Lifetime CGHS pensioners eligible for ward entitlement upgrade per revised pay slabs without additional subscription.

KOMAK C O AT M A Ba L n R g A a N O R D E R Per: Hon’ble Shri Santosh Mehra ……Member(A)

Through this OA, the applicant has sought the following reliefs:

a. Direct the Respondents to allow for up gradation of ward entitlement from Semi Private to Private Ward as per revised entitlement issued vide Letter No. Min of Health and Family Welfare, Department of Health and Family Welfare (EHS Section) F.No.S.11011/11/2016-CGHS(P)/EHS dated the 28^th October, 2022 (Annexure A/3, Page 32) or as per the 6^th Pay commission considering the pay of 6^th PC BP+GP taken for fixation of pay as on 1.1.2016 or entitlement as on 30.11.2016, on the day of retirement.

b. Re-issue CGHS card showing revised entitlement of Private Ward. c. Set aside the letter issued by the Additional Director, CGHS, Bangalore letter OA 481/2023/2219 dated 11.9.2024(Annexure A /

2 )

d. Direct the first addressee to issue necessary instructions to second addressee and if required the matter may be referred to Min of Expenditure to authorise the Applicant to bring to the Private ward entitlement considering the pay either 7th PC or 6th PC fixation of pay as on 1.1.2016 granting merger of Pay + GP.

2. The facts in a nutshell are as follows:

The applicant superannuated from the Central Government as a Defence Civilian employee in the post of Senior Stores Superintendent in Group 'B', Pay Band level-7 on 30/11/2016 and joined Central Government Health Scheme with effect from 02.12.2016 by paying the subscription amount of Rs. 39,000 for the life time CGHS facility. The applicant was issued with CGHS Card Nos.5231315 (self) and 5231317 (wife). The applicant was entitled for KOMAK C O AT M A Ba L n R g A a N Semi-Private Ward as per OM dated 09.01.2017. The applicant was drawing a Basic Pay of Rs.56,900/- on the date of his retirement in the 7th Pay Commission. Government of India, Ministry of Health and Family Welfare vide OM dated 28.10.2022 has revised the entitlement from Semi-Private Ward to Private Ward for those drawing Basic Pay of Rs.50,500/- and above. Based on the said OM, the applicant sought for revised CGHS Card claiming Private Ward facilities. The representation submitted by the applicant dated 22.08.2023 was rejected vide email dated 04.09.2023 by the respondents. Being aggrieved, the applicant filed an OA No. 481/2023. This Bench of CAT directed the Respondents to reconsider his representation dated 28.08.2023. Since the same was rejected by the respondents, the applicant filed a Writ Petition before the Hon’ble High Court of Karnataka, which on 07.04.2025, directed the applicant to challenge the order of the respondents again before the CAT. Hence this OA.

3. Applicant (i) The applicant, who is Party in Person submits that he was drawing a Basic Pay of Rs. 56,900/- as on 30.11.2016 i.e. on the date of his retirement and Rs. 21,450/- as on 1.1.2016. He points out that the 7^th Pay Commission was implemented with effect from 01.01.2016 for all purposes including arrears of pay, pay fixation, pension etc. He submits that since the 7^th Pay Commission was implemented with effect from 01.01.2016, therefore as per revised Ward entitlement, he becomes eligible for up gradation from Semi Private to Private Ward in the hospitals. He also avers that the contribution to CGHS and Ward entitlement are not inter related in the light of letter vide S.11011/11/2016-

KOMAK C O AT M A Ba L n R g A a N CGHS(P) dated 22.11.2022. He further points out that the directive of Ministry of Health and Family Welfare vide letter No. S.11011/11/2016-CGHS(P)/EHS dated 09.02.2017 stated that employees who have retired on or before 31.1.2017 need not pay the revised contribution as the revised contribution was effective from 02.02.2017 only. He further points out that though the Government initially fixed the ward entitlement as Basic Pay up to Rs. 47,600/- for General Ward, from 47,601/- to Rs. 63,