Wallem Maritime Services v. Quillao
REITERATIONFacts
The Antecedents: Respondent Edwinito V. Quillao was hired as a fitter aboard the vessel Crown Garnet by Wallem Maritime Services, Inc. (WMS) for its foreign principal, Wallem Shipmanagement Ltd. (WSL). Respondent alleged his employment was covered by a collective bargaining agreement (CBA). He experienced neck and lower back pain, and numbness and weakness in his left hand. Upon signing off on July 13, 2009, he was referred to company-designated physicians. He was diagnosed with cervical radiculopathy, thoracic and lumbar spondylosis, and carpal tunnel syndrome. He underwent surgery and physical therapy. On November 23, 2009, AMOSUP informed WMS of respondent's claim for disability benefits. Respondent requested a final assessment from the company-designated doctor on November 24, 2009, but received none. On March 12, 2010, the company-designated doctor gave respondent a final disability rating of Grade 10, stating he had reached maximum medical wellness but had poor response to therapy. Respondent later consulted an independent orthopedic surgeon, Dr. Renato P. Runas, who diagnosed him with cervical and lumbar spondylosis with nerve root compression and declared him permanently unfit for sea duty with a Grade 8 impediment. Procedural History: The Panel of Voluntary Arbitrators (PVA) ordered WMS and WSL to pay respondent US$98,110.00 as disability benefits, finding that the company-designated doctor failed to issue an assessment within 120 days and giving more credence to Dr. Runas's assessment over Dr. Estrada's. The Court of Appeals (CA) affirmed the PVA's decision with a slight modification in the awarded amount, reiterating that the opinion of the seafarer's chosen physician prevails in case of conflict and that the company-designated physician failed to issue a fitness certification. The Petition: Petitioners Wallem Maritime Services, Inc., Reginaldo A. Oben, and Wallem Shipmanagement, Ltd. challenged the CA's decision, arguing that respondent had no cause of action when he filed his complaint as he was still undergoing treatment and the company doctor had not yet issued a final assessment. They also contended that respondent was entitled only to the Grade 10 disability rating assessed by the company doctor and that he was guilty of medical abandonment. They further argued against the award of attorney's fees.
Issue(s)
Whether respondent is entitled to permanent and total disability benefits and whether the complaint was premature. Whether respondent was guilty of medical abandonment. Whether the assessment of the company-designated physician or the seafarer's chosen physician should prevail. On the application of the 240-day rule. Whether attorney's fees are warranted.
Ruling
The Supreme Court granted the petition, reversed the Court of Appeals' decision, and dismissed the complaint for lack of merit.
Ratio Decidendi
On the entitlement to permanent and total disability benefits and the prematurity of the complaint: The Court ruled that respondent had no cause of action when he filed his complaint because the company-designated physician had not yet issued a final assessment, and the 240-day maximum period for treatment had not yet lapsed. The Court clarified that for complaints filed after October 6, 2008, the 240-day rule applies, not the 120-day rule. Respondent filed his complaint on November 23, 2009, well within the 240-day period, and had not yet consulted his own physician. Therefore, the complaint was premature as the company-designated doctor had no opportunity to definitively assess his condition while he was still undergoing treatment. On medical abandonment: The Court found that respondent was guilty of medical abandonment. The company-designated doctor's report dated January 9, 2010, indicated that respondent's chance of being declared fit to work was "quite good" if he completed his remaining therapy sessions. However, respondent failed to report for consultations after November 12, 2009, until the filing of his complaint on November 23, 2009, and beyond. This failure to report, without valid explanation, led the company-designated doctor to believe there was an intent to prolong treatment and seek disability. The Court cited that under Section 20(D) of the POEA-SEC, no compensation is payable for injury resulting from "intentional breach of his duties," and respondent's failure to comply with medical treatment constituted such a breach. On the conflict of medical opinions: While the CA gave credence to the opinion of respondent's chosen physician, Dr. Runas, the Supreme Court's ruling in C.F. Sharp Crew Management, Inc. v. Obligado and other cases emphasize that the company-designated physician's assessment should generally prevail unless there is a clear conflict and the seafarer seeks a third doctor's opinion. However, the primary issue here was the prematurity of the claim and medical abandonment, which precluded the need to definitively resolve the conflict of opinions. On the application of the 240-day rule: The Court reiterated that the 120 or 240-day period to determine a seafarer's disability or fitness to work is reckoned from his repatriation. Respondent reported to the company-designated physician within three days of arrival and received medical attention. However, he failed to abide by the rule that the company-designated physician determines his fitness to return to work or the degree of disability within the 240-day period. His premature filing of the complaint and subsequent failure to continue treatment prevented this determination. On attorney's fees: The Court found no bad faith in the denial of respondent's claims, as the denial was based on legal grounds, including the prematurity of the action and medical abandonment. Therefore, the award of attorney's fees was deemed improper.
Main Doctrine
A seafarer's complaint for disability benefits is premature and lacks a cause of action if filed before the company-designated physician has issued a final assessment or before the lapse of the 240-day maximum period for treatment, provided the seafarer has not consulted his own physician.