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1991 Supreme(Online)(Ker) 48

KERALA HIGH COURT
*Varghese Kalliath, Guttal, JJ.
Vasudevan Nair v. Regional Director ESI Corporation
M. F. A. No. 376 of 1990



The judgment emphasizes the necessity for courts to critically evaluate expert medical assessments in disability cases under welfare legislation.

Headnote:This judgment concerns an appeal addressing a disability benefit dispute under the Employees' State Insurance Act. The court analyzed the specifics of the appellant's disability and the Medical Board's assessment. It found that the Employees' Insurance Court failed to properly determine the correctness of the Medical Board's decision leading to a remand for fresh examination of the evidence. The central issue was whether the assessment of 4% permanent disability was justified under the circumstances (paragraphs 1-10). Ultimately, the court concluded that the Employees’ Insurance Court did not adequately address the disability assessment, emphasizing the necessity for the court to critically evaluate expert medical assessments (paragraphs 8, 9). The appeal was remitted back to the Employees' Insurance Court for reconsideration.

Table of Content
1. disability assessment and its implications (Para 1 , 2 , 3)
2. arguments surrounding disability benefit assessment (Para 4 , 5 , 6)
3. role of the employees' insurance court in disability cases (Para 7 , 8 , 9)
4. court's directive for reassessment of disability (Para 10 , 11)

1 This is an appeal against the order of the Employees' Insurance Gouri, Alleppey. The subject matter of the appeal was a dispute as regards the disability benefit of the appellant herein.

2. Appellant is an insured employee. He met with an accident in the course of his employment. This happened on 25-7-1985. Appellant is a loading helper. As we understand from the terminology of his work, viz., loading helper, it must be a strenuous work, which requires physical exertion. There was no dispute that as a result of the accident, he sustained a compound fracture at his right hand. He has undergone a long treatment, for about 144 days. Even at the time when the certificate of disability was issued, it was revealed that a steel plate has been inserted for the purpose of uniting the fractured bone. From the fact that the appellant has undergone treatment for a period of 144 days and from the nature of the fracture, we feel that there is possibility of suffering a substantial disability, particularly in view of the fact that he has to do strenuous work which involves physical exertion.

3. The ESI Medical Board had occasion to examine the appellant. The Board found 10% provisional disability and after one year, on an examination on 23-6-1987, it was found that the appellant has 4% permanent disability. A certificate was issued showing disablement benefit at 4%.

4. Appellant submits that the assessment of disability by the Board is absolutely unjustifiable in the circumstances and facts disclosed in the case. The Board has not taken into account all the relevant facts before issuing the certificate. According 10 him, one of his arms is practically rendered unfit to do any work. This aspect of the matter has not been taken into account in fixing 4% disability.

5. Before the Employees' Insurance Court, appellant herein tendered evidence. He deposed that while undergoing treatment, a steel plate was inserted in his body and that he is not in a position to do any work, which requires physical exertion. Of course, he has stated that he is still working as a helper. The Employees' Insurance Court has not considered the question whether the 4% disability found by the Board is correct or not. The court has considered his potentiality to do work and found that his monthly salary is enhanced to Rs.1,710/- This happened on 19-10-1989. It may be due to inflation and spiralling rise of price of commodities. This has nothing to do with the case.

6. The question of a rise in the wages on account of certain circumstances should not enter in the consideration of the decision as to the correctness of the disability determined and the consequential benefit the insured worker is entitled to. The benefit the worker is entitled to, has to be assessed on the basis of the disablement he has to carry through out his life and net on any other materials or fortuitous circumstances.

7. The jurisdiction of the Employees' Insurance Court in the matter also has to be considered in this case. Disablement is a matter which has to be ascertained by an expert body like a Medical Board. If a Medical Board gives a disability certificate and if that certificate would not enable the insured worker to receive his legitimate benefit under the insurance scheme and if he approaches in such circumstances the Employees' Insurance Court, what is the area of investigation assigned to the Employees' Insurance Court? Is it possible for the Employees' Insurance Court on the basis, of the evidence tendered before it to say that the assessment of the Medical Board as to the disability of the insured worker is incorrect? We feel that though the Insurance Court may not have the expertise, the statute has em





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