[1] Hospital leave may be granted to railway servants other than in Group A and Group B, while under medical treatment for illness or injuries if such illness or injury is directly due to risks incurred in the course of official duties.

[2] Hospital leave shall be granted on production of medical certificate from an Authorized Medical Attendant.

[3] 
(a) Hospital Leave may be granted for such period as the authority granting it may consider necessary on leave salary: - 
    → Equal to leave salary while on leave on average pay for the first 120 days of any period of such leave; and 

    → Equal to leave salary during half pay leave for the remaining period of any such leave. 

(b) The amount of hospital leave which may be granted by the General Managers to railway servant is unlimited. 

[4] Hospital leave shall not be debited against the leave account and may be combined with any other kind of leave which may be admissible, provided the total period of leave, after such combination, does not exceed 28 months.

Note: - 
If the railway servant is one to whom the WC Act 1923 applies the amount of leave salary payable during Hospital Leave shall be reduced by the amount of compensation payable under Section 4 [1] [d] of the said Act.

President’s Decisions:-

[1] The General Managers are empowered to relax the provisions of this rule in individual cases meriting sanction of Hospital Leave beyond a period of 120 days on leave salary equal to leave salary while on leave on average pay, subject to such cases being reviewed by CMD [erstwhile CMO] with financial concurrence of FA & CAO
[SC 169/91] 

[2] DRM s / CWE s are also empowered to relax the provisions of this rule in individual cases meriting sanction of Hospital Leave beyond a period of 120 days on leave salary equal to leave salary while on leave on average pay, subject to such cases being reviewed by Medical Superintendents with financial concurrence of Associate Finance. 
[SC 7/93] 

[3]  Heads of non-divisional units, such as Workshops, Stores, Zonal Training Centers etc., the Junior Administrative Grade / Selection Grade Officers are also empowered to relax the provisions of this rule in individual cases meriting sanction of Hospital Leave beyond a period of 120 days on leave salary equal to leave salary while on leave on average pay, subject to such cases being reviewed by Medical Superintendents with financial concurrence of Associate Finance. Where the Heads of non-divisional units are in lower than JA Grade, all cases of grant of Hospital leave should be put up to the controlling SAG officer concerned, for relaxing provisions of this rule in individual cases meriting sanction of Hospital Leave beyond a period of 120 days on leave salary equal to leave salary while on leave on average pay, subject to such cases being reviewed by Medical Superintendents with financial concurrence of Associate Finance. …
[SC 79/93] 

Note: - 
The cases falling under the purview of President’s Decision No [2] & [3] above, a list of all such cases should be put up to the General Managers half-yearly for their post-facto approval, papers being routed through the controlling SAG officers. It may also be ensured that payment against Hospital leave whenever due is made regularly and not allowed to pend.