G.R. No. 225190 July 29, 2019
EFREN J. JULLEZA, Petitioner, vs. ORIENT LINE PHILIPPINES, INC., ORIENT NAVIGATION CORPORATION AND MACARIO DELA PEÑA, Respondents.

FACTS

Petitioner Efren Julleza was employed as a bosun by respondents. On December 19, 2012, while his contract was extended, he allegedly slipped and injured his lower back while cleaning a cargo hold in bad weather. He was advised to wait until his repatriation on December 25, 2012, for medical attention. Upon return, the company-designated physician diagnosed him with bilateral nephrolithiasis and lumbar spondylosis, issuing a final disability grading of Grade 8 (loss of 2/3 lifting power of the trunk) on April 23, 2013. Petitioner later consulted an independent physician who declared him unfit for strenuous duties. He filed a complaint for permanent total disability benefits.
The Labor Arbiter and the NLRC ruled in petitioner’s favor, awarding him full disability benefits under the CBA, finding his incapacity exceeded 120 days and that he suffered a work-related accident. The Court of Appeals partially granted respondents’ petition, reversing the award of total disability. The CA held that the company-designated physician’s Grade 8 assessment was final due to petitioner’s failure to refer the conflicting medical opinions to a third doctor, as required by the CBA’s conflict-resolution procedure. It also cast doubt on the occurrence of an accident, noting only an unnotarized statement supported the claim.

ISSUE

Whether the Court of Appeals erred in awarding only partial permanent disability benefits based on the company-designated physician’s Grade 8 assessment, instead of granting permanent total disability benefits.

RULING

The Supreme Court denied the petition and affirmed the CA decision. The legal logic centers on the procedural mechanism for resolving conflicting medical assessments as stipulated in the governing Collective Bargaining Agreement (CBA). The CBA provides that if a doctor appointed by the seafarer disagrees with the company doctor’s assessment, the parties shall agree on a third doctor whose decision is final. Petitioner secured an opinion from his own doctor but did not initiate the step of jointly appointing a third doctor to resolve the conflict.
This failure to observe the agreed conflict-resolution procedure is fatal to petitioner’s claim for a higher disability rating. The Court emphasized that when parties have contractually bound themselves to a specific procedure, they must comply with it. Consequently, in the absence of a binding third doctor’s opinion, the assessment of the company-designated physician, who issued a final Grade 8 partial permanent disability rating within the 240-day period, must be upheld. The claim for permanent total disability benefits, which would require a finding of total and permanent unfitness for sea duty, cannot supersede the contractual finality of the Grade 8 rating due to the procedural lapse. The award was correctly computed based on the CBA’s schedule for a Grade 8 disability.