GOVERNMENT OF INDIA MINISTRY OF RAILWAYS (Railway Board) S.No.PC-V/505 PC-V/2011/A/Med/1 RBE No. 83/2011 New Delhi, dated 7-06-2011 The General Managers (P), ALL Zonal Railways & Pus (As per standard mailing list) Sub:-Grant of Fixed Medical Allowance revised from Rs100 to RS 300 from 01 -09-2008 vide Boards letter No PC-V/2011/A/Med/1 dated 29-06-2010 to the Railway pensioners/family pensioners-clarifications regarding Pursuant to receipt of references from Railway Federations etc. seeking to modify the Undertaking Form annexed with Board’s letter No PC-V/2006/A/Med/1, dated 15-09-2009 (RBE No.168/2009) so as to ensure that the pensioners/family pensioners availing OPD facility for chronic diseases are not deprived of the Fixed Medical Allowance, the matter has been examined and it has been decided to modify the Undertaking Form suitably. 2. The revised Undertaking Form is enclosed. Henceforth, Railway pensioner/family pensioners who opt to claim Medical Allowance should submit the claim for Medical Allowance to the concerned Pension Disbursing Authority in the revised Undertaking Form. 3. Hindi version is enclosed. sd/- (P.P.Pandey) Director, pay Commission-I Railway Board Annexure-I UNDERTAKING FORM (to be submitted in DUPLICATE by pensioners/family pensioners to his/her Pension Disbursing Authority (PDA) One copy to be retained by PDA and the other copy to be furnished to Pension Sanctioning Authority by PDA) I ................................................a retired employee/family pensioner whose................................(specify relation of family pensioner with deceased Railway employee) was an employee of (office address).........................................declare that I am residing at (residential address indicated in PPO)...................................................which is beyond 2.5 KMs from the nearest Railway hospital/health unit.......................................(Name of the Hospital/Health Unit as contained in Annexure-III to Railway Board's letter No.PC-V/98/1/7/1/1, dated 21.4.1999. 2. Accordingly I hereby opt to claim Fixed Medical Allowance of Rs.100 and / or Rs.300 per month as per prescribed rate. Necessary endorsement may please by made in my PPO in this regard. Simultaneously, I undertake that I will not avail of OPD facilities (except in cases of chronic diseases as mentioned in Board's letter No.2006/H/DC/JCM, dated 12.10.2006 at Railway hospital/Health Unit from the day I claim Medical Allowance. I also understand that grant of Medical Allowance is subject to the terms and conditions specified in Board's letter No.PC-V/2006/A.Med/1, dated 15.9.2009. 3. I also declare that I have not availed of any treatment as Out Door Patient (except in cases of chronic diseases as mentioned in Para-2 above) for the period from.................(indicate here the date of retirement or the date of availing OPD facility on the last occasion or 1.12.1997, whichever is later) to this day..............................(indicate here the date on which this declaration is signed). I may accordingly be paid arrear of Medical Allowance Rs.100 and /or Rs.300 per month for the period mentioned above as per prescribed rate. 4. The above information furnished by me is correct to the best of my knowledge and belief. I also understand, that, if at any stage, it is found that the undertaking submitted by me is incorrect or carries false information, my FMA is liable to be stopped with immediate effect and further suitable action could be taken to recover the excess amount paid to me. Signature............................……. Name of Full............................. PPO No………………………………………………… Issued By…………………………………………….. SB A/c No……………………………………………. Post Office / Bank…………………………….. Brach………………………………………………….. Place…………………………………………………… Date……………………………………………………. Attention ! Pensioners / Family Pensioners – If you fulfill the following conditions You are entitled to FMA @ Rs100 pm up to 1.09.08 & @ Rs. 300 pm after that. (Vide Rly. Board’s letter No. RBE 168-2009 Dated 15-9-2009 & RBE No. 92-2010 dated 29-06-2010) (Published in the July-September, 2010 & Oct -Dec, 2010 issues of Pensioners Rail Sampark) and Railway Board’s letter No. PC V/2011/Med/1 Dated 7-6-2011 (RBE – 83-2011) Published in PRS April -June, 2011 (Page 5) CONDITIONS FOR ENTITLEMENT OF FIXED MEDICAL ALLOWANCE (FMA): i) Residing more than 2.5 Km from Railway Hospital & ii) Not joined the RELHS – 97 OR Not taking OPD Facility from Railways (except for Chronic Diseases) EVEN THOUGH JOINED RELHS If you are not getting the FMA but fulfill the above said conditions then - Apply to your Bank for FMA on the above Undertaking - circulated by Rly Bd to all Banks (vide RBE 83-2011) If Bank doesn’t pay, ask them to give it in writing & send the request to the Regional Manager of the Bank Send a copy to Pension Sanctioning Authority (i.e. the Office from which you retired) - With a copy of PPO Source : IRTSA

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(Railway Board)

S.No.PC-V/505
PC-V/2011/A/Med/1   

RBE No. 83/2011
New Delhi, dated 7-06-2011

The General Managers (P),
ALL Zonal Railways & Pus
(As per standard mailing list)

Sub:-Grant of Fixed Medical Allowance revised from Rs100 to RS 300 from 01 -09-2008 vide Boards letter No PC-V/2011/A/Med/1 dated 29-06-2010 to the Railway pensioners/family pensioners-clarifications regarding
Pursuant to receipt of references from Railway Federations etc. seeking to modify the Undertaking Form annexed with Board’s letter No PC-V/2006/A/Med/1,  dated 15-09-2009 (RBE No.168/2009) so as to ensure that the pensioners/family pensioners availing OPD facility for chronic diseases are not deprived of the Fixed Medical Allowance, the matter has been examined and it has been decided to modify the Undertaking Form suitably.

2. The revised Undertaking Form is enclosed. Henceforth, Railway pensioner/family pensioners who opt to claim Medical Allowance should submit the claim for Medical Allowance to the concerned Pension Disbursing Authority in the revised Undertaking Form.
3. Hindi version is enclosed.

sd/-
(P.P.Pandey)
Director, pay Commission-I
Railway Board

Annexure-I

UNDERTAKING FORM

(to be submitted in DUPLICATE by pensioners/family pensioners to his/her Pension Disbursing Authority (PDA) One copy to be retained by PDA and the other copy to be furnished to Pension Sanctioning Authority by PDA)
I ................................................a retired employee/family pensioner whose................................(specify relation of family pensioner with deceased Railway employee) was an employee of (office address).........................................declare that I am residing at (residential address indicated in PPO)...................................................which is beyond 2.5 KMs from the nearest Railway hospital/health unit.......................................(Name of the Hospital/Health Unit as contained in Annexure-III to Railway Board's letter No.PC-V/98/1/7/1/1, dated 21.4.1999.
2. Accordingly I hereby opt to claim Fixed Medical Allowance of Rs.100 and / or Rs.300 per month as per prescribed rate. Necessary endorsement may please by made in my PPO in this regard. Simultaneously, I undertake that I will not avail of OPD facilities (except in cases of chronic diseases as mentioned in Board's letter No.2006/H/DC/JCM, dated 12.10.2006 at Railway hospital/Health Unit from the day I claim Medical Allowance. I also understand that grant of Medical Allowance is subject to the terms and conditions specified in Board's letter No.PC-V/2006/A.Med/1, dated 15.9.2009.
3. I also declare that I have not availed of any treatment as Out Door Patient (except in cases of chronic diseases as mentioned in Para-2 above) for the period from.................(indicate here the date of retirement or the date of availing OPD facility on the last occasion or 1.12.1997, whichever is later) to this day..............................(indicate here the date on which this declaration is signed). I may accordingly be paid arrear of Medical Allowance Rs.100 and /or Rs.300 per month for the period mentioned above as per prescribed rate.
4. The above information furnished by me is correct to the best of my knowledge and belief. I also understand, that, if at any stage, it is found that the undertaking submitted by me is incorrect or carries false information, my FMA is liable to be stopped with immediate effect and further suitable action could be taken to recover the excess amount paid to me.

Signature............................…….

Name of Full.............................

PPO No…………………………………………………

Issued By……………………………………………..

SB A/c No…………………………………………….

Post Office / Bank……………………………..

Brach…………………………………………………..

Place……………………………………………………

Date…………………………………………………….

Attention ! Pensioners / Family Pensioners –
If you fulfill the following conditions

You are entitled to FMA @ Rs100 pm up to 1.09.08 & @ Rs. 300 pm after that.

(Vide Rly. Board’s letter No. RBE 168-2009 Dated 15-9-2009 & RBE No. 92-2010 dated 29-06-2010)
(Published in the July-September, 2010 & Oct -Dec, 2010 issues of Pensioners Rail Sampark) and
Railway Board’s letter No. PC V/2011/Med/1 Dated 7-6-2011 (RBE – 83-2011) Published in PRS April -June, 2011 (Page 5)

CONDITIONS FOR ENTITLEMENT OF FIXED MEDICAL ALLOWANCE (FMA):

i) Residing more than 2.5 Km from Railway Hospital & ii) Not joined the RELHS – 97
OR Not taking OPD Facility from Railways (except for Chronic Diseases) EVEN THOUGH JOINED RELHS

If you are not getting the FMA but fulfill the above said conditions then -

Apply to your Bank for FMA on the above Undertaking - circulated by Rly Bd to all Banks (vide RBE 83-2011)
If Bank doesn’t pay, ask them to give it in writing & send the request to the Regional Manager of the Bank
Send a copy to Pension Sanctioning Authority (i.e. the Office from which you retired) - With a copy of PPO

Source : IRTSA