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The claim of the petitioner for medical reimbursement was rejected by the Competent Authority on 1.7.2013 with the observations "Railway Board Guidelines and Referral Procedures do not allow for reimbursement of expense for Cochlear Implant carried by ignoring extant Instructions".

The learned Tribunal dismissed the Original Application holding that from the material on record, it was clear that as per guidelines of Government of India/ Railway Board dated 31.12.2009, the daughter of the 4 of 20 CWP-22482-2017 [5] petitioner being prelingually deaf was not eligible for undergoing Cochlear Implantation Surgery at the age of 18 years, because as per these guidelines in case of prelingually deaf children the surgery could be performed between the age of 1-10 years. For the post-lingually deaf children it would be performed upto the age of 21 years. The Tribunal further held that the petitioner had gone ahead with the surgery of his daughter in violation of the Instructions on the reverse page of the referral slip dated 19.7.2011. As per the Circular dated 31.12.2009, approval for the surgery had to be obtained from the Chief Medical Director/ Medical Board and surgery could only be conducted at the centres approved for Cochlear Implantation as per the circular dated 31.12.2009. PGIMER was not such an approved centre. Accordingly, the Original Application was dismissed.

d) Deafness due to lesion of acoustic nerve or central auditory pathways.

7 of 20 CWP-22482-2017 [8]

(iv)Patients/parents should have high motivations and realistic expectations from the implant.

3. Types of Implant :

Only multi channel implants should be recommended.

4. Centres :

Cochlear implant surgery should be allowed only in Government or private hospitals/ centers having proper postoperative rehabilitation. These centers should have well trained speech therapist relating to cochlear implant.

The daughter of the petitioner was deaf and dumb since childhood. On 18.07.2011 she was refereed by the the Chief Medical Superintendent, Northern Railway, Ambala Cantt. to the PGI for further evaluation and Management. Thereafter she visited the PGI a number of times. On 27.9.2011, Dr. Naresh Panda, the Head of Department of ENT, PGI recommended the daughter of the petitioner for Cochlear Implantation Surgery.

His recommendation is reproduced as under:-

"Department of Otolaryngology and Head & Neck surgery Post Graduate Institute of Medical Education and Research Chandigarh-160012 (India) Dr.Naresh K.Panda Ph.(O)2756760 (OPD) 2756957 MS DNB, FICS, FRCS Fax 91-172-2744401, 2744450 Professor & Head Email:[email protected] Website: http://pgimer.nic.in No.ENT/11/1476 Dated: 27.9.11 16 of 20 CWP-22482-2017 [17] TO WHOM IT MAY CONCERN It is hereby certified that Ms. Harjit Kaur, 18 years, female child, D/o Rampal, CR No.2011-0327-6644 resident of Ward No.10, Shaheed Bhagat Singh Colony, Lehragaga, Tehsil Lehragaga, District Sangrur-1480031 (Mobile No.93505-55713/ 84276-96815) has been diagnosed to have bilatral severe to profound hearing loss on both the ears. He is a suitable candidate for Cochlear Implantation. Cochlear implantation is sophisticated ear surgery, which is done in order to regain hearing capability and is being done only in a few centers in Asia.
It is also certified that Nucleus 24 cochlear implant is essential requirement of the cochlear implant surgery and forms its part.
(Dr.Naresh Panda) MS. DNB, FICS, FRCS Head, Department of ENT PGIMER, Chandigarh"

17 of 20 CWP-22482-2017 [18] She was admitted in the PGI on 6.1.2012 and successfully underwent the surgery. She was discharged on 17.1.2012 and thereafter, visited PGI for follow up as advised. An expenditure of Rs.5,78,825/- was incurred by the petitioner on the treatment. After the surgery, as directed by the Railway Authorities she got admitted in the Railway Hospital, Northern Railway, Ambala Cantt. to appear before the Medical Board for assessing her response to the treatment. She was reported to have made more than satisfactory progress.