employer’s duty to participate in a fair process for resolving medical disputes in disability claims. |
For inquiries regarding the application of this ruling to specific circumstances, please contact Atty. Gabriel Ablola through gaboogle.com or via email at connect@gaboogle.com.
Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: Dagasdas v. Trans Global, G.R. No. 248445 & 248488, May 12, 2021
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