Chan v. Magsaysay
REITERATIONFacts
The Antecedents: Petitioner Richie P. Chan, a fireman engaged by Magsaysay Maritime Corporation, sustained a right knee injury after slipping during a boat drill. He was repatriated on May 13, 2013, and subsequently treated by the company-designated physician, who diagnosed him with gouty arthritis with meniscal tear (right knee) and advised surgery. Petitioner initially refused surgery but later agreed. Despite surgery and subsequent therapy, his condition did not improve. The company-designated physician issued a Grade 10 Disability assessment on August 16, 2013, and again on October 29, 2013, stating he had reached maximum medical improvement. Petitioner consulted an independent medical expert who declared him unfit for sea duty. Petitioner then claimed permanent total disability benefits, which were denied. Procedural History: The Labor Arbiter ruled in favor of Chan, awarding US$60,000.00 in total permanent disability benefits. The NLRC affirmed with modification, awarding attorney's fees. The Court of Appeals reduced the award to Grade 10 Disability Benefits, holding that Chan disregarded the conflict resolution procedure under the POEA-SEC by not referring the conflicting findings to a third doctor, thus the company-designated physician's findings should prevail. The Petition: Chan seeks reversal of the Court of Appeals' decision, arguing that he was not duty-bound to avail of the third-doctor referral because respondents failed to furnish him a copy of the company-designated physician's final assessment. He contends that the assessment was not complete, final, or definite, and that the respondents' failure to provide the assessment within the prescribed period deemed him totally and permanently disabled by operation of law.
Issue(s)
Whether the October 29, 2013 medical assessment of the company-designated physician was complete, final, and definite. Whether referral to a third doctor is mandatory under the circumstances. Whether petitioner is entitled to total and permanent disability benefits.
Ruling
The petition is GRANTED. The Decision dated June 29, 2017 and Resolution dated April 25, 2018 of the Court of Appeals are REVERSED. The April 10, 2015 Resolution of the NLRC is REINSTATED with MODIFICATION, imposing legal interest of six percent (6%) per annum on the total monetary award from finality of this decision until fully paid.
Ratio Decidendi
On the completeness, finality, and definiteness of the October 29, 2013 medical assessment: The Court ruled that the medical assessment issued by the company-designated physician on October 29, 2013, was not complete, final, and definite. While it stated that the petitioner had reached maximum medical improvement and assessed his disability at Grade 10, it did not show how this assessment was arrived at. Jurisprudence requires a definite declaration by the company-designated physician to be conclusive; an abdication of this duty transforms temporary total disability into permanent total disability. The assessment lacked the necessary details to be considered conclusive. On the mandatory nature of the third-doctor referral: The Court held that the mandatory third-doctor referral under Section 20(A)(3) of the 2010 POEA-SEC is not applicable in this case. This provision presupposes that the company-designated physician has issued a valid, final, and definite assessment within the 120-day or 240-day period. Since no such complete, final, and definite assessment was issued, and furthermore, the alleged October 29, 2013 assessment was not even conveyed to the petitioner, the third-doctor rule was not triggered. The absence of a valid final assessment from the company-designated physician makes the third-doctor rule inapplicable. On the entitlement to total and permanent disability benefits: The Court found that petitioner is entitled to total and permanent disability benefits. The company-designated physician failed to issue a complete, final, and definite medical assessment within the 120-day period. Although the petitioner's request for time to decide on surgery might have justified an extension to 240 days, the assessment was not conveyed to the petitioner within this extended period. The Court noted that the respondents failed to prove that the petitioner was duly informed of the disability grading within the 240-day period. Consequently, the law steps in to transform the petitioner's temporary total disability into one of total and permanent disability.
Main Doctrine
The medical assessment of the company-designated physician must be complete, final, and definite, and must be issued and conveyed to the seafarer within the 120-day or 240-day period to be considered valid. Failure to comply with these requirements transforms the seafarer's temporary total disability into permanent total disability.