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 Boards 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, radiologic al 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 employees 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 Boards 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.