Disablitiy Pension Claim = not entitled – mental disorder at the time of recruitment cannot normally be detected when a person behaves normally. Since there is a possibility of non-detection of mental disorder, therefore, it cannot be said that Schizophrenia is presumed to be attributed to or aggravated by military service.= The appellant was enrolled in the Indian Army on December 2, 2003. The invaliding Medical Board found the appellant to be suffering from Schizophrenia, which disability was assessed at 20% for a period of five years. The opinion of the Board was that disability was neither attributable to nor aggravated by military service and consequently, the appellant was discharged from army service on May 8, 2007. The claim of the appellant for disability for short, ‘Tribunal’ 1 pension was rejected departmentally and later by the Tribunal and still aggrieved, the appellant is before this Court.= Apex court held that In the present case, clause 14(d), as amended in the year 1996 and reproduced above, would be applicable as entitlement to disability pension shall not be considered unless it is clearly established that the cause of such disease was adversely affected due to factors related to conditions of military service. Though, the provision of grant of disability pension is a beneficial provision but, mental disorder at the time of recruitment cannot normally be detected when a person behaves normally. Since there is a possibility of non-detection of mental disorder, therefore, it cannot be said that Schizophrenia is presumed to be attributed to or aggravated by military service.

REPORTABLE
IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO. 7672 OF 2019
(DIARY NO. 27850 OF 2017)
NO. 14666828M EX CFN NARSINGH YADAV …..APPELLANT(S)
VERSUS
UNION OF INDIA & ORS. …..RESPONDENT(S)
J U D G M E N T
HEMANT GUPTA, J.
1) The challenge in the present appeal is to an order passed by the
Armed Forces Tribunal, Lucknow1
on September 23, 2011 whereby,
the claim of the appellant for grant of disability pension was not
accepted.
2) The appellant was enrolled in the Indian Army on December 2,

  1. The invaliding Medical Board found the appellant to be
    suffering from Schizophrenia, which disability was assessed at 20%
    for a period of five years. The opinion of the Board was that
    disability was neither attributable to nor aggravated by military
    service and consequently, the appellant was discharged from army
    service on May 8, 2007. The claim of the appellant for disability
    1 for short, ‘Tribunal’
    1
    pension was rejected departmentally and later by the Tribunal and
    still aggrieved, the appellant is before this Court.
    3) The appellant was appointed as CFN – Craftsman (Military Rank). In
    Annexure RP1 which includes the signed Personal Statement of the
    appellant, he was posted at 3 EME Centre, Bhopal from December
    2, 2003 to August 23, 2005 and thereafter at AD Static Workshop
    from August 24, 2005 till the time, he was produced before the
    invaliding Medical Board. Both the places of posting of the
    appellant were the peace stations. In respect of disease, the
    appellant declared that he was treated, firstly, at INHS, Nivarini
    Chilka on September 7 and 8, 2006, then, at Command Hospital,
    Kolkata from September 9, 2006 to December 23, 2006.
    Thereafter, he was treated at Military Hospital, Allahabad from
    January 21, 2007 to February 21, 2007 and finally, at Command
    Hospital, Kolkata from February 23, 2007 till the time, he was
    examined by the invaliding Medical Board. In Part I of the Personal
    Statement, the Question asked was to “Give details of any
    incidents during your service which you think caused or made your
    disability worse”. The answer given by the appellant was ‘NIL’. In
    Part II of the Report, the Commanding Officer answered ‘No’ to the
    question – “Did the Duties involve Severe/exceptional stress and
    strain?”
    4) The summary and opinion of the Specialist in Psychiatry of
    Command Hospital (Eastern Command), Kolkata dated April 10,
    2
    2007 read as under:
    “Summary
    Period of Hospitalization:
    Sec Hospital, Gopalpur 07 Sep 06 to 07 Sep 06
    INHS Kaiyani, Vizag 07 Sep 06 to 15 Sep 06
    CH (EC), Kolkata 16 Sep 06 to 23 Dec 06
    Sick Leave 24 Dec 06 to 21 Jan 07
    MH Allahabad 21 Jan 07 to 22 Feb 07
    CH (EC), Kolkata 23 Feb 07 onwards till date
    AFMSF-10 dated 07 Sep 06 mentions “punctual,
    disciplines, dedicated, social drinker, above average
    competence, cheerful, active and outgoing,
    retention recommended, developed fever and
    headache on 06 Sep 06 following which he was
    noted to be behaving abnormally.
    History of Present Illness:
    Individual was brought to psychiatric attention in
    mid Sep at the behest of unit authorities as he was
    talking irrelevantly, laughing and crying for no
    apparent reason, in the background of febrile
    episode. Apparently functioning well until Sep 06
    when he was noted to be aloof, lacked interest in
    his work, not taking self care nor reporting for duty
    in time. Found to be wandering aimlessly in the
    unit. Felt that others were planning to harm him;
    could hear them talking about him. Further when
    onboard the train to Vizag felt he was being
    followed and things happening around him was in
    reference to him. When offered fruits by copassenger felt it had a special meaning often noted
    to be taking irrelevantly, crying for his mother who
    had died about 12 years back. Felt that others
    came to know what he was thinking. Become
    violent when others tried to stop him or gave
    instructions to follow.”
    “Opinion
    21½ years old EME/Veh Mech with nearly 3½ years
    service, no past or family h/o psychiatric illness.
    Had a psychotic breakdown of schizophrenic nature
    in Sep 06 Managed as a case of Schizophrenia F 20
    3
    and treated with antipsychotics, ECT and other
    supportive measures. Poor response to treatment.
    Presently asymptomatic, residual negative features
    persist.
    In view of the above, onset of his psychotic
    breakdown at the start of the career, and
    persistence of residual negative features, he is
    unlikely to be a fit soldier for further service. Hence
    recommend to be invalided from service in category
    S5 of SHAPE classification as a case of
    Schizophrenia F20.”
    5) The Medical Board concluded that the disability is neither
    attributed to army service nor aggravated by military service
    though it assessed the disability at 20% for five years. Such
    opinion of the Medical Board dated April 20, 2007 is the basis of
    the discharge of the appellant. The opinion of the Medical Board is
    as under:
    “CERTIFICATE
  2. Certified that the IMB held in respect of
    No.14666828m CFN NS Yadav of AD State Wk Sp
    C/o 99 APO to a case of SCHIZOPHRENIA F. 20.0.
  3. Individual is found fit for civil job.
    Date: 20 Apr. 2007 Lt. Col.
    (Rajiv Kamra)”
    6) The appellant relies upon an order passed by this Court in Ex. Gnr.
    Laxmanram Poonia (Dead) through Legal Representatives v.
    Union of India & Ors.
    2
    as also the judgments in Dharamvir
    Singh v. Union of India & Ors.
    3
    and Union of India & Anr. v.
    2 (2017) 4 SCC 697
    3 (2013) 7 SCC 316
    4
    Rajbir Singh
    4
    to contend that since no note was given at the time
    of enrolment of the said disease in the Army, therefore, such
    disability is to be attributed to military service.
    7) In Laxmanram Poonia, there was a positive finding that appellant
    was overburdened with work due to scarcity of staff and he
    suffered hypertension resulting in lack of sleep and hunger due to
    continuous restless duty hours for several days. This Court allowed
    the appeal of the appellant and granted disability pension.
    8) In Dharamvir Singh, the appellant was sepoy in the Corps of
    Signals of the Indian Army and was boarded out of service after
    nine years of service when he was suffering from schizophrenia.
    This Court relied upon Guide to Medical Officers (Military Pension),
    1980 and the Entitlement Rules for Casualty Pensionary Awards,
    19825
    to hold that since no note was given at the time of enrolment
    of the person, therefore, such disease is presumed to be attributed
    to or aggravated by military service. The Guide to Medical Officers
    (Military Pensions), 2002 — “Entitlement: General Principles” has
    mentioned following diseases in para 27 of the judgment, which
    ordinarily escape detection at the time of enrolment:
    “(a) Certain congenital abnormalities which are
    latent and only discoverable on full investigations
    e.g. Congenital Defect of Spine, Spina bifida,
    Sacralisation,
    (b) Certain familial and hereditary diseases e.g.
    Haemophilia, Congential Syphilis,
    4 (2015) 12 SCC 264
    5 for short, ‘1982 Rules’
    5
    Haemoglobinopathy.
    (c) Certain diseases of the heart and blood vessels
    e.g. Coronary Atherosclerosis, Rheumatic Fever.
    (d) Diseases which may be undetectable by physical
    examination on enrolment, unless adequate history
    is given at the time by the member e.g. Gastric and
    Duodenal Ulcers, Epilepsy, Mental Disorders, HIV
    Infections.
    (e) Relapsing forms of mental disorders which have
    intervals of normality.
    (f) Diseases which have periodic attacks e.g.
    Bronchial Asthma, Epilepsy, Csom, etc.”
    (Emphasis Supplied)
    9) This Court also extracted the relevant provisions from the 1982
    Rules in the order, which read as under:-
    “5. The approach to the question of entitlement to
    casualty pensionary awards and evaluation of
    disabilities shall be based on the following
    presumptions:
    Prior to and during service
    (a) A member is presumed to have been in sound
    physical and mental condition upon entering service
    except as to physical disabilities noted or recorded
    at the time of entrance.
    (b) In the event of his subsequently being
    discharged from service on medical grounds any
    deterioration in his health, which has taken place, is
    due to service.
    xx xx xx
  4. Onus of proof.—The claimant shall not be called
    upon to prove the conditions of entitlements.
    He/She will receive the benefit of any reasonable
    doubt. This benefit will be given more liberally to
    the claimants in field/afloat service cases.
    6
    xx xx xx
  5. Diseases.—In respect of diseases, the
    following rules will be observed—
    (a) Cases in which it is established that conditions of
    military service did not determine or contribute to
    the onset of the disease but influenced the
    subsequent courses of the disease will fall for
    acceptance on the basis of aggravation.
    (b) A disease which has led to an individual’s
    discharge or death will ordinarily be deemed to
    have arisen in service, if no note of it was made at
    the time of the individual’s acceptance for military
    service. However, if medical opinion holds, for
    reasons to be stated, that the disease could not
    have been detected on medical examination prior to
    acceptance for service, the disease will not be
    deemed to have arisen during service.
    (c) If a disease is accepted as having arisen in
    service, it must also be established that the
    conditions of military service determined or
    contributed to the onset of the disease and that the
    conditions were due to the circumstances of duty in
    military service.”
    10) The Rule 14, as reproduced above, was amended vide Government
    of India, Ministry of Defence letter No. 1(1)/81/D(Pen-C) dated 20th
    June, 1996. The amended Clauses read as follows:
    “Rule 14 (a)- For acceptance of a disease as
    attributable to military service, the following two
    conditions must be satisfied simultaneously:
    (i) That the disease has arisen during the period of
    military service, and
    (ii) That the disease has been caused by the
    conditions of employment in military service.
    (b) If medical authority holds, for reasons to be
    stated, that the disease although present at the
    7
    time of enrolment could not have been detected on
    medical examination prior to acceptance for
    service, the disease, will not be deemed to have
    arisen during service. In case where it is established
    that the military service did not contribute to the
    onset or adversely affect the course disease,
    entitlement for casualty pensionary award will not
    be conceded even if the disease has arisen during
    service.
    (c) Cases in which it is established that conditions
    of military service did not determine or contribute
    to the onset of the disease but, influenced the
    subsequent course of the disease, will fall for
    acceptance on the basis of aggravation.
    (d) In case of congenital, hereditary, degenerative
    and constitutional diseases which are detected after
    the individual has joined service, entitlement to
    disability pension shall not be conceded unless it is
    clearly established that the course of such disease
    was adversely affected due to factors related to
    conditions of military services.”
    11) In Rajbir Singh, this Court held that the respondents having been
    discharged from service on account of medical disease/disability,
    the disability must be presumed to have been arisen in the course
    of service which must, in the absence of any reason recorded by
    the Medical Board, be presumed to have been attributable to or
    aggravated by military service. There is initial presumption that
    the respondents were all physically fit and free from any disease
    and in sound physical and mental condition at the time of their
    entry into service. The Court held as under:
    “9. As regards diseases Rule 14 of the Entitlement
    Rules stipulates that in the case of a disease which
    has led to an individual’s discharge or death, the
    disease shall be deemed to have arisen in service, if
    no note of it was made at the time of individual’s
    acceptance for military service, subject to the
    8
    condition that if medical opinion holds for reasons
    to be stated that the “disease could not have been
    detected on medical examination prior to
    acceptance for service, the same will not be
    deemed to have so arisen”. ……
    xx xx xx
  6. The legal position as stated in Dharamvir Singh
    case [Dharamvir Singh v. Union of India, (2013) 7
    SCC 316 : (2013) 2 SCC (L&S) 706] is, in our
    opinion, in tune with the Pension Regulations, the
    Entitlement Rules and the Guidelines issued to the
    Medical Officers. The essence of the rules, as seen
    earlier, is that a member of the armed forces is
    presumed to be in sound physical and mental
    condition at the time of his entry into service if
    there is no note or record to the contrary made at
    the time of such entry. More importantly, in the
    event of his subsequent discharge from service on
    medical ground, any deterioration in his health is
    presumed to be due to military service. This
    necessarily implies that no sooner a member of the
    force is discharged on medical ground his
    entitlement to claim disability pension will arise
    unless of course the employer is in a position to
    rebut the presumption that the disability which he
    suffered was neither attributable to nor aggravated
    by military service.
    xx xx xx
  7. Applying the above parameters to the cases at
    hand, we are of the view that each one of the
    respondents having been discharged from service
    on account of medical disease/disability, the
    disability must be presumed to have been arisen in
    the course of service which must, in the absence of
    any reason recorded by the Medical Board, be
    presumed to have been attributable to or
    aggravated by military service. There is admittedly
    neither any note in the service records of the
    respondents at the time of their entry into service
    nor have any reasons been recorded by the Medical
    Board to suggest that the disease which the
    member concerned was found to be suffering from
    could not have been detected at the time of his
    entry into service. The initial presumption that the
    respondents were all physically fit and free from any
    9
    disease and in sound physical and mental condition
    at the time of their entry into service thus remains
    unrebutted. Since the disability has in each case
    been assessed at more than 20%, their claim to
    disability pension could not have been repudiated
    by the appellants.”
    12) A three Judge Bench of this Court in Veer Pal Singh v. Secretary,
    Ministry of Defence
    6
    rejected the opinion of invaliding Medical
    Board but directed the respondents to refer the case to Review
    Medical Board to reassess the medical condition of the appellant
    and to find out whether at the time of discharge from service, he
    was suffering from disease which made him unfit to continue in
    service. In the said case, the appellant was appointed in the year
    1972 and was discharged in view of the opinion of the invaliding
    Medical Board dated November 14, 1977. The appellant has
    prayed for constitution of a fresh Medical Board to assess his
    disease and disability in a writ petition filed before the Allahabad
    High Court. This Court held as under:
    “10. Although, the courts are extremely loath to
    interfere with the opinion of the experts, there is
    nothing like exclusion of judicial review of the
    decision taken on the basis of such opinion. What
    needs to be emphasised is that the opinion of the
    experts deserves respect and not worship and the
    courts and other judicial/quasi-judicial forums
    entrusted with the task of deciding the disputes
    relating to premature release/discharge from the
    army cannot, in each and every case, refuse to
    examine the record of the Medical Board for
    determining whether or not the conclusion reached
    by it is legally sustainable.
    xx xx xx
    6 (2013) 8 SCC 83
    10
  8. F.C. Redlich and Daniel X. Freedman in their
    book titled The Theory and Practice of
    Psychiatry (1966 Edn.) observed:
    “Some schizophrenic reactions, which we call
    psychoses, may be relatively mild and
    transient; others may not interfere too
    seriously with many aspects of everyday
    living…. (p. 252)
    Are the characteristic remissions and relapses
    expressions of endogenous processes, or are
    they responses to psychosocial variables, or
    both? Some patients recover, apparently
    completely, when such recovery occurs
    without treatment we speak of spontaneous
    remission. The term need not imply an
    independent endogenous process; it is just as
    likely that the spontaneous remission is a
    response to non-deliberate but nonetheless
    favourable psychosocial stimuli other than
    specific therapeutic activity….” (p. 465)
    (emphasis supplied)
  9. In Controller of Defence Accounts
    (Pension) v. S. Balachandran Nair [(2005) 13 SCC
    128 : 2006 SCC (L&S) 734] on which reliance has
    been placed by the Tribunal, this Court referred to
    Regulations 173 and 423 of the Pension Regulations
    and held that the definite opinion formed by the
    Medical Board that the disease suffered by the
    respondent was constitutional and was not
    attributable to military service was binding and the
    High Court was not justified in directing payment of
    disability pension to the respondent. The same view
    was reiterated in Ministry of Defence v. A.V.
    Damodaran [(2009) 9 SCC 140: (2009) 2 SCC (L&S)
    586] . However, in neither of those cases, this Court
    was called upon to consider a situation where the
    Medical Board had entirely relied upon an inchoate
    opinion expressed by the psychiatrist and no effort
    was made to consider the improvement made in the
    degree of illness after the treatment.
  10. As a corollary to the above discussion, we hold
    that the impugned order as also the orders dated
    14-7-2011 and 16-9-2011 passed by the Tribunal
    11
    are legally unsustainable. In the result, the appeal is
    allowed. The orders passed by the Tribunal are set
    aside and the respondents are directed to refer the
    case to the Review Medical Board for reassessing
    the medical condition of the appellant and find out
    whether at the time of discharge from service he
    was suffering from a disease which made him unfit
    to continue in service and whether he would be
    entitled to disability pension.”
    13) In the aforesaid case, the Court referred the matter to the Review
    Medical Board in view of the fact that Psychiatrist has noted that
    the appellant has improved with treatment. The Court referred to
    Merriam Webster Dictionary; Report of National Institute of Mental
    Health, USA; Modi’s Medical Jurisprudence and Toxicology; and the
    book titled ‘The Theory and Practice of Psychiatry’ authored by F.C.
    Redlich and Daniel X. Freedman, to hold that the observations
    made by Psychiatrist was substantially incompatible with the
    existing literature on the subject.
    14) However, in the present case, we find that there is no such infirmity
    in the report of the Medical Board which may warrant
    reconsideration of the physical condition and the extent of
    disability by the Review Medical Board.
    15) We find that it is not mechanical application of the principle that
    any disorder not mentioned at the time of enrolment is presumed
    to be attributed to or aggravated by military service. The question
    is as to whether the person was posted in harsh and adverse
    conditions which led to mental imbalance.
    12
    16) Annexure I to Chapter IV of the Guide to Medical Officers (Military
    Pensions), 2002 — “Entitlement: General Principles” points out that
    certain diseases which may be undetectable by physical
    examination on enrolment including the Mental Disorders; Epilepsy
    and Relapsing forms of mental disorders which have intervals of
    normality, unless adequate history is given at the time by the
    member. The Entitlement Rules itself provide that certain diseases
    ordinarily escape detection including Epilepsy and Mental Disorder,
    therefore, we are unable to agree that mere fact that
    Schizophrenia, a mental disorder was not noticed at the time of
    enrolment will lead to presumption that the disease was
    aggravated or attributable to military service.
    17) The 1982 Rules classify the diseases which are affected by climatic
    conditions, stress and strain and dietary complications. The stress
    and strain cause the following injuries as per the said classification
    of diseases:
    “(a) Psychosis and psychoneurosis.
    (b) Bronchial Asthma.
    (c) Myocardial infarction, and other forms of IHD.
    (d) Peptic ulcer.”
    18) Therefore, each case has to be examined whether the duties
    assigned to the individual may have led to stress and strain leading
    to Psychosis and psychoneurosis. Relapsing forms of mental
    disorders which have intervals of normality and Epilepsy are
    13
    undetectable diseases while carrying out physical examination on
    enrolment, unless adequate history is given at the time by the
    member.
    19) The appellant was a young boy of 18 years at the time of
    enrolment and had been boarded within 3½ years of his service.
    Even if he was suffering from any mental disorder prior to
    enrolment, the same could not be detected as there were intervals
    of normality. The appellant was posted in peace station as a
    Vehicle Mechanic. Neither the nature of job nor the place of
    posting was such which could have caused stress and strain
    leading to disability as attributed to or aggravated by military
    service.
    20) In the present case, clause 14(d), as amended in the year 1996 and
    reproduced above, would be applicable as entitlement to disability
    pension shall not be considered unless it is clearly established that
    the cause of such disease was adversely affected due to factors
    related to conditions of military service. Though, the provision of
    grant of disability pension is a beneficial provision but, mental
    disorder at the time of recruitment cannot normally be detected
    when a person behaves normally. Since there is a possibility of
    non-detection of mental disorder, therefore, it cannot be said that
    Schizophrenia is presumed to be attributed to or aggravated by
    military service.
    21) Though, the opinion of the Medical Board is subject to judicial
    14
    review but the Courts are not possessed of expertise to dispute
    such report unless there is strong medical evidence on record to
    dispute the opinion of the Medical Board which may warrant the
    constitution of the Review Medical Board. The invaliding Medical
    Board has categorically held that the appellant is not fit for further
    service and there is no material on record to doubt the correctness
    of the Report of the invaliding Medical Board.
    22) Thus, we do not find any merit in the present appeal, accordingly,
    the same is dismissed.
    ………………………………………J.
    (L. NAGESWARA RAO)
    ………………………………………J.
    (HEMANT GUPTA)
    NEW DELHI;
    OCTOBER 03, 2019.
    15