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Sunday, September 23, 2012

Wake up time: Drastic changes required in the military medical set-up


This subject has been discussed on the blog umpteen number of times, and please be advised that the idea behind this post is not to criticize but to aid introspection.

The declaration by a medical board of an in-service incurred disability as ‘attributable to, or aggravated by service’ or ‘connected with service’, is what determines the pensionary entitlement of our men and women in uniform including whether he or she would be entitled to any kind of pension at all or not, and it also has a direct bearing on the survival of the family through thick and thin as also the right to lead a life of adequate dignity.

However, the sensitivity to this very important aspect is totally lacking in the military medical set-up, which, in a routine manner treats this issue more like an administrative and mathematical joke rather than something which affects the survival and the right to live a dignified life of our veterans and their families. It’s just a stroke of a pen – ‘Yes’ or ‘No’, and therein lies the answer whether the veteran and his family would be entitled to any kind of livelihood and facilities or not.

Direct to the point, today, to put it succinctly, it’s a pretty easy job for military medical boards. The thumb rule in use currently by the system, for most disabilities, is – if the disability had arisen in a field area, then it’s attributable to / aggravated by service, if it emanated in a peace area, then it is neither attributable to, nor aggravated by service (NANA). Needless to state, in actual terms, Regulation 423 of the Regulations for Medical Services of the Armed Forces (RMSAF) clearly provides that service in peace or field has no bearing on attributability.

So there you have it, in the ultimate analysis as to how the system is functioning, an Army Major who may be suffering from mild hypertension but is serving in say Udhampur in J&K though in an easy undemanding appointment, would be provided the benefit of ‘aggravation’ and hence disability pension because technically he’s in a field area, but a Major who may be the Garrison Engineer in a high pressure appointment and zone like Delhi or say perhaps a cardiologist in a high profile and highly demanding faculty in Army Hospital (R&R), even if suffers a massive heart attack due to excessive pressure of his job, would not be granted the benefit of ‘aggravation’ since he was posted in a peace area.

The above is how the Guide to Medical Officers (Military Pensions) issued by the office of Director General Armed Forces Medical Services (DGAFMS) deals with the subject. And it’s going from bad to worse, since while the earlier version of the same guidebook published in the year 1980 emphasized on dealing with disabilities on a case to case basis, and the one published in 2002 also provided for discretion and application of mind on a case to case basis, the supplement published in 2008 takes it all away and makes it mathematical and mechanical. To top that, the office of DGAFMS is known to issue strange letters to hospitals and boards, communications such as asking boards not to provide attributability / aggravation to diseases such as hypertension in peace areas, which is not only alien to principles of medical science but also in direct contravention of RMSAF and Entitlement Rules promulgated by the Govt of India.

What does peace and field have to do with a disability? The rigours of military service inherently involve a live link with disabilities, especially psychiatric ones and those related to the cardiovascular system. It is otiose to compare military personnel, even when posted in peace areas, with civilians. An extract of an earlier blogpost on the subject is relevant here:-

“While dealing with disabilities of military personnel, the much argued comparison with an ordinary person on the street by medical authorities is also incomprehensible. There are times when it is remarked that such a disease may also have arisen had the particular person not been in the Army and that the Army is one of the most stress-free organisations in the country. The question arises that here is a man who is 24 hours / 365 days on call, sometimes under the shadow of gun, mostly away from his family, in a strictly regimented routine, can he be simplistically compared with say a civilian employee who goes to office at 9 in the morning returns at 5, only five days a week, lives with his family, in his hometown, enjoys his gazetted holidays, retires at 60 ? !. It won’t take an expert to reply in the negative. Wouldn’t common ailments such as hypertension or IHD or minor psychiatric illnesses or psycho-somatic disorders get aggravated by even seemingly insignificant incidents at the home front such as non-performance of children in school, property disputes, sarkari red-tapism in other spheres, family problems etc ? The answer would be in the positive….”

When a person is away from his family and has no control over events in the environment, including the insensitivity of the civil administration towards the issues facing him and his kin, it hardly matters if he’s in field or peace, and many disabilities are bound to aggravate.

The archaic system of assessment of disabilities is proving to be burden on the organization, on the judicial system and is also bringing about much heartburn amongst the veteran community. When asked about the background or studies on the basis of which (regressive) changes were brought about in the Guide to Medical Officers (Military Pensions) from time to time, especially the 2008 supplement, the answer of the office of the DGAFMS has been elusive and less than satisfactory. There are no footnotes, no studies mentioned, there are no references as to how the conclusions in the said guide were reached about attributablitiy and aggravation of various diseases. For example, in the 2002 version, this was expressly mentioned in relation to heart diseases :

“…Hence no clear cut distinction can be drawn between service in peace areas and field areas taking into account quantum of work, mental stress and responsibility involved. In such cases, aggravation due to service should be examined in favour of the individual….”

But the above lines are completely missing in the 2008 supplement. Isn’t this retrograde? Has anyone questioned the office of DGAFMS as to how and on the basis of which studies was the line omitted? And when the militaries of all democracies make no distinction between peace and field and examine diseases on a case to case basis, what right did the office of DGAFMS have to impose its thought process on the future of millions of disabled veterans and also their families? Can we, and should we let a couple of officers holding key appointments decide the fate of disabled personnel and their families?

The guide is also inconsistent on various disabilities, for example, in the 2002 publication, it is stated that a regimented lifestyle in peace may adversely affect heart diseases, the same is not mentioned in the case of hypertension though it is commonly known that the factors affecting both may be intertwined.

The way how policies are handled by us in the official establishment was also highlighted earlier in yet another blogpost in the past in the following manner:-

“…Then there is the tendency to thrust one’s thought process on others in the system and on to the affected parties without deep analysis of issues. An officer wakes up one day, drafts a letter which he or she thinks is the epitome of intelligence, floats a minute sheet, gets it approved on file and viola we have a ‘policy decision’ which is imposed on others who sadly have no say in the arrangement. Or else what could explain letters from the office of DGAFMS asking medical boards not to grant attributability or aggravation to disabilities such as hypertension if the onset is not in a field / high altitude area, when on the contrary, the rule governing the issue states the below mentioned :-

‘For the purpose of determining whether the cause of a disability or death is or is not attributable to service, it is immaterial whether the cause giving rise to the disability or death occurred in an area declared to be a field service/active service area or under normal peace conditions’

So what should prevail over medical boards, the bright-morning idea of the gentleman who signed the policy letter or the rule extracted above ? It is sad but such illegal letters are prevailing over our system rather than the actual legally promulgated rules….”

The problem with us is self-righteousness, the inability to see reason, clinging on to fiefdom, not realizing the damage in the long run. I would have wanted to render a benefit of doubt to the system but there are some very glaring examples which come to mind, thankfully the veracity of which I can vouch since I personally handled them:-

1.  A soldier went into coma due to cerebral malaria and was later invalided out on the basis of ‘Opium Addiction’ without pension. The said person had not even touched alcohol in his life, and here he was, branded an opium addict. The medical establishment refused to see reason. After much struggle and after the inception of the RTI Act, it was discovered that probably his papers were mixed up with those of another patient while he remained in an MH in the north-east. With intervention of the Army HQ, he was finally granted disability pension.

2.  A Gunner of Clerical trade briefly posted in CI Ops faced an ambush like situation and thereafter used to experience flashbacks about the same. His disability pension claim was rejected by the medical board on the ground that he was posted in field area for less than 2 years. When a fresh medical board was ordered on judicial intervention, rather than recording the flashbacks, the psychiatrist simply wrote that the soldier had ‘disturbed sleep patterns’. Now there is a world of difference between the two, but based on this slipshod opinion his claim was again rejected but thankfully he got his pension later, again on directions of the Court. Till date, it seems that the military medical establishment has not realized that a stressor or a triggering event for a psychiatric disability can happen in  one single second of a person’s presence in a particular event, and length of service in field area has no role to play.

3.  Medical restrictions were imposed on a soldier that he may not be posted in a high altitude area since he was suffering from Psoriasis. He was still posted to an area beyond Leh from where he was invalided out and the remarks of the medical board were predictable – that the disability was neither attributable to, nor aggravated by service. Again disability pension was granted on judicial intervention.

4. An officer, a volunteer for OP Meghdoot, was diagnosed as a case of excessive dandruff while posted to the glacier. Afterwards he was diagnosed as a case of psoriasis. Claim of disability pension refused on the pretext that the disability was neither attributable to, nor aggravated by service. Now if this isn’t related to service conditions, what is?  

5.  A soldier diagnosed with cancer was continually posted to field and CI areas despite undergoing chemotherapy. When just about to complete pensionable service, and almost on his death bed, he was forcefully invalided out of service. Disease declared neither attributable to, nor aggravated by service though guidelines clearly provide that if a person with cancer has had an operational tenure within a window of 30 days to 5 years, he is to be granted attributability. He died 9 days later. Family pension refused on the ground that he died after invalidation. The family was then granted pension on the orders of the Court.

The list is endless. These are people who had the wherewithal to fight it out or to approach judicial fora, but countless others suffer in ignorance and silence. Isn’t it the duty of all of us, especially the serving community and senior military staff to order a complete overhaul of the system and make it more logic and medicine oriented? Other democracies are way ahead. In most countries, attributability / aggravation is the rule if it occurs in active service, while rejection is an exception, whereas in our military, it is the other way round.

Already, military personnel are not provided the benefit of protection of service and pension in case of a disability as is provided to all civilian government employees.

The issue is not clearly in open public domain like say corruption in the military, but the way disabled personnel are being treated by us is the greatest disservice to the very foundation of our armed forces in particular and society in general.

Do not keep your eyes closed. Wake up. Please.

34 comments:

kprakash650 said...

Navdeep,

People who are asleep can be woken up, but you can not awaken those who are pretending to be asleep.

Prakash

Anonymous said...

In maximum cases, our bosses are well aware of the outcome of their decisions. May be, their ego and feeling of kingship force them to take these types of decisions and find happiness in that...

सप्त ॠषि सहगल said...

Sir, my father is going through same, He was released in 1976 with 20% Disability, perceptive deafness left year with right ear had mild damage. He had to go through 2 RSMB, one after 2 years and another after 10 years. both stating 20% disability. But in late 1990's his hearing further deteriorated and was assessed at 60% by CIVIL AUTHORITIES. We approached DGAFMS and CDA(P) for RSMB but was declined as award was sanctioned for life and board cannot be held. We later filed a case in 2006 for his service pension, in which court ordered for RSMB in which disability was assessed at 80%, but only 20% was assessed at attributable to his Military services and 60% was because of natural progression of the disability and again was declined and matter is still in court.
Broad-banding of disability pension was also declined because he was Released from army and not Invalided. Its pity that armed force officers are treated in this manner. He is still getting only Rs. 1176/- +DA as his pension for 20% Disability.

Billoo said...

here how the mindet changes.. When i was young in NDA... it really didnt matter to me whether my back is bleeding or my legs got fractures or had a black eye in a boxing bout and the likes. .. My attitude used to be that "dimag aur deh fauj ki hai... i gotta give my best shot" and life carried on... Now so many years on im still in a very hazardous profile.. The only difference is that im not as brash with my bones as i wa earlie because i know if something goes wrong... my fsmily really would suffer. .. Within fauj our people have become indifferent snd couldnt car less about what the man sacrificed.. all that matters probably is a timely packup to the person deciding the fate of these families..at ANY cost to THEM.. Most of the times even n our offices as oofiers, we shirk away from going through policy files to decide a critical issue and blindly trust the clerk who mostly is limited by his outlook nd at times mischievious. WE REALLY NEED TO WAKE UP ..lest we start getting 2 hoots from the men we command for if we cant assure "natha singh" a decent life if he invalidates himself on our command...we got no business to lead him in combat......

FOR OUR HIGHER DEFENCE ORGANISATION..SO CALLED THINK TANKS.,,,,if a babu in 9 to 5 job has his service and pension protected in case he is invalidated... why the hell cant you get the same for the man who really needs it and is far more vulnerable...... pl wake up before we lose the little left hope in you guys..

Anonymous said...

Our bosses who makes these types of policies and decisions are not going to change their attitudes particularly towards the lower rank personnel of the armed forces. In the broad perspective, their decisions in this context hardly serves any interest of nation or service, but definitely serves against the interest of its own personnel. We are ultimately depended on the so called corrupt and inefficient politicians to take call in this regard so that the lower rank personnel get relived of uncertainties that they face in the course of their service to the nation.

P Singh said...

I had horrendous experience while undergoing RMB. The medical officer who was presiding officer of the board was a Col (TS) shunted out of Air Force to Army. He hardly knew orders on the grant of percentage of disability. He had an old army order with him. He would not know that when two disabilities are not related to each other - these are to be arithmetically added. He would do compound addition for all such cases. No amount of argument of reasoning or even on having shown the order - deterred him. Even staff officer (ADH)at next Headquarters was clueless. He wont understand the basic English where clear orders are written on the subject. Ultimately I had to walk up to Commandant of the Hospital and DDMS of the make these clueless officers understand the basic orders. I, being aware of the subject, could fight for it - but imagine the Jawans - what would they do. This particular presiding officer of RMBs had very bad temperament and would shout and shoo off the Jawans on slight excuses. This is how we treat disabled solders Leave them at the mercy at such officer (mostly are those who have no worthwhile use for AMC). Year of disabled have gone - with no effort to overhaul this system.

SG said...
This comment has been removed by a blog administrator.
Yogi said...

Litigation is the answer.

Anonymous said...

There are plenty of genuine cases misjudged by medical boards but there are plenty of cases which are out there in the courts because greedy advocates who are promoting litigation byex-servicemen. The modus operandi is that the case will be on share basis if the litigant wins and no fees if he loses.
Recently we had a case of a recruit invalided out of service after 3 months of recruit training on account of undisplaced stress fracture of tibia. He continues to get his disability pension for last 30 years, although he would have fully recovered from effects of stress fracture within one year. He was invalided out only on technical grounds that he should have recovered within maximum of 180 days from the time of onset. Now he is claiming higher disability through the courts 30 years after being invalided out. If that is not sheer opportunism then what is???

Anonymous said...

Dear Maj Navdeep,

The natural history of Psoriasis is available at http://en.wikipedia.org/wiki/Psoriasis

How does military service be attributable or cause aggravation of this condition?
Medical boards may have errors of judgement (nobody is perfect) but let's not call every decision of theirs as faulty.
Even advocates are not always right!!!

Anonymous said...

anonymous who posted at 9.17

Sir, are you a doctor?

Because if you are then I do not know who many cases you must have spoiled and I can only wish that you were never a part of a medical board.

My dear Sir, I'm a GDMO and not a dermatologist, but please read the whole link that you had quoted. The condition is directly affected by stress as well as climate.

For more details, please see this official website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/

The disease is aggravated by stress, dry air, extreme heat and extreme cold. If a person is posted in HAA, then it is bound to get aggravated. The example quoted by Major Navdeep Singh is to the point and correct, medically speaking.

Sorry.

Anonymous said...

@Anonymous at 9.13 PM

There is no denying the opportunism, it is an extension of basic human tendencies. Still, the details of the case you narrated suggests that the fault primarily lies with the MO/ specialist, on whose opinion the recruit was invalided out for stress fracture.

Prakash

Navdeep / Maj Navdeep Singh said...

Thanks Anony for filling in.
For the other anonymous post at 21-13 : The Pension Regulations cater for such cases under Regulation 181. The person has not misused the system. Disability pension comprising a service element and disability element is admissible to soldiers as well as recruits even if they have a single day of service. Even in the disability improves and is cured, the service element of pension is not discontinued. Similar system is followed for civilians also. Think about it this way, had the poor man not joined the army and had instead joined some other organisation, would he have been discharged on account of a stress fracture? Therein lies the answer. It is not that he has used the system, it is the other way round. And people like you and I are trained to think the other way round as if something is going out of our own pockets. If the person is eligible for pension under the rules, he has to get it, your opinion or mine has no role to play.

Anonymous said...

Dear Maj Navdeep,

I am posting anonymous as I am presently serving and working as President Medical Board of a service hospital and day to coming in contact with the issues raised in your post. I am no fan of the decision making capabilities of the AMC top brass, being the victim of their highhanded arbitrariness myself, however some points need to be mentioned.

1 You get a biased view of the issue possibly because of your profession you get to know things where things have been done wrongly.
2 You may have seen some service hospitals but they possibly do not represent the functioning of greater majority of service hospitals.
3 Just by saying that the descretion of Med bds have been taken away due to GMO(MP) 2008, it is understood that you have no idea how medical boards are held in the hospitals. GMO(MP)2008 is an effort to get rid of arbitrariness and subjectivity and this would have benifitted lot more people than you can imagine.

4 GMO(MP) 2008 is a Govt Order and the DGAFMS/his staff has not single handedly written it. It is the fault in the govt system if there is no provision of vetting by any independent third party of all policy issues.

5 GMO(MP)2008 is heavily biased towards grant of attributability/aggravation and not otherwise as implied in your post.

6 Lastly, a considerable space on your blog and its comments are towards AMC bashing. However this is the only corps that is working full thottle 24*7 even without a war and from the time of independence is catering to a clientile 4 times its original without a single increase in its strength. Nobody is perfect. But then if everyone else was doing thier jobs even a little bit, we should not have needed the Kargil war.

Navdeep / Maj Navdeep Singh said...

Thanks for the detailed post Anony at 0801 hrs

My take on the points raised by you:

(a) Of course, the problem only arises when things are done wrongly. No occasion for protest arises if things are done correctly.

(b) I have made no comment about functioning of service hospitals. The only issue the blogpost discusses is about the policies on attributability and aggravation.

(c) I do have an idea about how medical boards function. While you may be currently dealing with a medical board as its President, I have been dealing with the same subject threadbare since the last (much) more than a decade. If things were so fine, there would have been no litigation in the field. Courts are clogged with litigation on this account, and please do not blame the petitioners for it!

(d) Sorry, the GMO is entirely the work of the office of DGAFMS, the Govt has no role to play in its drafting. The Govt only promulgates Entitlement Rules which override the GMO but still medical boards go by what is written in the blue book rather than reading through the actual rules. And let me tell you another thing, even the Entitlement Rules 1982 reproduced in the GMO are incomplete and INCORRECT. Send me a private email, and I shall corroborate.

(e) Absolutely wrong. This simply means that you haven't gone through the GMO 1980 and 2002 carefully. Kindly again peruse the live example I've quoted in the post. The only progress in the 2008 supplement is in the section of Psychiatric diseases (Paragraph 54).

(f) There is no space for AMC bashing on the blog. In fact, this blog has been on the forefront of defending the rights of AMC officers including DACP. Critical approach is the only approach that can lead to improvement in the system, if you take it as AMC bashing, so be it!. From my side, my intention is never to bash any organisation or organ. It is also crystal clear that the M Block is not particularly known to possess proper administrative acumen in handling critical policy matters, the earlier we realise it, the better.

Anonymous said...

... :-) It ios pleasure to see that not everyone is an unfortunate bandhua majdoor of this mighty organisation.. there are Short Service Officers too.. who can show a mirror to the org and give them cues for correction.. if only their conscious gets out of drugged madness of power and hollowness of king-ship

Rahul said...

My suggestion to all Serving Officers and Men would be to leave the Fauj at 20 years. Take your life long pension and settle into the Corporate World. Things are much better here. More respect and more money. Most companies provide medical treatment in private hospitals.
The Military is not worth, repeat not worth after 20 years service. Start a new life at 40. I did it and am not repenting. No point blaming the military. These guys are not going to change.

Unknown said...

One Rank One Pension cleared by Cabinet

Anonymous said...

just saw news that OROP has been approved by cabinet in the meeting today. and 2300 crore has been sanctioned forthe same. I hope it is true. Like always, I am sure there will be some strings attached and of course, the benefit would have been extended to civilians automatically. It is not so when something isgiven to civilians, it is not extended automatially to faujis. and what about NFFU, grade pay, disability pension issues, common pay scale for PBOR etc etc

Anonymous said...

Maj Navdeep is bang on in what all he has written in his most recent post. He surely does not indulge in AMC bashing. Please refer to his posts where he has discussed DACP threadbare at least twice in the last three years. Besides he has been fighting our battle in AFT for implementation of DACP.
If one of my AMC colleagues feels offended that is just too bad. We guys need to mend our ways without feeling offended.
Another clear cut instance where o/o DGAFMS is putting lot of retiring personnel at a terrible disadvantage and financial loss is in calculating 'composite disability' for multiple unrelated disabilities with entirely different functional effects. Please read on & judge for yourself how we are our own enemies, specifically o/o DGAFMS. Why blame the bureaucracy or the Govt Of India..!
AMENDMENT TO CHAPTER VI & VII : GUIDE TO MEDICAL OFFICERS (MILITARY PENSIONS) published by Ministry Of Defence, Government Of India, New Delhi in 2008 - (a) Para 17 A (i) of this amendment reads “ Where there are two or more disabilities due to service, compensation will be based on the composite assessment of the degree of disablement. Generally speaking, when separate disabilities have entirely different functional effects, the composite assessment will be the arithmetical sum of their separate assessments. But where the functional effects of the disabilities overlap, the composite assessment will be reduced in proportion to the degree of overlapping. There is a tendency for some Medical Boards to reduce the composite assessment in the former group of cases. This is not correct.”
(b) In about 15 months from the date of issue of the amendment to chapter VI & VII vide letter 16036/RMB/IMB/DGAFMS/MA(Pens) dated 14 Dec 2009 paras 3 to 7 reads "for disabilities with completely different functional effects has recommended calculating composite disability as per the formula recommended by them and not taking their arithmetical sum."
To give an example, if a retiring personnel with say 40% disability for hypertension (aggravated/attributable by service) also has 30% disability due to back ache (aggravated/attributable by service), then composite disability as per this latest modification is not 40% + 30% = 70%, but 40%+ 30% of (100-40)= 58%. This needlessly puts a retiring personnel at a financial loss due to an arbitrarily decided lower total disability percentage as ordained by this Dec 2009 letter.
This is happening day in and day out in all service hospitals for jawans and officers alike. The bureaucracy & the Govt Of India could not but be pleased as they are required to shell out less..!
Who is to blame ?

Anonymous said...

Disability pension for premature retirees of Air Force officers is still not being granted despite innumerable court cases granting disability pension to pre mature retirees too. Besides 'rounding off' of disability pension has yet to start despite the apex court observations in Lt Gen Oberoi's case. We care two hoots for court judgements..!

Anonymous said...

Dear Maj Navdeep,

There is no debate about lifelong pension for stress fracture which I had mentioned in my earlier post. Definitely nothing going out of my own pocket!

The question I raised was that the ex-recruit was claiming higher disability for same after 30 years, claiming that he is still symptomatic due to stress fracture and is actually worse off and needs higher disability!!! If anybody thinks that he deserves higher pension, then I think each and every pensioner should automatically granted that higher scale without bothering to see the already overburdened specialists. Why just bother seeing the patient? Just give him what he/she wants, it's a welfare organization that we are running. The specialists can definitely devote their time to betterment of a needy patient rather than being involved in this paperwork.

Anonymous said...

maj navdeep!
i must tell you it is not your fault that you have published this blog because you have been dealing with these kind of cases, thanks to your profession. but let me tell you that you are dealing with a very small percentage of all disabled faujis. i am not saying that it is OK if they are less in number, if injustice has been caused to even a single person its unfortunate. but to err is human. we are not gods neither all people are same. you know LAW much more than me, but probably in the same ratio i know MEDICAL more than you. i have worked with hundreds of doctors in my career, all of different nature, but believe me till very extent most of them want to help our patients. we don't have to pay from our pocket...why should we deny somebody's due to him/her. many a factors work together, you will not believe people from individual's own unit create pressure not to help him because of their personal grudge or some other issues. everybody likes money including me and you, this is the reason once an individual is disabled because of any reason, he will fight till end to get advantage of that. all of us will be happy if these 'aggravated'/ 'attributable' caps are removed; because ultimately we will also benefit from that. everybody knows that smoking causes lung cancer, if an individual smokes to relieve himself because of enormous stress he is undergoing...and ends up with lung cancer...is he fit to get disability pension? almost every disease can be related with some kind of aggravating/attributable factor directly or indirectly. believe me most of us are very lenient; because if we start going very strictly by rules, half of the so called dependents will find themselves ineligible for treatment in service hospitals. this is never ending topic...but from bottom of my heart i really feel sorry for them who have been victim of injustice. finally i reiterate that number of non-deserving faujis who have been benefited is far more than those who are deserving and not benefited. this is not because of error....but because of good faith!

Anonymous said...

Yes most of you comments are right but unfortunately in the forces all rule pertaining to the AFMS are made by the non medicos.

Anonymous said...

This is a good one and and hats off to Maj Navdeep.
I have been dealing with med boards at various levels and to put the record straight, majority of staff officers dealing with med boards, are very liberal and want to grant attributability/aggravation, but are bound by the regulations on the matter. The books need to be rewritten and more freedom needs to be granted to MOs and staff officers dealing with med boards.

Sreenivasa said...

Without any doubts any one severed his/her mother land even a single day in uniform deserves the best, if board wants there are many ways to give attribution and aggravation.

Till doctors start thinking as doctors these thinks will continue. If policy makers don't understand the disease better they outsource to people in service known to be expert and "humans".

Anonymous said...

Govt's statement that OROP in principle has merit and would be implemented stage-wise. Release of 2300 crores package for Ex-servicemen is out of those stages. Since implementation of OROP needs heavy budget and Indian Govt has financial constrain so OROP can not be implemented in one go. Such notion of Govt is welcomed. BJP on other hand has promised to implement it in one go if comes to power and has also given its justification as to why they nod for OROP which is admireable.
Not withstanding what political developments are taking place but it is a big victory for Ex-servicemen organisation. Our efforts must continue to achieve our goals set time to time.
one very important point of disparity still needs to be settled down by our Ex-servicemen organisation and all the three chiefs with Govt. Still there is a difference of Rs 8060'pm in basic pension between Majors and Lt Cols pension., Such huge difference has never been in the history of armed force services and even is not there in any other rank. This need to be addressed and sorted out on highest priority and if not settled now it would affect will continue to VII pay commission where this rank would again suffer.

Anonymous said...

Reading the comments i am surprised people are cursing the medical board .People think that if u do service in army it is attributable . One can find similair problems like Hypertension, Psoriasis , IHD in more % of people working in civil sectors they should be getting disablity??? There are some diseases related to hazards of army like frost bite etc Lifesyle diseases are as common outside as in army, Please do not blame board section and AMC for all this.

Dr M said...

I would like to comment briefly.
The entire procedure of boards and opinions is grossly mismanaged. It is common for ppl to come and report sick for disabilities when the unit moves to high altitude, CI etc, and then seek a sheltered appointment. When the unit returns to a good station thereafter, all these so-called LMC cases come back to the unit in SHAPE 1, frequently requesting the board to help them as they are due for promotion, staff, instr appointment etc.
I fully agree with Maj Navdeep, the system needs a major overhaul. But it cannot be done unless there is a clear input on the functional aspect of the indl on behalf of the unit, much like an AFMSF 10. I know so many offrs who have requested LMC for arthritis when it comes to trg, but they have no such problems while playing golf. And a few disabilities are beyond me. I for one cannot understand why Alcohol dependent patients can access alcohol within units? And why we have this concept of cheap alcohol in the first place?
The answer to the maladies of the fauji med set up are massive increase in manpower. The available staff are grossly overburdened, and have no incentives to look forth to. Patients and board decisions are extremely time-taking matters, and they cannot be done properly unless doctors have adequate time. Why is the disability issue being examined by a board in the first place? Why can we not have JAG reps specially trained in medical law and jurisprudence give the final 'verdict', with the opinion of the relevant specialist serving as a 'jury'?
The units on their part also need to look at their disabled with sympathy and understanding. They are treated more as liabilities, and any requests for sheltered appointments are turned down at the company level itself. These issues magnify the existing problem, and disabilities get aggravated. Treatment is not sought because a LMC is the first hurdle to any course, appointment, promotion, even a decent life in the unit. I have had so many jawans come and request us to upgrade their med category, or else the CO will send them home forthwith, without fulfillment of pensionable service. It is not that the doctors want to play god (some have that feeling though). The COs of the unit already are fulfilling that role. It is ultimately the choice of leaders, arms and services notwithstanding, which affects the functioning of the entire army, incl the med services.

Jai Hind.

Dr M

Anonymous said...

Sir, I am diagnosed with Primary Hypothyroidism during my RMB, however, I have been denied attributability or aggravation and no disability. It is pertinent to mention that the disease requires constant following up with specialist along with various blood and hormone reports and life long medication. Is the board correct in accessing so? Please advice. Yours Sincerely

yahoo said...

I am sure some day some senior officer like late FM Sam Bahadur or Gen Bhagat would realise the issues facing the defence mass and get cracking rather than think of their own rehabilitation. With all respect and humility I dare say that nothing can be expected from the Political lots since they are deeply involved in their own welfare and the Babu clan who hate to see anyone in the run with them. Thanks. - Lt Col (Retd) AK Mukerji

Anonymous said...

A very well written article.
Just for the information of all, GMO 08 is under revision since last 3 years. DGAFMS has forwarded many a times the revised GMO for approval but MoD babu are sitting on that. So it's been a long pending issue now. After the revision, it is supposedly will become more practical.

Unknown said...

Plz provide pdf copy of GMO mp 2008

Anonymous said...

Plz provide pdf copy of GMO mp 2008