The company physician: legal duties and obligations in filling up SSS and ECC claims
By Roy Mangubat, MD, DPCOM
I find myself being very blessed to have a sister for a lawyer and accountant (CPA-Lawyer) at same time providing me legal and financial advices without having to pay a retainer’s fee for any legal and financial consultations. As the saying goes “you only need two important professionals in life, a good doctor to take care of you and a good lawyer to take care of the rest of your problems”.
Company physicians are frequently required to fill up forms and certificates as to their findings and opinions in cases where employees' health is an issue such as SSS (Social Security) and ECC (Employees Compensation Commission) claims. It is advice to be judicious in filling up those forms and having supporting documents like medical records to back those claims. The integrity of the Physician is his best asset, always be truthful, objective and firm.
Sometimes, the company physician may face conflicting ethical obligations in weighing the physician-patient relationship against the needs of the employer or vice-versa. There is no dilemma if your decision is truthful and you have the conviction to stand with your opinion as a Professional.
If the employee seeks outside health care assistance, the company physician may have to testify against other health care professionals. Knowledge, experience and training will be the basis of credibility in this type of circumstances, are you qualified and train to do those types of examinations? Can it be reproducible? Currently in the country, disability evaluation is done by government doctors specially those in medical underwriting divisions of the SSS and the GSIS. Few outside the two agencies knows about disability or impairment evaluations, some specialist are confined with the knowledge of disability and impairment inline and limited only within their specialty (e.g. visual impairment are assess by an ophthalmologist to determine whether the patient can be legally blind even with some degree of vision still left). The Diplomate Course of the Philippine College of Occupational Medicine includes disability evaluation in its core curriculum. There are 2 schools of thoughts in terms of impairment evaluation the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment and the WHO International Classification of Functioning, Disability and Health (ICF).
The three most common forums in which the company physician may be asked to submit medical reports and/or testify are
1. arbitration hearings
2. workers' claims for Social Security disability
3. workers' compensation insurance benefits.
Company physicians should be aware of the nature of each type of proceeding and they should be prepared to render persuasive expert testimony.
My first experience to go in the stand was very pleasing having had the opportunity to be summoned by the court is quite exciting and interesting at the same time, that is… because I’m ready and prepared to answer what the counsels and the judge may ask me.
The author is a diplomate of the Philippine College of Occupational Medicine (PCOM) and a graduate of The Pamantasan ng Lungsod ng Maynila (PLM)
. PCOM is an accredited Occupational Health and Safety Organization of the Bureau of Working Conditions of the Department of Labor and Employment (DOLE), a subspecialty society under the Philippine Medical Association (PMA). PCOM is also affiliated with the International Commission on Occupational Health (ICOH) and the Asian Association of Occupational Health (AAOH). College of Medicine
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