Wenceslao v. C.F. Sharp Crew Management, Inc.
REITERATIONFacts
The Antecedents: Petitioner Michelle Miro Wenceslao (Michelle) was hired as a waitress onboard M/S Norwegian Sky by C.F. Sharp Crew Management, Inc. (CSC) on March 31, 2017. While performing her duties on August 8, 2017, she experienced low back pain and was unable to straighten her right hip and knee. She was medically repatriated to the Philippines on October 16, 2017. Upon examination, she was diagnosed with disc bulge and disc desiccation. Despite physical therapy, she claimed minimal improvement. The company-designated physician recommended surgery (Transforminal Lumbar Interbody Fusion of L5-S1) on January 18, 2018. Michelle opted for alternative treatment, and on January 26, 2018, she was discharged by the company-designated physicians with a prescription for analgesics and instructions for self-directed exercises. Michelle consulted a second physician who assessed her with Grade 8 disability rating, partial and permanent, rendering her unfit to work as a seafarer. Parties agreed to refer the matter to a third doctor, Dr. Leander Peralta, who also assessed Michelle's condition with Grade 8 disability rating, partial and permanent. CSC furnished Michelle a copy of the company-designated assessment dated January 26, 2018, stating no definitive management was possible due to her refusal of surgery. Michelle insisted on full disability benefits under the Collective Bargaining Agreement (CBA) due to her inability to return to work for more than 240 days. CSC refused, leading Michelle to file a labor complaint. Procedural History: The Labor Arbiter (LA) awarded Michelle disability benefits based on the third doctor's Grade 8 rating, finding the CBA inapplicable as the condition was not an accident. The National Labor Relations Commission (NLRC) affirmed the LA's ruling. The Court of Appeals (CA) also affirmed the NLRC's decision, holding that the third doctor's medical opinion was binding. The Petition: Michelle filed a petition for certiorari with the Supreme Court, arguing that her disability should be deemed permanent and total due to her inability to return to work for over 240 days, overriding any disability grading. She also claimed the company-designated physician failed to issue a valid, final, and definitive assessment within the mandated period and that the Grade 6 assessment was never furnished to her timely, violating due process. Lastly, she argued for full disability benefits under the CBA, asserting her injury resulted from an accident.
Issue(s)
Whether the Court of Appeals erred in applying the third doctor rule despite the alleged failure of the company-designated physician to issue a timely, final, and definitive assessment. Whether Michelle is entitled to permanent and total disability benefits based on her inability to return to work for more than 240 days. Whether Michelle is entitled to full disability benefits under the Collective Bargaining Agreement (CBA).
Ruling
The Supreme Court reversed and set aside the Decision of the Court of Appeals. Respondents were ordered to pay petitioner Michelle Miro Wenceslao US$60,000.00 representing permanent and total disability benefits under the 2010 Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC), sickness allowance if none had been paid, and attorney's fees at ten percent (10%) of the monetary award. All amounts shall earn six percent (6%) interest per annum from finality of this Decision until full satisfaction.
Ratio Decidendi
On the failure to issue a timely, final, and definitive assessment and the applicability of the third doctor rule: The Court held that the third doctor rule under Section 20(A)(3) of the 2010 POEA-SEC presupposes that the company-designated physician must have issued a valid, final, and definitive assessment. Such an assessment must state whether the seafarer is fit to work, the exact disability rating, or whether the illness is work-related, and must be issued within 120 days from repatriation, or 240 days if justified. Failure to issue a final assessment within these periods renders the seafarer's illness or injury permanent and total. Furthermore, the company or its doctors are mandated to furnish the seafarer with a copy of this assessment. In this case, Michelle consistently claimed she was only furnished the company-designated physician's assessment during consultations with the third doctor, which was 269 days after her repatriation. The assessment dated January 26, 2018, was merely a narration of events and treatments, not a final and definitive assessment. Even if the Grade 6 assessment dated January 27, 2018, were considered, the company did not furnish it to Michelle within the mandated periods, as she only learned of it when CSC appended it to its position paper at the Labor Arbiter proceedings, long after the 240-day period. This failure to furnish the final assessment within the mandated periods violated Michelle's due process and rendered her disability permanent and total, negating the applicability of the third doctor rule. On entitlement to permanent and total disability benefits: The Court found that CSC's failure to furnish Michelle a final assessment from the company-designated physician within the mandated 120/240-day periods rendered her disability permanent and total. Without a definitive and final assessment from the company-designated physician to contest, the process of seeking a second or third physician's opinion could not have validly ensued. Consequently, Michelle is conclusively presumed to be suffering from a permanent and total disability. On entitlement to full disability benefits under the CBA: The Court ruled that the provisions of the 2010 POEA-SEC were applicable, not the CBA. Article 21 of the CBA requires that the seafarer's disability must have resulted from an "accident" to be entitled to compensation. An accident is defined as an unfortunate happening, an unexpected personal injury resulting from an unlooked-for mishap or occurrence. In Michelle's case, her back pain resulted from turning her trunk while performing her duties, which was an aggravation of her condition by work, not an accident in the legal sense. There was no proof of unlooked-for mishaps or fortuitous events that caused her condition. Therefore, the CBA provisions were inapplicable.
Main Doctrine
The failure of the company-designated physician to issue a final and definitive assessment within the 120/240-day period, and to furnish a copy thereof to the seafarer, renders the seafarer's illness or injury permanent and total, regardless of justification, and negates the applicability of the third doctor rule.