MEDICAL AND DENTAL PROCEDURES

MEDICAL TREATMENT

SECTION 1 - GENERAL

SECTION 2 - FACILITIES FOR MEDICAL TREATMENT

SECTION 3 - ABSENCE FROM DUTY ON ACCOUNT OF ILLNESS

SECTION 4 - INJURIES

SECTION 5 - DEATHS, REPATRIATION OF CORPSES.

SECTION 1 - GENERAL

Definitions

09101 - "Hospital" means a Government Hospital or any hospital run by a Government Agency.

"Medical Officer" means a Government Medical Officer or a Medical Officer in a hospital run by a Government Agency.

"Private practitioner" means any other Registered Medical or Dental Practitioner.

Medical documents to be treated as confidential

09102 - The medical certificates, reports of medical boards, dental treatment records, reports of private practitioners and confidential health reports mentioned in this chapter will be treated as strictly confidential. No copies of these reports except those mentioned in this chapter shall be furnished, except that this rule shall not preclude the keeping of an officer's health record in the Ministry of Health or the transfer of such record to the corresponding office when a staff is transferred to the service of another Government.

Medical Examination on Appointment

09103 - Every person selected for appointment either in a temporary Medical or in a permanent capacity shall be required to present himself for examination to a Government Medical Practitioner (or one so approved by Government) with a view to its being ascertained whether he is physically fit for service. Unless otherwise provided in the offer of appointment, the fee for such examination shall be paid by the State Government. If the candidate is not finally passed as physically fit for service, his appointment shall not be proceeded with.

Special Medical Tests

09104 - The Permanent Secretary/Head of Extra Ministerial Department may at any time (and shall, if the officer so requests) call upon an officer to present himself for examination to an approved or Government medical practitioner, or to a duly constituted medical board with a view to its being ascertained whether the officer is physically capable of performing the duties of his appointment or of any appointment to which it may be proposed to transfer him.

09105 – An officer on leave of absence may be required or at his own request may be permitted by the State Government or its accredited representative, to present himself for examination to an approved medical practitioner, with a view to obtaining a report as to the officer's physical fitness to return to his duties or to take up a fresh appointment.

09106 - In the case of examinations under either of the two preceding Rules:

1. any fees in respect of the examination shall in the absence of any special regulations or arrangement to the contrary, be paid by the Government;
2. the person or persons appointed to conduct the examination on shall have discretion to call a specialist into consultation and any fee due to the specialist for assistance in rendering a report to the Government shall be paid from public funds;
3. the report of the examination shall be furnished to Government and may be communicated to the officer concerned at the discretion of the Medical Officer;
4. the officer shall, however, be informed at the earliest possible date of the decision reached upon his case by the Government after consideration of the report; and if the officer is dissatisfied with that decision, he shall be at liberty to make representation to this effect, in which event the Government shall decide at its discretion whether any further medical evidence shall be called for.

Leave to Visit Medical Specialist Dentist

09107 - An officer may be granted leave by his Permanent Secretary/Head of Extra-Ministerial Department for the purpose of visit medical visiting a medical specialist/dentist, but only if it is certified by the handling Government Medical Officer that he is unable to deal with the case himself and that it will definitely affect the health of the officer if consultation is postponed. An officer granted leave in such circumstances will be treated for the purpose of free transport facilities (but not for traveling allowance) as traveling on duty. If no medical certificate is given, it will be open to an officer to apply for casual leave under Rule 13121.

SECTION 2 - FACILITIES FOR MEDICAL TREATMENT

Government Facilities in Nigeria

09201 - The Government medical facilities provided free to all officers and their families and the scale of charges for other Government medical facilities are specified in the current Hospital Fees Regulations and amendments thereto.

TREATMENT BY PRIVATE PRACTITIONERS

Patient Bears Expenses

09202 - A staff who prefers to be treated by a private practitioner Patient instead of availing himself of Government medical facilities must himself bear all expenses incurred through such treatment.

09203 - (a) When owing to the state of his health, a staff or a member of his family is compelled, in the absence of a Medical Officer, to avail himself of the services of private medical practitioners, he will be responsible in the first instance for the fees payable. If, however, the circumstances are recognized by the Permanent Secretary, State Ministry of Health as requiring such service, he may authorize a refund to the staff at such rates as he, the Permanent Secretary considers fair and reasonable.

(b) When an officer or a member of his family gets a prescription from a Medical Officer in a Government Hospital/Clinic but is unable to obtain the drugs from Government Hospital, he shall, on application to the Permanent Secretary, State Ministry of Health, be reimbursed the cost of purchasing the drugs on production of receipt issued to that effect.

TREATMENT ON BOARD, SHIP/AIRCRAFT AND ABROAD

Officers Embarked as Invalids

09204 - If an officer is embarked by Government or its accredited representative in a sea-going vessel as an invalid and placed in the invalids. charge of the ship's surgeon, the latter's fees for medical attendance on the officer during the voyage will be payable by the Government.

Officers Faling Seriously ill on Voyage to or from Nigeria

09205 - Government will consider claims for the refund of medical expenses incurred by officers and their families during voyages duly authorized by the Government in cases of serious illness occurring enroute and provided that the illness is not attributable to the officer's Nigeria. or his family's negligence. Claims for petty bills incurred on board ships/aircraft will not, however, be entertained.

Medical Expenses During Overseas Leave or on Duty

09206 - The State Ministry of Health may authorize a refund of medical expenses (including charges for maintenance) incurred by an officer while overseas on leave or on duty provided:

1. the illness was not due to the officer's own negligence;
2. the illness was attributable to conditions in, or the climate overseas;
3. the officer sought to avail himself of the services of the Local National Health Service (where applicable) and could not obtain the requisite attention thereunder within a reasonable time;
4. the officer informed the nearest accredited representative of the Abia State Government of Nigeria at the earliest date possible that he was unable to obtain the requisite attention through the National Health Service; and
5. the officer showed reasonable diligence, expedition and economy in seeking and obtaining medical attention.

Medical Treatment Overseas

09207 - Approval for journeys outside Nigeria for medical treatment will only be given by the Office of the Head of Service on the recommendation of the Permanent Secretary, State Ministry of Health and will be confined to serious cases where a patient's life is in danger or where the examination is necessary for diagnosis of difficult cases or to ensure that a patient is fully recovered and able to undertake the duties of his office. Where the officer is treated as an out-patient, he will be entitled to estacode allowance at the appropriate rate.

(b) In exceptional cases where dependents of officers are compelled to travel abroad for medical treatment/checkup, government involvement will be limited to half of the estimated expenses.

(c) Every application for medical treatment abroad must be supported by a consultant's report from a government hospital. It must be submitted to the Permanent Secretary, State Ministry of Health by the sponsoring Local Government, State Government Ministry/Department or Parastatal/Organization. The Permanent Secretary will then make his recommendations to the Head of the Civil Service of Abia State. Applications approved will be notified to the applicant by the Head of the

Civil Service of Abia State with copies to the State Ministry of Finance, the Federal Ministry of Foreign Affairs and the appropriate Nigerian Mission abroad. As a further control measure, the choice of consultants/clinics abroad will be made by the Nigerian Mission. However, where contact already exists between a patient and a consultant, the Mission may endorse the arrangement. The Mission's Medical Consultant will vet all bills before settlement to ensure that they are proper and reasonable.

MEDICAL CHECK-UP

(d) (i) Approval for public officers to receive periodic medical check- up at Government expense either locally or abroad will be given by the appropriate authority as stated below:

(ii) Officers for whom the Governor's approval is required:

Members of the State House of Assembly

Members of the State Executive Council;

Chief Judge of Abia State;

Judge of the State High Courts,

The President and Judge of the Customary Court of Appeal;

Chairman of the State Civil Service Commission;

Chairman of the Local Government Service Commission

Secretary to the State Government (SSG),

Head of Service of the State

Permanent Secretaries/Director-General/Equivalents.

(iii) Public Functionaries for whom the Approving Authority

is the Head of Service of the State:

All Staff in Ministries/Extra-Ministerial Departments on salary Grade Level 13 and above;

Other members of the Judiciary;

State Civil Service Commissioners;

(iv) Conditions for spouse accompanying ailing officers: Permission may be granted an officer's spouse to accompany him/her at Government expense where the ailing officer is considered to be in 'Life or death' condition, in consequence of which immediate medical treatment or hospitalization abroad is recommended. In such a case, the commitment of the State Government shall be limited to the provision of return air passage for the two of them, together with the payment of estacode rate in respect of only one spouse, it being assumed that if the patient is hospitalized his or her spouse will remain in a hotel, or that if the officer remains as an out-patient, the two of them will utilize the same hotel accommodation. Even then this privilege (by which spouse is permitted to accompany the officer) shall not be automatic, it being a necessary requirement specific approval for the competent authority must be obtained prior to the journey abroad.

PROCEDURE FOR MEDICAL CHECK-UP

(e) (i) The Governor's approval in respect of officers in category d(ii) above will be conveyed to the officers in writing by the Head of Service with copies to the Ministries of Health, Finance and Foreign Affairs and the appropriate Nigerian Mission.

(ii) officers in category (d) (iii) above will submit their applications through their Permanent Secretaries or Heads of Departments to the Head of Service of the State for the Director of Medical Services of the State Ministry of Health to counter-sign the Certificate of recommendation issued by a local consultant which should be attached to the application.

OFFICERS ENTITLED TO MEDICAL CHECK-UP

(f) (i) Officers on salary Grade Level 15 and above are entitled to medical check-ups locally once a year. If as a result of such check-up.

it is recommended that a further medical consultation and/or treatment should be undertaken/given abroad, permission to do so may be granted by either the Governor or Head of Service of the State as the case may be, where such officers happen to be abroad on official business, they may undertake the once-a-year medical check-up abroad, provided that they obtain prior permission from either the Governor or Head of Service as the case may be, prior to their departure abroad.

(ii) Officers on salary Grade Level 12 to Grade Level 14 are entitled to medical check-ups locally once in two years. If as a result of such check-ups it is recommended that a further medical consultation and/or treatment should be undertaken/given abroad, permission to do so may be granted by the Head of Service; where such officers happen to be overseas on official business, they may take their once-in-two years medical check-up abroad provided that they obtain prior permission from the Head of the Civil Service of the State before the medical consultation takes place, and provided also that the medical adjacent practitioner to be consulted is one that is recommended by the Nigerian Mission located in or to the particular country concerned.

It should be noted that a local medical check-up may only be authorized if the applicant chooses a Government Hospital or a University Teaching Hospital.

(g) Hospital bills in respect of medical check-ups authorized under this scheme should be settled by the relevant Ministries/Extra- Ministerial Department.

SECTION 3 - ABSENCE FROM DUTY ON ACCOUNT OF ILLNESS-MEDICAL CERTIFICATE

Types

09301 - The following types of Medical Certificate are used in connection with the sickness of staff:

1. Excuse Duty Certificate, combined Medical Form No. Med. 166
2. Light Duty Certificate, combined Medical Form No. Med. 167
3. Medicine and Duty Certificates, combined Medical Form No. Med. 168
4. Certificates issued by hospitals run by Government agencies.

How obtained

09302 - An officer seeking one of these certificates should do so either:

1. by presenting himself to the appropriate Medical Officer for examination in which case he will, unless admitted to hospital as inpatient be given by the Medical Officer who examines him whichever certificate the latter considers appropriate; or
2. by forwarding to the Senior Administrative Medical Officer at his station a detailed report on his sickness by the private medical practitioner who is attending to him, and arranging for the collection from such Medical Officer of whichever certificate the latter decides to issue in the light of the private practitioner's report (see Rule 09315)

RESPONSIBILITY OF OFFICERS

09303 - Every officer is responsible for keeping his Ministry/Departmental informed in writing of the address at which it shall be possible to find him or ascertain his whereabouts in the event of his being prevented by illness from attending duty.

Duty to Notify Address

09304 – (a) An officer not being on leave of absence or an in-patient in a Government Hospital who is prevented by illness from performing his duties at his place of work, must either report the fact immediately to his department or, within 24 hours, cause to be delivered to his department an excused duty certificate, signed by the appropriate Medical Officer, with the contents of which the officer has made himself acquainted.

(b) on reporting such to his Department an officer shall either:

(i) receive instructions to seek medical advice forthwith in which case he must cause one or other of the medical certificates listed in Rule 09301, with the contents of which he has acquainted himself, to be delivered to his department within 24 hours. Or

(ii) be authorized by a responsible officer to absent himself from duty without a medical certificate for a specified period; in a place where a Medical Officer is available such specified period shall not exceed two days; in a place where no Medical Officer is available the specified period shall be at the discretion of the responsible officer.

(c) Unless absence from duty through illness is covered either by admission to a Government hospital, by Departmental authority as explained above or an excuse Duty Certificate, it shall be treated as absence without leave (see Rule 04412).

Duty to Self and Comply with Medical Advice

09305 - An officer stationed at a place where a Medical Officer available must when he has been prevented by illness for two days from performing his duties at his place of work (whichever event occurs first), seek medical advice. An officer may seek such advice either from the Medical Officer or if he prefers, from a private medical practitioner in the neighborhood. In either case, he must comply with the advice given. If he prefers to be treated by a private practitioner, he must obtain the latter's consent to meet the medical officer in consultation. An officer stationed at a place where no Medical Officer is available must, when so instructed by his Ministry, comply with any official arrangements made to provide him with medical advice and must comply with the advice so obtained. An officer who has failed to comply with this Rule shall render himself liable to be treated as having been absent without leave.

Duty to Attend Medical Boards and Comply with Recommendations

09306 - If for any reason it is decided that an officer should be examined by a Medical Board, he must present himself for examination at the place and time instructed, and must afterwards comply with the recommendations of the Board, which will supersede comply with any medical advice already given to him by a Medical Officer or Sieg private practitioner. An officer who has failed to comply with this Rule shall render himself liable to be treated as having been absent without leave.

RESPONSIBILITIES OF MINISTRIES/EXTRA MINISTERIAL DEPARTMENTS

Who is responsible

09307 - The Permanent Secretary/Head of Extra-Ministerial Department will arrange for the responsibilities described in the following four Rules to be allocated to appropriate officers.

Recording of Addresses

09308 - In each Ministry/Extra-Ministerial Department an up-to-date record must be maintained of the residential addresses of the officers and staff employed there (see Rule 09303).

Enquires about Absentees

09309 - If an officer's absence from duty is not explained by him within 24 hours, enquiry shall be made at his recorded address to ascertain the cause of absence.

Reporting of Staff’s Sickness

09310 - Whenever an officer becomes so ill that he is physically unable to present himself for medical examination, the circumstances and his whereabout should be reported by his Ministry/Extra- Ministerial Department to the nearest Medical Officer. 09311 - When an officer reports that he is prevented from performing his duties, he should (unless Rule 09310 applies) be instructed or authorized as explained in Rule 09304 (b) and be provided with a note requesting the Medical Officer to examine and treat him.

Instruction to Staff Reporting Sick

09312 - When it is desirable to appoint a Medical Board, it is the responsibility of the Permanent Secretary/Head of Extra-Ministerial Department to initiate action in that regard.

RESPONSIBILITY OF MEDICAL OFFICER

When Patient Attends in person

09313 - When an officer presents himself to a Medical Officer for examination, the latter shall examine and treat him and give him either of the certificates listed in Rule 09301 as the Medical Officer considers appropriate or, if he admits him to hospital as an in-patient, inform his Ministry/Extra-Ministerial Department.

When Ministry Extra-Ministerial Department Report Patient Unable Attend

09314 - When a Ministry/Extra-Ministerial Department reports to a Medical Officer that an officer of the Ministry/Extra-Ministerial Department is so ill that he is physically unable to present himself for medical examination, the Medical Officer shall, as appropriate, either arrange for the officer to be brought to hospital for examination and treatment or visit the officer to examine and treat him. If the examination results in the officer being admitted to a Government hospital as an in-patient, the Medical Officer will so inform the officer's Ministry/Extra-Ministerial Department, otherwise he shall give the officer whichever of the certificates listed in Rule 09301 he considers appropriate.

09315 – When an officer forwards to a Medical Officer a report on his sickness by the private practitioner attending him, the Medical Officer will, after such consultation with the private practitioner as he may deem necessary, issue whichever of the certificates listed in Rule 09301 he considers appropriate in the light of the private medical practitioner's report. The period of excuse duty or light duty entered on the first certificate he issues shall not exceed three days unless the Government Medical Officer has himself examined the patient, in which case the period may be for up to seven days. Each period of extension thereto shall not exceed seven days and not more than a total of thirty-one days sick leave may be allowed on such certificates. If the officer is still not fit for duty after thirty-one days sick leave he shall be examined by a Medical Board. This shall also apply to an officer admitted to a private hospital on the instruction of a Government Medical Officer, but it shall not apply when an officer is admitted to a Government hospital unless the period exceeds three months where a Medical Board would have to be held.

Ministries/Extra-Ministerial Department

09316 - On any of the occasions listed in this Rule the Medical Officer shall report the circumstances to the officer's Ministry/Extra- Ministerial Department.

1. When an officer is admitted to and when he is discharged from a government hospital;
2. When an officer refuses to carry out or in the opinion of the Medical Officer is neglecting to carry out, the medical advice he has been given;
3. When in the opinion of the Medical Officer an officer is feigning ill-health.

SICK LEAVE RULES

09317 - An officer not being on leave of absence who is absent from duty on the grounds of ill-health will, provided such absence is covered by proper authority, be regarded as being absent on sick leave.

09318 - An officer on vacation leave who is prevented from-resuming duty at the expiration of his authorized leave by reason of ill-health duly certified by a Government Medical Officer may be granted an extension of leave.

Aggregate Sick Leave

**09319 **- (i) The maximum aggregate sick leave' which can be allowed by an officer, who is not hospitalized, during any period of twelve months shall be six weeks.

Where such an officer has been absent from duty on the ground of ill-health for an aggregate period in excess of six weeks within 12 calendar months the officer should be made to appear before a Medical Board with a view to its being ascertained whether he should be invalided for the service. Any period of absence on the ground of ill-health in excess of the prescribed aggregate period will be without pay and will not be reckoned for purpose of increment or pension.

(ii) An officer who is incapacitated as a result of injury sustained in the course of his official duties shall be entitled to draw full salary until he is discharged from sick leave or permanently invalid.

09320 - (a) An officer who is recommended by a Medical Board or a Medical Officer to be permanently invalided will forthwith commence vacation leave prior to retirement in accordance with Rule 13203.

(b) Where an officer who is incapacitated in the course of his official or duties has not completed the not completed the minimum qualifying service and is not on the termination of his service, eligible for a pension under the pension Act No. 102 of 1979, the appropriate authority responsible for pension matters, may in lieu of gratuity stipulated in the relevant pension Schedule, grant to such officer, in addition to injury pension stipulated in Table C of the Pension Act and in the said Schedule, a pension calculated at the rate of 2 percent of the officers accrued pension from the date of the officers retirement.

09321 - Sick leave for a period up to three months in the first instance may be allowed on the certificate of a Government Medical Officer to an officer who is hospitalized. If at the end of that period the officer is still hospitalized, his Permanent Secretary/Head of Extra-Ministerial Department must make an arrangement for him to be examined by a Medical Board with a view to its being ascertained whether he should be invalided from the service or allowed further paid sick leave,

SECTION 4 - INJURIES

Application

09401 This section does not apply to any person who is a workman to whom the provisions of the Workmen's Compensation Act, (Cap.470 of 1990), Laws of the Federation of Nigerian, apply.

Action by Injured Officer

09402 - When an officer sustains an injury as a result of an accident encountered in the course of performing his duty, he must immediately inform the nearest Medical Officer unless he is unable, by reason of his injury to do so.

Action by Medical Officer

09403 - When a Medical Officer receives information of injury to an officer whether the information is received from the injured person or from any other source, he shall as soon as possible report details of injury to the appropriate Permanent Secretary/Head of Extra-Ministerial Department or his representative.

09404 - When a Permanent Secretary/Head of Extra-Ministerial Department or his representative is informed by a Medical Officer or any other person, of an injury sustained by an officer as a result accident in the course of his duty which might lead to a claim under the Pensions Act or otherwise, he shall call for a report by a Medical Officer if no such report has already been received. On receipt the medical report, the Representative shall enquire into the circumstances of the accident and if satisfied that the injury was not incurred in the actual discharge of duty, he shall so report to the Bureau of Establishments sending a copy of his report to the injured person's Ministry/Extra-Ministerial Department. If, however, after his injury the representative has any doubt on these points, he shall as soon as possible convene a Board to consider the matter to report its

Findings on the following questions:

1. Did the accident occur in the actual discharge of duty
2. Was the accident due to any fault of the injured person?
3. Was the accident specifically attributable to the nature of the duty being discharged?

The Board's report shall be forwarded by the Representative together with his report thereon to the Bureau of Establishments through the Permanent Secretary/Head of Extra-Ministerial Department concerned.

In the case of fatal injury, the representative shall convene a Board in the same way unless the information provided by the coroner's inquest is clearly sufficient for the purpose of deciding whether a special award should be made.

SECTION 5 - DEATH: REPATRIATION CORPSES

Death of Serving pensionable Officer

09501 - (a) The Government shall repatriate, at the request of the deceased's family, the corpse of a Nigerian Officer who dies abroad while on official duty tour or course of instruction, or the corpse of wife of the official who was duly authorized to accompany him on the duty tour or course of instruction. Government's responsibility shall be limited to the following:

1. preparation of the body (embalmment).
2. purchase of a reasonable priced coffin or casket including inner zinc and wooden coffin as stipulated by Airline Regulations,
3. transportation of the corpse to the officer's home town, at reasonable cost, and
4. payment of N45,500.00 to the immediate family of the deceased for the publication of obituary.

(b) When a pensionable officer dies in the service of the Government, it shall be the responsibility of the Government to provide the following:

(i) preparation of the body for embalmment where necessary;

(ii) settlement of mortuary bills;

1. provision of coffin or casket subject to the following maximum

amount:

GL. 01-06 : N20,000.00

GL. 07-10 : N30,000.00

GL. 12-14 : N40,000.000

GL. 15-16 : N60,000.00

Consolidated salary : 100,000.00

(iv) Notification of the death of serving pensionable officers and

retired officers in the Directorate Cadre shall be done at

Government expense.