On-Duty Injury Benefits: Can My Employee Get Travel Reimbursement Too?

Query Regarding On-Duty Injury Benefits

One of my subordinates was injured while "On-Duty"; he is a government employee. He will receive all benefits like medical reimbursement, sick leave, and everything. Are there any additional benefits he may be eligible for? Is he eligible for travel reimbursement if he goes home?

Regards,
Astha Saxena

As per the Employees Compensation Act 1923, read as follows:

1. All persons covered under the definition of “employee” u/s 2(1)(dd) read with Schedule-II can take benefit of this provision irrespective of the amount of salary/wages drawn by them.

2. As per notification No.S.O. 1258(E) dated 31.5.2010, monthly wages of Rs.8,000/- have been fixed for the purpose of compensation u/s 4(1). However, this limit is not applicable to the reimbursement of medical expenditure u/s 4(2A). Hence, medical expenses can be claimed by any employee without any limit.

3. Reimbursement of medical expenses u/s 4(2A) is in addition to compensation payable u/s 4(1).

4. Medical expenses can be incurred anywhere (i.e., either at the office/home or at any hospital (government or private) in India or abroad).

5. Section 3(1) talks about the employer's liability to pay compensation in case of injury caused ‘by accident’ arising ‘out of and in the course of employment’. However, Section 4(2A) only talks of injury caused during the course of employment. Hence, it is not necessary for the purpose of Sec.4(2A) that the injury should be caused ‘by accident’ and ‘out of employment’.

6. Section 53 of the ESI Act puts a bar on an insured person or his dependant to claim any compensation or damages under the Employees Compensation Act or any other law. However, reimbursement of medical expenses cannot be said to be compensation or damages.

Regards

Your post is not clear about whether the injury is serious or not. Whether the injured was directly admitted to a hospital or received outpatient treatment and reached home immediately after the medical aid. However, the following inputs may be useful to you.

Issues Involved in Employment Injury

There are three different issues involved in this:

1. Injury while on duty
2. Entitlement of medical facilities/reimbursement
3. Medical/Sick Leave

Whether the employee is injured within the premises of his employment or outside while performing his official duty, it will be treated as an employment injury. Since it is an employment injury, he is entitled to TA/DA from the place of the accident to a nearby hospital.

He/she is eligible for medical expenses as per his entitlement (Refer to Medical Rules). He can also receive treatment from the Central Government Health Scheme (CGHS) if he is a member of the same. He can also claim reimbursement for medical expenses if he is admitted to or receives treatment from hospitals other than recognized/referral hospitals, citing an emergency. Settlement of his bills will be subject to the prevailing rules of his department.

Regarding his leave, he/she has to avail the leave in his credit. In case of loss of pay, he can request leave in anticipation of his/her earning leave, which can be granted subject to the approval of the competent authority.

I hope this clarifies your queries.

Regards,
Balamurugan Sivaprakasam

Hello Siva, The injury is serious. He was directly admitted to the hospital and stayed there for 3 days. Currently, the doctors are waiting for the swelling around his eye area to reduce, and only then will they decide if an operation is required. Do you have any links or rules available regarding TA/DA? Can't he get travel reimbursement if he wants to move to his hometown for better care?

Regards,
Astha Saxena

I would also like to know if he can claim travel reimbursement if he moves to his hometown for better care. In addition, what about leaves? Will leaves be deducted from his account only, or is there any other way to ensure his leave balance remains the same?

Regards,
Astha Saxena

Yes, he could claim the travel expenses if any such policy exists in your company. He can utilize his EL/PL accounting for his leaves.

Hello Astha,

Thanks for your immediate reply/input.

Guidelines for Central Government Employees

For central government employees, the guidelines for TA/DA, medical, etc., are available as circulars, memorandums, notices, etc., in their respective departments/sections. Sometimes, they may be available as a soft copy on their website. A Chennai-based publisher compiles and releases these guidelines as "Swamy's handbook," which is available in all major bookstores. State governments also follow these guidelines if they do not have their own. I doubt whether they have any online publication.

Meanwhile, kindly suggest your friend get treatment in a hospital recognized by his department in case he has to undergo any operation/procedure, so that his medical expenses will be reimbursed. Also, ask him to inform his superior about the injury and hospitalization immediately, because there are chances of his claim being denied if he does not do so.

I do not think his claim will be permitted if he wants to get treatment at his hometown. The employee is eligible for medical treatment/reimbursement only at his place of posting and not elsewhere. Kindly check whether their department has any norms for seeking permission for the above. Generally, it is decided on a case-by-case basis.

I understand the mental agony the concerned person is undergoing; it is always safe to follow the guidelines.

Regards,
Balamurugan Sivaprakasm

The information provided by Mr. Siva is correct. Different officers interpret the laws differently, so it is best for him to take inpatient treatment in CGHS-approved hospitals at government-approved rates. However, in cases of accidents or emergencies where immediate treatment is needed, a note can be submitted to the Head of Department (HOD) explaining the situation. Once the employee is out of danger, he can then be shifted to a CGHS-approved hospital for further treatment. It is advisable to inform the HOD and seek their approval or consent to avoid any issues with claims in the future.

The information provided by Siva is correct, but for one aspect. In many organizations, staff injured while on duty receive special leave until they are found fit. I am working in a central government undertaking, and we provide such leave until the company's medical officer issues a fit certificate to the concerned staff.

It is not clear whether you are a State or Central Government employee.

State Government Employees

1. If you are a State Government employee, the grants from the government are either Block Grants or Regular Grants, and the payment is released by the Treasury.

Central Government Employees

2. Alternatively, Central Government employees are covered under CGHS.

Please refer to the Government Resolutions for State employees or the Notifications for Central employees.

Regards,
Ramakant