GR 202885; (January, 2016) (Digest)
G.R. No. 202885 January 20, 2016
WALLEM MARITIME SERVICES, INC., REGINALDO A. OBEN and WALLEM SHIPMANAGEMENT, LTD., Petitioners, vs. EDWINITO V. QUILLAO, Respondent.
FACTS
Respondent Edwinito V. Quillao was hired by petitioner Wallem Maritime Services, Inc. as a fitter. During his contract, he began experiencing neck, back, and hand pain. Upon repatriation, he was placed under the care of the company-designated physician, who diagnosed him with cervical radiculopathy, spondylosis, and carpal tunnel syndrome. He underwent surgery and extensive physical therapy. While still under treatment, respondent, through his union, filed a claim for disability benefits. The company doctor later issued a final assessment declaring respondent had reached maximum medical improvement with a Grade 10 disability rating under the POEA-SEC.
Dissatisfied, respondent consulted his own physician, who declared him permanently unfit for sea duty with a Grade 8 disability. He thus claimed entitlement to permanent and total disability benefits. The Panel of Voluntary Arbitrators ruled in his favor, awarding disability benefits. The Court of Appeals affirmed the award but corrected the monetary amount. Petitioners elevated the case to the Supreme Court, arguing respondent violated the conflict-resolution procedure under the POEA-SEC by unilaterally consulting his own doctor while still under treatment.
ISSUE
Whether respondent is entitled to permanent and total disability benefits despite allegedly failing to comply with the conflict-resolution procedure under the POEA-SEC.
RULING
No. The Supreme Court reversed the Court of Appeals and dismissed the complaint. The legal logic centers on the mandatory procedure for contesting a company-designated physician’s assessment under the POEA-SEC and prevailing jurisprudence. The law requires that if a seafarer disagrees with the company doctor’s assessment, the conflicting opinions must be referred to a third doctor jointly agreed upon by the parties, whose decision shall be final and binding. This procedure is a mandatory precondition for claiming disability benefits.
The Court found that respondent breached this procedure. He sought the opinion of his personal doctor, Dr. Runas, in August 2011, long after the company physician had issued a final Grade 10 assessment in March 2010. Respondent did not initiate or pursue the referral to a third doctor. His unilateral action rendered his personal doctor’s opinion inadmissible to contradict the company assessment. Consequently, the final and binding assessment remained the company doctor’s Grade 10 rating. The failure to observe the prescribed conflict-resolution mechanism is fatal to his claim, as it precludes an adjudicator from granting an award based on a unilateral medical opinion. The entitlement to disability benefits is thus forfeited.