Medical Assistance (GBOCWWB)

What is the Medical Assistance scheme of the Goa BOCW Welfare Board?

Medical Assistance is a welfare scheme of the Goa Building and Other Construction Workers Welfare Board (GBOCWWB) under the Department of Labour and Employment, Government of Goa. The Board sanctions financial assistance to a registered construction worker who is hospitalised for five or more days due to an accident or any disease.

The rate structure is fixed and simple, and it is worth reading precisely because readers routinely overestimate it. From the Board's consolidated statement of schemes dated 8 September 2015:

Eligibility criteria: If the beneficiary is hospitalized for 5 or more days due to accident or any disease. Documents to be submitted: Form No. XLII or XLVI. Quantum of benefits: Rs 400/- hospitalized for first 5 days and Rs 40/- for remaining days, subject to maximum Rs 2000/-.

This is a revision of the original rule, which set Rs 400 for the first five days, Rs 20 for each remaining day and a Rs 1,000 ceiling. The printed Scheme No. 10 form on the Labour Department's website still carries that older text. Where the two differ, the 2015 consolidated statement: Rs 400 plus Rs 40 per day, capped at Rs 2,000 to is the operative figure, and it is the rate myScheme publishes for this scheme.

Medical Assistance is compensation towards the cost of being hospitalised, not health insurance. It does not reimburse hospital bills and it does not scale with the seriousness of the illness. A worker facing a large medical bill should also look at central health cover and at the Board's separate disability and funeral benefits.

Key features

• Rs 400 for the first 5 days of hospitalisation.
• Rs 40 for each remaining day.
• Overall ceiling of Rs 2,000.
• Triggered by accident or any disease, with a minimum stay of 5 days.
• Extended to a beneficiary put in plaster at residence after an accident.
• Applied for offline in Form No. XLII, or Form No. XLVI for ex-gratia accident assistance under rule 285.

What does the assistance actually work out to?

The ceiling of Rs 2,000 is reached at roughly 45 days of hospitalisation. Beyond that the amount does not increase.

Who is eligible for Medical Assistance?

You can apply if:

• You are a building or other construction worker.
• You are between 18 and 60 years of age.
• You have completed ninety days of service as a registered worker in the year.
• You are registered with the Goa Building and Other Construction Workers Welfare Board.
• You have been hospitalised for five or more days.
• The cause of hospitalisation is an accident or a disease.

Unregistered workers and their dependants are also eligible in one specific way; on production of a certificate from the builder or the Inspector of the area stating that the person is a building worker. This is the route for a worker who was engaged on site but never got on the Board's rolls.

You cannot apply, or are not eligible, if:

• You are under 18 or over 60 years of age.
• You were hospitalised for four days or fewer. The five-day threshold is absolute.
• You have not completed ninety days of service as a registered worker in the year and cannot produce the builder's or Inspector's certificate instead.
• You work outside the building and other construction trades, which places you outside the Board's coverage entirely.
• You are claiming reimbursement of hospital bills. The scheme pays a fixed per-day rate, not the cost of treatment.

What documents are required?

How to apply for Medical Assistance

1. Obtain the prescribed form. Print Form No. XLII from the official website of the Department of Labour and Employment, Goa, or visit the Office of the Commissioner, Labour and Employment, 2nd Floor, Shrama Shakti Bhavan, Patto Plaza, Panaji, Goa (phone 0832-2437081 / 82 / 83, email com-labo.goa@nic.in) and request a hard copy. Use Form No. XLVI instead if you are claiming ex-gratia medical assistance for an accident.
2. Fill in all mandatory fields, name and address, age and date of birth, registration number, the dates and banks of your first and last subscription, the total amount remitted, the details of the disease or surgery, any resulting disability, and the exact period of treatment showing the date of admission to and discharge from the Government hospital. Paste the passport-size photograph and sign it across if the form asks for one.
3. Attach self-attested copies of all documents, especially the hospital admission and discharge papers that establish the five-day minimum, and, if you are an unregistered worker, the certificate from the builder or the Inspector of the area.
4. Submit the duly filled and signed form with the documents to the concerned authority at the Office of the Commissioner, Labour and Employment, Panaji.
5. Collect the receipt issued on submission and keep it for following up on the sanction.

What if the accident causes a disability?

The Board's rules go further than the per-day rate where an accident leaves lasting damage:

• Disability from an accident — the worker is eligible for financial assistance up to a maximum of Rs 5,000 depending on the percentage of disability, claimed through Form No. XLVI, the application for ex-gratia medical assistance for accidents.
• Permanent disability from paralysis, leprosy, tuberculosis or an accident, the Board's separate Disability Pension gives Rs 300 per month, plus an ex-gratia payment of not more than Rs 10,000 depending on the disability percentage, applied for in Form No. XXXIX.

Form No. XLVI also asks whether the applicant was put in plaster at residence and for how many days, which is how the Board extends the benefit to accident cases that were treated at home rather than admitted.

How do I check the status of my claim?

There is no online tracking for this scheme. Follow up at the Office of the Commissioner, Labour and Employment in person or by phone on 0832-2437081, 0832-2437082 or 0832-2437083, quoting the receipt number issued at submission and your Board registration number.

Why a claim may be rejected

• Hospital stay under five days, which is the most common single reason.
• Age outside 18 to 60 on the date of hospitalisation.
• Ninety days of service as a registered worker not completed in the year, with no builder's or Inspector's certificate offered instead.
• Lapsed subscription record, the form's questions on first and last subscription exist precisely to catch this.
• Missing hospital records, so the admission and discharge dates cannot be verified.
• Benefit already availed for the same episode, which serial 11 of the form asks about.
• Treatment outside a Government hospital where the form's wording on the period of treatment as a patient in a Government hospital cannot be satisfied: confirm with the Board before assuming a private hospital stay will be accepted.

Where to get help

• Office of the Commissioner, Labour and Employment, 2nd Floor, Shrama Shakti Bhavan, Patto Plaza, Panaji, Goa, phone 0832-2437081 / 2437082 / 2437083, email com-labo.goa@nic.in.
• Goa Building and Other Construction Workers Welfare Board, for registration, subscription history and claim status.
• Department of Labour and Employment, Goa website, which hosts the prescribed form for each Board scheme, including this one.

Other Board benefits worth checking alongside Medical Assistance are Funeral Assistance of Rs 5,000 to the nominees or dependants, Financial Assistance for Marriage of Rs 4,000, and Family Pension at 50% of the pension received by the pensioner or Rs 200.