Seafarer Rights to Medical Repatriation and Assistance Under Philippine Maritime Law

I. Introduction

Filipino seafarers constitute one of the largest maritime labor forces in the global shipping industry. Because they work at sea inherently involves high risk of injury and illness, Philippine law provides one of the most protective regimes in the world for seafarers’ medical rights, particularly the right to full medical assistance and to medical repatriation at the employer’s exclusive expense.

These rights are mandatory, non-negotiable, and form part of the public policy of the State. Any contractual stipulation that diminishes or waives them is void.

II. Governing Legal Framework

The rights are derived from multiple overlapping sources that must be read together:

1. 1987 Philippine Constitution, Article XIII, Section 3 – special protection to labor
2. Labor Code of the Philippines (Presidential Decree No. 442, as amended), particularly Books V and VI
3. Migrant Workers and Overseas Filipinos Act of 1995 (Republic Act No. 8042, as amended by Republic Act No. 10022 and Republic Act No. 11641)
4. Maritime Labour Convention, 2006 (MLC 2006) – ratified by the Philippines and accorded suppletory application
5. Department Order No. 130-2023 (DMW Standard Terms and Conditions Governing the Employment of Filipino Seafarers On-Board Ocean-Going Ships) – the current governing contract that replaced the 2010 POEA-SEC
6. Rules and Regulations Governing the Recruitment and Employment of Seafarers (DMW Advisory No. 01 series of 2023 and related issuances)
7. Supreme Court decisions interpreting the above instruments (jurisprudence is part of the legal system under Article 8, Civil Code)

III. Nature of the Seafarer’s Employment Contract

The employment contract of every Filipino seafarer on an ocean-going vessel is the DMW-approved Standard Terms and Conditions. It is a contract of adhesion, but its minimum provisions are deemed written into every individual contracts even if not physically attached. Any side agreement that reduces the standard terms is null and void.

IV. Right to Medical Care On Board and Ashore

Under Section 11(A) of the DMW Standard Terms and Conditions:

• The shipowner is liable for the full cost of medical, dental, surgical, and hospital treatment, medicines, and therapeutic appliances required by the seafarer’s illness or injury, whether work-related or not, from the moment of engagement until he is repatriated or declared fit to work or until his disability grade is finally determined.

• Medical care must be prompt, adequate, and provided by qualified medical personnel.

• The shipowner must maintain medical chest, medical equipment, and medical guide in accordance with MLC Standard A4.1.

• The ship must carry adequate medicines and be equipped for medical emergencies, including telemedicine capability when practicable.

V. Right to Immediate Medical Repatriation

Section 12(A)(3) and Section 18 of the DMW Standard Terms explicitly provide:

The seafarer shall be entitled to immediate repatriation at the shipowner’s expense when:

(a) the seafarer is physically or mentally incapable of continuing work due to illness or injury, or
(b) continued stay on board would endanger his health or the safety of the vessel, or
(c) the required medical treatment cannot be adequately provided on board or in the port where the vessel is located.

The decision to medically repatriate may be made by:

• the master (in consultation with a port doctor when possible), or
• the company-designated physician, or
• a competent port authority doctor.

The seafarer himself may request medical repatriation; refusal by the master or company without justifiable cause constitutes constructive dismissal and breach of contract.

VI. Costs Covered by Medical Repatriation

The shipowner/principal is solely liable for the following (Section 18(B)):

1. Transportation costs from the vessel/port to the Philippines by the fastest available means (business-class airfare if medically required)
2. Medical treatment en route
3. Board and lodging while awaiting repatriation and during transit
4. Medical escort (doctor or nurse) if medically necessary
5. Salaries/wages from the date of medical sign-off until actual repatriation
6. All incidental expenses (airport fees, taxes, quarantine costs, COVID-19 testing if required, etc.)

There is no monetary ceiling. The obligation is absolute.

VII. Sickness Allowance During Treatment

Upon medical sign-off, the seafarer is entitled to 100% of his basic wage as sickness allowance from the date of sign-off until:

• he is declared fit to work, or
• his disability grade is finally determined, or
• expiration of the maximum 120-day period (extendible to 240 days in justifiable cases).

This is separate from and in addition to medical expenses and repatriation costs.

VIII. Post-Repatriation Medical Assistance

After repatriation, the company-designated physician must continue treatment at the employer’s expense until:

• the seafarer is declared fit to work, or
• the degree of permanent disability is established.

The treatment period may not exceed 240 days from sign-off unless the seafarer is still under active treatment with reasonable prospect of improvement (Crystal Shipping / Jebsens Maritime doctrine as modified by Elburg Shipmanagement v. Quiogue, G.R. No. 211882, July 10, 2017, and subsequent cases).

If the company physician declares the seafarer fit within 120 days but the seafarer disputes the assessment and consults his own doctor who finds him unfit, the Supreme Court applies the “reasonable connection” test: if the seafarer’s personal physician’s findings are supported by diagnostic tests and are more credible, the seafarer is entitled to total permanent disability benefits (Magsaysay Maritime v. Velasquez, G.R. No. 179802, July 4, 2018; Skippers United Pacific v. Lagne, G.R. No. 217036, August 20, 2018).

IX. Work-Related vs. Non-Work-Related Illness/Injury

1. Work-related or work-aggravated illness/injury

   • Full medical expenses without time limit
   • Full disability benefits under the Schedule of Disability Allowances (Grade 1 = US$50,000 minimum, now US$60,000 under some CBAs)
   • Sickness allowance up to 120/240 days
   • Death benefits if fatality occurs

2. Non-work-related illness/injury (not listed in Section 32-A, not work-aggravated)

   • Medical expenses and repatriation costs until repatriation or fitness
   • Sickness allowance up to 120 days
   • No disability compensation (unless the illness developed during the contract term and is not pre-existing)

Pre-existing illnesses that are disclosed during the Pre-Employment Medical Examination (PEME) and accepted by the employer are treated as work-aggravated if they worsen substantially due to working conditions (Phil-Man Marine v. Dedal, G.R. No. 198523, June 18, 2014).

X. Prohibition Against Abandonment

It is unlawful for the shipowner or manning agency to:

• delay medical repatriation without justifiable cause
• require the seafarer to advance repatriation or medical expenses
• abandon the seafarer in a foreign port

Violation constitutes illegal dismissal and serious breach of contract, entitling the seafarer to:

• full reimbursement of expenses advanced
• unpaid salaries for the unexpired portion of the contract
• moral and exemplary damages
• 10% attorney’s fees

(Section 10, RA 8042 as amended; Interorient Maritime Enterprises v. Creer, G.R. No. 181921, September 17, 2009)

XI. Remedies and Jurisdiction

1. Money claims arising from medical repatriation and assistance fall under the exclusive original jurisdiction of the National Labor Relations Commission (NLRC) through the Single-Entry Approach (SEnA) or regular labor arbitration (30-day prescriptive period for illegal dismissal, 3 years for money claims under Article 306, Labor Code).

2. The Labor Arbiter’s decision is appealable to the NLRC, then to the Court of Appeals via Rule 65, then to the Supreme Court.

3. The seafarer may also file criminal cases for estafa if the agency collects placement fees in violation of law, or for violation of Section 6(m) of RA 8042 (abandonment).

XII. Effect of Collective Bargaining Agreements (CBAs)

Most Filipino seafarers are covered by IBF/ITF-affiliated CBAs that provide superior benefits (higher disability compensation, extended medical coverage, critical illness benefits, loss-of-profession benefits, etc.). CBA provisions prevail over the DMW Standard Terms when more favorable to the seafarer (principle of favorability).

XIII. Conclusion

Under Philippine law, the seafarer’s right to immediate, full-cost medical repatriation and continuing medical assistance is absolute, non-waivable, and constitutes public policy. The shipowner’s obligation is strict and personal liability that cannot be limited by contract, financial difficulty, or flag-state law. Any attempt to shift the burden to the seafarer is void, and courts consistently rule in favor of the seafarer when evidence shows delay, abandonment, or inadequate treatment. This protective stance has made Philippine maritime law the gold standard for seafarer welfare worldwide.