Supplemental Guidelines on the Implementation of the Mental Health Policy and Program in the Workplace, Labor Advisory No. 19, September 15, 2023 | Disability and Death Benefits | SOCIAL LEGISLATION

On September 15, 2023, the Philippine Department of Labor and Employment (DOLE) issued Labor Advisory No. 19, Series of 2023, providing supplemental guidelines for implementing Mental Health Policies and Programs in the workplace. This advisory builds upon DOLE Department Order No. 208, Series of 2020, and aligns with Republic Act No. 11036, known as the Mental Health Act.

Key Provisions of Labor Advisory No. 19-2023:

1. Access to Mental Health Services:

   • Employers are mandated to ensure that employees have effective access to mental health and self-care services. This includes utilizing resources such as the Department of Health's (DOH) Lusog-Isip mobile application, which offers mental health support and information.

2. Referral to Health Facilities:

   • Employees requiring mental health services should be referred to appropriate facilities, including DOH-retained hospitals and rural health units, for consultation, screening, diagnosis, medication, treatment, and psychosocial support.

3. Work Accommodations and Arrangements:

   • Employers are encouraged to provide reasonable accommodations for employees needing medical attention due to mental health conditions. These accommodations may include:
     • Paid leave benefits in addition to existing leave entitlements under company policy, collective bargaining agreements, the Labor Code, and special laws.
     • Flexible work arrangements, such as rescheduling work hours or adopting telecommuting practices.
     • Other supportive benefits as deemed appropriate.

4. Confidentiality and Data Privacy:

   • Employers must uphold the confidentiality of all information and medical records related to employees with mental health conditions. This is in compliance with Republic Act No. 10173, or the Data Privacy Act of 2012, to prevent unauthorized access, alteration, disclosure, or any unlawful processing of sensitive information.

5. Reporting Requirements:

   • An Annual Medical Report Form must be submitted to the DOLE, detailing:
     • The number of mental health cases handled or referred to service providers.
     • Activities and programs implemented to promote mental health within the workplace.

Context and Legal Framework:

The issuance of Labor Advisory No. 19-2023 reinforces the Philippine government's commitment to mental health, as established by the Mental Health Act (Republic Act No. 11036) enacted in 2018. This Act emphasizes the promotion of mental health, the protection of rights for individuals with mental health conditions, and the integration of mental health services into the nation's healthcare system.

In 2020, DOLE released Department Order No. 208, which provided initial guidelines for implementing mental health policies and programs in the private sector. Labor Advisory No. 19-2023 serves to supplement these guidelines, ensuring that employers adopt comprehensive mental health policies that include:

• Advocacy, information dissemination, education, and training on mental health.
• Mechanisms for work accommodation and reintegration of employees with mental health conditions.
• Assurance of confidentiality for all information related to employees' mental health conditions.
• Support mechanisms facilitating access to counseling and other mental health services.

Implications for Employers and Employees:

Employers are required to develop and implement mental health policies and programs tailored to their specific workplace environments. This includes providing access to mental health services, ensuring confidentiality, and accommodating employees' mental health needs through flexible work arrangements and additional leave benefits.

Employees, on the other hand, are encouraged to utilize the mental health resources and support systems made available by their employers. They should also be aware of their rights concerning confidentiality and the accommodations they are entitled to under the law.

In summary, Labor Advisory No. 19-2023 underscores the importance of mental health in the workplace and delineates the responsibilities of employers in fostering a supportive and inclusive environment for employees with mental health needs.

Rules on referral to third doctor | Disability and Death Benefits | SOCIAL LEGISLATION

Rules on Referral to a Third Doctor under Philippine Labor Law

In the context of disability and death benefits under labor law and social legislation in the Philippines, the referral to a third doctor arises when there is a disagreement between the findings of the company-designated physician and the employee’s chosen physician regarding the employee’s fitness to work or disability grading. The procedure is governed by jurisprudence, notably in cases involving seafarers under POEA contracts, and by the Labor Code and its implementing rules. Below is a detailed discussion of the rules and jurisprudential principles on this subject:

---

1. Legal Basis

The rules on referral to a third doctor are primarily rooted in:

• The Philippine Overseas Employment Administration-Standard Employment Contract (POEA-SEC) for seafarers, particularly Section 20, which outlines the duties of the company-designated physician, the process of contesting medical findings, and the procedure for referral.
• Labor Code of the Philippines, as supplemented by relevant social legislation (e.g., Employees’ Compensation Act).

---

2. Company-Designated Physician’s Role

The company-designated physician has the primary responsibility to assess the medical condition of an employee who suffers from work-related injury or illness. This physician must:

• Issue a medical assessment or final disability grading within the prescribed period (usually 120 to 240 days, depending on the circumstances and compliance with legal and procedural requirements).
• Certify whether the employee is fit to work or assign a degree of permanent disability.

Failure to issue a timely and complete medical assessment may result in the presumption of permanent total disability in favor of the employee.

---

3. Dispute with the Employee’s Chosen Physician

If the employee disputes the findings of the company-designated physician, they may consult their own physician of choice. The employee’s physician may issue a differing opinion on:

• Fitness to work, or
• The degree of disability.

---

4. Referral to a Third Doctor

If a conflict arises between the assessments of the company-designated physician and the employee’s chosen physician, the third-doctor referral rule applies:

A. Who Can Initiate Referral?

• Either the employer or the employee can initiate the referral to a third doctor, provided there is a conflict between the findings of the two prior physicians.

B. Binding Nature of the Third Doctor’s Findings

• The findings of the third doctor, mutually agreed upon by both parties, are final and binding on both the employer and the employee.

C. When Should Referral Be Made?

• Referral must be made immediately or within a reasonable time after the issuance of the conflicting medical opinions.
• Delays in referral or failure to invoke the third-doctor rule may prejudice the case of the party responsible for the delay.

D. Procedure for Referral

• There is no fixed procedural requirement for the referral, but it is generally expected that the parties agree on the third doctor and cooperate in the referral process.
• The cost of the referral is typically borne by the employer.

E. Employer’s Obligation to Act Promptly

• Employers must act promptly in addressing the dispute and in facilitating the referral process. Failure to do so may result in a presumption in favor of the employee’s claims.

---

5. Jurisprudence on Third-Doctor Referral

Philippine courts have consistently emphasized the importance of compliance with the third-doctor referral rule in cases involving disability claims. Key rulings include:

A. Vergara v. Hammonia Maritime Services, Inc. (2008)

• Established the 120/240-day rule and clarified that the referral to a third doctor is the mandatory recourse in case of conflicting medical findings.
• The third doctor’s decision is final and binding.

B. Wallem Maritime Services, Inc. v. Tanawan (2016)

• Highlighted that failure to invoke the third-doctor referral process results in the binding effect of the employee’s chosen physician’s findings if they are supported by substantial evidence.

C. Elburg Shipmanagement Phils., Inc. v. Quiogue, Jr. (2017)

• Clarified the procedural aspects of invoking the third-doctor rule, emphasizing the need for prompt and reasonable action by both parties.

D. C.F. Sharp Crew Management, Inc. v. Taok (2020)

• Reiterated that a valid referral to a third doctor must be mutually agreed upon and conducted in good faith.

---

6. Practical Implications

For Employees:

• Ensure that disagreements with the company-designated physician’s findings are substantiated by a credible medical opinion from a qualified physician.
• Promptly request referral to a third doctor if disagreement arises.

For Employers:

• Strictly observe the timelines and procedural requirements for medical assessments and third-doctor referrals.
• Facilitate the referral process and act in good faith to avoid adverse rulings.

For the Third Doctor:

• The third doctor must be a mutually agreed-upon, independent medical expert who will issue an impartial assessment based on the employee’s condition.

---

7. Key Takeaways

• The third-doctor referral rule is mandatory in resolving disputes over medical findings.
• Failure to comply with this process can significantly impact the outcome of disability or death benefit claims.
• Both parties must act promptly, reasonably, and in good faith to ensure compliance with the rule.

This framework ensures fairness in the resolution of disability claims, balancing the rights of employees and employers.

POEA Standard Employment Contract – Sec. 32 POEA Standard Employment Contract | Disability and Death Benefits | SOCIAL LEGISLATION

LABOR LAW AND SOCIAL LEGISLATION: POEA Standard Employment Contract – Section 32 (Disability and Death Benefits)

The POEA Standard Employment Contract (SEC), issued by the Philippine Overseas Employment Administration (POEA), provides the standard terms and conditions governing the employment of Filipino seafarers onboard ocean-going vessels. Section 32 specifically outlines the rules on disability and death benefits for seafarers and their beneficiaries.

---

A. Overview of Section 32

Section 32 of the POEA Standard Employment Contract is a critical provision in safeguarding the rights of seafarers and their dependents. It provides:

1. Enumerated Occupational Diseases and Conditions: Lists compensable illnesses and injuries.
2. Compensation for Disability: Defines the schedule of disability benefits based on the severity of the condition.
3. Compensation for Death: Outlines benefits payable to legal beneficiaries upon a seafarer’s death.
4. Procedures for Medical Assessment: Establishes the procedures for medical treatment and disability grading.
5. Exclusions from Liability: Specifies conditions under which claims are not compensable.

---

B. Coverage

Section 32 applies to Filipino seafarers employed under POEA-approved contracts. The benefits cover:

• Disabilities resulting from work-related illnesses or injuries sustained during the term of employment.
• Death occurring during the employment contract, whether due to work-related causes or natural causes while onboard or ashore during employment.

---

C. Key Provisions

1. Disability Benefits

• Compensable Disabilities: A seafarer is entitled to disability benefits for illnesses or injuries that:
  • Are work-related.
  • Occur during the term of the contract.
• Grading System: Section 32-A provides a detailed schedule of disabilities and corresponding grades (Grades 1 to 14), with Grade 1 being the most severe.
  • Grade 1 Disability: Entitles the seafarer to the maximum disability benefit.
  • Grade 14 Disability: Entitles the seafarer to the minimum benefit.
• Permanent Total Disability (PTD): Even if not explicitly covered by the grading, a seafarer may be entitled to full compensation if the condition results in a complete inability to perform usual work.
• Compensation Amount: The POEA SEC sets a cap on disability benefits, typically based on the seafarer’s rank and contractual provisions.

---

2. Death Benefits

• Amount of Compensation: In the event of death during the term of the contract, the legal heirs (spouse, children, or parents) are entitled to death benefits:
  • US$50,000 for the primary beneficiary (spouse or children).
  • US$7,000 additional benefit per child (up to four children under the age of 21).
• Repatriation and Burial Expenses: The employer is responsible for the cost of repatriating the remains and covering burial expenses.

---

3. Medical Procedures and Certification

• Mandatory Reporting: The seafarer must report any illness or injury sustained during employment.
• Company-Designated Physician:
  • The seafarer must undergo treatment and assessment by a company-designated physician.
  • The physician must issue a final medical assessment within 120 days (extendable to 240 days in certain cases) to determine the degree of disability.
• Second Medical Opinion:
  • If the seafarer disagrees with the company-designated physician’s assessment, they may consult a doctor of their choice.
  • Disputes may be resolved through a third doctor jointly chosen by the employer and the seafarer, whose decision is final and binding.

---

4. Work-Relatedness of Illnesses

Section 32 includes a list of occupational diseases presumed work-related if certain conditions are met, such as:

• Diseases due to physical, chemical, or biological factors in the work environment.
• Cardiovascular diseases or hypertension resulting from stressful working conditions.
• Musculoskeletal injuries due to repetitive strain or physical labor.

---

5. Exclusions

The employer is not liable for disability or death benefits if:

• The injury or illness is due to the seafarer’s willful misconduct, negligence, or pre-existing condition not disclosed during the pre-employment medical examination (PEME).
• The seafarer’s condition arose after the contract period or during an unauthorized absence.

---

D. Jurisprudence on Section 32

The Philippine Supreme Court has issued landmark rulings interpreting Section 32, emphasizing the following:

1. Liberal Interpretation in Favor of the Seafarer: Any ambiguity in the POEA SEC is resolved in favor of the seafarer, given the protective mantle of labor law.
2. Permanent Total Disability: Even if the condition is graded lower under Section 32-A, a seafarer may be deemed totally disabled if unable to return to sea.
3. Work-Connection: The Court has ruled that even non-listed illnesses may be compensable if causally linked to the nature of the seafarer’s work.

---

E. Recent Amendments and Developments

The POEA regularly updates the Standard Employment Contract to align with international standards, such as those under the Maritime Labour Convention (MLC, 2006). These updates ensure better protection for Filipino seafarers while addressing evolving maritime challenges.

---

F. Practical Steps for Claiming Benefits

1. Immediate Reporting: Report any illness or injury to the employer and seek medical attention promptly.
2. Medical Records: Keep thorough documentation of treatment and assessments.
3. Consult Legal Counsel: In case of disputes over compensation or disability grading, seek assistance from labor lawyers or accredited unions.

---

Section 32 of the POEA Standard Employment Contract remains a vital instrument in protecting the rights and welfare of Filipino seafarers and their families, ensuring compensation for the risks inherent in maritime work.

Labor Code, Article 198 | Disability and Death Benefits | SOCIAL LEGISLATION

Article 198 of the Labor Code: Disability and Death Benefits under Social Legislation

I. Overview: Article 198 of the Labor Code of the Philippines primarily addresses the provision of disability and death benefits for employees under the Employees' Compensation Program (ECP). This provision operates within the framework of Presidential Decree No. 626, as amended, which institutionalized a state insurance program for workers suffering work-related injuries, diseases, or death.

The article underscores the obligation of employers to secure their employees under the ECP and ensure access to benefits administered by the Social Security System (SSS) for private sector employees or the Government Service Insurance System (GSIS) for public sector employees.

---

II. Scope of Coverage:

1. Employees Covered:

   • All employees, whether permanent, temporary, or casual, are covered, provided they are enrolled in the Employees' Compensation Program.
   • It applies to employees in both the private and public sectors.
   • Self-employed individuals and voluntary SSS members are excluded.

2. Risks Covered:

   • Work-connected disability or death, arising from accidents, illnesses, or diseases during the course of employment.
   • The injury or disease must be shown to have been acquired or aggravated during work.

---

III. Benefits under Article 198: Employees or their beneficiaries are entitled to the following benefits under the ECP:

1. Disability Benefits:

   • Temporary Total Disability (TTD):
     • Compensation is provided during the period the employee is unable to work.
     • Benefits include a daily income benefit equivalent to 90% of the average daily salary credit (ADSC), not exceeding 120 days (extendable to 240 days for exceptional cases).
   • Permanent Partial Disability (PPD):
     • Compensation for loss or impairment of body parts or functions.
     • Benefits vary depending on the specific injury and are computed based on a schedule of disabilities prescribed by the law.
   • Permanent Total Disability (PTD):
     • Benefits for cases of permanent incapacity to perform gainful work.
     • Monthly pension equivalent to the employee's ADSC, subject to minimum and maximum limits.

2. Medical and Rehabilitation Services:

   • Coverage for necessary medical, surgical, and hospital treatment, as well as rehabilitation services to restore work capacity.
   • Includes prosthetics, therapy, and other medical supplies or devices.

3. Death Benefits:

   • Provided to the primary beneficiaries (e.g., spouse, children) or secondary beneficiaries (e.g., parents) in the absence of primary beneficiaries.
   • Lump-sum or monthly pension, depending on the employment contributions and ADSC.

4. Funeral Benefits:

   • A fixed amount provided to the family or designated beneficiaries of the deceased employee for burial expenses.
   • As of recent amendments, the funeral benefit is ₱30,000.00 but may vary based on prevailing regulations.

---

IV. Conditions for Compensation:

1. Causality:

   • The illness, injury, or death must be work-related or aggravated by employment conditions.
   • Occupational diseases listed under the ECC guidelines are presumed compensable. For unlisted diseases, proof of causation is required.

2. Timeliness:

   • Notice of injury or illness must be reported to the employer within five (5) days from occurrence. Failure to report may bar claims unless justified.

3. Good Faith:

   • Claims must not be fraudulent or intended to deceive. Misrepresentation can result in denial or penalties.

---

V. Administration and Claims Process:

1. Responsible Agencies:

   • The Employees’ Compensation Commission (ECC) oversees policy formulation and implementation.
   • The SSS administers benefits for private-sector employees, while the GSIS administers benefits for government employees.

2. Filing of Claims:

   • Claims for disability or death benefits must be filed with the SSS or GSIS, supported by appropriate documentation, including medical reports and employment records.

3. Adjudication and Appeals:

   • Denied claims may be appealed to the ECC and subsequently to the Court of Appeals or Supreme Court as necessary.

---

VI. Employer Obligations:

1. Registration and Contributions:

   • Employers must register employees under the SSS or GSIS and remit contributions for ECP coverage.
   • Failure to register deprives the employer of the right to contest claims and makes them directly liable for benefits.

2. Workplace Safety:

   • Employers must maintain safe working conditions to prevent occupational injuries or diseases.
   • Non-compliance with safety standards may result in administrative or criminal liability.

---

VII. Limitations and Prohibitions:

1. Exclusive Remedy Rule:

   • ECP benefits are the exclusive remedies for work-related disability or death, precluding civil claims unless due to gross negligence or intentional harm by the employer.

2. No Duplication of Benefits:

   • Employees cannot claim compensation under both ECP and regular social insurance for the same contingency.

3. Prescriptive Period:

   • Claims must be filed within three (3) years from the date of injury, illness, or death, beyond which the right to compensation is barred.

---

VIII. Recent Amendments and Jurisprudence:

1. Updates on Benefit Amounts:

   • Recent increases in funeral and disability benefit rates reflect adjustments to inflation and cost-of-living changes.

2. Landmark Cases:

   • GSIS v. De Leon (2016): Clarified that aggravation of a pre-existing condition may render it compensable.
   • ECC v. Sanico (2019): Emphasized strict compliance with the causality requirement for unlisted occupational diseases.

---

IX. Conclusion: Article 198 ensures the welfare of employees through disability and death benefits under the Employees' Compensation Program. Its provisions reflect the state’s commitment to protect workers and their dependents from the adverse effects of employment-related risks, balancing the needs of employees with the responsibilities of employers. Proper understanding and implementation are crucial for safeguarding the rights and obligations under this critical aspect of labor law.

Disability and Death Benefits | SOCIAL LEGISLATION

LABOR LAW AND SOCIAL LEGISLATION: DISABILITY AND DEATH BENEFITS IN THE PHILIPPINES

The Philippine legal framework for disability and death benefits is primarily rooted in the Labor Code of the Philippines, Social Security Act, Employees’ Compensation Act, and various related regulations. Below is a detailed and meticulous discussion:

---

I. DISABILITY BENEFITS

Disability benefits are granted to employees who suffer work-related injuries or illnesses that result in partial or total disability. They are governed by both private employment law (Labor Code) and state insurance systems like SSS, GSIS, and the Employees’ Compensation Commission (ECC).

A. Categories of Disability

1. Permanent Total Disability (PTD)
   Defined as a disability that permanently prevents an employee from performing any gainful occupation. Examples include loss of two limbs, total blindness in both eyes, and insanity.

2. Permanent Partial Disability (PPD)
   Refers to the loss or impairment of a specific body part or function that reduces earning capacity but does not completely prevent employment. Examples: amputation of a finger, hearing loss in one ear.

3. Temporary Total Disability (TTD)
   Applies when the employee is unable to work for a certain period due to injury or illness but is expected to recover.

B. Benefits Under the Labor Code and Employees’ Compensation Act

1. Income Benefits

   • Compensation is provided for loss of income due to disability.
   • The benefit is equivalent to 90% of the average daily salary credit (ADSC), subject to a maximum and minimum threshold.

2. Medical and Rehabilitation Services

   • Injured employees are entitled to immediate and adequate medical care, including rehabilitation services.
   • These include hospitalization, therapy, and prosthetics as necessary.

3. Disability Retirement

   • Workers who meet the criteria for permanent total disability may also qualify for disability retirement benefits under SSS or GSIS.

C. Filing Process

1. Report of Injury
   The employer is required to report the injury to the Social Security System (SSS) or ECC within 3 days.

2. Documentation

   • Claimants must provide medical records, employment records, and proof of injury or illness.

3. Adjudication
   Claims are evaluated by the SSS/ECC, and disputes may be elevated to the ECC Appeals Division or the courts.

---

II. DEATH BENEFITS

Death benefits are provided to the beneficiaries of an employee who dies due to a work-related injury, illness, or during the performance of their duties.

A. Beneficiaries

1. Primary Beneficiaries

   • Legal spouse (if not legally separated) and dependent legitimate, illegitimate, or legally adopted children.

2. Secondary Beneficiaries

   • If no primary beneficiaries exist, death benefits are paid to dependent parents or other legal heirs.

B. Coverage

Death benefits are governed by:

1. Social Security Act of 2018 (Republic Act No. 11199)
   Provides benefits for private-sector employees.

2. Employees’ Compensation Act (Presidential Decree No. 626)
   Grants benefits to employees who die from work-related causes.

C. Benefits

1. Monthly Pension

   • SSS: Dependents receive a monthly pension equivalent to the member’s total credited years of service.
   • ECC: Grants a fixed monthly pension for primary beneficiaries.

2. Lump Sum Benefit
   If the deceased employee does not meet the minimum contributions for a monthly pension, the beneficiaries receive a lump sum equivalent to their contributions.

3. Funeral Benefits

   • SSS: A fixed funeral grant (currently Php 40,000).
   • ECC: An additional funeral grant (Php 30,000 under ECC rules).

4. Medical Reimbursement

   • Covers medical expenses incurred by the employee prior to death due to a work-related injury or illness.

D. Filing Process

1. Notification by Employer
   Employers must file an employer's report of death within 3 days of the incident.

2. Claim Application

   • Beneficiaries submit death certificates, proof of relationship, and other required documentation.
   • Claims are filed with SSS or ECC.

3. Adjudication and Appeals
   Decisions by the SSS or ECC may be appealed to the Employees’ Compensation Appeals Board (ECAB) or higher courts.

---

III. RELATIONSHIP TO OTHER LAWS AND PROGRAMS

A. Overlap with Social Security Benefits

SSS provides additional disability and death benefits outside the Employees' Compensation Program, but double compensation is prohibited for the same contingency.

B. PhilHealth

• Provides hospitalization and medical expense coverage for illnesses and injuries but does not directly provide disability or death compensation.

C. DOLE Labor Standards Enforcement

• Ensures employer compliance with safety standards to prevent work-related injuries and fatalities.

D. Seafarers and Overseas Workers

• Governed by special laws and contracts, such as the POEA Standard Employment Contract, which provides specific benefits for seafarers and OFWs who suffer disability or death while deployed.

---

IV. RECENT JURISPRUDENCE

1. Disability Claims in Seafarers

   • Cases such as Vergara v. Hammonia Maritime Services emphasize the need for medical certifications from company-designated physicians within 120-240 days.

2. Dual Coverage Disputes

   • In cases like ECC v. Supreme Court of the Philippines, it was clarified that ECC benefits are distinct and complementary to SSS or GSIS benefits.

3. Cause of Death

   • Rulings often hinge on whether the illness or injury is work-related, as in San Miguel Foods, Inc. v. Rivera.

---

V. COMPLIANCE AND PENALTIES

1. Employer’s Obligation

   • Employers are required to remit contributions to SSS, ECC, and other relevant programs.
   • Failure results in penalties, fines, and criminal prosecution.

2. ECC Monitoring

   • The ECC has the mandate to investigate and ensure compliance with reporting requirements and benefit distribution.

3. Employee Awareness

   • Workers are encouraged to report unsafe conditions and file for benefits promptly to avoid prescription of claims.

---

This comprehensive overview of disability and death benefits ensures that workers and their families are adequately protected against the risks associated with employment in the Philippines. For further case-specific advice, consultation with a labor law expert or a legal counsel specializing in social legislation is essential.