Hello All, Greetings!! Here i come with my another query. One of my subordinate injured while "On-Duty", he is a government employee, He will get all the benefits like medical reimbursement, sick leave ...everything. Is there any more benefits other than than these he can be eligible for? Is he eligible for travel reimbursement also if he go to his home?
Regards,
Astha Saxena
From India, Indore
Regards,
Astha Saxena
From India, Indore
Dear Ms. Astha Saxena,
As per the Employees Compensation Act 1923 read as under :-
1. All persons covered under the definition of “employee” u/s 2(1)(dd) read with Schedule-II can take benefit of this provision irrespective of amount of salary/wages drawn by them.
2. As per notification No.S.O. 1258(E) dated 31.5.2010 monthly wages of Rs.8,000/- has been fixed for the purpose of compensation u/s 4(1). However, this limit is not applicable to reimbursement of medical expenditure u/s 4(2A). Hence medical expenses can be claimed by any employee without any limit.
3. Reimbursement of medical expenses u/s 4(2A) is in addition to compensation payable u/s 4(1).
4. Medical expenses can be incurred anywhere [i.e. either at office/home or at any hospital (government or private) in India or abroad].
5. Section 3(1) talks about employer’s liability to pay compensation in case of injury caused ‘by accident’ arising ‘out of and in the course of employment’. However, Section 4(2A) only talks of injury caused during the course of employment. Hence it is not necessary for the purpose of Sec.4(2A) that the injury should be caused ‘by accident’ and ‘out of employment’.
6. Section 53 of ESI Act puts a bar on an insured person or his dependant to claim any compensation or damages under Employees Compensation Act or any other law. However, reimbursement of medical expenses cannot be said to be compensation or damages.
From India, Visakhapatnam
990As per the Employees Compensation Act 1923 read as under :-
1. All persons covered under the definition of “employee” u/s 2(1)(dd) read with Schedule-II can take benefit of this provision irrespective of amount of salary/wages drawn by them.
2. As per notification No.S.O. 1258(E) dated 31.5.2010 monthly wages of Rs.8,000/- has been fixed for the purpose of compensation u/s 4(1). However, this limit is not applicable to reimbursement of medical expenditure u/s 4(2A). Hence medical expenses can be claimed by any employee without any limit.
3. Reimbursement of medical expenses u/s 4(2A) is in addition to compensation payable u/s 4(1).
4. Medical expenses can be incurred anywhere [i.e. either at office/home or at any hospital (government or private) in India or abroad].
5. Section 3(1) talks about employer’s liability to pay compensation in case of injury caused ‘by accident’ arising ‘out of and in the course of employment’. However, Section 4(2A) only talks of injury caused during the course of employment. Hence it is not necessary for the purpose of Sec.4(2A) that the injury should be caused ‘by accident’ and ‘out of employment’.
6. Section 53 of ESI Act puts a bar on an insured person or his dependant to claim any compensation or damages under Employees Compensation Act or any other law. However, reimbursement of medical expenses cannot be said to be compensation or damages.
From India, Visakhapatnam
Hello Astha,
Your post is not clear about whether the injury is serious or not.
Whether the injured was directly admitted in a hospital or got out patient treatment and reached home immediately after the medical aid.
However, the following inputs may be useful to you.
There are three different issues involved in this.
1. Injury while on duty
2. Entitlement of medical facilities / reimbursement
3. Medical / Sick Leave.
Whether the employee is injured within the premises of his employment or outside while performing his official duty, it will be treated as employment injury. Since being an employment injury he is entitled for TA/DA from the place of accident to a nearby hospital.
He/she is eligible for medical expenses as per his entitlement. (Refer - Medical Rules). He can also get treatment from Central Government Health Scheme(CGHS), in case he is a member of the same. He can also claim for reimbursement his medical expenses, in case he is admitted / got treatment from hospitals other than recognized / referral hospitals, quoting emergency. Settlement of his bills will be subject to prevailing rules of his dept.
So far as his leave is concerned he/she has to avail the leave in his credit. In case of Loss of pay he can seek leave in anticipation of his/her earning leave, which can be granted subject to the approval of competent authority.
Hope this clarifies your queries.
Regards
Balamurugan Sivaprakasam
From India, Madras
Your post is not clear about whether the injury is serious or not.
Whether the injured was directly admitted in a hospital or got out patient treatment and reached home immediately after the medical aid.
However, the following inputs may be useful to you.
There are three different issues involved in this.
1. Injury while on duty
2. Entitlement of medical facilities / reimbursement
3. Medical / Sick Leave.
Whether the employee is injured within the premises of his employment or outside while performing his official duty, it will be treated as employment injury. Since being an employment injury he is entitled for TA/DA from the place of accident to a nearby hospital.
He/she is eligible for medical expenses as per his entitlement. (Refer - Medical Rules). He can also get treatment from Central Government Health Scheme(CGHS), in case he is a member of the same. He can also claim for reimbursement his medical expenses, in case he is admitted / got treatment from hospitals other than recognized / referral hospitals, quoting emergency. Settlement of his bills will be subject to prevailing rules of his dept.
So far as his leave is concerned he/she has to avail the leave in his credit. In case of Loss of pay he can seek leave in anticipation of his/her earning leave, which can be granted subject to the approval of competent authority.
Hope this clarifies your queries.
Regards
Balamurugan Sivaprakasam
From India, Madras
Hello Siva,
The injury is serious, he was directly admitted to the hospital, he was admitted there for 3 days. Now Doctors are waiting for his swelling around eye area to come down and only after that they will decide if operation is required or not. Do you have any link or rules available regarding TA/DA? Can't he get travel reimbursement if he want to move to his hometown for better care?
Regards,
Astha Saxena
From India, Indore
The injury is serious, he was directly admitted to the hospital, he was admitted there for 3 days. Now Doctors are waiting for his swelling around eye area to come down and only after that they will decide if operation is required or not. Do you have any link or rules available regarding TA/DA? Can't he get travel reimbursement if he want to move to his hometown for better care?
Regards,
Astha Saxena
From India, Indore
Thanks Sharmila,
I would also like to know if he can claim travel reimbursement also if he moves to his hometown for better care? Other than this, what about leaves?? Leaves will be deduct from his account only or else their is any other way so that his leave balance remain same?
Regards,
Astha Saxena
From India, Indore
I would also like to know if he can claim travel reimbursement also if he moves to his hometown for better care? Other than this, what about leaves?? Leaves will be deduct from his account only or else their is any other way so that his leave balance remain same?
Regards,
Astha Saxena
From India, Indore
Dear Ms. Astha, Yes, he could claim the travel expenses if any such policy exists in your company. He can utilize his EL/PL accounting to his leaves.
From India, Visakhapatnam
From India, Visakhapatnam
Hello Astha,
Thanks for your immediate reply/input.
For central government employees, the guidelines for TA/DA, medical etc, are available as circulars, memorandums, notice etc., in their respective departments / section, some times in may be available as soft copy in their website. Whereas, a Chennai based publishers compile and release these guidelines as “ Swamy’s handbook” which is available in all major book stores. State governments also follow in case they do not have their own guidelines. I doubt whether they have any online publication.
Meanwhile, kindly suggest your friend to get the treatment in a hospital recognized by his department, in case he has to undergo any operation / procedure, so that his medical expenses will be reimbursed. Also ask him to intimate his superior about the injury and hospitalization, immediately. Because there are chances of his claim getting denied in case he does not do so.
I do not think his claim will be permitted in case he wants to get the treatment at his home town. Because, the employee is eligible for medical treatment / reimbursement only at his place of posting and not elsewhere. Kindly, check whether their department has any norms for seeking permission for the above. Generally, it is decided on case to case basis.
I understand, the mental agony the concerned person is undergoing, it is always safe to follow the guidelines.
Regards
Balamurugan Sivaprakasm
From India, Madras
Thanks for your immediate reply/input.
For central government employees, the guidelines for TA/DA, medical etc, are available as circulars, memorandums, notice etc., in their respective departments / section, some times in may be available as soft copy in their website. Whereas, a Chennai based publishers compile and release these guidelines as “ Swamy’s handbook” which is available in all major book stores. State governments also follow in case they do not have their own guidelines. I doubt whether they have any online publication.
Meanwhile, kindly suggest your friend to get the treatment in a hospital recognized by his department, in case he has to undergo any operation / procedure, so that his medical expenses will be reimbursed. Also ask him to intimate his superior about the injury and hospitalization, immediately. Because there are chances of his claim getting denied in case he does not do so.
I do not think his claim will be permitted in case he wants to get the treatment at his home town. Because, the employee is eligible for medical treatment / reimbursement only at his place of posting and not elsewhere. Kindly, check whether their department has any norms for seeking permission for the above. Generally, it is decided on case to case basis.
I understand, the mental agony the concerned person is undergoing, it is always safe to follow the guidelines.
Regards
Balamurugan Sivaprakasm
From India, Madras
Info provided by Mr.Siva is correct and different officers interpret the laws differently so best is he has to take inpatient treatment in CGHS approved hospitals and at govt approved rates, but since it is not possible in case of accidents, emergencies, a note can be put up to HOD regarding this and once the employee is out of danger he can be shifted to CGHS approved hospital for further treatment. Best is put up note to HOD and take their approval / consent so that tomorrow there wont be any issue in claims.
From India, Madras
From India, Madras
hi astha !
information provided by siva is correct but for one aspect.in many organisations the staff injured while on duty gets special leave till found fit.i am working in a central government undertaking and we give such leave till the company's medical officer gives fit certificate to the staff concerned.
From India, New Delhi
information provided by siva is correct but for one aspect.in many organisations the staff injured while on duty gets special leave till found fit.i am working in a central government undertaking and we give such leave till the company's medical officer gives fit certificate to the staff concerned.
From India, New Delhi
Hi Astha,
It is not clear that State / Central Government Employee.
1. If employee is State Govt. then about the grants From Government either Block Grants or Regular Grants. Payment is released by Treasury.
2. Else Central Govt Employees are covered under CGHS.
Please see the Government Resolutions for State or Notifications for Central.
Ramakant
From India, Pune
It is not clear that State / Central Government Employee.
1. If employee is State Govt. then about the grants From Government either Block Grants or Regular Grants. Payment is released by Treasury.
2. Else Central Govt Employees are covered under CGHS.
Please see the Government Resolutions for State or Notifications for Central.
Ramakant
From India, Pune
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