Indian Railway Codes and Manuals-Establishment code- Vol-I-Chapter-6 (VI)
Chapter 6
Medical Attendance and
Treatment Rules
601. 1. The authorised medical officer means
the Railway Medical Officer within whose jurisdiction the Railway employee is
headquartered or one who is specifically nominated for the purpose.
(Railway Board’s letter No.89/H/6-1/dated 10-7-1989)
Note: (1) The authorised medical officer may as per
the requirement of a particular case, refer the case to any other medical
officer of the required speciality.
(2) The jurisdiction of a Railway Medical Officer will be taken to cover the
railway employees and their beneficiaries residing within a radius of 2.5 km.
of the hospital/Health Unit/Station of the Railway.
2. “Medical attendance” means:--
(a) Attendance
on a railway employee, a member of his family or dependent relatives at the
consultation room maintained by the authorised medical officer or any Railway
hospital/Health unit.
(b) If there is no
such consultation room/health unit/hospital, then attendance in any railway
hospital/health unit/dispensary to which the railway employee or a member of
his family or dependent relatives, is referred to by the authorized medical
officer.
(c) Attendance
on a railway employee at his residence.
(d) Such
pathological, bacteriological, other tests etc. or other methods of examination
for the purpose of diagnosis and treatment as are available in any Railway
Hospital and are considered necessary by the authorised medical officer.
Note: When such facilities are not available in the
Railway hospital, then such examination may be conducted in any Government or
recognized hospitals (Government hospitals include hospitals run by local
bodies), at the instance of the authorised medical officer. State
Governments where agreeable, should debit the cost of treatment to the Railway
administration concerned, preferring bills or raising debits in such
cases. Otherwise reimbursement to railway employees concerned, would be
permissible as per rules. Reimbursement of claims on account of such
investigations even at non–recognised institutions may be decided by the General
Manager in consultation with FA & CAO, provided these were done at the
instance of the authorised medical officer and the amount involved does not
exceed Rs.1000/- per case.
(e) Such
consultation with a specialist or other medical officer in the service of Government,
stationed at places served by the Railway administration as the authorized
medical officer with the approval of Chief Medical Director, certifies to be
necessary to such extent and only in such measure as the specialist or the
Medical officer may, in consultation with the authorised medical officer
determine.
Note : A patient should not be referred to –
(i) a
specialist or a medical officer not in service of Government.
(ii) a
specialist or medical officer in the service of Government but posted
outside the place served by the Railway.
(f) Consultation
with specialists or other medical officer means taking advice on the line of
treatment and management but not treatment by the Consultant.
(g) If the
authorised medical officer feels that the patients condition is of a
serious nature as to require medical attendance by some person other than
himself, with the approval of the Chief Medical Director of the Railway (which
shall be obtained before hand) unless the delay entails serious danger to the
health of the patient:
(i) send the
patient to the nearest specialist or medical officer by whom, in his opinion
medical attendance is considered necessary for the patient, or
(ii) if the
patient is too ill, request such specialist or medical officer to attend the
patient.
(h) A
specialist or medical officer summoned as above, on production of a certificate
by the authorised medical officer on this behalf, will be entitled to
travelling allowance as admissible to him under the rules applicable to
him.
(i) Honorary
specialists attached to Government hospitals or recognised hospitals, may be
considered as Government specialists for the purpose of this sub-para, subject
to the condition that such consultation will be permissible only in places
where Government specialists are not available and is only on the advice of the
authorised medical officer with prior approval of the CMD. The fees paid
to Honorary consultants for consultation at their private consulting rooms will
be reimbursed to the railway employees in accordance with the rates prescribed
for Government specialists. Consultation with honorary specialists at
their consultation room will be permissible only in emergent cases.
3. A. Treatment means—
(a) Use of all medical
and surgical facilities available at railway hospitals/health units or
consultation room of the authorized medical officer.
(b) The employment
of such pathological, bacteriological, radiological and other investigations as
are considered necessary by the authorised medical officer.
(c) Supply of
such medicines, vaccines, sera, as are ordinarily stocked in the
hospital.
(d) The supply of
such medicines, sera etc. not ordinarily stocked which the authorised medical
officer may certify in writing to be essential for the recovery or for the
prevention of serious deterioration, in the condition of the
patient.
(e) Such
accommodation as is ordinarily provided in the hospital, suited to the
status of the railway employee concerned. If accommodation suited
to the status is not available, accommodation of a higher class may be allowed
provided it can be certified by the medical officer incharge of the Government
recognized hospital that:--
(i) that
accommodation of the appropriate class was not available at the time of
admission of the patient, or if subsequently available , the condition of the
patient did not permit shifting; and
(ii) that the
admission of the patient into the hospital could not be delayed due to the
nature of illness until accommodation of the appropriate class became
available.
(f) such
nursing as is ordinarily provided to in-patients by the Hospital (engagement of
special nurses will be allowed to the extent indicated in sub-section 3
of Section 3 of this Chapter).
(g) the
specialist consultation as described above.
(h) confinement
in the case of a female railway employee or a dependent female member of
a railway employee’s family.
(i) pre-natal
and post-natal treatment received before and after child birth for
physiological or other disability attributable to child bearing or child
birth.
(j) sterilization
irrespective of the fact whether it is intended to serve as a measure of
family limitation.
----reimbursement of
medical expenses for sterility per-se.
(Railway Board’s letter
No. 86/H/6-4/58 dated 21-12-88)
----re-canalisation in
case of loss of child.
(k) termination
of pregnancy under the Medical Termination of Pregnancy Act 1971 and Medical
Termination of Pregnancy Rules 1972.
(l) Anti-rabic
treatment.
(m) Shifting of the
patient for treatment, or for examination from residence to a hospital, or from
one hospital to another hospital, in an ambulance belonging to the Railway or
Government or a local authority etc.
Note: (1) If an ambulance cannot be pressed into
service to attend on an exceptionally emergent cases, alternative arrangement
of taxi or other suitable and available transport vehicle should be made
to ensure prompt transport. The payments that may be involved in such
case can be made out of contingencies. These powers may be delegated to ADMOs.
However, where public transport facilities are hired, , these should be
reviewed by the comptent higher authority .
(2) In exceptional
cases when the patients are not fit to resume duty but are discharged from
Hospital as amputation, convalescent cases recommended sick leave, Fracture
cases with application of plaster of paris etc. with the specific
approval in writing of the medical officer, in- charge of the hospital, the
facility of transporting patients to their residence in an ambulance may also
be allowed free of cost.
(n) Blood
transfusion charges paid to a Government institution or any other local
organisation recognised by the State Government for the supply of blood to
patients in hospital.
Note: (i) There is no objection to the purchase
of blood plasma from a chemist or to obtain blood from a private donor,
provided the authorised medical officer certifies in writing that it was not
available in Government /recognised institution and the price paid for the
blood was reasonable. In such cases reimbursement of the charges will be
admissible.
(o) Free
diet to the extent indicated in sub-section 2 of Section “C” of this
chapter.
B. It does not
include:
(a)
Dental treatment or the supply of artificial denture except to the extent
indicated in para 608 of this chapter.
(b)
Massage treatment except that in the case of poliomyelitis, which may be
allowed as part of the general treatment.
(c) Testing
of eye-site for glasses except at Railway Hospital where facilities exist for
the same.
Note: (1) If local conditions warrant, railways may
have their own arrangement for manufacturing and supplying glasses to Railway
employees and their families and dependents on ‘no profit’ , ‘no loss’
basis. The scheme is to be financed from staff Benefit Fund. In the
case of Group ‘D’ staff, only 50% of the cost of spectacles may be borne by the
SBF.
(2) Reimbursement of
charges incurred by a patient by a private oculist is not admissible in any
circumstance.
(d) Taxi,
tonga or other conveyance charges incurred, to convey a patient from his
residence to the hospital or vice versa, except as provided in Para 601 III
A(M) above.
(e) Cottage
booking fee, admission fee, dhobi charges and charges for Attendants/ayah at
the Hospital.
(f) Special
articles of diet not ordinarily provided by the hospital to its in-patients.
(g) Charges
incurred on account of treatment for immunising or prophylactic purpose except
at Railway Hospital at the discretion of the authorised medical officer.
Note: Cost of vaccines, inoculations and
injections for prophylactic and immunising purposes taken before
the commencement of international travel by Railway employees and members of
their families and dependent relatives in order to procure health certificates
required under international travel regulations, may be reimbursed to them from
railway revenues provided they are travelling on duty or are on authorised
leave in circumstances in which they are entitled to fares at railway
expense.
4. Railway Employees’ for the rules contained in this Manual
mean persons who are members of a service, or who hold posts under the
administrative control of the Ministry of Railways, excepting such of the
employees of the Ministry of Railways as are covered by the medical attendance
and treatment rules issued from time to time by the Ministry of Health and
Family Welfare.
5. ‘Family
members’ and Dependent
relatives for the purpose of these rules, will include all such persons as are
eligible for passes under the Pass Rule.
6. ‘Patient’ means a person to whom the rules in this
chapter apply, and who has fallen ill.
(Rules 102(7), 102(13),
107(7), 901, 902, 903, 904(ii), Ministry of Railways decision below Rule
908, Note and Ministry of Railways decision below Rule 909(i), Note 2 under
Rule 916, 920 of the Indian Railway Establishment Code Volume I, and the notes
thereunder, and Paras 1432, 1433, 1435-A, 1437 1441 to 1443, 1445, 1446, 1454,
1455, 1457 (iii), 1502(iii) and 1502(iv) of the Indian Railway Establishment
Manual and Ministry of Railways letter No. E52 ME3/19/3 dated 29th
December, 1952, No. MH 59ME1/30/Medical dated 14th
May, 1960, No. 61/M & H/7/69 dated 23rd June,1961 No. 62/H/7/52
dt. 22nd October, 1962, No.63/H/1/4 dated 7th August,
1962, No. 65/H/1/51 dated 23rd May, 1966, No.
66/H/1/49 dt.7th March, 1967, No. 67/H/1/50 dated
31st January, 1968, No.66/H/1/33 dated 9th December,
1968, No.69/H/1/17 dated 19th August, 1969,
No.70/H/13/29 dated 23rd July, 1971 and 13th December,
1971, No.72H/6-1/27 dated 11th January, 1973, No.F(X)
I-64-PW4/dated 16th July, 1975, No.E(W)74/PSS-1/11 dated 8th September,
1976, F(X)I-64-PW4/8 dated 16th July, 1975, No.79/H/6-1/31
dated 5th April, 1980 and 87/H/6-1/3 dated 26-6-1987).
602. Section B: Extent of
Application
Sub-section 1
RAILWAY SERVANTS EMPLOYED IN THE OFFICE OF THE RAILWAY BOARD
THE RESEARCH, DESIGNS AND STANDARDS ORGANISATION AND OFFICE
OF THE RAILWAY LIAISON OFFICER, AT NEW DELHI AND THEIR
FAMILIES
All railway servants employed in the offices of the Railway Board,
the Research, Designs and Standards Organisation and the Railway Liaison
Office whose headquarters are at New Delhi and their families, shall be
entitled Medical Attendance and Treatment in accordance with such rules as may
be issued from time to time by the Ministry of Health and Family Welfare for
medical attendance and treatment of Central Government servants having
their headquarters at Delhi and New Delhi.
Note
1: - Railway servants of the Research Designs and Standards
Organisation and their families while employed at the Chittaranjan Locomotive
Works and at Tatanagar will lbe governed by lthe Railway Medical Attendance
Rules contained in Part II and will be attached the Chittaranjan
Locomotive Works and the Eastern Railway respectively.
Note
2: - Railway servants of Groups A & B who are governed by the
rules in Sub sec.2 may, on appointment in the offices mentioned in this rule,
may be allowed to exercise an option to be governed by the rules in Sub sec.1
or to continue to be governed by the rules in Sub sec.2. A similar option
may be allowed in the case of groups C & D employees governed by the rules
in Part II who come to the Railway Board’s office from railways on deputation
for limited period. Those electing the rules in Sub sec. 2 will be
regarded as attached to the Northern Railway for this purpose.
Sub-section 2 : Railway
employees
Medical attendance and treatment facilities
shall be available, free of charge, to all ‘Railway employees’ and their
‘family members and dependent relatives, irrespective of whether they are in
Group A, Group B, Group C, Group D, whether they are permanent or temporary, in
accordance with the detailed rules as given in Section ‘C’ of this
chapter.
Note:--Railway
staff employed in the offices mentioned below shall be regarded as attached to
Railway Administration.
1. Advance
Permanent Way Training School, Pune .
2. Railway
Staff College, Vadodara.
3. Director
Railway Movement, Kolkata.
4. RRB
Chairman where located.
5. Chief
Mining Engineer (Dy. Coal Commissioner Production) .
6. RDSO,
Lucknow.
7. Dy.
Director Railway Stores, Kolkata.
8. DLW,
Varanasi.
9. CLW,
Chittaranjan.
10. DCW,
Patiala.
11. Wheel
& Axle Plant, Bangalore.
12. Railway
Rates Tribunal, Chennai .
13. Chairman
& Vice Chairman of Railway Claims Tribunal at places where located.
14. Chairman,
Vice-Chairman & Members, Indian Railway School of Signal and
Telecommunication Engineering, Secunderabad.
15. Tank
Wagon Controller, Bombay.
16. MTP,
Kolkata, Mumbai, Chennai, Delhi.
17. ICF,
Perambur.
18. DCW,
Patiala.
(Rule 916(i) under Rule
916 & 918-RI, Paras 1403(b), 1405 & 2306 of Indian Railway
Establishment Manual and Ministry of Railway’s letter No. 69/H/1/38 dated
6th October, 1969, No. 71/H/1-1/35 dated 5th November,
1971 and No. 80/H/6-1/3 dated 22nd February, 1980 and No. 89/H/10/1 dated
30-11-1989).
Sub-section 3 : Railway employees on leave/leave
preparatory to retirement/post retirement
leave
A railway employee on leave including LPR is
eligible for medical attendance and
treatment.
(Rule 913 R.I. &
Para 1410 of IREM)
Sub-section 4 : Retired Railway employee on
re-employment
Retired railway employees on re-employment in the Railways are entitled to free
medical attendance and treatment facilities free of charge as per details given
in Section ‘C’ of this chapter.
(Ministry of Railway’s letter No. E51ME1/3/3 dated 26-2-1951).
Sub-section 5 : Officers and staff of the
Commissioner of Railway Safety
The staff and officers attached to this establishment are entitled for free
medical attendance and treatment for self and family members in accordance with
the detailed rules as given in Section ‘C’ of this Chapter, irrespective of
whether they were transferred from the Railways or recruited directly by the
Ministry of Tourism and Civil Aviation.
(Ministry of Railways letter No. 66/H/16/3 dated 16-2-1966)
Sub-section 6 : Audit staff
Medical attendance and treatment to the extent
available to the Railway employees of corresponding status will be available
free of charge to the Railway Audit staff and family members in accordance with
the detailed rules as given in Section ‘C’ of this Chapter.
Audit staff attached to Railways should exercise option if they want Railway
medical facilities for treatment under Railway or may continue their treatment
under the Central Health Services.
(Ministry of Railway’s letter No. E46 ME39/3 dated 24-6-1946 and 64/H/6/158
dated 9-11-64.)
Sub-section 7 : Railway employees on
deputation to RITES/IRCON
Railway employees on deputation to the above
organisations may be permitted to continue to avail the medical facilities in
accordance with the detailed rules as given in section ‘C’ of this
Chapter. However, RITES/IRCON should pay annual contribution on the basis
of per capita expenditure on a Railway employee on All India Railway Basis,
multiplied by the number of Railway employees on deputation, who have opted for
these rules.
(Ministry of Railway’s letter No. 79/H/6-3/8 dated 18-7-1980)
Sub-section 8 : Free Medical facilities to whole
time employees and officers employed by AIRF/NFIR
1. Whole time employees of Zonal recognized Unions Federations are
entitled to free medical treatment for self only.
2. Family members of whole time employees of aforesaid
federation/Unions in the hospitals and Health Units is limited to outdoor
treatment only.
(Railway Board letter No. 90/H/6-7/13 dated 22-6-1995)
Sub-section 9 : Quasi Railway Organisation
I. Free medical
attendance and treatment facilities are available to the staff themselves of
the
(i)
Consumer Cooperative Societies
(i) Staff
Benefit Fund Committees
(ii) Railway
Institutes
(iii) Railway
Officer’s Club
(iv) Station
Committees
The family members of
these employees will be given free OPD treatment.
II. The family members of the staff of Consumer
Co-operative Societies may be given medical attendance and treatment on
per capita basis, the charge being calculated on the basis of total expenditure
on medical services on All India basis excluding the cost of health
service.
III. Medical attendance and treatment
facilities are available to the staff and their families of the Co-operative
Credit Societies and Bank on per capita basis as stated above.
Note:--The
staff of the canteens on Railways run by cooperative Societies specially formed
for the purpose and in the Ministry of Railway’s office may be extended free
medical treatment in OPDs only. For any investigation charges are
leviable.
(MOR’s decision No. 2 deal rule 902 R. T. paras 1403 (a), 2922 & 2940 (vi)
of Indian Railway Establishment Manual, MOR’s letter No. 64/H/7/116 , dated
31-8-1965, 71/H/1-1/18 dated 14th September, 1971 and
73/H/6-1/24, dated 1-10-1973).
Sub-section 10 : Apprentice
Free medical attendance and treatment facilities will be admissible to all
apprentices other than those governed by the Apprentice Act, 1961 but not to
their family members, on the same scale as available to Railway employees but
confined only to the extent facilities are available in Health Units and
Railway hospitals. For the purpose of medical attendance and treatment
facilities, they may be classified according to the categories for which they
are apprentices. For the purpose of recovery of diet charges, the stipend
drawn by them should be considered as pay. No reimbursement facilities
are available in non-railway institutions, T.B. institutions where beds have
been reserved, for railway employees.
Note.—
(i) Trade Apprentices who are governed by the Apprentices Act 1961, but
come otherwise within the definition of the phrase ‘Family members or dependent
relatives’ of a railway employee, will be eligible for medical attendance and
treatment facilities, according to the status of the railway employee under the
normal rules.
(i) Free
medical treatment may be offered to apprentices including those governed by the
Apprentice Act 1961, when personal injuries are caused to them by accident
arising out of and in the course of training as an apprentice.
(MOR’s decision (i) below Rule 902 are RI, paras 1401, 2401 and 2409 of IREM
and MOR’s letter No. MH58ME1/24 Medical, dated 12-1-60 and No.
E(TRJ)1/67/TRI/15 , dated 8-2-1968)
Sub-section 11 : Railway employees
enrolled/commissioned in the territorial army
A Railway employees enrolled/commissioned in the territorial army will be
entitled to military medical services during the period of training and embodiment.
The family members and dependent relatives of the employees will be governed by
the railway medical attendance and treatment rules during the above period.
(Para 4 II of the IREM)
Sub-section 12 : Private servants
A private servant of a railway employee (i.e. a person employed on whole time
basis on a salary in the personal services of the railway employee), who is
eligible for passes, is also eligible for medical attendance and
treatment as out-door patient and also, to the extent accommodation is
available as in-door patient, at all railway hospitals and health units.
In case of in-door treatment, charges at 40% of the schedule of charges laid
down for out-siders may be levied for the specialized and indoor treatment and for
radiological examination.
NOTE.—The
out-patient treatment should be confined to short routine illnesses and not
diseases requiring prolonged management of cases.
(Rule 932 RI and Railway Board’s letter No. 65/H/7/189 dated 3-2-1967 and
10-11-1967 and No 71/H/1-1/16 dated 29-3-1972)
Sub-section 13 : Casual labour
1. Casual labour project as well as
non-project, may be given medical facilities for self only in the out-patients
Department. The service cards of the employees may be utilised as the
identification cards for this purpose.
2. There should be no artificial break in the service of casual
labours.
Note:
1. When they develop post-vasectomy complications and require indoor treatment,
free, diet is also admissible.
2. Casual labourers with more than three months service will become entitled to
the same rights and privileges as admissible to regular railway employees.
(Railway Board’s letter No.66/H(EP)/6/74 dated 11-6-1973, No. E(NG)II 77CL-12
dated3-5-78)
Sub-section 14 : Contractors, their staff and
labourers
Staff of contractors engaged by Railway administration are not entitled to free
medical attendance and treatment facilities. They and their family
members may be treated in railway hospitals and health units in places where
there is no other hospitals are available provided the contractor pays the cost
of diet, medicines and dressings.
(Para 1409 of IREM)
Sub-section 15 : Commissioned vendors
1. Free medical facilities in OPD are available to Commissioned vendors/bearers
engaged in departmental catering as out door patients for self only. As
in-door patient it will be available when they are injured during the course of
the duties.
2. The patients treatment should be confined to short routine illness and
not disease requiring prolonged management of
cases.
(Railway Board’s letter No. 62/H/1/70 dated 16-2-63 and 61/H/70 pt.a dated
17-3-64 and 71/H/1-1/16 dated 16-6-1971)
Sub-section 16: Central Government employees
governed by C.S.(M.A.) Rules 1944
Central Government employees governed by these rules subject to
availability of accommodation can avail of medical attendance and treatment as
admissible to outsiders in railway hospitals on payment of charges prescribed
for outsiders. Preference would, however be given to these employees amongst
outsiders.
(Railway Board’s letter No.74/H/6-3/14 dated 4-8-75)
Sub-section 17 : Families of railway employees
on secondment of foreign service.
The families of railway employees on secondment abroad on foreign service terms
left behind in India may be treated at par with the families of retired railway
employees governed by the Retired Railway Employees Contributory Health
Scheme.
(Railway Board’s letter No. 78?H/6-1/27 dated 21-9-1978)
Sub-section (24) : Identity cards
necessary for availing of facilities in railway hospitals
1. If a railway beneficiary does not produce a medical identity
card no medical treatment should be afforded to the railway beneficiary, except
emergency first-aid.
2. Licensed Porters, Commissioned vendors, etc. who are not regular
railway employees may be issued identity cards with additional endorsement
indicating the category to which they belong.
3. For casual labours, their service book will serve as the medical
identity card.
4. In emergencies, however, a patient, even in the absence of
identification papers has to be attended first, including administration
of such medicines and use of such appliances as may be necessary. With
welfare inspectors, efforts should be made to establish the patient’s identity.
In case of patient is found to be a non-railway beneficiary, he should be
treated as an out-sider, charged accordingly or transferred to a non-railway
hospital as soon as the patients’ condition stabilises and the expenditure
written off with the concurrence of the competent authority.
(Railway Board’s letter Nos 79/H/6-1/24 dated 30-7-79, 76/H/6-1/10 dated
25-5-1978 and 79/H/6-1/22 dated 26-7-79.)
Sub-section 18
A Government employee transferred temporarily or
permanently to a post under the Ministry of Railways shall be entitled to opt
for medical attendance and treatment facilities in the course of the detailed
rules as given in Section ‘C’ of this chapter.
(Rule 912 RI)
Sub-section 19 : Railway employees
on deputation in India/abroad posted abroad
1. Railway employees on deputation in India-Railway employees sent on
deputation to other Government Departments/Corporations/Undertakings may be
governed by the medical attendance rules of the borrowing Departments/Corporations/Undertakings.
The borrowing Departments/ Corporations/ Undertaking may, however, allow the
Railway employee, at his option, to enjoy Railway medical facilities provided a
contribution to Railway revenues is made by the borrowing Departments/Corporations/Undertaking
or by the Railway employee concerned, as may be mutually agreed upon between
them, at the rates of recovery prescribed from time to time for government
employees of his status under the Central Government Health Scheme.
(Note under Rule 911-R.I.)
2. Railway employees on deputation abroad and India-based Railway
employees posted abroad.—(i) Railway employees working in posts
outside India and /or sent abroad on deputation may be divided into the
following three categories for the purpose of grant of medical facilities, viz.
(a) those
who are sent on ‘short-term’ deputation abroad, i.e. when the period of
continued stay abroad does not exceed six months;
(b) those
who are sent on ‘long-term’ deputation abroad; i.e. for a period in excess of
six months; and
(c) India
based Railway employees posted abroad.
(ii) Railway
employees falling under category 1(a) above will be governed by the orders
issued by the Ministry of External Affairs from time to time, whereas those
falling under i(b) and i(c) above will be entitled to medical facilities as are
admissible under the Assisted Medical Attendance Scheme as published by the
Ministry of External Affairs and as corrected from time to time.
(ii) Subject
to the provisions the Assisted Medical Attendance Scheme, the concessions
admissible thereunder are also applicable to wives, children and step-children
residing with and wholly dependent on the employees falling under i(b) and i(c)
above.
(Min. of External
Affairs Memorandum No. 1(i) 19/MP-55 dated 13th September,
1955).
3. Families in
India of employees posted abroad—(a) Free medical attendance and treatment will also be admissible
to families in India of employees posted abroad, provided medical attendance
and/or treatment is in accordance with the rules and orders in force in
India.
(b) The employee concerned
should arrange to collect from his family in India all the necessary
certificates, bills, receipts, vouchers, etc. that are required to accompany
and claim for refund under the relevant rules and orders. He should then submit
his claim to his Accounts Officer through the Head of the Mission/Post in which
he is serving. The claim should be made out in the salary bill form and
supported by the prescribed application form, necessary bills, vouchers and
certificates as required under the rules. When the payment is authorised by the
Accounts Officer, it should be made payable in India to a person duly nominated
by the employee to receive payment on his behalf. Refunds for expenditure
incurred in India shall not be made in a foreign currency. The nomination
shall generally accompany the claim so that after the claim has been passed by
the Accounts Officer, that officer can issue a letter of authority to the
nominee to receive the payment. The expenditure on such refunds should be
debited to the Railways.
(Min. of External
Affair’s Memorandum No. 1(i) 19/MP-55 dated 13th September,
1955).
4. The Controlling Officer—The ‘Controlling Officer’ in the
case of medical claims of the Railway employees serving in Missions/Post abroad
will be the Head of the Mission/Post concerned.
(Note below Rule 35 of Appendix V—R.I.)
603. Section ‘C’ –Scope of medical attendance
and treatment
Sub-section I : General
1. Medical attendance and treatment.—The
Railway employees, their family members and dependent relatives are entitled
free of charge medical attendance and
treatment;
2. In such railway hospitals/health unit or consulting room
maintained by the authorised medical officer, at or near the place where the
patient falls ill, as can, in the opinion of the authorized medical attendant,
provide necessary suitable facilities; or
3. If there is no such hospital, health unit or consulting room about, as
mentioned above, any such government hospital/health centers or dispensaries
are near the place, as can in the opinion of the authorised medical officer
provide the necessary suitable facilities; or
4. If there is no such hospital, as mentioned in paras 2 and 3 above, or
any other hospital with which arrangements have been made for the treatment of
the railway employees at or near the place as can, in the opinion of the
authorised medical officer, provide the necessary and suitable
facilities.
NOTE :
I. Allotment of
hospital accommodation in railway hospitals depends on the condition and
seriousness of the disease and not on the status of the patients. However, in
some government hospitals, accommodation in special wards is provided according
to the status of the patient. As far as railway employees are concerned,
those drawing basic pay of Rs.1600/- or above per month, would be considered
eligible for special wards.
II. Family
members may avail of medical facilities from a medical institution referred to
in sub-paras 1, 2 and 3 above without the intermediary of the authorised
medical officer.
(Rule 906 R.I., Railway Board’s letter No. 67/H/1/58 dated 23-5-68, 71/H/1-1/6,
dated 9th October, 1971, 79/H/6-1/5 dated 3-2-1980 and
82/H/6-1/22 dated 25th May, 1987).
604. Attendance at Residence.—1. Attendance at residence is restricted to :
(a) a
gazetted railway employee, when he falls sick, attendance is free,
(b) a non-gazetted
railway employee, when he falls sick, and is as a result compelled to be
confined at his residence, no charges to be levied.
(c ) a member of a
gazetted/non-gazetted railway employee’s family or dependent relatives, when
the authorised medical officer certifies in writing that removal of the patient
to a hospital is dangerous or injurious to life. In all such cases, the
employee concerned should pay the visiting fee as per schedule.
Note.—Railway
employees are expected not to call the medical officer for minor ailments
thereby wasting their time and depriving other patients of their service.
2. For visits at a
residence of a railway employee, drawing Rs. 1200 and over per months, for
attendance on their family members and dependent relatives, emergent or
otherwise, the railway medical officer are entitled to receive fees. The
payment of fees in such cases may be regulated by the visit.
605. The medical officer shall be entitled to
charge the following fees as indicated below:
|
|
Employees drawing a pay of Rs. 1600/- (new scales) or more
per month |
Employees drawing pay less than Rs. 1600/- (new scale )
but not less than 1200/- per month |
|
1. M.S./Sr.D.M.O. |
Rs.20/- |
Rs.12/- |
|
2. D.M.O. |
Rs. 16/- |
Rs. 10/- |
|
3. A.D.M.O. |
Rs. 12/- |
Rs. 6/- |
No fees for domiciliary visits shall be
charged from employees drawing pay of less than Rs.1200 p.m.
(Railway Board’s letter
No. 82/H/6-1/22, dated 25-5-1987).
Note:
(a) When more than one member
of a railway employees family or dependent relative are to be examined at the
residence, visiting fees may be charged for each separately.
(b) When a railway medical officer is called upon to render assistance to
a railway employee or a member of his family or dependent relatives at an
outstation, he may be granted traveling allowance as per rule when the medical
service rendered is free. When, however, the medical officer is entitled to
charge fees as provided above, he may claim travel allowance only if he
deposits the fee received into the railway revenues. When preferring such
claims for travel allowance, the medical officer should indicate the amount of
fees received by him and also certify on the bill that the fee received
have already to the railway revenues.
(c ) No extra fees
to be charged for conveyance except for very great distances where the decision
of the Chief Medical Director is final. No higher fees for night
visit.
(d) No railway
employee shall be compelled to adopt any of the foregoing system of payment for
medical attendance or to employ any railway medical officer for this
purpose.
(e) A railway
employee may obtain services of a medical officer of a lower grade than that of
the medical officer to whose services he is entitled, on payment of the scale
of contract fees or fees by the visits fixed for the medical officer he
chooses.
(Rule 330, 903(3),
921-929 and 931 RI, note below no.1453 of the IREM and Railway Board’s letter
No.62/H/1/20 dated 6-5-64 and 65/H/7/44 dated 7-10-66).
606. Special provisions regarding female and
children beneficiaries.—At
places where there are no railway hospitals or government hospitals,
female beneficiaries and children of railway employees upto 12 years of age,
may directly obtain medical attendance and treatment without the intermediary
of the authorized medical officer from the nearest Govt./Private
Hospital.
(Rule 919 R.I. and
Ministry of Railway’s decision no.1 thereunder, paras 1446 (v) and (vi) of the
IREM and Railway Board’s Letter Nos. 64/H/154 dated 11-12-1964, 6/H/11/9 dated
20-3-1967, 76/H/11/11 dated 17-4-1970 and 80/H/6-4/15 dated 21-8-1980.)
607. Supply of artificial limbs and appliances.—A railway employee, a member of his family or
dependent relatives whether injured on duty or not, requiring artificial limbs
and appliances, would be entitled to reimbursement of both
hospitalisation charges and full cost of artificial limbs and appliances, as
also cost of repairs, renewals and adjustments thereof from time to time
payable from railway revenues subject to the following
conditions:-
(a) Production of a
certificate from a specialist in the concerned speciality in the railway
hospital that the above was essential.
(b) Apparatus
repairs renewals or adjustments being done at the Rehabilitation department of
a Medical College, Artificial Limb Centre of Pune or other organisations and centres
recognised for the purpose by the Central/State Government concerned.
(c ) The cost of
repairs or adjustment of a limb appliances should not exceed the cost of
replacement of that limb appliances.
Note.—The above para does not apply to the supply or
replacement of heart pace makers and heart valves.
(Railway Board’s letter
No. 80/H/6-4/33 dated 5-12-80 and Feb. 1981).
608. Provision of dental treatment:--1. Free treatment be given to railway
employees and beneficiaries incurred to following ailments in all railway
dental clinics and at all places where railway dental attention facilities have
been provided.
(i)
Extraction
(ii) Scaling and gum
treatment
(iii) Root canal
treatment
(iv) Filling of
teeth
2. In addition, free
dental treatment of a major type is also admissible in cases where it is
considered as a part of any general or consequential ailment and when the teeth
are the source of disturbance. Treatment of such conditions may include
treatment of any condition involving the operations on gums, for extraction of
growths, surgical operations needed for the removal of Odon tomes and impacted
wisdom teeth.
Note:
(1) Arrangements may be made to hire the
services of a local dentist to work part time in a railway hospital. In
such cases no charges should be levied for normal cases like extraction,
scaling etc. but for other items like filling of cavities etc., a schedule of
charges may be prescribed and recoveries made from such staff .
(2) The supply of artificial dentures is excluded from the scope of dental
treatment.
(Para 1440 of the IREM and Railway Board’s letter No. E57MES/85/Medical dated
9/10 March 1961 and 62/H/7/31 dated 30-4-1962)
609. Donation of blood.—1. No prior permission of the Government is
required for donating blood in Blood Banks attached to railway hospitals or
government hospitals or if called upon in emergencies to donate blood in any
Blood Bank.
2. No prior permission is necessary for acceptance of an amount on account of
donation of blood, since it is considered that receipts from the sale of
blood does not attract the provisions of Rule RII 2035 and 2216.
3. When a railway employee or a member of his family donates blood to a railway
hospital or a government hospital, he may receive payment at the rate of
Rs.50/- (Rupees fifty only) per donor per bottle or blood i.e. 300
c.c. However, no incentive money should be paid to voluntary blood
donors against their wishes and every effort should be made to encourage the
voluntary free Blood donors.
The Railway may consider issue of cards to voluntary blood donors with the
offer of free replacement if the donor needs blood transfusion for self within
a period of 12 months.
(Authority: Railway Board’s letter No. 84H/6-1/17 dated 4-6-85 and 90/H/68/3
dated 15-3-91.)
4. Railway employee who donates blood to a railway hospital on a working
day may be granted special Casual Leave, for that day.
5. A railway employee who comes from out-station to donate blood to a railway
hospital may be granted a complementary pass of the same class as admissible to
him under the normal rules to cover the journey. He may be allowed a
minimum journey time apart from one day special casual leave.
6. As blood is a therapeutic substance used in treatment of patients,
expenditure incurred for obtaining blood shall be debited to ordinary railway
revenues and allocated under the head ‘medicines’.
Note:
(a) As far as possible, railway employees should be
encouraged to donate blood voluntarily and not with any mercenary motive.
(b) Hence there should be no occasion to force a person to accept
the permissible payments.
(c ) Blood collected for use in Non-Railway hospitals should not qualify
for payment from Railway revenues, even if the collection has been done in
Railway premises.
(Railway Board’s letter No. 65/H/7/248 dated 5-2-1966.)
Multiple choice questions:
1. Who is considered the authorized medical officer for a Railway employee?
a) Any medical officer in the vicinity of the employee's residence
b) A Railway Medical Officer within whose jurisdiction the Railway employee is
headquartered
c) Any specialist doctor in a Government hospital
d) A private medical practitioner appointed by the employee
Answer: b) A Railway Medical Officer within whose jurisdiction
the Railway employee is headquartered
2. What does "Medical attendance" include for a Railway employee?
a) Only attendance at the residence of the railway employee
b) Attendance at the consultation room of the authorized medical officer,
railway hospital, or health unit
c) Attendance by any private doctor chosen by the employee
d) Attendance limited to pathological tests
Answer: b) Attendance at the consultation room of the
authorized medical officer, railway hospital, or health unit
3. Under what condition can an authorized medical officer refer a case to another medical officer?
a) When the employee demands it
b) Only if the employee pays extra
c) As per the requirement of a particular case, with specialization needs
d) If the authorized officer is on leave
Answer: c) As per the requirement of a particular case, with
specialization needs
4. What is included in the term "Treatment" for a Railway employee?
a) Only consultation and diagnosis
b) Use of all medical and surgical facilities available at railway hospitals
c) Dental treatment and supply of artificial dentures
d) Only supply of medicines not ordinarily stocked in the hospital
Answer: b) Use of all medical and surgical facilities
available at railway hospitals
5. Who is eligible for medical facilities under the rules mentioned in this context?
a) Only the Railway employee
b) The Railway employee and their immediate family
c) The Railway employee, their family members, and dependent relatives
d) Any person related to the Railway employee
Answer: c) The Railway employee, their family members, and
dependent relatives
6. What is the responsibility of an authorized medical officer if a patient's condition requires urgent medical attendance by someone else?
a) Wait for the next available specialist
b) Send the patient to the nearest specialist or request the specialist to
attend the patient
c) Refer the patient to a private hospital
d) Call the employee’s family for further instructions
Answer: b) Send the patient to the nearest specialist or
request the specialist to attend the patient
7. What is NOT included in the "Treatment" as per the context provided?
a) Supply of medicines stocked in the hospital
b) Massage treatment except in the case of poliomyelitis
c) Blood transfusion charges paid to a Government institution
d) Anti-rabic treatment
Answer: b) Massage treatment except in the case of
poliomyelitis
8. In what situations can an ambulance be used to transport a Railway employee?
a) Only when the employee is on duty
b) For shifting a patient for treatment or examination
c) Only for moving the patient between Railway hospitals
d) For any travel the employee wishes to make
Answer: b) For shifting a patient for treatment or examination
9. What kind of dental treatment is generally NOT covered under the "Treatment" category?
a) Treatment for cavities
b) Extraction of teeth
c) Supply of artificial dentures
d) Preventive dental care
Answer: c) Supply of artificial dentures
10. What action can be taken if an ambulance is not available in an emergency situation?
a) Wait for the ambulance to become available
b) Arrange alternative transport, like a taxi, and cover the costs from
contingencies
c) Call for help from nearby non-Railway hospitals
d) Delay the treatment until the ambulance arrives
Answer: b) Arrange alternative transport, like a taxi, and
cover the costs from contingencies
11. Which of the following groups of
employees are eligible for medical attendance and treatment facilities during
leave, including leave preparatory to retirement (LPR)?
A. Railway employees on deputation
abroad
B. Railway employees on leave, including LPR
C. Retired railway employees on re-employment
D. Casual laborers
Answer: B. Railway employees on leave, including LPR
12. Retired railway employees on
re-employment in the Railways are entitled to medical facilities as per which
section of the chapter?
A. Section A
B. Section B
C. Section C
D. Section D
Answer: C. Section C
13. Which group of staff is entitled
to medical attendance and treatment regardless of whether they were transferred
from the Railways or recruited directly by the Ministry of Tourism and Civil
Aviation?
A. Casual laborers
B. Railway employees on deputation
C. Staff and officers of the Commissioner of Railway Safety
D. Contractors and their staff
Answer: C. Staff and officers of the Commissioner of Railway Safety
14. The medical facilities for Audit
staff attached to Railways are available:
A. Free of charge for self and
family
B. Only for outpatient department
C. Only for short-term illnesses
D. Only for in-patient department
Answer: A. Free of charge for self and family
15. Railway employees on deputation
to RITES/IRCON may avail medical facilities provided:
A. They opt for Central Health
Services
B. RITES/IRCON pays an annual contribution to Railway revenues
C. They return to Railway service after deputation
D. They pay out-of-pocket for services
Answer: B. RITES/IRCON pays an annual contribution to Railway
revenues
16. Whole time employees of Zonal
recognized Unions Federations are entitled to medical treatment for:
A. Self only
B. Family members only
C. Self and family members
D. Dependent relatives only
Answer: A. Self only
17. Quasi Railway Organisation staff
are entitled to free medical attendance and treatment for:
A. Both self and family members
B. Self only
C. Family members only
D. None
Answer: B. Self only
18. Apprentices are eligible for
free medical attendance and treatment facilities, but these are limited to:
A. Only in non-railway institutions
B. The extent facilities available in Health Units and Railway hospitals
C. The entire railway hospital network
D. Only for outdoor treatment
Answer: B. The extent facilities available in Health Units and
Railway hospitals
19. A Railway employee enrolled in
the Territorial Army is entitled to medical services during the period of
training and embodiment. What medical facilities are available for their family
members and dependent relatives?
A. Military medical services
B. Railway medical attendance and treatment rules
C. Central Government Health Scheme
D. No medical facilities
Answer: B. Railway medical attendance and treatment rules
20. A private servant of a railway
employee is eligible for medical treatment as an:
A. Indoor patient with charges
levied for specialized treatment
B. Indoor patient free of charge
C. Outdoor patient with no treatment restrictions
D. Outdoor patient only for short routine illnesses
Answer: D. Outdoor patient only for short routine illnesses
21. Casual laborers with more than
three months of service are entitled to:
A. No medical facilities
B. The same rights and privileges as regular railway employees
C. Only outpatient treatment
D. Emergency first-aid only
Answer: B. The same rights and privileges as regular railway
employees
22. Staff of contractors engaged by
Railway administration may be treated in railway hospitals if:
A. They are permanently employed
B. The contractor pays for the cost of diet, medicines, and dressings
C. They opt for Central Government Health Services
D. They are injured on duty
Answer: B. The contractor pays for the cost of diet, medicines, and
dressings
23. Commissioned vendors engaged in
departmental catering are eligible for:
A. Free medical treatment for self
and family
B. Medical treatment only when injured during duty
C. Medical treatment only for prolonged illnesses
D. No medical treatment
Answer: B. Medical treatment only when injured during duty
24. Central Government employees
governed by C.S.(M.A.) Rules 1944 can avail of medical attendance in railway
hospitals on:
A. Payment of charges prescribed for
outsiders
B. Free of charge
C. Payment of nominal charges
D. No medical facilities
Answer: A. Payment of charges prescribed for outsiders
25. Families of railway employees on
secondment abroad on foreign service terms are treated at par with:
A. Central Government employees
B. Retired railway employees
C. Casual laborers
D. Apprentices
Answer: B. Retired railway employees
26. What is required for a railway
beneficiary to avail medical facilities in railway hospitals?
A. A service card
B. A medical identity card
C. A signed letter from a superior
D. A government-issued ID
Answer: B. A medical identity card
27. Railway employees on deputation
in India may be governed by the medical attendance rules of:
A. The Ministry of Health
B. The Ministry of Railways
C. The borrowing Departments/Corporations/Undertakings
D. The Central Government Health Scheme
Answer: C. The borrowing Departments/Corporations/Undertakings
28. Railway employees on long-term
deputation abroad are entitled to medical facilities under:
A. The Central Government Health Scheme
B. Assisted Medical Attendance Scheme
C. The rules of the country they are posted in
D. The Ministry of Railways
Answer: B. Assisted Medical Attendance Scheme
29. The families of railway
employees posted abroad are eligible for:
A. No medical attendance and
treatment
B. Free medical attendance and treatment in India
C. Only outpatient treatment
D. Treatment under local health services abroad
Answer: B. Free medical attendance and treatment in India
30. Who is the Controlling Officer
for medical claims of Railway employees serving in Missions/Post abroad?
A. The Ministry of Railways
B. The Ministry of External Affairs
C. The Head of the Mission/Post concerned
D. The Central Government Health Scheme
Answer: C. The Head of the Mission/Post concerned
31. Who is entitled to free medical
attendance and treatment in railway hospitals?
a) Only Railway employees
b) Only family members of Railway
employees
c) Railway employees, their family
members, and dependent relatives
d) Only dependent relatives of Railway
employees
Answer: c) Railway employees, their
family members, and dependent relatives
32. Where should medical attendance
and treatment be provided according to the rules?
a) Only in the railway hospital
closest to the employee's residence
b) In any government hospital,
health center, or dispensary near where the patient falls ill
c) In private hospitals only
d) In the railway headquarters
hospital only
Answer: b) In any government
hospital, health center, or dispensary near where the patient falls ill
33. What determines the allotment of
hospital accommodation in railway hospitals?
a) The status of the patient
b) The condition and seriousness of
the disease
c) The patient's position within the
Railway department
d) The availability of hospital beds
Answer: b) The condition and
seriousness of the disease
34. Which category of employees is
eligible for special wards in government hospitals according to the railway
rules?
a) Employees drawing a basic pay of
Rs. 1200/- or above per month
b) Employees drawing a basic pay of
Rs. 1000/- or above per month
c) Employees drawing a basic pay of
Rs. 1600/- or above per month
d) All railway employees
irrespective of their pay
Answer: c) Employees drawing a basic
pay of Rs. 1600/- or above per month
35. When is attendance at the
residence provided free of charge for non-gazetted railway employees?
a) When the employee falls sick and
is compelled to be confined at home
b) When the employee requests it
c) Only for minor ailments
d) When the employee is over 50 years
old
Answer: a) When the employee falls
sick and is compelled to be confined at home
36. What is required for a member of
a railway employee’s family to receive medical attendance at their residence?
a) A special request from the
employee
b) The authorization of the
employee's supervisor
c) A certification from the
authorized medical officer that moving the patient to a hospital is dangerous
d) The presence of a critical
medical condition
Answer: c) A certification from the
authorized medical officer that moving the patient to a hospital is dangerous
37. What fee is applicable for a
Senior Divisional Medical Officer’s (Sr.D.M.O.) domiciliary visit to a railway
employee earning Rs. 1600/- or more per month?
a) Rs. 10/-
b) Rs. 20/-
c) Rs. 12/-
d) No fee is applicable
Answer: b) Rs. 20/-
38. What are the conditions under
which no fee is charged for domiciliary visits?
a) Employees drawing less than Rs.
1000/- per month
b) Employees drawing less than Rs.
1200/- per month
c) Employees drawing more than Rs.
1600/- per month
d) All railway employees
Answer: b) Employees drawing less
than Rs. 1200/- per month
39. Under what conditions can a
railway medical officer claim travel allowance when visiting an outstation for
medical service?
a) When he receives fees for the
service
b) When the service is provided free
and he deposits any fees received into railway revenues
c) When the travel is within the
same city
d) When the employee's family member
is seriously ill
Answer: b) When the service is
provided free and he deposits any fees received into railway revenues
40. What is the provision for female
beneficiaries and children of railway employees at places where there are no
railway hospitals?
a) They must wait until a railway
medical officer is available
b) They can directly obtain medical
attendance and treatment from the nearest government or private hospital
c) They can only receive treatment
from authorized railway doctors
d) They must travel to the nearest
railway hospital, regardless of distance
Answer: b) They can directly obtain
medical attendance and treatment from the nearest government or private
hospital
41. Who is eligible for
reimbursement for the supply of artificial limbs and appliances?
a) Only railway employees injured on
duty
b) Only dependent relatives of
railway employees
c) Railway employees, their family
members, and dependent relatives, whether injured on duty or not
d) Only railway employees with a
disability
Answer: c) Railway employees, their
family members, and dependent relatives, whether injured on duty or not
42. What kind of dental treatment is
provided free of charge to railway employees and their beneficiaries?
a) Supply of artificial dentures
b) Cosmetic dental procedures
c) Extraction, scaling and gum
treatment, root canal treatment, and filling of teeth
d) Only emergency dental care
Answer: c) Extraction, scaling and
gum treatment, root canal treatment, and filling of teeth
43. What should a railway employee
do if called to donate blood in an emergency?
a) Seek prior permission from the
government
b) Donate blood only at railway
hospitals
c) No prior permission is required
for donating blood
d) Avoid donating blood without
government authorization
Answer: c) No prior permission is
required for donating blood
44. What benefit may a railway
employee receive when donating blood to a railway hospital on a working day?
a) Monetary compensation only
b) Special Casual Leave for that day
c) No benefits are provided
d) A certificate of appreciation
Answer: b) Special Casual Leave for
that day
45. How is the expenditure incurred
for obtaining blood categorized?
a) As a miscellaneous expense
b) As an employee welfare expense
c) Debited to ordinary railway
revenues under the head ‘medicines’
d) Not categorized under railway
expenses
Answer: c) Debited to ordinary
railway revenues under the head ‘medicines’
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