accredited physician but he was refused admission at the hospital. Respondent had to seek medical assistance elsewhere because his life was at stake. In this case, petitioner was under the care of a company-designated physician. Petitioner only sought the intervention of another physician when Dr. Quiambao refused to assess his disability grade and after Dr. dela Cruz-de Leon issued the medical certification that he was fit to work.In Sarocam v. Interorient Maritime Ent., Inc.,[18] the Court, citing German Marine Agencies v. NLRC,[19] ruled that it is the companydesignated physician who should determine the degree of disability of a seaman or his fitness to work. The Court ruled that the only requirement stated in the POEASEC is that the doctor be company-designated, and no other.   Petitioner alleges that Dr. dela Cruz-de Leon issued the fit to work certification in her capacity as Medical Director and not as attending physician. However, petitioner failed to refute the factual finding of the NLRC, as cited by the Court of Appeals, that Dr. dela Cruz-de Leon issued the fit to work certification with the knowledge, approval and upon the advi[c]e of Dr. Quiambao.[20]   Petitioner is Entitled to Permanent Disability Benefits   Nevertheless, while the Court rejects the medical certificate issued by Dr. Rigonan, we note that the fit to work certification was issued by Dr. dela Cruz-de Leon only on 20 August 1997. Petitioner was repatriated on 23 March 1997. Petitioner was unable to perform his job for more than 120 days from the time of his repatriation, which entitles him to permanent disability benefits. Even in the absence of an official finding by a company-designated physician that petitioner is unfit for sea duty, he is deemed to have suffered permanent disability[21] because of his inability to work for more than 120 days. The Court of Appeals erred in ruling that petitioners operation involving the removal of his gallbladder is not a compensable injury, disease, or illness under Appendix 1 of the POEA-SEC. Permanent disability refers to the inability of a worker to perform his job for more than 120 days, regardless of whether he loses the use of any part of his body. [22] What