Whether a patient has been treated as an emergency case cannot be decided on the basis of the doctor’s certificate always,the CAT has held.
“Whether the case is of emergency nature or not is not always decided on the basis of the certificate of a doctor who treats the patient and performs the surgery,” the principal bench of the Central Administrative Tribunal (CAT) said.
The remark was made in a case in which a Railway employee had sought medical reimbursement of his wife’s treatment for knee replacement surgery by categorising it as an emergency case.
The tribunal agreed with the Railways’ which had ruled out the knee replacement surgery as an emergency case as it was not a life threatening disease.
“By no stretch of imagination,a person who has been suffering from knee pain,however acute it is,can claim that he/she has been admitted in the hospital as an emergency case.
“Knee pain which requires complete knee replacement is not a disease which if not treated immediately will jeopardise his or her life. It is not like a road accident or acute heart attack,” the bench presided by Member G George Paracken said.
Sardari Lal,a chief parcel supervisor in the Northern Railway,had claimed reimbursement of Rs 2.56 lakh contending that his wife underwent the surgery as the medical experts in Fortis had advised not to delay the same.
The Railways in their reply had contended that the case was not one of emergency as the discharge summary of Lal’s wife did not indicate any threat to her life and the knee problem had not developed overnight as she was suffering from it for over five years.
It had said ’emergency cases’ under the Railway Policy included those conditions or symptoms which arise suddenly and if not treated quickly could be dangerous to the health of the patient,like road accidents,other types of accidents,acute heart attack,etc.