Tabaosares vs. Barko International, Inc., et al.

A seafarer's temporary total disability does not ripen into permanent and total disability where he abandons his medical treatment by failing to report for the company-designated physician's scheduled re-evaluation before the expiration of the 240-day extended period, thereby preventing a final disability assessment; such abandonment forfeits his right to claim total and permanent disability benefits, and he is entitled at most to the partial disability rating already assessed by the company-designated physician.

Barko International, Inc. hired Roque T. Tabaosares as a No. 1 oiler under a nine-month employment contract, with Azalea U.T. Corp. as the vessel owner and Captain Fernando J. Alano as the responsible officer; the engagement was governed by the Philippine Overseas Employment Administration – Standard Employment Contract (POEA-SEC), deemed incorporated in every seafarer's employment contract, and by the All Japan Seamen's Union / Associated Marine Officers' and Seamen's Union of the Philippines (AMOSUP) and International Marine Transport Corp. Collective Bargaining Agreement (CBA). A seafarer's entitlement to disability benefits is governed by Articles 197 to 199 (formerly Articles 191 to 193) of the Labor Code, as amended, in relation to Section 2(a), Rule X of the Amended Rules on Employee Compensation, alongside the POEA-SEC and the parties' CBA. The dispute concerns the interplay between the statutory and contractual 120/240-day periods for the company-designated physician's assessment and the seafarer's correlative duty to complete medical treatment.

On November 6, 2013, Barko International, Inc. hired Roque T. Tabaosares as a No. 1 oiler under a nine-month contract for service onboard M/V Meridian, a vessel owned by Azalea U.T. Corp. and commanded by Captain Fernando J. Alano. On March 24, 2014, while making his way to the engine room, Tabaosares slipped and fell off the stairs, striking his left shoulder and thigh against a step at the foot of the staircase. He rose and worked the entire day notwithstanding the pain; the following day, he reported to the Chief Engineer that he could not move his left arm, and was given an analgesic, a band of Salonpas for his left shoulder, and advised to rest for the whole day.

On March 26, 2014, he was referred to Dr. Kenya Watanabe of the Nikko Memorial Hospital in Muroran, Hokkaido, Japan, who diagnosed him with "left burner fracture (greater tuberosity)" and placed a bast band on his shoulder. He was medically repatriated on March 28, 2014 and referred the next day to the Ygeia Medical Center, where the company-designated physician, Dr. Ryan Carlo R. Talosig, recommended casting of the left shoulder for six to eight weeks followed by 10 to 14 physical therapy (PT) sessions. A cast was placed on April 3, 2014 and removed on May 8, 2014. Tabaosares then underwent 13 PT sessions from May 12 to June 9, 2014 at the Rehabilitation Pain Clinic of the Iloilo Doctor's Hospital. Upon re-examination on June 11, 2014, Dr. Talosig recommended a second set of 14 PT sessions.

On July 8, 2014, Dr. Talosig issued an interim disability assessment of Grade 11, described as inability to raise the arm more than halfway from horizontal to perpendicular, and opined that further treatment would depend on re-evaluation after the second batch of PT sessions. Tabaosares was paid his sickness allowance from March 29, 2014 to May 31, 2014, and on July 10, 2014 was paid his allowance for June 2014. He completed the second batch of PT sessions on August 18, 2014. Re-evaluated on August 26, 2014, he was still noted to have a limited range of movement in his left shoulder, and Dr. Talosig recommended a third set of 10 to 14 PT sessions, with instructions to return for follow-up check-up or re-evaluation after their completion, tentatively by the end of September or the first week of October 2014.

Tabaosares reported that he completed his PT sessions only on November 17, 2014. The company-designated physician required him to report to the clinic the following day, November 18, 2014, but he failed to heed the directive despite the company shouldering his plane ticket, and refused to take its calls. Meanwhile, on August 29, 2014, he had been paid his sickness allowance for July 2014 and for August 1 to 5, 2014. On September 17, 2014, during the course of his third set of PT sessions, he consulted a personal physician, Dr. Alan Leonardo R. Raymundo, who diagnosed him with "shoulder impingement syndrome secondary to a displaced greater tuberosity fragment" and informed him that he was no longer fit to return to work. On November 28, 2014, Barko prepared a check for his sickness allowance covering August 6 to 26, 2014, which he failed to claim.

On December 12, 2014, Captain Alano sent Tabaosares a letter reminding him of his failure to appear at the November 18, 2014 re-evaluation and warning that failure to report on the dates set by the company-designated physician would result in forfeiture of his right to claim benefits, and requiring him to report to the office within five days from notice. On January 30, 2015, Captain Alano sent another letter informing him that the company was cancelling all his illness benefits due to his failure to report for follow-up treatment and/or examination by the company-designated doctor despite verbal and written notice. On May 29, 2015, Tabaosares requested a grievance conference before the AMOSUP seeking full disability benefits, but no settlement was reached; the case was referred to the NCMB for mandatory conciliation, which likewise failed, and the parties agreed to indorse the case to the Office of the Voluntary Arbitrator.

The OVA found no basis to sustain the prayer for total and permanent disability benefits, reasoning that the company-designated physician's inability to assess whether the injury required further treatment was attributable to Tabaosares's failure to report back for check-up or re-evaluation, and instead adjudged him entitled to permanent partial disability benefits in light of respondents' submissions that they were willing to sustain the July 8, 2014 interim Grade 11 rating. The CA, for its part, found Tabaosares guilty of medical abandonment when he failed to report for re-evaluation or complete his medical treatment before the lapse of the 240-day extended period, and held that he remained under temporary total disability, entitled only to its corresponding benefits, absent any disability assessment by the company-designated physician.

• Financial Incapacity: Petitioner claimed that financial incapacity to shoulder the expenses of staying in Manila prevented him from returning to the company-designated physician for re-evaluation.
• Total and Permanent Disability: Petitioner asserted that his injury was total and permanent on the basis of his incomplete medical treatment, and relied on the assessment of his personal physician, Dr. Alan Leonardo R. Raymundo, who diagnosed "shoulder impingement syndrome secondary to a displaced greater tuberosity fragment" and declared him no longer fit to return to work.
• Damages and Attorney's Fees: Petitioner sought total and permanent disability benefits, damages, and attorney's fees against respondents.

• Sustaining the Grade 11 Rating: Respondents submitted that they were willing to sustain the company-designated physician's July 8, 2014 interim Grade 11 disability rating and to pay the amount corresponding to that rating in accordance with the CBA.

• Total and Permanent Disability Benefits: Whether the Court of Appeals committed reversible error in finding that petitioner is not entitled to total and permanent disability benefits.

• Total and Permanent Disability Benefits: No. The petition was denied. Petitioner's failure to complete his medical treatment by reporting for the scheduled November 18, 2014 re-evaluation, before the expiration of the 240-day extended period, constituted medical abandonment that barred his claim for total and permanent disability benefits and left him entitled only to the Grade 11 partial disability rating and any unpaid differential sickness allowance.

• Total and Permanent Disability Benefits: A seafarer's entitlement to disability benefits is governed by law, by the parties' contracts, and by the medical findings. The relevant statutory provisions are Articles 197 to 199 (formerly Articles 191 to 193) of the Labor Code, as amended, in relation to Section 2(a), Rule X of the Amended Rules on Employee Compensation; the material contracts are the POEA-SEC, deemed incorporated in every seafarer's employment contract and considered the minimum requirements acceptable to the government, the parties' CBA, if any, and the employment agreement between the seafarer and the employer. Under the rules summarized in Elburg Shipmanagement Phils., Inc. vs. Quiogue, Jr., the company-designated physician must issue a final medical assessment within 120 days from the time the seafarer reported to him; if no assessment is given within that period without justifiable reason, the disability becomes permanent and total; if the failure is with sufficient justification — such as the seafarer's need for further medical treatment or his uncooperativeness — the period of diagnosis and treatment is extended to 240 days, with the employer bearing the burden of proving sufficient justification; and if no assessment is still issued within the extended 240-day period, the disability becomes permanent and total regardless of justification. The Court found the extension of the initial 120-day period justified because petitioner's condition necessitated therapy and rehabilitation during the interim. Tracing the timeline: petitioner was repatriated on March 28, 2014 and first seen by Dr. Talosig on March 29, 2014; after his first set of PT sessions ended on June 9, 2014, a second batch was recommended on June 11, 2014, or on the 74th day; on July 8, 2014, or the 101st day, Dr. Talosig gave an interim Grade 11 assessment and opined that further treatment would depend on re-evaluation after the second batch, completed on August 18, 2014, or the 142nd day; on August 26, 2014, or the 150th day, re-evaluation still showed a limited range of movement, prompting a recommendation for a third set of PT sessions and a follow-up check-up; petitioner finished his PT sessions on November 17, 2014, or the 233rd day, and was advised to return for re-evaluation on November 18, 2014, which he failed to heed despite the company shouldering his plane ticket, and he refused to take its calls. The Court thus found petitioner guilty of medical abandonment, which it defined as a seafarer's failure to complete his treatment before the lapse of the 240-day period, preventing the company physician from declaring him fit to work or assessing his disability. Under Section 20(D) of the POEA-SEC, no compensation and benefits are payable in respect of any injury, incapacity, disability, or death of the seafarer resulting from his willful or criminal act or intentional breach of his duties, provided the employer can prove that the injury, incapacity, disability, or death is directly attributable to the seafarer; it is the seafarer's duty to comply with the medical treatment provided by the company-designated physician, and one who abandons his treatment forfeits his right to claim disability benefits. A seafarer is duty-bound to report regularly to the company-designated physician during treatment and to complete that treatment until declared fit to work or assessed with a permanent disability rating, because re-evaluation forms a significant part of medical treatment, determining his actual condition and whether further treatment is needed, whether maximum medical treatment warranting a disability rating has been reached, or whether he has been cured entailing a fit-to-work declaration. The 240-day period had not yet expired when petitioner failed to comply with the directive to report for re-evaluation on November 18, 2014; he was therefore remiss in his duty to complete his medical treatment, and respondents could not be faulted for failing to give a final and definite disability rating. Petitioner's claim of financial incapacity was rejected for lack of proof: under Antolino vs. Hanseatic Shipping Phils., Inc., while financial incapacity to travel to and from the place of treatment may serve as an acceptable justification for failure to attend a check-up, like all allegations it must be supported by clear and convincing evidence, especially where the manning agency consistently provided the seafarer with sickness allowance during the treatment period, as here, where petitioner was paid sickness allowance from March 29, 2014 to August 5, 2014, with only the allowance for August 6 to 26, 2014 remaining unclaimed prior to the grievance meeting. The second paragraph of Section 20(A)(3) of the POEA-SEC entitles the seafarer to reimbursement of the cost of medicines prescribed by the company-designated physician and, for out-patient treatment, to the reasonable cost of actual traveling expenses and/or accommodation, subject to liquidation and submission of official receipts and/or proof of expenses; petitioner never showed that he requested approval for payment or reimbursement of travel and accommodation expenses, or that such request was denied. While jurisprudence recognizes that the absence of a final and definite disability rating does not prevent a seafarer from claiming total and permanent disability benefits, this must be reconciled with the periods provided by the POEA-SEC, and the declaration of permanent and total disability must still observe the 120/240-day period. No clear finding of permanent and total disability could be made because petitioner failed to complete his medical treatment when he ignored the directive to report for re-evaluation on November 18, 2014, prior to the expiration of the 240-day extended period; his claim that his injury was total and permanent merely on the basis of incomplete medical treatment would not suffice, and it was his decision not to return for re-evaluation that rendered it impossible to determine the degree of disability he suffered or whether he could have fully recovered. He is therefore entitled to sickness benefit and medical allowance, which respondents had already provided during his treatment, including the differential sickness allowance offered during the grievance meeting. Temporary total disability only becomes permanent when so declared by the company-designated physician within the periods allowed, or upon the expiration of the maximum 240-day medical treatment period without a declaration of either fitness to work or the existence of a permanent disability. While a seafarer has the right to seek the opinion of other doctors under Section 20(A)(3) of the POEA-SEC, that right may be availed of on the presumption that the company-designated physician had already issued a definite declaration on the seafarer's condition and the seafarer finds it disagreeable; without the company-designated doctor's certification, petitioner cannot rely on the assessment made by his personal physician. His failure to observe the procedure under the POEA-SEC provided sufficient ground for the denial of his claim for permanent total disability benefits, and at most he is entitled to disability benefits equivalent to Grade 11 under the POEA-SEC, as reflected in Dr. Talosig's July 8, 2014 medical report, which respondents were willing to pay, as well as any differential sickness allowance remaining unpaid. The POEA-SEC, being a labor contract, is imbued with public interest, and its provisions must be construed fairly, reasonably, and liberally in favor of the seafarer; this does not mean, however, that every dispute regarding the POEA-SEC shall be decided in favor of the seafarer, since management also has rights entitled to respect and enforcement in the interest of simple fair play. Social justice authorizes neither oppression nor self-destruction of the employer, and when it is the employee who is at fault, the Court shall not hesitate to rule against labor and in favor of capital. Petitioner's claim for damages and attorney's fees was likewise denied, since his failure to appear at the scheduled re-evaluation within the 240-day period negated any act or omission constituting bad faith on respondents' part; while the Court adheres to the principle of liberality in favor of the seafarer, it cannot allow claims for compensation based on whims and caprices, and when the evidence presented negates compensability, the claim must fail lest it cause injustice to the employer. Finally, in accordance with prevailing jurisprudence, the monetary awards due to petitioner should earn 6% legal interest from finality of the ruling until full payment.

• The 120/240-Day Rule in Seafarers' Disability Claims — The company-designated physician must issue a final medical assessment on the seafarer's disability grading within 120 days from the time the seafarer reported to him. If no assessment is issued within 120 days without justifiable reason, the seafarer's disability becomes permanent and total. If the failure is with sufficient justification — such as the seafarer's need for further medical treatment or his uncooperativeness — the period of diagnosis and treatment is extended to 240 days, with the employer bearing the burden of proving sufficient justification. If no assessment is still issued within the extended 240-day period, the disability becomes permanent and total regardless of any justification. The Court applied this framework, holding that the extension was justified because petitioner's condition necessitated therapy and rehabilitation, and that the 240-day period had not yet expired when he failed to report for re-evaluation.
• Medical Abandonment by a Seafarer — A seafarer commits medical abandonment when he fails to complete his treatment before the lapse of the 240-day period, which prevents the company physician from declaring him fit to work or assessing his disability. The Court found petitioner guilty of medical abandonment after he ignored the directive to report for re-evaluation on November 18, 2014, the 233rd day from his first consultation, thereby preventing a complete and definite medical assessment.
• Seafarer's Duty to Report and Complete Treatment — A seafarer is duty-bound to regularly report to the company-designated physician during the course of his medical treatment and to complete that treatment until declared fit to work or assessed with a permanent disability rating. Re-evaluation forms a significant part of medical treatment because it determines the seafarer's actual medical condition and assesses whether further treatment is needed, whether maximum medical treatment warranting a disability rating has been reached, or whether he has been cured entailing a fit-to-work declaration. Failure to comply with the medical treatment provided by the company-designated physician results in forfeiture of the right to claim disability benefits under Section 20(D) of the POEA-SEC.
• Financial Incapacity as Justification for Non-Appearance — Financial incapacity to travel to and from the place of treatment may serve as an acceptable justification for failure to attend a check-up, but like all allegations it must be supported by clear and convincing evidence, especially where the manning agency has consistently provided the seafarer with sickness allowance during the treatment period. Petitioner's unsubstantiated claim was rejected, particularly since he had been paid sickness allowance from March 29, 2014 to August 5, 2014 and never requested approval for or reimbursement of travel and accommodation expenses under Section 20(A)(3) of the POEA-SEC.
• Second-Opinion Rule under the POEA-SEC — A seafarer has the right to seek the opinion of other doctors under Section 20(A)(3) of the POEA-SEC, but that right may be availed of only on the presumption that the company-designated physician had already issued a definite declaration on the seafarer's condition and the seafarer finds it disagreeable. Without the company-designated doctor's certification, the seafarer cannot rely on the assessment made by his personal physician.
• Temporary Total Disability Becoming Permanent — Temporary total disability only becomes permanent when so declared by the company-designated physician within the periods he or she is allowed to do so, or upon the expiration of the maximum 240-day medical treatment period without a declaration of either fitness to work or the existence of a permanent disability.
• Liberality in Favor of Labor Is Not Absolute — The POEA-SEC, being a labor contract, is imbued with public interest, and its provisions must be construed fairly, reasonably, and liberally in favor of the seafarer. This does not mean that every dispute under the POEA-SEC shall be decided in favor of the seafarer, since management also has rights entitled to respect and enforcement in the interest of simple fair play. Social justice authorizes neither oppression nor self-destruction of the employer, and when the employee is at fault, the Court shall not hesitate to rule against labor and in favor of capital.

• "A seafarer commits medical abandonment when he fails to complete his treatment before the lapse of the 240-day period, which prevents the company physician from declaring him fit to work or assessing his disability. Medical abandonment by a seafarer carries with it serious consequences." — This passage supplies the canonical definition of medical abandonment as applied to seafarers and states the threshold factual condition — failure to complete treatment before the lapse of the 240-day period — that the Court found satisfied in this case.
• "it is but the seafarer's duty to comply with the medical treatment as provided by the company-designated physician; otherwise, a sick or injured seafarer who abandons his or her treatment stands to forfeit his or her right to claim disability benefits." — This states the ratio decidendi on forfeiture, tying the seafarer's non-compliance with prescribed medical treatment to the loss of the right to claim disability benefits under Section 20(D) of the POEA-SEC.
• "temporary total disability only becomes permanent when so declared by the company-designated physician within the periods he/she is allowed to do so, or upon the expiration of the maximum 240-day medical treatment period without a declaration of either fitness to work or the existence of a permanent disability." — This articulates the operative test for when a temporary total disability ripens into a permanent one, and explains why petitioner's claim failed absent either a declaration or the expiration of the 240-day period.
• "it must be stressed that while the Court adheres to the principle of liberality in favor of the seafarer, it cannot allow claims for compensation based on whims and caprices. When the evidence presented negates compensability, the claim must fail, lest it causes injustice to the employer." — This passage delimits the doctrine of liberality in favor of seafarers and is frequently invoked to justify denying claims where the evidence negates compensability.

• Elburg Shipmanagement Phils., Inc. vs. Quiogue, Jr., 765 Phil. 341 (2015) — Controlling precedent. The Court adopted the four-part summary of the rules governing a seafarer's claim for total and permanent disability benefits, including the 120-day assessment period, the 240-day extension upon sufficient justification, the employer's burden to prove justification, and the automatic ripening of total and permanent disability upon lapse of the extended period without assessment.
• Antolino vs. Hanseatic Shipping Phils., Inc., 871 Phil. 896 (2020) — Followed. Cited for the rule that financial incapacity to travel to and from the place of treatment may justify failure to attend a check-up, but must be supported by clear and convincing evidence; also cited for the principle that social justice authorizes neither oppression nor self-destruction of the employer.
• Crown Shipping Services vs. Cervas, G.R. No. 214290, July 6, 2021 — Followed. Cited for the definition of medical abandonment and its serious consequences, for the rule that the absence of a final and definitive disability rating does not prevent a claim but must be reconciled with the POEA-SEC periods, and for the significance of the employer's consistent provision of sickness allowance.
• Rodriguez vs. Philippine Transmarine Carriers, Inc., G.R. No. 218311, October 11, 2021 — Followed. Cited for the rule that a seafarer's inability to work and the company-designated physician's failure to determine fitness despite the lapse of 120 days will not automatically shift the disability from total and temporary to total and permanent, and for the rule that temporary total disability becomes permanent only upon declaration within the allowed periods or upon expiration of the 240-day period without declaration.
• Kestrel Shipping Co., Inc. vs. Munar, 702 Phil. 717 (2013) — Cited (through Rodriguez) for the same proposition on the non-automatic conversion of temporary total disability into permanent total disability upon the lapse of 120 days.
• Tradephil Shipping Agencies, Inc. vs. Dela Cruz, 806 Phil. 338 (2017) — Cited (through Rodriguez) for the rule that the seafarer's continued treatment and evaluation by the company-designated physician constitutes sufficient justification for extending the initial 120-day period.
• Manila Shipmanagement & Manning, Inc. vs. Aninang, 824 Phil. 916 (2018) — Followed. Cited for the seafarer's duty to regularly report to the company-designated physician during the course of his medical treatment.
• Lerona vs. Sea Power Shipping Enterprises, Inc., 859 Phil. 332 (2019) — Followed. Cited for the seafarer's duty to complete his treatment until declared fit to work or assessed with a permanent disability rating by the company-designated physician.
• Guadalquiver vs. Sea Power Shipping Enterprise, Inc., 858 Phil. 708 (2019) — Followed. Cited for the rule that without the company-designated doctor's certification, the seafarer cannot rely on the assessment made by his personal physician.
• Philippine Transmarine Carriers, Inc. vs. Tena-e, G.R. No. 234365, July 6, 2022 — Followed. Cited for the entitlement to disability benefits equivalent to Grade 11 under the POEA-SEC as reflected in the company-designated physician's medical report, and for the rule that claims based on whims and caprices must fail when the evidence negates compensability.
• Javier vs. Philippine Transmarine Carriers, Inc., 738 Phil. 374 (2014) — Followed. Cited for the rule that the POEA-SEC, being a labor contract imbued with public interest, must be construed fairly, reasonably, and liberally in favor of the seafarer.
• Reyes vs. Glaucoma Research Foundation, Inc., 760 Phil. 779 (2015) — Followed. Cited for the principle that management must be sustained when it is in the right, and that the Court's preference toward labor does not authorize oppression or self-destruction of the employer.
• Reyes vs. Jebsens Maritime, Inc., G.R. No. 230502, February 15, 2022 — Cited for the proposition that the POEA-SEC is deemed incorporated in every seafarer's employment contract and is considered the minimum requirements acceptable to the government, together with the parties' CBA and the employment agreement.
• Gamboa vs. Maunlad Trans, Inc., 839 Phil. 153 (2018) — Cited (through Reyes vs. Jebsens Maritime, Inc.) for the same proposition on the mandatory incorporation of the POEA-SEC into the seafarer's employment contract.
• Lara's Gifts vs. Midtown, G.R. No. 225433, September 20, 2022 — Cited for the imposition of 6% legal interest per annum on monetary awards from finality of the ruling until full payment.

• Articles 197 to 199 (formerly Articles 191 to 193), Labor Code, as amended — The statutory basis for temporary total disability, permanent total disability, and permanent partial disability benefits. Article 197 governs temporary total disability income benefits and the 120-day limit on continuous payment; Article 198 governs permanent total disability and provides that temporary total disability lasting continuously for more than 120 days, except as otherwise provided in the Rules, is deemed total and permanent; Article 199 governs permanent partial disability. These provisions, read with the implementing rules, supplied the statutory framework against which the timeliness of the company-designated physician's assessment was measured.
• Section 2(a), Rule X, Amended Rules on Employee Compensation — Provides that the income benefit for temporary total disability shall not be paid longer than 120 consecutive days, except where the injury or sickness still requires medical attendance beyond 120 days but not to exceed 240 days from onset of disability, in which case the benefit shall be paid; the System may declare total and permanent status at any time after 120 days of continuous temporary total disability as warranted by the degree of actual loss or impairment. This rule supplied the regulatory basis for the 240-day extended period invoked by the Court.
• Section 20(D), POEA-SEC — Provides that no compensation and benefits shall be payable in respect of any injury, incapacity, disability, or death of the seafarer resulting from his willful or criminal act or intentional breach of his duties, provided the employer can prove that such injury, incapacity, disability, or death is directly attributable to the seafarer. The Court applied this provision to hold that petitioner's abandonment of his treatment barred his claim for total and permanent disability benefits.
• Section 20(A)(3), POEA-SEC — Entitles the seafarer to reimbursement of the cost of medicines prescribed by the company-designated physician and, where treatment is on an out-patient basis, to the reasonable cost of actual traveling expenses and/or accommodation, subject to liquidation and submission of official receipts and/or proof of expenses. The Court cited this provision in rejecting petitioner's claim of financial incapacity, noting that he never requested approval for payment or reimbursement of travel and accommodation expenses, nor showed that such a request was denied.
• Article 28, All Japan Seamen's Union / AMOSUP and International Marine Transport Corp. Collective Bargaining Agreement — The contractual basis for the permanent partial disability benefits equivalent to Grade 11 computed at 14.93% of the maximum disability compensation, or USD 19,100.25, awarded to petitioner.

Leonen, SAJ (Chairperson), M. Lopez, and J. Lopez, JJ., concur. Lazaro-Javier, J., on official business.