Section 7 in The M.P. Workmens Compensation (Occupational Diseases) Rules, 1963
7. [ Certification of cases. [ubstituted by Notification No. 7937-3661-XVI, dated 24-11-1965.]
- The claim for any compensation in respect of workman contracting any disease specified in Part C, of Schedule III to the Act shall be supported by a certificate issued by a qualified medical practitioner in the Form A appended to these rules :Provided that where the contracting of such disease has resulted in death or permanent disablement of the workman the claim shall also be supported by an endorsement on the certificate, in the Form B appended to these rules by the Medical Board and in case of difference of opinion between the qualified Medical Practitioner, and the Medical Board, the opinion of the Medical Board shall prevail.][Form A] [Inserted by Notification No. 7937-3661-XVI, dated 24-11-1965.][See Rule 7]Certificate of Disability/DeathThis is to certify that Shri........son of.........age......years, is..... who died on ........ was suffering from pneumoconiosis/pneumoconiosis with pulmonary tuberculosis, and the contracting of the disease is/was reasonable attributable to his employment in.......(1)Temporary disablement(a)The disability is in my opinion of a temporary nature likely to last for .... years months. He is unfit or work in his present employment/fit for (State employment for which he is considered fit).(2)Permanent disablementThe disability is of a permanent nature and is assessed at ......... per cent.(3)DeathDeath is attributable to the contracting of the disease.Cancel out portions not applicable.Place.........Date...............................................Signature of the qualifiedMedical PractitionerForm B[See Rule 7]Endorsement to be Made by Medical Board in Cases of Permanent Disability or DeathThis is to certify that Shri ............. is/was suffering from pneumoconiosis/pneumoconiosis with pulmonary tuberculosis, and the contracting of the disease is/was reasonably attributable to his employment in......................(1)Permanent disabilityIt is certified that the disability is of a permanent nature and is assessed at............per cent.(2)DeathIt is certified that the death of Shri ............... is attributable to the contracting of the disease.Place..........Date............................................Signature of membersof the Medical Board
