1) Why the “company doctor grading” matters

In Philippine maritime disability disputes, the assessment (often called “grading” or “final medical assessment”) issued by the employer-designated physician is usually the pivot point for whether a seafarer receives disability benefits, and at what level. It affects:

Entitlement to disability benefits under the employment contract (commonly the POEA Standard Employment Contract or successor standard terms) and any applicable Collective Bargaining Agreement (CBA).
Degree of disability (partial vs total, and the corresponding amount).
Timing of claims, because the assessment is tied to the contract’s medical management timeline and to prescriptive periods.

The legal system treats this “grading” as important but not automatically controlling. It can be challenged, especially when it is incomplete, premature, or inconsistent with the seafarer’s actual capacity to work.

2) Basic framework: contract + labor standards + evidence rules

A typical seafarer disability claim is built from three layers:

Contractual disability regime Standard terms (POEA/standard contract) provide the basic disability benefit schedule and procedures, including post-repatriation medical care and assessment.
CBA (if applicable) A CBA may provide higher disability benefits or different conditions. If both apply, the seafarer commonly invokes whichever is more favorable, provided the CBA coverage and conditions are met.
Labor and jurisprudential standards Philippine case law has refined how the timelines, medical assessments, and “third-doctor” mechanisms operate—especially where the company doctor’s findings conflict with the seafarer’s doctor.

3) The post-repatriation medical process and the “120/240-day” concept

After repatriation due to illness or injury, the employer is generally obligated to provide medical care through its designated physicians and facilities. During this period:

The seafarer undergoes treatment, rehabilitation, and monitoring.
The employer-designated physician is expected to issue a definitive assessment within a legally significant timeframe.

The 120 days

A common rule is that disability becomes total and permanent if the seafarer is unable to return to sea duty within 120 days from repatriation (or from the start of medical management) unless there is a valid justification to extend treatment.

Extension to 240 days

If further treatment is medically justified, the period may extend up to 240 days, but this is not automatic. It is usually supported by ongoing therapy plans, follow-up schedules, and a clear explanation that additional time is necessary to arrive at a final determination.

Practical consequence

If no valid final assessment is issued within the allowable period (120 or properly extended to 240 days), tribunals often treat the disability as permanent and total for benefit purposes, depending on the facts.

4) What a “final medical assessment” should look like

A credible final assessment should typically include:

A clear statement of fitness to work (fit/unfit) or a definitive disability classification.
Medical findings supporting the conclusion (diagnostics, functional limitations).
If disability is partial, the specific disability grade and basis.
If fit to work, a basis showing functional capacity consistent with sea duty.

Red flags that often weaken an employer’s grading:

“Fit to work” declaration despite persistent symptoms and documented limitations.
Incomplete work-up, missing diagnostics, or abrupt issuance.
Conflicting interim reports with no explanation.
A grading issued after the timeline without adequate justification.

5) Common dispute pattern: company doctor vs seafarer’s doctor

Disputes usually arise in one of these scenarios:

Company doctor declares “fit to work,” seafarer remains symptomatic Seafarer secures an independent medical opinion stating continued incapacity or need for further treatment.
Company doctor assigns a low disability grade, seafarer’s doctor opines total disability Seafarer’s doctor may emphasize inability to resume sea service, recurrence risk, or functional incapacity.
No final company assessment within the period The claim shifts from “grade correctness” to “lack of timely definitive assessment,” supporting permanent total disability.

6) Second opinion: what it is (and what it is not)

A “second opinion” in practice is the seafarer’s consultation with a doctor of choice, usually to:

confirm diagnosis,
evaluate functional capacity,
recommend further treatment,
assess work restrictions,
opine on disability level.

It is not automatically binding on the employer. Its legal value depends on:

the thoroughness of examination,
objectivity,
diagnostic support,
consistency with the overall medical timeline,
and the procedural step of triggering the contract’s dispute-resolution mechanism (commonly a third-doctor referral).

7) The third-doctor mechanism (tie-breaker) and why it can make or break the case

Where the company-designated physician and the seafarer’s chosen physician disagree, standard maritime employment terms typically require referral to a third doctor jointly appointed by both parties. The third doctor’s opinion is often treated as final and binding (as to the medical issue), provided the mechanism is properly invoked and followed.

Key points in using the third-doctor process

Timeliness matters: it should be raised promptly once there is a conflict.
Document the request: the seafarer (through counsel, union, or representative) should formally request third-doctor referral.
Joint selection: both parties should participate in choosing the third doctor.
Scope: the third doctor resolves the medical disagreement—diagnosis, fitness, disability grading.

When failure to refer to a third doctor hurts the seafarer

If there is a clear conflict between doctors and the seafarer simply files a claim without properly invoking the third-doctor procedure, adjudicators may treat the company doctor’s assessment as controlling—especially if the company grading is timely and well-supported.

When failure to refer does NOT defeat the claim

There are important exceptions frequently recognized in practice:

No timely final assessment by the company doctor within the 120/240-day framework.
The company assessment is not truly final, ambiguous, or repeatedly deferred.
The employer refuses or unreasonably fails to cooperate in third-doctor referral despite request.
The company grading is shown to be patently baseless, issued in bad faith, or contradicted by substantial evidence.

In these situations, tribunals may give more weight to the seafarer’s evidence or treat disability as total and permanent due to procedural failure on the employer side.

8) Disability “grade” vs “permanent total disability”: not the same thing

A recurring source of confusion is that a contract disability “grade” (often a schedule of partial disabilities) is not always the same as the legal concept of permanent total disability (PTD).

A seafarer may be considered permanently and totally disabled for benefit purposes if he cannot resume sea duty within the legally significant period, even if the medical condition corresponds to a “partial” grade in a schedule.
Conversely, a high grade does not automatically mean PTD if evidence shows capacity to resume sea work.

Philippine maritime disability jurisprudence often focuses on capacity to work, not merely the anatomical impairment.

9) Benefits: what a seafarer can claim after a company grading

Depending on facts and instruments (contract/CBA), benefits can include:

A. Disability compensation

Partial disability: based on the schedule/grade and corresponding amount.
Permanent total disability: usually a higher fixed amount under standard terms and often higher under CBA.

The claimant typically argues either:

the grade should be higher; or
the disability is PTD because the seafarer is unable to return to sea duty within the period, or because the final assessment is defective/late.

B. Medical expenses (contract-based, post-repatriation)

Where supported, seafarers may claim:

reimbursement for necessary medical expenses not covered (depending on contract terms),
continued treatment costs when unjustly discontinued, subject to evidence of necessity and causal link.

C. Sickness wages / sick pay (as contract provides)

Standard terms commonly provide sickness allowance for a period subject to compliance with post-repatriation reporting and medical management rules.

D. Attorney’s fees

Often claimed when the seafarer is compelled to litigate due to unjust denial or withholding of benefits. Award depends on findings.

E. Damages (limited, fact-specific)

Moral/exemplary damages are not automatic and generally require proof of bad faith, fraud, or oppressive conduct. They are harder to obtain in typical contract-benefit disputes absent aggravating facts.

10) Work-relatedness and causation: the core evidentiary battle

Even after a grading, the employer may resist paying by arguing the condition is not work-related or not compensable. The seafarer must address:

Work-relatedness/work-aggravation: many conditions need only be shown as work-related or aggravated by work conditions, depending on contract language and case law approach.
Pre-existing illness: not always a bar; what matters is whether work contributed or aggravated, and whether the seafarer was declared fit pre-employment.
Compliance with reporting/medical rules: post-repatriation reporting and cooperation with treatment can become contentious; employers may allege non-compliance to avoid liability.

11) How claims are won or lost: recurring practical issues

A. Timing and documentation

Winning claims are usually document-heavy:

repatriation papers,
medical referrals,
progress notes,
diagnostic results,
fit/unfit declarations,
communications requesting third-doctor referral,
proof of inability to return to work.

B. Fitness declarations are scrutinized

A “fit to work” certification is tested against:

actual functional capacity,
recurrence risk,
the physical demands of sea duty,
consistency with objective tests and specialist findings.

C. The company doctor must be credible, not just “designated”

Designation does not immunize an assessment from being rejected when it is inconsistent with the totality of evidence.

D. Third-doctor procedure is a procedural battleground

Seafarers should show they invoked it (or explain why it was impossible or futile).
Employers should show cooperation if they want to rely on the company doctor’s findings.

12) Litigation tracks and forum considerations (Philippine setting)

Seafarer disability disputes typically proceed through labor dispute mechanisms (administrative/quasi-judicial), with appeals as allowed by law and rules. The key practical point is that these disputes are resolved largely on:

paper record (medical documents and correspondence), and
credibility of medical evidence.

13) Drafting and strategy guide: what “all there is to know” looks like in practice

For seafarers (claim-building checklist)

Secure the company doctor’s complete records: interim reports, diagnostics, final assessment.
Get an independent doctor’s report that is diagnosis + functional capacity + sea duty analysis, not a bare conclusion.
Track the 120/240-day timeline precisely.
If there is disagreement, formally request third-doctor referral and keep proof of receipt.
Document inability to resume sea duty: attempted return, persistent restrictions, medication dependence, therapy plans.

For employers (defense-building checklist)

Ensure timely and definitive final assessment.
Keep evidence supporting any extension to 240 days (treatment plan, progress, necessity).
Respond properly to third-doctor requests; propose a list of specialists.
Show that “fit to work” is grounded on functional testing relevant to maritime duties.

14) Typical outcomes by scenario (illustrative)

Timely final grade + no third-doctor invoked + weak seafarer medical proof Company grade more likely sustained.
Timely grade, but seafarer promptly requested third-doctor and employer stonewalled Tribunal may disregard company grade, credit seafarer evidence, or treat employer non-cooperation as significant.
No final assessment within 120/240 days Strong basis for PTD, depending on circumstances and evidence of continuing incapacity.
Final assessment exists but is contradictory, unsupported, or premature Tribunal may prefer independent/third-doctor findings or infer PTD if incapacity persists.

15) Key takeaways distilled

The company doctor grading is important but not absolute.
The 120/240-day medical management timeline is often decisive.
A second opinion is valuable, but when there is a conflict, the third-doctor mechanism is the procedural keystone—unless exceptions apply (late/no final assessment, employer non-cooperation, or other serious defects).
Disability benefits turn on capacity to work and timely, credible medical assessment, not merely the label of a grade.
Most cases are won on paper trail discipline: timeline, medical evidence quality, and documented invocation (or justified non-invocation) of the third-doctor process.