Copy of Directorate of Sainik Welfare Punjab Memo No 14/1/2W/2009/Med/1393-

1396 dated 20 July 2009

To:
1. Adjutant General, South Block, New Delhi – 110 011
2. Director General of Armed Forces Medical Services, M-Block, Army HQ, New
Delhi – 110 001
3. Director MS (Health), o/o DGMS (Army), L-Block, Army HQ, New Delhi – 110
011
4. Director (Medical), Room No 242-A, A-Wing, Sena Bhawan, DHQ PO, New
Delhi – 110 011

Memo No 14/1/2W/2009/Med/1393-1396 20 July 2009

Sub :- Availability of medical facilities to non-pensioners such as ECOs and

SSCOs who have been granted the status of ‘ex-servicemen’ and the need for
sensitising service medical establishments about Govt of India policy on re-
imbursement of medical expenses for major surgeries of such non-pensioner ex-
servicemen

1. Please refer to the following :-

(a) Govt of India, Min of Def letter No 44047/DGAFMS/DG-

IC/2372/96/D(Med) dated 26 Sep 1996 (copy enclosed as Annexure-1)

(b) Army Order 08 of 1998 (Annexure-2)

(c) Govt of India, Min of Def, Kendriya Sainik Board letter dated 19 May
1997 (Annexure-3)

(d) Govt of India, Min of Def, Kendriya Sainik Board letter dated 07 Jan 2000
(Annexure-4)

(e) Govt of India, Min of Def, Kendriya Sainik Board letter dated 08 Nov
2004 (Annuexure-5)

2. Prior to 26 Sept 1996, medical attendance / facilities in Service Medical

Establishments were only available to pensioners of the defence services as per
Paragraph 296 (O) of the Regulations of the Medical Services for Armed Forces
(RMSAF in short). These were the categories of individuals entitled to medical
facilities till 26 Sept 1996 :

(i) Ex-Service Pensioners

(ii) Families of Ex-Service Pensioners

(iii) Families of deceased personnel drawing pension of some kind

3. However Govt of India took a conscious decision in the year 1996 to include
under the ambit of medical facilities all personnel who had been grated the status
of ‘ex-servicemen’ according to Department of Personnel and Training definition
from time to time. Accordingly, a Presidential sanction was issued on 26 Sept
 1996 amending Para 296 (O) of RMSAF wherein the term ‘ex-service pensioners’
was replaced by the term ‘ex-servicemen’ leading to the following regime of new
entitlement as per the enclosed Annexure-1 :

(i) Ex-Servicemen covered under the definition of ‘Ex-

Serviceman’ issued by Department of Personnel and Training
(DoPT) from time to time

(ii) Families of Ex-Servicemen

(iii) Families of deceased personnel drawing pension of some kind.

4. Consequently, even the relevant Army Order (10/97) was suitably amended under
the hand and seal of the Chief Of the Army Staff through the Adjutant General
and the term ‘ex-service pensioners’ was replaced by the term ‘ex-servicemen’
hence eliminating the requirement of pension for the purposes of limited medical
facilities in service medical establishments. The amendment vide AO 08/98 is
enclosed herewith as Annexure-2. It is however regretted that neither have these
amendments to RMSAF and AOs been made known to service medical
establishments all over the country nor are non-pensioner ex-servicemen being
universally granted facilities which have been duly approved through a
Presidential sanction. As it is, medical facilities are only available to ex-
servicemen who are not re-employed in civil organisations and the number of
such entitled non-pensioner ex-servicemen is not very large. It is regrettably not
being appreciated by the medical establishment that the fact that the term
‘pensioner’ has been removed clearly points out that ex-servicemen who are non-
pensioners are also now entitled to medical facilities. There was no requirement of
removal of the term ‘pensioner’ from Para 296 (O) if the facility was not to be
extended to non-pensioners. It is also important to point out here that though
medical facilities are available to non-pensioner ex-servicemen, but after the life-
time of an ex-serviceman, the facility is only available to families of deceased
personnel who are in receipt of a pension of any kind. Hence, facilities to non-
pensioner ex-servicemen and their families are only restricted during the life-time
of the ex-serviceman.

5. The problem of lack of awareness of this issue is now also percolating down to
the functioning of the system of re-imbursement of major medical surgeries of
non-pensioners. Though non-pensioner ex-servicemen are entitled to medical
facilities as above, they are not authorised to become members of Ex-Servicemen
Contributory Health Scheme (ECHS) and the reimbursement system to be
followed for non-pensioners is different than that of ECHS applicable to
pensioners. While ex-service pensioners are covered under the Ex-Servicemen
Contributory Health Scheme, non-pensioner ex-servicemen are covered by
medical reimbursement scheme of the Kendriya Sainik Board (KSB) wherein
serious diseases of non-pensioners can be treated at civil hospitals and 60% of
expenditure of officers and 75% of PBOR can be borne by the KSB by following
the procedure mentioned in Para 5 of Govt of India letter dated 07 Jan 2000
(Annexure-4). The rates were further increased to 75% and 90% for Officers and
PBOR respectively by Govt of India, MoD, KSB Letter No 102/KSB/AFFDF/6th
MC/Progress/2001/D dated 09 Jan 2001. Moreover, non-pensioner Ex-
Servicemen can also report for by-pass surgery at Army Hospital (R&R) Delhi
and MH (CTC) Pune, the cost of which can be reimbursed to the hospital as per
terms of Govt of India letter dated 19 May 1997 (Annexure-3). Please note that
the above mentioned letters for reimbursement are now applicable only to
non-pensioner ex-servicemen such as SSCOs and ECOs as per Para 5 of Govt
of India letter dated 08 Nov 2004 (Annexure-5).

6. Just as the facilities of ECHS are only available to pensioner Ex-Servicemen, the
above mentioned re-imbursement facilities are only extended to non-pensioner ex-
servicemen who are not in receipt of any financial assistance and the same is
made clear in Para 5 of Govt of India Letter dated 08 Nov 2004 (Annexure-5) and
 Para 3 (d) of Govt of India letter dated 19 May 1997 (Annexure-3). The
unfortunate part however is that for availing such facilities, non-pensioner ex-
servicemen have to first visit a service medical establishment for a reference /
certificate that the said facility is not available in the MH vide Para 3 (e) of Govt
of India letter dated 19 May 1997 (Annexure-3) and Para 5 of Govt of India letter
dated 07 Jan 2000 (Annexure-4) but most service medical establishments refuse to
even entertain non-pensioner ex-servicemen leading to the redundancy and failure
of the entire scheme for non-pensioners initiated by Govt of India. When the
above mentioned Govt of India letters for non-pensioner ex-servicemen clearly
provide that to avail re-imbursement for treatment from civil hospitals, such non-
pensioner ex-servicemen first have to visit service medical establishments, then
service medical establishments are totally bound to accept non-pensioner ex-
servicemen for treatment.

7. You are requested to undertake the following to ensure that facilities provided by
Govt of India to non-pensioner ex-servicemen are not rendered redundant :-

(a) Issue and circulate a copy of the amendment of Para 296 (O) dated 26 Sept
1996 (Annexure-1) to all military medical establishments which signifies
that the term ‘ex-service pensioner’ has been replaced by the term ‘ex-
servicemen’. Issue instructions to all defence medical establishments to
provide medical attendance / services to SSC/EC Officers with immediate
effect.

(b) Circulate a copy of AO 08 / 98 (Annexure-2) to all service medical

establishments which also provides that the term ‘ex-service pensioners’
stands replaced by ‘ex-servicemen’.

(c) Circulate a copy each of Govt of India letters dated 19 May 1997, 07 Jan
2000 and 08 Nov 2004 (Annexures 3 to 5) to all service medical
establishments so as to sensitise them of the procedure of medical
reimbursement for non-pensioner ex-servicemen. It may be pointed out
that the copies had already been endorsed to your office at the time of
issuance.

(d) Sensitise service medical establishments to accept all ex-servicemen

irrespective of ‘pensioner’ status on production of the ‘ex-serviceman
identity card’ issued by Sainik Boards which are the competent authorities
to issue the same for availing all such schemes meant for ex-servicemen.

8. An early action is requested please since the issue has legal as well as emotional
connotations.

Sd/-
(IS Gakhal)
Brig (Retd)
Director

Copy to :

1. Kendriya Sainik Board, West Block-IV, RK Puram, New Delhi – 110 066 :
With a request to advise all addressees to follow the Govt of India
directions in letter and spirit

2. Director General Resettlement, Govt of India, Ministry of Defence, West

Block-IV, Wing-V, RK Puram, New Delhi – 110 066 : Ditto

3. Commandant, Command Hospital, Western Command, Chandimandir,

Distt Panchkula, Haryana : For information
 4. A Branch, HQ Western Command, Chandimandir, Distt Panchkula,
Haryana : For information

ANNEXURE-1
ANNEXURE-2

Extract

ARMY ORDER 08 of 1998

AO 10/97 is amended as follows :

(a)The term “Ex-Service Pensioner” wherever used in the

AO is replaced with the term “Ex-Servicemen”
ANNEXURE-3
ANNEXURE-4
ANNEXURE-5