Narayan Behera vs Director Of Accounts (Post) & Anr.

Mr.Sudhi Ranjan Mishra, J.M.

The fact of the case as narrated by the applicant is that the applicant is a pension holder having PPO No. CK-3335-P Ex-015 Mail and was getting Fixed Medical Allowances (FMA in short). On receiving an information that he is entitled to get CGHS benefit, he requested the respondents to allow him to avail the medical facilities provided under CGHS. After submitting such application, the respondents have stopped his FMA from 1.5.2020 vide order dated 26.5.2020 and till today he is not getting the FMA dues to which he is entitled. The Additional Director CGHS, BBSR vide letter dated 10.8.2022 stated that after duly verifying the database of Bhubaneswar, Cuttack and Berhampur under the administrative control of CGHS, Bhubaneswar, it is found that the applicant being PPO No. CK-3335-P is not a CGHS beneficiary. The applicant requested the authorities to disburse FMA dues again on 12.10.2022 and 16.10.2022. The Addl. Director (Welfare) vide his letter dated 1.11.2022 sent application to DA(P), Cuttack to take necessary steps. The applicant again on 1.12.2022 requested the Director of Accounts (Postal) to consider for disbursement of FMA in his favour since he is not covered under CGHS. On 26.12.2022 the applicant requested the Sr. Superintendent (Postal) to reconsider the disbursement of FMA w.e.f. 1.5.2020 as he was getting earlier. The Sr. Superintendent of Post Offices vide letter dated 6.1.2023 stated that as per existing rules one applicant can change FMA to CGHS once in a life time and the applicant cannot be considered for CGHS as he is not coming within the zone of consideration. The applicant has submitted that the action on the part of the respondents is quite bad and illegal in the eyes of law. Being aggrieved the applicant has

filed the present OA seeking the following reliefs :

Per contra, the respondents by filing reply have submitted that the applicant, holder of PPO No. CK-3335-P submitted an application during April 2020 to avail CGHS facility. Accordingly the respondent No.1 vide letter dated 28.5.2020 addressed to the Postmaster, Chandinichowk HO ordered for stoppage of drawal of Fixed Medical Allowance (FMA) in favour of the applicant from 1.5.2020. Subsequently the applicant intimated respondent No.2 that because of his ill health condition, he was unable to avail the medical facilities provided under the CGHS and requested not to stop his FMA. Respondent No.1 vide letter dated 2.7.2020 addressed to respondent No.2 intimated that one time option for change of FMA to CGHS has been approved vide letter dated 28.5.2020 and since one time option has been approved, reconsideration for FMA will not be entertained. In the meantime in reply to the CPGRAM of the applicant, the Additional Director, CGHS, Bhubaneswar vide letter dated 10.8.2022 certified that “Sri Narayan Behera, Holder of PPO No. CK-3335-P is not a beneficiary under CGHS in these cities Bhubaneswar, Cuttack & Berhampur. Thereafter Circle Office, Bhubaneswar intimated the applicant that as per clarification mentioned in the Column-VIII of DOP and PW Memo No. 45/57/97-P and PW(C) dated 30.12.1998 that “One pensioner can change FMA to CGHS and vice versa only once in life time to prevent misuse of claiming of medical allowance. It is noticed that the pensioner opted again (2^nd time) for availing FMA, the request cannot be acceded to as per existing rules in force”. The applicant went on requesting to respondent No.1 vide application dated 1.12.2022 and to respondent No.2 vide application dated 26.12.2022 for consideration of drawal of FMA in his favour. Subsequently the applicant was replied by respondent No.1 vide letter dated 9.12.2022. Being aggrieved the applicant has filed the present OA.

The respondents have submitted that as the applicant was residing in the location beyond 5 km radius of CGHS Wellness Centre, he was entitled for grant of FMA and it was granted to him. Despite knowing the rule position the applicant applied for CGHS facilities from Cuttack Wellness Centre and when it was approved, he then applied for continuing of his FMA. It is also submitted by the respondents that one can enroll him under CGHS scheme after depositing the required fees. But in the instant case though the authority approved CGHS facility to the applicant, he did not deposit the required fee. As such his name was not found under CGHS beneficiaries. Moreover, as per clarification mentioned in the Column-VIII of DOP and PW Memo No. 45/57/97-P and PW(C) dated 30.12.1998 that one pensioner can change FMA to CGHS and vice versa only once in life time to prevent misuse of claiming of medical allowance. It is noticed that the pensioner opted again (2^nd time) for availing FMA and hence his request could not be acceded to as per existing rules in force. The respondents have therefore prayed for dismissal of the present OA being devoid of any merit.

The applicant has filed rejoinder to the counter filed by the respondents stating that the letter dated 26.5.2020 stopping FMA to the applicant is not permissible under the rules. It is submitted that mere requesting to avail medical facilities under CGHS scheme does not empower the respondents to stop the FMA. Further it is submitted that no sanction letter or approval letter granting CGHS facilities to the applicant has been filed by the respondents. The applicant has also stated that he is staying more than 15 km away from the CGHS Wellness Centre and not 5 Km as stated by the respondents. The applicant has submitted that he opted first time to avail FMA and want to continue the same. So he has not applied 2^nd time to get FMA and hence the order stopping FMA in his favour without granting CGHS benefit is liable to be quashed.

The respondents have filed reply to the rejoinder filed by the applicant. It is submitted that every pensioner can easily avail the facilities provided under Central Government Health Scheme (CGHS) and there is no stipulation for pensioners who are residing in non-CGHS covered areas to avail the facilities provided under CGHS. When a pensioner is drawing FMA, he/she can submit one time option form to choose CGHS facilities to his Pension Sanctioning Authority (PSA) or Pension Disbursing Authority i.e. DDO and immediate action is to be taken to issue ‘No Objection Certificate’ regarding non-drawal of FMA to avoid further loss/inconvenience to the pensioner for continuance of his/her medical facilities. Thereafter it is the sole responsibility of the pensioner to apply for CGHS card online to avail medical facilities at the nearest CGHS dispensaries and a hard copy is to be sent to the office of Additional Director, CGHS Bhubaneswar as per provisions for issuance of the CGHS Card.

In the instant case the applicant had applied for stoppage of FMA since he desired to avail CGHS facilities vide his representation dated 10.2.2020 addressed to the Postmaster, Chandinichowk HO who is the DDO. On the basis of the representation dated 10.2.2020 the request of the applicant was considered and FMA was stopped by respondent No.1 vide order dated 28.5.2020 and the same was intimated to the applicant. It is not the duty of the respondents to extend CGHS facilities to the applicant. Rather it is the duty of the applicant to obtain the CGHS card from the office of the Additional Director, CGHS, Bhubaneswar under the rules. Hence the present OA is without any merit and is liable to be dismissed.

Heard learned counsel for both the parties and perused the materials available on record.

In view of the above discussion, since right to health is a fundamental right and the respondents without issuing any CGHS card to the applicant has stopped the Fixed Medical Allowance in favour of the applicant, he is deprived of the medical facilities that should be available to him. The applicant has only applied for CGHS facilities and that has not been approved or sanctioned in his favour. Only applying for CGHS facilities by the applicant does not allow the respondents to stop his Fixed Medical Allowance. Therefore the respondents are directed to reconsider the prayer made by the applicant in the present OA and disburse the Fixed Medical Allowance due w.e.f. 1.5.2020 till today and onwards as per existing rules.

The OA is therefore allowed. No order as to costs.