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REPORTABLE

IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO.5922 OF  2012

Veer Pal Singh          …Appellant

versus

Secretary, Ministry of Defence …Respondent

J U D G M E N T

G. S. Singhvi, J.

1. This appeal is directed against order dated 19.12.2011 of the Armed  

Forces Tribunal, Lucknow Bench (for short,  ‘the Tribunal’) dismissing the  

application filed by the appellant for grant of leave to  file appeal  against  

orders  dated  14.7.2011  and  16.9.2011  passed  in  Transferred  Application  

No.1431/2010 and Review Application No.22/2011 respectively.

2. The  appellant  was  enrolled  in  the  Army  (Corps  of  Signals)  on  

20.6.1972 in Medical Category “AYE”.  Before his enrolment, the appellant  

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was subjected to medical examination, the report (Annexure R-II) of which is  

reproduced below:

“PRIMARY MEDICAL EXAMINATION REPORT

1. Service No. 14289930 2. Name VEER PAL SINGH 3. Father’s Name SUKHBIR SINGH 4. Date of birth 01.10.53 5. Appellant Age MA 6. Service/Corps/A

ir Force SIGNALS

7. Permanent  address

Village – Dhanor  Tikkri Teh. & Dist.  Sardhana, Meerut.

8. Identification  Marks 1. A  mole  over  middle  

of forehead 2. A mole 3 cm from Lt  

angle of mouth 9. Relevant  family  

history NIL

10. Past  medical  history,  Specially of fits.

NIL

11. EYES a. Distance  Vision  

without Glass R-6/9

Without Glass L-6/6 Near Vision Any evidence of  trachoma  or  its  Complications

NIL

12. Hearing a. R Ear 600 cms

L Ear b. Any evidence of otitls  

media NAD

13. Upper  Limbs  and  

(a) Upper Limbs NAD

Locomoter  System  

(b) Locomotion NAD

14. Physical  

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Developments: Height: 174 cm Weight: 54 Kgs.

15. Chest  Measurements (a) Full expiration 81 cms (b) Range of expiration 5 cms

16. Urine (a) Albumen -- (b) Sugar -- (c) Other abnormalities

17. Any evidence of  skin

NIL

Venereal  disease(s)

18. Cardio-vascular  system (a) Pulse 76 pm

NAD 19. Central Nervous system NAD 20. Abdomen: NAD 21. Liver: NP 22. Spleen: NP 23. Hernia: NIL 24. Teeth:

(a)  No dental points 16/16 Healthy

25. Mental  capacity  and  Emotional  Stability (a) Speech NORMAL

i. Mental backwardness NIL ii. Emotional Instability NIL

26. Slight  Defects  not  sufficient  of  cause  Rejection

NIL

27. Found fit in category A (AYE)

PLACE: MEERUT Date: 22/5/72

Sd/- [RK Gupta]

Captain AMC                                                                 Recruiting Medical  

Officer”

3. After completion of training, the appellant was posted in 54 Infantry  

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Division Signals Regiment and his regular service commenced with effect  

from 21.2.1974.  After about two years, he was admitted in Military Hospital,  

Secunderabad  for  the  treatment  of “INTESTINAL-COLIC”.   He  was  

discharged  from  the  hospital  on  18.2.1976.   Between  March,  1976  to  

October,  1977  he  was  treated  in  different  Army  Hospitals  at  Pune,  

Secunderabad and Meerut. He was downgraded to Medical Category “CEE”  

(Temporary) for a period of six months with effect from 3.1.1977.  His case  

was  considered  on  14.11.1977  by  the  Invaliding Medical  Board  held  at  

Military Hospital, Meerut and on its recommendations,  he was discharged  

from service.   His  claim for  disability pension was  rejected  by Principal  

Controller of Defence Accounts (Pension), Allahabad on the ground that the  

disease, i.e., Schizophrenic Reaction, which was the cause of his discharge  

was not attributable to the military service.

4. The  appellant  challenged  his  discharge  from  military  service  and  

rejection  of  his  claim for  disability  pension  in  Civil  Misc.  Writ  Petition  

No.42946/1997 filed before the Allahabad High Court. He prayed that a fresh  

Medical Board be constituted to assess his disease and disability.  The same  

was disposed of by the Allahabad High Court vide order dated 26.3.1998 and  

a direction was given to the competent authority to decide the appellant’s  

representation.  Thereafter,  the  Government  of  India,  Ministry  of  Defence  

rejected the appellant’s representation vide order dated 16.9.1998, paragraph  

9 of which reads thus:

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“You  have  been  diagnosed  as  a  case  of  SCHIZOPHRENIC  REACTION  and  not  LUNATIC.  As  such  your  request  to  produce you before a medical board to examine you whether you  are Lunatic or free from LUNACY does not arise. Therefore no  resurvey medical board can be held in your case.”

5. The  appellant  challenged  the  aforesaid  order  in  Writ  Petition  

No.40430/1999 and prayed that the respondents be directed to constitute a  

Review Medical Board to re-evaluate his disease.   

6. The second writ petition filed by the appellant remained pending before  

the High Court for 13 years. On the establishment of Lucknow Bench of the  

Tribunal under the Armed Forces Tribunal Act, 2007 (for short, ‘the Act’),  

the same was transferred to the Tribunal and was registered as Transferred  

Application No.1431/2010. The Tribunal examined the record of the Medical  

Board,  referred  to  the  judgment  of  this  Court  in  Secretary,  Ministry  of  

Defence v. A.V. Damodaran (2009) 9 SCC 140 and dismissed the application  

by making the following observations:

“In view of the aforesaid the Medical Board’s opinion is to be  accorded supremacy. We in exercise of our jurisdiction can not  sit over the opinion expressed by the Medical Board which is an  expert body. The disease that the applicant was suffering from  has  been  found  to  be  constitutional  and  not  aggravated  by  military  service.  We  can  not  hold  anything  contrary  to  the  medical opinion.”

7. The review application and the application filed by the appellant for  

grant  of  leave  to  appeal  were  dismissed  by  the  Tribunal  with  a  cryptic  

observation that the recommendations made by the Medical Board are binding  

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and the same cannot be subjected to judicial review.      

8. The  appellant,  who  appeared  in  person,  referred  to  report  dated  

22.5.1972 of the Recruiting Medical Officer as also report dated 14.11.1977  

of the Invaliding Medical Board and argued that in the absence of evidence  

about his disease, i.e., Schizophrenic Reaction at the time of enrolment, the  

opinion of the Psychiatrist, who examined him, could not be relied upon for  

recording a finding that his disease is constitutional and is not attributable to  

military service. The appellant submitted that mere irritability or quarrelsome  

nature cannot lead to an inference that he was suffering from Schizophrenic  

Reaction and the Tribunal committed grave error by declining his prayer for  

making a reference to the Review Medical Board.  He also invited the Court’s  

attention to the averments contained in paragraph 5 of the counter affidavit  

filed before this Court to show that the disease had developed after entering  

the service and argued that it should be treated as directly attributable to the  

military service.

9. Learned counsel for the respondent fairly stated that except the opinion  

of  the  Psychiatrist-Major  (Mrs.)  N.  Lalitha  Rao,  no  other  evidence  is  

available to support the opinion of the Medical Board that the appellant was  

suffering from Schizophrenic Reaction.  He also conceded that at the time of  

enrolment, the appellant was not suffering from any disease but argued that  

the Court cannot sit in appeal over the opinion formed by the experts who  

constituted Invaliding Medical Board.

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10. We  have  considered  the  respective  arguments.   For  the  sake  of  

convenience,  the  relevant  portions  of  the  proceedings  of  the  Invaliding  

Medical Board which constituted the foundation of the appellant’s discharge  

from Army and denial of disability pension read as under:

“CONFIDENTIAL

              MEDICAL BOARD PROCEEDING INVALIDING ALL RANKS Authority  for  Board  AO  537/72

Place  M.H. Meerut

Date 14 Nov. 77

Name  Veerpal  Singh

Service  No.  14289930

Rank/Rate SIG/MAN

Unit/Sh ip 676SIG (04  C1056  APO

Date  birth  01.10. 53

Service Army/Corps/Bra nch/Trade

Total Service Total  flying  hours/Servic e afloat

Permanent    address:  ViQ Dhanaura   (Tikri)   P.O.  Dhanaura  The.  Sardhana  Dist. Meerut, U.P.

Identification marks: - i   Mole over   middle, of forehead.  ii. Mole over the It. cheek

Field/Operational/Overseas Service: Giving dates and place

From To Place From To Place NIL

PART – I

PERSONAL STATEMENT

(The  questions  should  be  answered  in  the  individual's  own  words. This statement will be checked from official records as  

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far as possible) ---------------------------------------------------------------------------- 1. Give  particulars  of  previous  service  in  

ARMY/NAVY/AIR/FORCE and state  whether you  were invalided out of Service.

2. Give   particulars   of  any   diseases,   wounds  or  injuries from which you are suffering:- ----------------------------------------------------------------

Illness, wound, injury Shizoph Renic Reactio n

First Stated

Date Place

(295) Mar 76 Secunderbad MH Secunde -rabad

25.3.76  to  12.5.76

CHSE  Pune

13.5.76  to  5.9.76

23.11.7 6  to  5.1.77

MH Secunde rabad

5.7.77  to  30.8.77

MH  Meerut

14.10.7 7  to  DATE

3. Did you suffer from any disability mentioned in question  2 or anything like it before joining the Armed Forces? If  so give details and dates.

NIL 4. Give details of any incidents during your service which  

you think caused or made your disability worse?  NIL

CONFIDENTIAL 5. In case of wound or injury, state now they happened and  

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whether or not (a) Medical Board or Court of Inquiry was  held, (b) Injury Report was submitted.  

N.A. 6. Any other information you wish to give about your health.  

NIL I certify that I have answered as fully as possible all the  questions about my service and personal history and that  the information give is true to the best of my knowledge.

Witness : Signature Sd/-                                                            Sd/-   14289930 ---------------------------------------------------------------------- (In  case  of  illiterate  persons  thumb  and  fingers  impressions of left hand will be taken here)

PART - II STATEMENT OF CASE

(Not to be communicated to the Individual)

Disabilities Date of origin Place  and  unit  where  serving  at  the time

SCHIZOPHRE NIC  Reaction  - 295

Mar. 76 676  SIG  Coy  C/056APO

2. Clinical details a. Give the salient facts of:-

i.  Personal and relevant family history. ii. Specialist report; and iii.Treatment

b. State present condition in details. c. In this statement and in answering questions in  

Part-Ill  the  Board  will  differentiae  carefully  between  the  Individuals  statement  and  the  evidence recorded in the medical documents.

CONFIDENTIAL Sd/- Lt. Col.  

Chief Record Officer  Signals Records

SUMMARY OF THE CASE

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NO. 14289930 Rank: Sigman: Name:  Veer  Pal  Singh

Time: 24 years

Unit: 676  Signal  Coy  C/o  56 APO

Diagnosis: SCHIZOPHRENIC  reaction (295)

=============================================         A case of Schizophrenic Reaction admitted for review  after sick leave from MH Secunderabad. At present he has  no complaints.

       Perusal of the documents show that this patient was treated  earlier at the following hospitals for the same illness:-

1. MH Secunderabad - 25.3.76 to 12.5.76 2. From to CH (SC) Pune - 13.5.76 to 5.9.76 sent on sick  

leave 3. CH (SC) Pune - Nov. 76 Cat CEE Temp w.e.f. 3.1.77. 4. MH Secunderabad - 05.7.77 to 30.8.77 sick leave.

Observation in the Ward:- Showed him to be irritable, impulsive quarrel some with a  tendency to suspect the staff and other patients.

Past Illness: Nil significant  

Family History Belong to U.P. Father - farmer - healthy. Mother healthy.  He has three brothers. No history of mental illness to the  family. Personal History: Youngest, Studied up to BA. Unmarried Gives history of  heterosexual experience.   Smokes but does not rink. Service: 6 years, Nil Punishment

On Exam: GC fair, TPR - Normal, Lungs, Heart and Abdomen -NAD ,

Treatment: Antipaychotic drugs- -Improvement - Not maintained.

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OPINION  OF  MAJOR  (MRS)  N  LALITHA  RAO,  CLASSIFIED SPECIAL BT (PSYCHIATRY) MH MEERUT  DATED 09. NOV. 77.

A  case  of  Schizophrenic  Reaction (ICD  295)  in  cat  ‘CEE'  Temp  w.e.f.   3.1.77  was  admitted and treated at MH  Secunderabad with self inflicted. Injuries, in Jul 77, while in the hospital there, he had become  quarrels   irritable  and impulsive with treatment he improved  when  he  was  sent  in  six  weeks  sick  leave.   Review  as  admission, now shows him to be still irritable and argumentative  with persecutory delusions and suspicious. Residual features of  psychosis persist  

- Therefore he is recommended invalidment from service.

Recommended Cat 'CEE' Sd/- x x x x  

[N LALITHA RAO]  MAJOR, AMC  

PSYCHIATRIST

I view of the above, the individual is brought before Invaliding  Medical Board.

[N LALITHA RAO]  MAJOR, AMC

CONFIDENTIAL PART – III

OPINION OF THE MEDICAL BOARD (Not to be communicated to the Individual)

Note:  Clear  and decisive  answers  should be  filed in by the  Board, Expressions such as 'night',  ‘may',  probably',  should  be avoided. ----------------------------------------------------------------------------- 1. Did  the  disability/ies  exist  before  entering  

service. NO

2. In respect of each disability the Medical Board  on the evidence before it will express its views  as to whether:-

i. It  is  attributable  to  service  during peace  or  

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under field service conditions; or ii. It has been aggravated thereby and remains so;  

or iii. It is not connected with service.

The  Board  should state  fully the  reasons  in  regard to each disability on which its opinion  is based.

Disability A B C SCHIZOP- HRENIC  REACTION

NO NO NO

b. In  respect  of  each  disability  shown  as  attributable  under  A,  the Board  should state  fully,  the  specific  condition  and  period  in  service which caused the disability.  

N.A. c. In  respect  of  each  disability  shown  as  

attributable  under  A,  the Board  should state  fully:-

N.A. i. The  specific  condition  and  period  in  

service which aggravated the disability N.A.

ii. Whether  the  effects  of  such aggravation  still persist.  

N.A.

iii .

If the answer to (ii) is in the affirmative,  whether effect of aggravation will persist  for a material period.  

N.A. d. In the case of a disability under C, the Board  

should state what exactly in their opinion is the  cause thereof. The  disease  is  constitutional  and  is  unconnected with service.

3.              a. Was  the  disability,  attributable  to  the  individual's own negligence or misconduct? If  so, in what way?  

NO b. If  not  attributable,  was  it  aggravated  by  

negligence or misconduct? If so, in what way  

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and  to  what  percentage  of  the  total  disablement?  

N.A. c. Has  the  individual  refused  to  undergo  

operation/treatment? If so, individual's reasons  will be recorded.  

N.A. NOTE: In  case  of  refusal  of  operation/treatment  a  

certificate from the individual will be attached. d. Has the effect of refusal been explained to and  

fully understood by him/her, viz., a reduction  in, or the entire withholding of, any disability  pension to  which he/she  might otherwise  be  entitled?  

N.A. e. Do  the  Medical  Board  consider  it  probable  

that the operation/treatment would have cured  the disability or reduced its percentage?  

N.A. f. If the reply to (e) is in affirmative, what is the  

probable percentage to which the disablement  could be reduced .by operation/treatment?  

N.A. g. Do the Medical Board consider the operation  

to be server and dangerous to life?  N.A.

h. Do the Medical Board consider the individual's  refusal  to  submit  to  operation/treatment  reasonable?  Give  reasons  in  support  of  the  opinion  specifying  he  operation/treatment  recommended.  

N.A. 4. What  is  present  degree  of  disablement  as  

compared with a healthy person of the same  age and sex? (Percentage will be expressed as  Nil or as follows:-

1-5%, 6-19%, 11-14%, 15-90% and thereafter  in multiples of ten from 10% to 100%.

Disability (as  numbered in  question I,  part II)

Percentage  of  disablement

Probable  duration  of  this degree of  disablement

Composite  assessment  (all  disabilities)

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SCHIZOPHR- ENIC   REACTION  (295)

30%  THIRTY  PERCENT

2 YEARS 30%  THIRTY  PERCENT

CONFIDENTIAL

CERTIFICATE

No.14289930 Rank Sigman   Name    VEER PAL SINGH

The   disability   will   not   interfere   with the performance of  normal/sabentuary suitable civil employment.

Disability SCHIZOPHERNIC REACTION Sd/-

[OM PRAKASH] Lt. Col. AMC  

President Medical Board Dated: 14 Nov. 77”

11. 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 emphasized 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.

12. A recapitulation of the facts shows that at the time of enrolment in the  

Army, the appellant was  subjected to medical examination and Recruiting  

Medical Officer found that he was fit in all respects. Item 25 of the certificate  

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issued by the Recruiting Medical Officer is quite significant.  Therein it is  

mentioned that speech of the appellant is normal and there is no evidence of  

mental  backwardness  or  emotional instability.  It  is,  thus,  evident  that  the  

doctor who examined the appellant on 22.5.1972 did not find any disease or  

abnormality in the behaviour of the appellant. When the Psychiatrist - Dr.  

(Mrs.) Lalitha Rao examined the appellant, she noted he was quarrelsome,  

irritable and impulsive but he had improved with the treatment. The Invaliding  

Medical Board simply endorsed the observation made by Dr. Rao that it was  

a case of “Schizophrenic Reaction”.  

13. In Merriam-Webster Dictionary “Schizophrenia” has been described as  

a psychotic disorder characterized by loss of contact with the environment, by  

noticeable deterioration in the level of functioning in everyday life, and by  

disintegration of personality expressed as disorder of feeling, thought (as in  

delusions),  perception  (as  in  hallucinations),  and  behavior  –  called  also  

dementia praecox; Schizophrenia is a  chronic,  severe,  and disabling brain  

disorder that has affected people throughout history.

14. National  Institute  of  Mental  Health,  USA  has  described  

“Schizophrenia” in the following words:  

“Schizophrenia is a chronic, severe, and disabling brain disorder  that  has  affected  people  throughout  history.  People  with  the  disorder may hear  voices  other  people don’t  hear.  They may  believe other people are  reading their minds,  controlling their  thoughts, or plotting to harm them. This can terrify people with  the  illness  and  make  them withdrawn or  extremely agitated.  

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People with schizophrenia may not make sense when they talk.  They may sit for hours without moving or talking. Sometimes  people  with schizophrenia  seem perfectly fine until  they talk  about  what  they are  really thinking. Families and society are  affected by schizophrenia too. Many people with schizophrenia  have difficulty holding a job or caring for themselves, so they  rely on others for help. Treatment helps relieve many symptoms  of schizophrenia, but most people who have the disorder cope  with symptoms throughout their lives.  However,  many people  with schizophrenia can lead rewarding and meaningful lives in  their communities.”  

Some of the symptoms of schizophrenia are:

Positive symptoms

Positive symptoms are psychotic behaviors not seen in healthy people. People  

with positive symptoms often “lose touch” with reality. These symptoms can  

come and go. Sometimes they are severe and at other times hardly noticeable,  

depending on whether the individual is receiving treatment. They include the  

following:

Hallucinations  – “Voices”  are  the most  common type of hallucination in  

schizophrenia. Hallucinations include seeing people or objects  that are not  

there, smelling odors that no one else detects, and feeling things like invisible  

fingers touching their bodies when no one is near.

Delusions - The person believes delusions even after other people prove that  

the beliefs are  not  true or  logical.  They may also  believe that  people  on  

television are directing special messages to them, or that radio stations are  

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broadcasting their thoughts aloud to others. Sometimes they believe they are  

someone else, such as a famous historical figure. They may have paranoid  

delusions and believe that others are trying to harm them.

Thought disorders - are unusual or dysfunctional ways of thinking. One form  

of thought disorder is called “disorganized thinking”. This is when a person  

has trouble organizing his or her thoughts or  connecting them logically, a  

person  with  a  thought  disorder  might  make  up  meaningless  words,  or  

“neologisms”.

Movement disorders - may appear as agitated body movements. A person  

with a movement disorder may repeat certain motions over and over. In the  

other extreme, a person may become catatonic. Catatonia is a state in which a  

person does not move and does not respond to others. Catatonia is rare today,  

but it was more common when treatment for schizophrenia was not available.

Negative symptoms

Negative symptoms are associated with disruptions to normal emotions and  

behaviors. These symptoms are harder to recognize as part of the disorder and  

can be mistaken for depression or other conditions. These symptoms include  

the following:

• “Flat affect” (a person’s face does not move or he or she talks in  a dull or monotonous voice)

• Lack of pleasure in everyday life

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• Lack of ability to begin and sustain planned activities

• Speaking little, even when forced to interact.

15. In Modi’s Medical Jurisprudence and Toxicology (24th Edn. 2011) the  

following varieties of Schizophrenia have been noticed:  

Simple Schizophrenia – the illness begins in early adolescence. There is a  

gradual  loss  of  interest  in  the  outside  world,  from  which  the  person  

withdraws.  There  is  an  all  round  impairment  of  mental  faculties  and  he  

emotionally becomes flat and apathetic. He loses interest in his best friends  

who are few in number and gives up his hobbies. He has conflicts about sex,  

particularly  masturbation.  He  loses  all  ambition  and  drifts  along  in  life,  

swelling  the  rank  of  chronically  unemployed.  Complete  disintegration  of  

personality does  not occur,  but when it does,  it occurs after a  number of  

years.  

Hebephrenia- hebephrenia occurs at an earlier age than either the katatonic  

or the paranoid variety. Disordered thinking is the outstanding characteristic  

of this kind of schizophrenia. There is great incoherence of thought, periods  

of wild excitement occur and there are illusions and hallucinations. Delusions  

which are bizarre in nature, are frequently present. Often, there is impulsive  

and  senseless  conduct  as  though  in  response  to  their  hallucination  or  

delusions. Ultimately the whole personality may completely disintegrate.  

Katatonia -  katatonia is  the condition in which the period of  excitement  

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alternates  with that  of  katatonic  stupor.  The patient  is  in a  state  of  wild  

excitement, is destructive, violent and abusive. He may impulsively assault  

anyone without the slightest provocation. Homicidal or suicidal attempts may  

be made. Auditory hallucinations frequently occur, which may be responsible  

for their violent behaviour. Sometimes, they destroy themselves because they  

hear God’ voice commanding them to destroy themselves. This phase may  

last from a few hours to a few days or weeks, followed by stage of stupor.  

The katatonic stupor begins with a lack of interest, lack of concentration and  

general apathy. He is negative, refuses to take food or medicines and to carry  

out his daily routine activities like brushing his teeth, taking bath or change  

his clothes…. The activities are so very limited that he may confine himself in  

one place and assume one posture however uncomfortable, for hours together  

without getting fatigued. His face is expressionless and his gaze vacant….  

They may understand clearly everything that is going on around them, and  

sometime without warning and without any apparent cause,  they suddenly  

attack any person standing nearby.  

Paranoid Schizophrenia,  Paranoia and Paraphrenia -  Paranoia  is  now  

regarded as a mild form of paranoid schizophrenia. The main characteristic of  

this  illness  is  a  well elaborated  delusional system in a  personality that  is  

otherwise well preserved. The delusions are of a persecutory type. The true  

nature  of  the  illness  may  go  unrecognized  for  a  long  time  because  the  

personality is well preserved, and some of these paranoiacs may pass off as  

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social reformers or founders of queer pseudo-religious sects.  The classical  

picture is rare and generally takes a chronic course.  

Paranoid schizophrenia,  in the vast  majority of cases,  starts  in the fourth  

decade  and  develops  insidiously.  Suspiciousness  is  the  characteristic  

symptom of the early stage. Ideas of reference occur, which gradually develop  

into delusions of  persecution.  Auditory hallucinations follow which in the  

beginning, start as sounds or noises in the ears, but become fixed and definite,  

to lead the patient to believe that he is persecuted by some unknown person or  

some superhuman agency. He believes that his food is being poisoned, some  

noxious gases are blown into his room and people are plotting against him to  

ruin him. Disturbances of general sensation give rise to hallucinations, which  

are attributed to the effects of hypnotism, electricity, wireless telegraphy or  

atomic agencies. The patient gets very irritated and excited owing to these  

painful and disagreeable hallucinations and delusions.  

Since so many people are against him and are interested in his ruin, he comes  

to believe that he must be a very important man. The nature of delusions thus,  

may change from persecutory to grandiose type. He entertains delusions of  

grandeur, power and wealth, and generally conducts himself in a haughty and  

overbearing manner. The patient usually retains his money and orientation and  

does  not  show signs of  insanity,  until the  conversation is  directed  to  the  

particular type of delusion from which he is suffering. When delusions affect  

his behaviour, he is often a source of danger to himself and others.  

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The  name  paraphrenia  has  been  given  to  those  suffering  from paranoid  

psychosis who, in spite of various hallucinations and more or less systemized  

delusions,  retain  their  personality  in  a  relatively  intact  state.  Generally,  

paraphrenia begins later in life than the other paranoid psychosis.  

Schizo Affective Psychosis - Schizo affective psychosis is an atypical type of  

schizophrenia, in which there are moods or affect disturbances unlike other  

varieties  of  schizophrenia,  where  there  is  blunting or  flattening of  affect.  

Attacks of elation or depression, unmotivated rage, anxiety and panic occur in  

this form of schizophrenic illness.  

Pseudo-Neurotic  Schizophrenia -  schizophrenia  may  start  with  

overwhelmingly neurotic symptoms, which are so prominent that in the early  

stages,  it may be diagnosed as neurosis.  When schizophrenia begins in an  

obsessional  personality,  it  may  for  a  long  time  remain  disguised  as  an  

apparently obsessional illness.

16. In  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  

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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)

17. Unfortunately,  the  Tribunal  did  not  even  bother  to  look  into  the  

contents  of  the  certificate  issued  by  the  Invalidating Medical  Board  and  

mechanically observed that it cannot sit in appeal over the opinion of the  

Medical Board. If the learned members of the Tribunal had taken pains to  

study  the  standard  medical  dictionaries  and  medical  literature  like  “The  

Theory and Practice of Psychiatry” by F.C. Redlich and Daniel X. Freedman,  

and Modi’s  Medical Jurisprudence and Toxicology, then they would have  

definitely  found  that  the  observation  made  by  Dr.  Lalitha  Rao  was  

substantially incompatible with the existing literature on the subject and the  

conclusion recorded by the Invaliding Medical Board that it was a case of  

Schizophrenic Reaction was not well founded and required a review in the  

context  of the observation made by Dr.  Lalitha Rao herself that  with the  

treatment the appellant had improved.  In our considered view, having regard  

to the peculiar facts of this case, the Tribunal should have ordered constitution  

of Review Medical Board for re-examination of the appellant.   

18. In Controller of Defence Accounts (Pension) v. S. Balachandran Nair  

(2005) 13 SCC 128 on which reliance has been placed by the Tribunal, this  

Court referred to Regulations 173 and 423 of the Pension Regulations and  

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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.  

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.  

19. As a  corollary to  the above discussion,  we hold that  the impugned  

order as also orders dated 14.7.2011 and 16.9.2011 passed by the Tribunal  

are legally unsustainable.

20. 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 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.

.........................................................J. (G.S. SINGHVI)

..........................................................J .

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(RANJANA PRAKASH DESAI)

..........................................................J .

(SHARAD ARVIND BOBDE) New Delhi July 02, 2013.

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