This article is for general information and education. It is not legal advice.

“Unfit to work” findings are among the most consequential documents in a seafarer’s career and claims. Depending on when and why the finding was issued, it can: (a) bar deployment at the pre-employment stage, (b) end a contract or prevent a return to duty after illness/injury, and/or (c) affect entitlement to sickness allowance and disability compensation under the standard employment terms for Filipino seafarers.

In the Philippine setting, “appealing” an unfit result does not always mean a single formal appellate procedure. The correct approach depends on the context:

Pre-employment medical examination (PEME) “unfit” (before signing-on/deployment), versus
Post-illness/injury “unfit” (during contract, upon repatriation, or after treatment), and
Whether the unfit result is being used to deny deployment or to deny/limit compensation.

What follows is a comprehensive guide to the governing rules, the practical steps, and the legal pitfalls.

1) Core Legal Framework (Why “Unfit” Is Not the End of the Story)

A. Contract and regulatory baseline

Filipino seafarers are typically covered by:

The POEA Standard Employment Contract (POEA-SEC) (as incorporated into overseas employment for seafarers), plus
The Collective Bargaining Agreement (CBA), if applicable (often more favorable),
Maritime Labour Convention (MLC), 2006 principles (medical care, repatriation, welfare), and
Philippine labor and social legislation and jurisprudence that interpret and enforce these contracts.

The POEA-SEC is critical because it provides the default mechanism to resolve conflicting medical opinions—especially in disability/fitness disputes—through the third-doctor referral process.

B. Two “unfit” categories with different rules

PEME unfit: a screening decision to determine if you meet medical standards to board and work at sea.
Post-injury/illness unfit: a medical assessment related to a work-related sickness or injury, repatriation treatment, and potential disability grading/compensation.

These are legally and practically different. A PEME unfit finding is often challenged through clinic/company processes and documentation; a post-injury/illness unfit finding is often challenged through the POEA-SEC dispute mechanism and labor proceedings when benefits are at stake.

2) PEME “Unfit to Work” (Before Deployment): What You Can Do

A. Understand what a PEME finding means (and what it doesn’t)

A PEME is generally a fitness-for-sea-duty screening, not a full diagnostic evaluation.
PEME clinics use company/industry standards and risk thresholds (often conservative).
A PEME unfit result may be:
- Temporary (pending additional tests/clearance), or
- Permanent/absolute (based on a disqualifying condition or risk profile).

Many “unfit” results are actually “unfit pending clearance” decisions—meaning you may be deployable if you produce acceptable specialist clearances.

B. Immediate steps (48–72 hours mindset)

Request your complete PEME records in writing:
- Laboratory results, ECG, X-ray reports, audiometry, spirometry, vision, medical history sheet, physician notes, and the exact “fitness” classification (fit / fit with restriction / temporarily unfit / permanently unfit).
Ask for the specific basis and standard:
- Which parameter triggered the unfit decision (e.g., uncontrolled hypertension, abnormal ECG, elevated HbA1c, chest X-ray finding, BMI-related risk, psychological screening, etc.).
Ask whether the result is appealable via retesting and what timelines apply (some clinics impose short windows).

C. Get a targeted specialist evaluation (not a generic “fit” certificate)

A generic “fit to work” certificate from a private doctor often carries less weight than:

A specialist’s report addressing the exact abnormal finding, with
Objective tests (e.g., repeat ECG/2D echo, stress test, ambulatory BP monitoring, repeat fasting labs, pulmonary function tests, imaging), and
A clear conclusion tied to sea duty demands (watchkeeping, confined spaces, heat, noise, shift work).

D. Seek re-evaluation through the correct channel

Most deployment systems work like this:

The manning agency/employer relies on its accredited clinic’s assessment.
Your best leverage is usually to submit specialist clearances and request the accredited clinic to reclassify you.
Some agencies allow a second opinion at another accredited facility, but it’s typically subject to company approval.

E. If the unfit finding is arbitrary or discriminatory

A PEME unfit decision can be challenged when it is:

Unsupported by test results,
Inconsistent with accepted standards, or
Applied in a discriminatory way.

In practice, these disputes are document-heavy and often resolved by:

Written requests for reconsideration,
Formal complaints depending on the circumstances (labor/administrative), and/or
Contract-related claims if you incurred costs or suffered damages due to improper processing.

PEME disputes are harder than post-injury disputes because you may not yet have a mature “work-related illness/injury” claim. Your strongest tools are records, specialist clearance, and proper reconsideration.

3) Post-Injury/Illness “Unfit to Work”: The High-Stakes Scenario

This is where “appeal” is most legally defined—because “unfit” may determine:

Sickness allowance entitlement, and
Disability compensation (or the denial of it).

A. The company-designated physician system

Under the POEA-SEC structure, after repatriation due to illness/injury:

The seafarer must be examined and treated by the company-designated physician.
The company doctor eventually issues a final medical assessment, typically:
- Fit to work, or
- Permanent disability grading (with a disability grade/benefit), or
- A definitive statement of incapacity.

B. The 120/240-day doctrine (why timing matters)

Philippine jurisprudence has developed a timing framework commonly summarized as:

The company-designated physician should issue a definitive final assessment within 120 days from repatriation (or commencement of treatment).
This may be extended up to 240 days when further medical treatment is reasonably required and properly justified.
Failure to issue a definite assessment within the allowed period can, in many cases, support a claim of total and permanent disability (depending on facts, continuous treatment, and the nature of assessments issued).

Practical takeaway: An “unfit” result that is vague (“not fit to work for now,” “continue therapy,” “for reevaluation”) is not the same as a final disability assessment. Many disputes are won or lost on whether the assessment was final, definite, and timely.

C. “Unfit to work” vs “permanent disability”

An “unfit to work” declaration can mean:

Temporarily unfit pending recovery, or
Permanently unfit for sea duty, or
Unfit at the moment but potentially fit with treatment.

For compensation disputes, what matters is whether the company doctor issued:

A final and definite finding and, if applicable, an appropriate disability grading under the contract/CBA.

4) The Main Appeal Mechanism: The Third-Doctor Referral Rule

A. When it applies

If:

The company-designated physician issues an assessment (fit/unfit/disability grade), and
The seafarer’s personal doctor issues a conflicting assessment,

then the POEA-SEC framework typically requires referral to a third doctor mutually agreed upon. The third doctor’s opinion is generally treated as final and binding in resolving the medical conflict—provided the process is properly invoked and complied with.

B. Why this is crucial

Many claims fail not because the seafarer lacked medical proof, but because the seafarer:

Did not properly trigger the third-doctor process, or
Filed a labor case without giving the employer a fair chance to refer the dispute to a third doctor, or
Presented only a conclusory private medical certificate without objective basis.

Conversely, employers can also lose where they:

Refuse unjustifiably to engage the third-doctor process, or
Rely on incomplete/late/ambiguous company-doctor assessments.

C. How to invoke third-doctor referral correctly (step-by-step)

Secure the company doctor’s written assessment (fit/unfit/disability grading), including the date.
Get your independent medical opinion from your chosen physician/specialist:
- It should explain findings, functional limitations, prognosis, and why it differs from the company assessment.
Send a written notice to the employer/manning agency:
- State that you disagree with the company assessment,
- Attach the contrary medical report,
- Formally request referral to a third doctor pursuant to the contract mechanism,
- Propose reputable specialists/hospitals as options.
Document all communications:
- Email with delivery/read receipts, registered mail/courier, or acknowledged receiving copy.
Participate in scheduling/exams:
- Attend third-doctor evaluation and comply with reasonable requirements.
Obtain the third-doctor report and keep certified copies.

D. Practical “make it stick” tips

Timelines: Act promptly after receiving the company assessment. Delays can be argued against you as waiver or lack of good faith.
Objectivity: A strong private report is diagnostic and functional; weak ones are one-page “fit/unfit” conclusions without tests.
Mutuality: The third doctor should be mutually agreed. If the employer ignores your request, preserve proof of refusal.

E. What if the employer refuses third-doctor referral?

If you can show you properly invoked the process and the employer refused or unreasonably ignored it, you may argue that:

The employer cannot later use the absence of a third-doctor opinion against you, and
Your independent evidence should be weighed with greater force.

This is fact-sensitive. The strength is in your paper trail: letters, emails, and proof of receipt.

5) Appealing an “Unfit” Finding Used to Deny Sickness Allowance

A. Sickness allowance basics

Sickness allowance is generally tied to:

Work-relatedness,
Proper reporting/medical management, and
Compliance with required examinations and treatment under company-designated physicians.

A seafarer can jeopardize sickness allowance by:

Missing scheduled follow-ups without valid reason,
Seeking outside treatment without coordinating (depending on contract rules),
Refusing reasonable medical procedures.

B. How to contest denial grounded on “unfit”

If the company uses an “unfit” finding to deny pay or stop benefits, check:

Was your condition declared work-related (or at least not properly refuted as non-work-related)?
Did you comply with post-repatriation reporting and treatment schedules?
Did the company issue a definite final assessment, or did it prematurely cut benefits?

Your best evidence includes:

Clinic attendance records,
Fit/unfit assessments with dates,
Treatment plans and compliance proof,
Receipts and prescriptions (even if reimbursable rules vary).

6) Appealing an “Unfit” Finding Used to Limit or Deny Disability Compensation

A. Typical employer defenses

Employers/manning agencies often defend by saying:

The company doctor declared you fit to work, or
You have only a partial disability grade, or
Your private doctor’s “total disability” finding is unsupported, or
You failed to refer to a third doctor.

B. Building a strong appeal record

To challenge an unfavorable “unfit” (or “fit”) assessment affecting disability compensation, build around:

Finality and definiteness of assessment
- Is it truly final, or a continuing-treatment note?
Timeliness
- Was the final assessment issued within the 120/240-day window as applied to your facts?
Consistency with medical evidence
- Imaging, neurologic deficits, range-of-motion tests, pulmonary function, cardiac workup, psychiatric assessments, etc.
Occupational demands
- A sea duty fitness analysis: can you safely perform essential duties (watchkeeping, lifting, confined spaces, ladder climbing, emergency response)?
Third-doctor process
- Properly invoked? Refused? Completed?

C. CBA-enhanced benefits

If you are covered by a CBA, benefits can be higher and the disability definition may differ. The “appeal” strategy should always include:

Obtaining and reviewing the CBA disability provisions,
Aligning medical findings to the CBA’s disability categories.

7) Where to Bring the Dispute (If It Escalates Beyond Medical Review)

“Appeal” may become formal litigation/administrative dispute if benefits or damages are contested. Common avenues include:

Labor arbitration for money claims arising from the employment contract (disability compensation, sickness allowance, damages when warranted).
Contractual dispute mechanisms (third-doctor) often serve as a pre-litigation medical resolution step.

Key point: In many compensation disputes, the success of a formal case depends heavily on whether you observed the contract’s medical-dispute process and whether your evidence shows definite, timely, and credible medical conclusions.

8) Common Mistakes That Weaken an Appeal

Relying on a one-page private certificate stating “unfit” without tests, narrative, or functional assessment.
Not requesting the company doctor’s full records and basing arguments on memory or summaries.
Missing follow-up appointments and creating a compliance gap.
Skipping the third-doctor step without documenting employer refusal.
Arguing only “I feel unfit” rather than proving objective impairment and occupational impact.
Ignoring the dates (repatriation date, first consult date, 120th/240th day, assessment issuance date).

9) A Practical Checklist (Use This to Structure Your Appeal)

A. Documents to collect

Employment contract/POEA-SEC + any CBA
PEME results (if relevant)
Repatriation documents (incident report, medical repatriation report)
Company-designated physician records: all consult notes, diagnostics, referrals, rehab notes
Final medical assessment (fit/unfit/disability grading) with date
Your independent specialist report with objective bases
Proof of compliance: appointment logs, messages, emails, receipts
Written request for third-doctor referral + proof of receipt

B. Key questions to answer in your appeal narrative

What is the diagnosis, and is it work-related under the contract presumptions or evidence?
What essential shipboard tasks can you no longer safely perform?
Was the company assessment final/definite and timely?
If you disagree: when and how did you invoke third-doctor referral?
If the employer refused: what proof shows refusal or unreasonable delay?

10) Sample “Third Doctor Referral” Letter (Adapt as Needed)

Subject: Request for Third-Doctor Referral – Dispute on Medical Assessment (Fit/Unfit/Disability)

To: [Manning Agency/Employer] Date: [Date]

I respectfully notify you that I disagree with the medical assessment issued by the company-designated physician dated [date], which states [fit to work / unfit to work / disability grade]. Attached is the medical report dated [date] from my personal physician/specialist, Dr. [name], which reaches a contrary conclusion based on [brief basis: diagnostic tests, functional limitations, prognosis].

Pursuant to the applicable employment contract mechanism for resolving conflicting medical opinions, I request that we refer this medical dispute to a mutually agreed third doctor for final determination. Kindly confirm within [reasonable period, e.g., 7] days from receipt and provide your proposed third-doctor options or confirm acceptance of any of the following proposed third doctors/facilities:

[Option A]
[Option B]
[Option C]

Please acknowledge receipt of this request and advise the schedule and requirements for the third-doctor evaluation.

Respectfully, [Name] [Contact details]

11) Bottom Line Principles

A seafarer can “appeal” an “unfit to work” result effectively only by matching the right process to the right context (PEME vs post-repatriation).
For post-injury/illness disputes affecting benefits, the third-doctor referral is usually the central mechanism that must be timely and well-documented.
Timing (120/240 days), finality of medical assessment, and objective evidence are often decisive.
Strong appeals are built on complete records + specialist evidence + procedural compliance.