A NANA opinion means the medical or adjudicating authority has treated the disability as Neither Attributable Nor Aggravated by military service. In disability pension cases, a NANA finding can be challenged where the medical board gives no proper reasons, ignores service conditions, disregards the presumption of fitness at enrolment, contradicts earlier medical categorisation, fails to explain why the disease could not be detected at entry, or mechanically labels the disability as constitutional, idiopathic, lifestyle-related or unrelated to service.
The Armed Forces Tribunal may be approached after rejection of entitlement, First Appeal or Second Appeal, depending on the facts, limitation and cause of action. The Department of Ex-Servicemen Welfare notes that disability element is linked with disability attributable to or aggravated by military service, and also recognises First Appeal and Second Appeal mechanisms under the casualty pensionary framework.
Non-Solicitation Note
This article is for general legal awareness and educational purposes only and may be published by Fastrack Legal Solutions LLP. It is not an advertisement, solicitation, invitation or inducement for professional engagement. Disability pension and NANA cases depend on the Release Medical Board, Invaliding Medical Board, Retention-cum-Impairment Assessment Medical Board, appeal orders, service profile, medical category, diagnosis, percentage, attributability, aggravation, onset history, postings, stress and strain of service, documents and limitation.
Introduction
In armed forces disability pension cases, the most common rejection phrase is:
“Neither Attributable Nor Aggravated by Military Service”
This is usually written as:
NANA
For a soldier, officer, JCO, sailor or air warrior, this one phrase can decide whether disability pension, disability element, impairment relief, broad-banding or related pensionary relief will be granted or denied.
But a NANA opinion is not always final. It can be challenged if it is unsupported, mechanical, contradictory or contrary to the service and medical record.
This article explains how to analyse a NANA opinion and build an AFT challenge.
What Does NANA Mean?
NANA means:
| Term | Meaning |
|---|---|
| Neither Attributable | The authority says the disability did not arise because of military service |
| Nor Aggravated | The authority says military service did not worsen or contribute to the disability |
| By Military Service | The disability is treated as disconnected from service conditions |
A NANA opinion is usually found in:
- Release Medical Board.
- Invaliding Medical Board.
- Re-survey Medical Board.
- Review Medical Board.
- Appeal Medical Board.
- Adjudication order.
- First Appeal rejection.
- Second Appeal rejection.
- PPO-related disability rejection communication.
Why NANA Opinion Matters
A NANA opinion directly affects entitlement.
If the disability is accepted as attributable to or aggravated by military service and assessed at the required percentage, the claimant may become eligible for disability-related pensionary benefit, subject to rules and facts. The DESW pension information records that disability pension is granted in invalided-out cases where disability is attributable to or aggravated by military service, and disability element is also linked with attributable/aggravated disability in non-invalided retirement cases.
Therefore, when a board records NANA, the government usually denies disability pension or disability element.
The legal fight is often not about whether the person has a disease. The fight is about whether the disease is connected with military service by way of attributability or aggravation.
Attributable vs Aggravated: Key Difference
| Concept | Meaning | Example |
| Attributable to service | Disability arose because of service conditions or service incident | Injury during duty, operational exposure, service-related trauma |
| Aggravated by service | Condition may have existed or arisen otherwise, but service worsened it | Hypertension worsened by prolonged stress, field posting, disturbed sleep, operational strain |
| NANA | Authority denies both connection and aggravation | Board says disease is constitutional/lifestyle/idiopathic and not service related |
Many cases are not purely “attributable” cases. They are often stronger as aggravation cases.
When Can a NANA Opinion Be Challenged?
A NANA opinion may be challenged where:
- No disease was noted at the time of enrolment/commissioning.
- The person served for many years in fit category.
- The disability arose during military service.
- The board gives no detailed reasons.
- The board uses generic phrases like “constitutional disorder” or “lifestyle disease”.
- Service stress, field posting, high altitude, operational duty or harsh conditions are ignored.
- Earlier medical boards accepted aggravation/attributability but RMB later says NANA.
- The adjudicating authority reverses the medical board without adequate reasons.
- The percentage assessment is accepted but entitlement is denied.
- The appeal order is non-speaking.
- Medical opinion does not explain why the disease could not have been detected at entry.
- The rejection ignores Supreme Court principles.
Supreme Court Principles on NANA and Disability Pension
Dharamvir Singh Principle
In Dharamvir Singh v. Union of India, the Supreme Court considered a case where the appellant was boarded out with disability and disability pension was denied on the ground that the disability was neither attributable to nor aggravated by military service. The judgment discusses the presumption arising where no disease was noted at the time of entry and the need for medical reasoning where disease is said to be unrelated to service.
This judgment is frequently relied upon in disability pension cases where the government denies entitlement through a NANA opinion.
Sukhvinder Singh Principle
In Sukhvinder Singh v. Union of India, the Supreme Court reproduced Regulation 173 of the Pension Regulations for the Army, 1961, noting that disability pension is linked with invalidment on account of disability attributable to or aggravated by military service and assessed at 20% or above by competent medical authority.
This is important because medical percentage and service connection both matter.
Rajbir Singh Principle
In Union of India v. Rajbir Singh, the Supreme Court explained that a member of the armed forces is presumed to be in sound physical and mental condition at entry if no note to the contrary exists, and deterioration in health after discharge on medical grounds is presumed to be due to military service unless the employer rebuts that presumption. The Court also stated that denial of disability pension on the ground of no service connection requires reasons and that the burden lies heavily on the employer.
This is one of the strongest principles against mechanical NANA opinions.
NANA Opinion Cannot Be Mechanical
The medical board cannot simply write:
“NANA”
or
“Not connected with military service”
or
“Constitutional disorder”
or
“Lifestyle disease”
without explaining why service did not cause or aggravate the disability.
A proper opinion should examine:
- Entry medical condition.
- Date of onset.
- Length of service before onset.
- Nature of duties.
- Postings and field conditions.
- Stress and strain of service.
- Whether disease could have been detected at entry.
- Whether military service contributed to aggravation.
- Medical literature and service profile.
- Reasons for rejecting attributability/aggravation.
A non-speaking NANA opinion is vulnerable.
Common Disabilities Where NANA Is Disputed
| Disability / Condition | Common Government Reason | Defence / AFT Argument |
| Primary Hypertension | Lifestyle disease / constitutional | Stress, service strain, field duties, no entry disease, aggravation |
| Diabetes Mellitus Type II | Lifestyle/metabolic | Long service, service stress, restricted lifestyle, aggravation evidence |
| Sensorineural Hearing Loss | Age-related / not service related | Noise exposure, firing, operational duties, service profile |
| Psychiatric illness | Constitutional / personality issue | Service stress, traumatic events, posting conditions, onset in service |
| Seizure disorder | Constitutional / idiopathic | No entry note, long fit service, onset during service, reasons required |
| Disc prolapse / spine issue | Degenerative | Physical military duties, load-bearing, field conditions |
| Knee / joint disability | Degenerative | Parade, PT, route march, terrain, service duties |
| Bronchial asthma | Constitutional/allergic | Field exposure, weather, high altitude, aggravation |
Each case depends on documents. The diagnosis alone does not decide the case.
ER 2023 and GMO 2023: Current Policy Context
The Ministry of Defence issued a press brief on the Entitlement Rules for Casualty Pension and Disability Compensation Awards to Armed Forces Personnel, 2023 and Guide to Medical Officers (Military Pensions), 2023. The PIB press brief states that all death and disability reported/recorded after 21.09.2023 will be governed by ER 2023 and GMO 2023, and that the 2023 framework does not affect past pensioners/family pensioners already receiving death/disability compensation/family pension.
The same PIB brief explains the distinction between Disability Pension for invalided-out personnel and “Impairment Relief” for personnel retained in service despite disability attributable to or aggravated by military service.
For litigation, this means the applicable rule framework must be checked according to the date, service category, medical board and nature of claim.
First Appeal and Second Appeal in NANA Cases
Before AFT, many disability pension cases go through departmental appeal.
The DESW pension information records that where a person is aggrieved by denial of entitlement, a First Appeal may be submitted before Record Office/Service HQrs within six months and considered by the Appellate Committee for First Appeal under the Entitlement Rules framework. It also records that a person aggrieved by the First Appeal decision may file a Second Appeal within six months to the committee constituted for that purpose.
In practice, the appeal should not be a one-page emotional request. It should be a structured legal-medical challenge.
How to Challenge NANA Opinion Before AFT
A strong AFT challenge should be built in this sequence:
Step 1: Identify the Exact NANA Finding
Check whether NANA is recorded by:
- Release Medical Board.
- Invaliding Medical Board.
- Review Medical Board.
- Appeal Medical Board.
- Medical adviser.
- Adjudicating authority.
- First Appeal Committee.
- Second Appeal Committee.
This matters because sometimes the medical board and adjudicating authority differ.
Step 2: Check Entry Medical Record
The first question is:
Was any disease or abnormality noted at the time of entry?
If no disease was noted, the claimant may rely on the presumption of soundness at entry, subject to the applicable rules and facts. Rajbir Singh strongly supports the principle that if no contrary note exists at entry, the burden shifts heavily on the employer to rebut service connection with reasons.
Step 3: Create a Service Profile Chart
Prepare a chart like this:
| Detail | Information |
| Date of enrolment/commissioning | |
| Medical category at entry | |
| Years of service before onset | |
| Field/high-altitude/operational postings | |
| Duties performed | |
| First diagnosis date | |
| Medical category awarded | |
| RMB/IMB percentage | |
| NANA reason given | |
| First Appeal result | |
| Second Appeal result |
This helps the Tribunal understand the factual connection.
Step 4: Attack the Reasoning, Not Only the Result
Do not merely say:
“NANA is wrong.”
Say:
- Why the NANA opinion is unsupported.
- Which service documents were ignored.
- Which medical history was misread.
- Why aggravation was not considered.
- Why entry medical presumption applies.
- Why the order is non-speaking.
- Why the appeal rejection is mechanical.
- Why the board’s conclusion conflicts with service conditions.
Step 5: Claim Broad-Banding / Rounding Off Where Applicable
If the disability is accepted at 20% or more and entitlement is established, broad-banding/rounding off may also become relevant depending on applicable law, policy, percentage and category of release.
The prayer should be carefully drafted. Do not only ask for “disability pension”. Ask for all consequential benefits where legally applicable.
Documents Required for AFT Challenge
| Document | Why It Is Needed |
| Enrolment/commissioning medical record | To show no disease at entry |
| Service profile/posting record | To prove stress, strain, field or operational exposure |
| Release Medical Board | Main disability and NANA record |
| Invaliding Medical Board | Relevant in invalided-out cases |
| Medical category documents | Shows onset and progression |
| Specialist opinion | Often contains better factual material than final board summary |
| Appeal Medical Board | Shows whether appeal reasoning was considered |
| First Appeal order | Cause of action and departmental remedy |
| Second Appeal order | Final departmental rejection, where applicable |
| PPO / Corrigendum PPO | Pension implementation status |
| Rejection letter | Shows exact reason for denial |
| Medical treatment record | Supports diagnosis and progression |
| CO/Unit certificate, if available | Helps prove duties and service stress |
| Operational/field posting proof | Supports aggravation |
| Prior representations | Shows grievance history |
Common Grounds in AFT OA Against NANA Opinion
An Original Application before AFT may raise grounds such as:
- No disease was noted at entry.
- Applicant served in fit medical category for substantial period.
- Disability arose during military service.
- NANA opinion is non-speaking.
- Medical board failed to give reasons.
- Service conditions were ignored.
- Aggravation was not examined independently.
- Rejection order is mechanical.
- Appeal order does not deal with grounds.
- Board ignored Supreme Court principles.
- Disability percentage is accepted but entitlement wrongly denied.
- Applicant is entitled to disability element/impairment relief/disability pension as per applicable rules.
- Applicant is entitled to broad-banding/rounding off where applicable.
- Denial violates beneficial interpretation of pensionary provisions.
Practical Draft Prayer for AFT
A practical prayer may read:
Set aside the NANA finding recorded in the Release Medical Board/Invaliding Medical Board and the consequential rejection orders, and direct the respondents to treat the applicant’s disability as attributable to or aggravated by military service, grant disability pension/disability element/impairment relief as applicable, along with broad-banding/rounding off and arrears with interest.
This must be customised according to the exact medical board, percentage, release date and applicable rules.
Practical Example
Suppose an officer joins service in SHAPE-1 with no note of hypertension. After long service involving field postings, operational stress, irregular sleep and high-pressure duties, he is diagnosed with Primary Hypertension. At retirement, RMB assesses disability at 30% but records NANA by saying “lifestyle disease”.
A strong challenge would argue:
- No hypertension at entry.
- Long fit service before onset.
- Service conditions contributed to aggravation.
- Generic “lifestyle disease” reasoning is insufficient.
- RMB failed to discuss postings and duties.
- Rejection is non-speaking.
- Presumption and burden principles support the claimant.
- Relief should include disability element and rounding off if applicable.
Common Mistakes in NANA Cases
| Mistake | Why It Hurts the Case |
| Filing appeal without medical board record | Cannot attack the actual reasoning |
| Only saying “I served the nation” | Emotional appeal is not enough legally |
| Not proving no disease at entry | Presumption argument becomes weaker |
| Ignoring service profile | Aggravation argument remains incomplete |
| Not challenging appeal rejection | Cause of action may be incomplete |
| Not claiming broad-banding | Relief may remain incomplete |
| Not explaining delay | Limitation objection may arise |
| Filing without specialist opinion | Medical basis may remain weak |
| Treating every NANA case as identical | Each diagnosis requires separate strategy |
Related AFT and Military Pension Guides
Readers studying NANA disability pension cases should also read:
- Disability Pension for Armed Forces Personnel in India
- Disability Pension for Hypertension in Armed Forces
- Disability Pension for Diabetes in Armed Forces
- Broad-Banding of Disability Pension
- Release Medical Board vs Invaliding Medical Board
- First Appeal Rejected in Disability Pension Case
- Second Appeal Rejected in Disability Pension Case
- Army Rule 180: Court of Inquiry Rights and AFT Remedy
Frequently Asked Questions
1. What is NANA in disability pension?
NANA means the disability has been held Neither Attributable Nor Aggravated by military service.
2. Can a NANA opinion be challenged before AFT?
Yes. A NANA opinion may be challenged before the Armed Forces Tribunal if it is unsupported, mechanical, contradictory, non-speaking or contrary to the service and medical record.
3. Is medical board opinion final?
Medical board opinion carries weight, but it is not immune from judicial scrutiny. If reasons are absent or legally defective, the finding may be challenged.
4. What is the strongest ground against NANA?
One strong ground is that no disease was noted at entry, the disability arose during service, and the authorities failed to rebut the presumption with proper reasons.
5. What documents are needed to challenge NANA?
Release Medical Board, Invaliding Medical Board, entry medical record, service profile, posting record, medical category documents, appeal orders and rejection letters are important.
6. Is First Appeal necessary before AFT?
Many cases go through First Appeal and Second Appeal. Whether AFT can be approached immediately depends on facts, limitation and the nature of the rejection.
7. Can hypertension be challenged if declared NANA?
Yes, depending on facts. The claimant must show entry fitness, onset during service, service stress/aggravation and defective reasoning in the medical board.
8. Can diabetes be challenged if declared NANA?
Yes, but the challenge must be fact-specific. Generic denial as lifestyle disease may be challenged where service conditions, onset history and aggravation are ignored.
9. What relief can AFT grant?
Depending on facts, AFT may set aside rejection, direct grant of disability pension/disability element/impairment relief, broad-banding, arrears and interest.
10. What is the limitation for disability pension appeal?
Departmental First Appeal and Second Appeal mechanisms generally mention six-month timelines as per DESW information, but AFT limitation must be examined separately based on cause of action and delay facts.
Conclusion
A NANA opinion is one of the most important points in an armed forces disability pension case. But it is not automatically final. The real question is whether the medical board and adjudicating authority gave legally sustainable reasons after considering entry medical fitness, onset during service, service conditions, aggravation, medical history and applicable pension rules.
A strong AFT case against NANA is built through documents, not emotion. The claimant must place the medical board record, service profile, appeal orders and rejection reasons before the Tribunal and show why the conclusion of “Neither Attributable Nor Aggravated” is legally and factually defective.
Where the disability arose during service, no disease was noted at entry, and the rejection is mechanical, the NANA opinion may be open to challenge before the Armed Forces Tribunal.
Disclaimer
This article is for general legal awareness and educational purposes only and may be published by Fastrack Legal Solutions LLP. It is not an advertisement, solicitation, invitation or inducement for professional engagement. Disability pension, NANA, RMB, IMB, impairment relief, broad-banding and AFT matters depend on service record, medical board findings, percentage, diagnosis, rules applicable by date, appeal orders, limitation and case-specific documents.