Central Administrative Tribunal - Delhi
Sushma Dargan vs Directorate General Of Health Services on 12 September, 2025
1
Item No. 23 (C-3) O.A No. 2581/2025
CENTRAL ADMINISTRATIVE TRIBUNAL
PRINCIPAL BENCH, NEW DELHI
O.A. No. 2581/2025
Reserved on : 08.09.2025
Pronounced on : 12.09.2025
Hon'ble Mrs. Harvinder Kaur Oberoi, Member (J)
Hon'ble Dr. Sumeet Jerath, Member (A)
SUSHMA DARGAN
W/o Rakesh Dargan,
R/o H. No. 5/2, Ashok Nagar, Near
Tilak Nagar,
New Delhi-110018 .....Applicant
(By Advocate : Ms. Ankita Sarangi)
Versus
1. GOVERNMENT OF N.C.T. OF DELHI
Through its Chief Secretary, Delhi
Secretariat,
I.P. Estate, New Delhi.
2. DIRECTORATE GENERAL OF HEALTH SERVICES
Through its Director General, Directorate General
of Health Services
F-17, Karkardooma, Delhi-110032
E-Mail: [email protected]
3. MINISTRY OF HEALTH AND FAMILY WELFARE
Through its Secretary,
Ministry of Health & Family Welfare,
Nirman Bhawan, New Delhi - 110011
4. DEEN DAYAL UPADHYAY HOSPITAL
Through its Managing Director
Deen Dayal Upadhyay Hospital, Hari Nagar,
New Delhi-110064
E-Mail: [email protected]
2 OA No. 2581/2025
Item 23 (C-3)
5. ALL INDIA INSTITUTE OF MEDICAL SCIENCE
Through its Director, Ansari Nagar,
New Delhi 110029
6. LOK NAYAK HOSPITAL
Through its Director JAWAHAR LAL NEHRU MARG,
New Delhi-110002 ....Respondents
(By Advocate : Ms. Purnima Maheshwari with Mr. Sona Kumar)
ORDER
Hon'ble Dr. Sumeet Jerath, Member (A):
The instant OA has been filed by the applicant under Section 19 of the Administrative Tribunals Act, 1985, seeking the following reliefs:-
"a) Quash and set aside the impugned letter and office memorandum dated Z16025/13/2022-MH-III/SAS-III (FTS 8168013) dated 31.12.2024 denying benefit to the Applicant;
b) Direct Respondent No. 2 to extend the DGEHS benefits to the Applicant's son; and
c) Direct the Respondents to issue a disability certificate.
d) Direct the Respondent No. 2 to start and extend the DGEHS benefits to the Applicant for her son till the pendency of the present Original Application.
e) Pass any other or further orders, as this Hon'ble Tribunal may deem fit and proper in the circumstances of the present case."
2. The factual matrix of this case as per the counsel of the applicant is that the applicant was appointed as a teacher at M.C. Primary School, Timarpur, New Delhi, under the MCD in 1995. Following her marriage, she was transferred to M.C. Primary School, Tihar No. 2, New Delhi. On 29.03.1999 the applicant's son was 3 OA No. 2581/2025 Item 23 (C-3) diagnosed with a very critical chronic disease called Cystic Fibrosis which is a very rare genetic disorder - a progressive disease (which deteriorates the patient's health with age) and requires round the clock assistance. Moreover, it is a life-threatening medical condition that results in permanent disability. For seeking medical aid for the said disease the applicant's son was time and again hospitalized for which she was availing the medical benefits and reimbursements from the MCD. Thereafter, the applicant was appointed as TGT (Mathematics) at SKV Ranjeet Nagar, New Delhi which provides DGEHS benefits to the applicant and her family. Subsequently, on medical grounds the applicant applied for her transfer to SKV Rajouri Garden which was accepted by the respondents and she joined the said school at Rajouri Garden on 07.07.2008. Thereafter vide letter dated 24.07.2023 the applicant requested the Lt. Governor, New Delhi for extension of the DGEHS benefits for her ailing son. However, on 03.10.2023, respondent no. 2-DGHS informed her that her son would need a Disability Certificate to continue receiving DGEHS benefits. Thereafter, the applicant ran from pillar to post to obtain the Disability certificate, but to no avail. However, in response to her application seeking Disability certificate of her son, the respondent no. 4 -Deen Dayal Upadhyay Hospital informed the applicant that the same cannot be issued as a Medical Board cannot be formed due to non-availability of Pulmonologist and was referred to AIIMS-respondent no. 5. In January, 2025 when the applicant's son attained the age of 25, the 4 OA No. 2581/2025 Item 23 (C-3) DGEHS benefits were abruptly stopped and the said benefit could be availed by her son only on production of a valid Disability Certificate. However, in spite of all the efforts, the applicant remained hapless and helpless due to which the applicant and her family had to bear substantial medical expenses from their pocket which caused financial strain upon them. Aggrieved, the applicant represented to the respondent no. 5 AIIMS for issuance of Disability Certificate after examining her son. However, AIIMS also showed its helplessness stating that they do not have any standing Medical Board and hence cannot undertake the said medical examination. The AIIMS referred the applicant to some other Government Hospital. The said hospital (Lok Nayak Hospital) - Respondent no. 6 also took a back seat stating that they don't have any provision to assess disability in chronic respiratory disease and no guidelines have been issued to them to access Pulmonary Disability. Then they referred the applicant to DGHS- Respondent no. 2. However, after so much persuasion, finally the applicant got a certificate from her son's treating Dr. at AIIMS which shows that only 20% of his lungs are functioning and the situation could worsen with time if proper treatment is not provided. According to the counsel the financial burden associated with the essential medications have been increasing day by day making it difficult for the family to bear. Moreover the mental trauma of her son's ailment made it more difficult for the family to live a peaceful life. Thus the applicant is constrained to file this OA. 5 OA No. 2581/2025 Item 23 (C-3)
3. The counsel of the applicant argued assiduously on the following grounds :-
"1. The eligibility criteria to avail the DGEHS benefits for the employee applicant's son is available up till he attains the age of 25 years,
2. The applicant's son is wholly dependent on his parents to carry out his day to day activities and requires round the clock attention.
3. The applicant's son is not in a condition which allows his body to do any extensive physical work without any support and hence carrying out any professional work is not possible for him at this stage of time when he is constantly dependent on medications.
4. For continuation of the DGEHS benefits, the person concerned is required to produce documents which reflect that the said person is dependent on his family or is permanently disabled. It is pertinent to note that the applicant made considerable efforts, going from pillar to post, in her quest to obtain the Disability Certificate for her son. Despite her persistent attempts, neither the respondent No. 3 nor the respondent Nos. 4 and 5 provide any assistance in facilitating this process. This lack of support is particularly concerning given their awareness of the critical condition of the applicant's son. The failure of these respondents to aid the applicant in securing the necessary documentation not only reflects a disregard for her situation but also exacerbates the challenges she faces in accessing essential medical care and benefits for her son.
5. Without a disability certificate, the patient is not legally recognized as disabled under government schemes. This excludes them from various entitlements such as disability pensions, financial aid, tax exemptions, and job reservations under disability quotas.
6. The applicant's son is suffering from a chronic condition known as Cystic Fibrosis, which necessitates ongoing medical support and expensive medications. The medications prescribed by the respondent No. 5, where the treatment is currently being administered, are prohibitively costly. The financial burden associated with these 6 OA No. 2581/2025 Item 23 (C-3) medications makes it infeasible for individuals with limited resources to maintain such a treatment regimen on a regular basis.
7. The applicant, on multiple occasions, has purchased medications out of her own pocket, particularly after the DGEHS benefits for her son were discontinued.
8. The applicant is currently in an unstable financial situation, making it difficult for her to afford the regular medications required for her son. The costs associated with these medications are significant and not manageable within her current circumstances.
9. The petitioner was previously reliant on the DGEHS benefits available for her son's treatment. However, with these benefits now discontinued, it has become a significant financial burden for her and her family to cover the costs of necessary medical care.
10. The medical condition of the applicant's son is sensitive, it being a chronic disease which requires ongoing medical support and assistance. This condition significantly impacts his ability to engage in normal daily activities without the necessary medical care.
11. Cystic Fibrosis affects various bodily systems, particularly the lungs and digestive system, leading to severe complications if not managed properly. The son's health condition necessitates regular medication and specialized treatments to maintain his quality of life and prevent exacerbations. Without these interventions, he may experience increased difficulty in performing essential activities of daily living, such as bathing, dressing, and even basic mobility.
12. The inability to access consistent medical support can severely hinder his daily functioning, making it challenging for him to participate in educational or social activities. This situation not only affects his physical health but can also have profound psychological implications, as children with chronic illnesses often face emotional challenges related to their condition.
13. Children with Cystic Fibrosis often require specialized diet and enzyme supplements to ensure they receive adequate nutrition. Failure 7 OA No. 2581/2025 Item 23 (C-3) to manage these needs can lead to malnutrition and growth issues, and all these impacts the overall condition.
14. As per the AIIMS doctor's certificate, the patient has suffered more than 20% lung darnage and requires a lung transplant. Despite this, hospitals have refused to issue a disability certificate, citing the absence of guidelines for assessing respiratory disability. This refusal is arbitrary and violates the principles of equal protection under the law (Article 14 of the Constitution of India), as other progressive genetic disorders like muscular dystrophy and hemophilia have established disability guidelines. The denial of similar recognition to chronic respiratory diseases amounts to discrimination against patients suffering from life- threatening pulmonary conditions.
15. The patient is on Long-Term Oxygen Therapy (LTOT) and a BIPAP machine, with an oxygen saturation level of 65% without support and a Pulmonary Function Test (PFT) confirming only 20% lung capacity. Such a severe condition makes gainful employment impossible, yet without a disability certificate, the patient is denied essential financial and social security benefits under The Rights of Persons with Disabilities Act, 2016 (RPWD Act). This Act mandates equal opportunities and protection for persons with disabilities, yet individuals suffering from severe respiratory distress are being unjustly excluded due to the absence of formal guidelines.
16. The situation is further exacerbated by Delhi's heavily polluted environment, which even affects healthy individuals. The patient requires nebulization four times a day to survive, further proving his complete dependence on medical support. Despite multiple attempts, he has been unable to obtain a disability certificate, leaving him with no legal recognition and no access to rightful benefits such as pension, employment support, or government assistance.
17. Additionally, no insurance policy covers genetic disorders, leaving families in extreme financial distress. The National Policy for Rare Diseases (NPRD), under which such conditions are currently classified, is inadequate, providing only 1 lakh in medical assistance for three months, 8 OA No. 2581/2025 Item 23 (C-3) whereas the actual cost is 24 lakh. This policy misclassification denies patients long-term disability benefits and imposes an unreasonable financial burden, violating the Right to Life under Article 21 of the Constitution. The State has a duty to protect the life and dignity of its citizens, and failure to recognize and support such individuals amounts to negligence in upholding fundamental rights.
18. At 27 years old, with a height of 152 cm and weight of 37 kg, the patient is on 24-hour oxygen support, entirely dependent on his family for survival. The absence of disability guidelines for chronic respiratory diseases results in systematic exclusion, financial hardship, and the denial of fundamental rights. The State cannot discriminate between disabilities, and immediate policy intervention is required to rectify this oversight, provide proper legal recognition, and ensure equitable access to financial and social security benefits for patients suffering from severe respiratory conditions."
4. Per contra, the counsel of the respondents vehemently opposed the OA as well as the arguments of the counsel of the applicant. While arguing, counsel for respondent no. 3 - Ministry of Health and Family Welfare handed across the Bar the following Letter No. C-18018/10/2025-SAS-III (FTS : 8358259) dated 04.09.2025 which states as follows :-
"I am directed to refer to your email dated 27.08.2025 regarding the matter presently before the Hon'ble Central Administrative Tribunal, Principal Bench, New Delhi. In this context, it is pertinent to mention that, as per directions of the Hon'ble Tribunal, the Ministry of Health & Family Welfare has been arrayed as Respondent No. 3. The Directorate General of Health Services (Dte.GHS), under the Ministry of Health & Family Welfare serves as a technical repository for the Government of India.
2. A clarification was earlier sought from this Directorate by the Directorate General of Health Services of Government of NCT Delhi regarding disability assessment in patients with chronic respiratory diseases such as advanced Cystic Fibrosis. The position was clarified vide our letter No. 9 OA No. 2581/2025 Item 23 (C-3) Z16025/13/2022-MH-11VSAS-III (FTS 8168013) dated 24.12.2024 (copy enclosed) It is reiterated that the "Guidelines for Assessing the Extent of Specified Disabilities", notified by the Department of Empowerment of Persons with Disabilities (Divyangjan) under the RPWD Act, 2016, govern such matters. The Act recognizes 21 specified disabilities which does not include Cystic Fibrosis. As per notified procedure, Disability Assessment Boards in hospitals are authorized to evaluate the listed disabilities only and issue disability certificates accordingly.
3. The above is submitted with the approval of the Competent Authority."
5. We have given our thoughtful consideration to the rival submissions; examined the pleadings and documents on record. We are of the considered opinion that this case deserves our empathy under Article 21 of the Constitution of India - Right to life. The applicant's son was born with this congenital rare disease - chronic respiratory disease - Cystic Fibrosis where as per the AIIMS Doctor's certificate, has now suffered more than 80% lung damage and requires a lung transplant. He is on Long Term Oxygen Therapy (LTOP) with a BIPAP machine. Till the age of 25 years he was getting free medical treatment under DGEHS benefit. But then on attaining the age of 25 years, the free treatment has stopped imposing a huge financial burden on the applicant who has to get the treatment done privately. We have observed that unfortunately, the guidelines for assessing specified disabilities notified by the Department of Empowerment of Persons with Disabilities (divyangjan) under the Rights of Persons With Disabilities (RPWD) Act, 2016 does not recognise the disability - Cystic Fibrosis from which the applicant's son 10 OA No. 2581/2025 Item 23 (C-3) suffers. However, we cannot remain a mute spectator to this legal lacuna as this OA involves the vital issue of a young precious life of a citizen who is hapless and her helpless mother - the applicant. Under Article 21 of our Constitution, the Right - Protection of Life and Personal Liberty enables and empowers every citizen of our Country to live a healthy and disease free life with dignity and respect. We, therefore, in the light of the above and on grounds of humanity, compassion and empathy allow this OA ; quash and set aside the impugned letter No. 24/13/UDID/Disab/DGHS/HQ/2024/156 dated 31.12.2024; direct Respondent no. 5 - AIIMS to issue a disability certificate and direct the Respondent no. 2 - DGHS to extend the DGEHS benefit to the applicant's son. This whole exercise should be completed within a period of eight weeks from the date of receipt of a certified copy of this order.
There shall be no order as to costs.
(Dr. Sumeet Jerath) (Harvinder Kaur Oberoi)
Member (A) Member (J)
/Mbt/