Thursday, 23 January 2025

Social security benefits under ESIC

Social security benefits under ESIC: (The section 46 of the Act)

  1. Medical Benefits
    • Full Medical Care: Comprehensive medical services for insured persons and their families from the first day of employment.
    • Retired and Disabled Persons: Medical care for retired and permanently disabled insured persons and their spouses with a nominal annual premium.
    • Specialist Consultations: Access to specialists for advanced medical advice.
    • In-Patient Treatment: Hospitalization services.
    • Imaging Services: Diagnostic and imaging services provided.
    • Artificial Limbs & Aids: Provision of prosthetics and other aids.
    • Reimbursement: For expenses incurred under specific circumstances.
  2. Sickness Benefits (SB)
    • Cash Compensation: 70% of wages for up to 91 days/year for certified sickness (requires 78 days of contributions in 6 months).
    • Extended Sickness Benefit (ESB): 80% of wages for up to 2 years for long-term diseases.
    • Enhanced Sickness Benefit: Full wage compensation for sterilization (7 days for vasectomy, 14 days for tubectomy).
  3. Maternity Benefits (MB)
    • Duration: 26 weeks of paid leave (extendable by one month) for confinement/pregnancy.
    • Eligibility: Requires 70 days of contributions in two preceding periods.
  4. Disablement Benefits
    • Temporary Disablement Benefit (TDB): 90% of wages from day one of employment during disability.
    • Permanent Disablement Benefit (PDB): 90% of wages monthly based on the loss of earning capacity as certified by a Medical Board.
  5. Dependants Benefits (DB)
    • Compensation: 90% of wages as a monthly payment to dependents in case of death due to employment injury or occupational hazard.
  6. Other Benefits
    • Funeral Expenses: Rs. 15,000 for last rites from the first day of employment.
    • Confinement Expenses: Financial support for childbirth if medical facilities are unavailable.
    • Vocational Rehabilitation: Training for permanently disabled workers.
    • Physical Rehabilitation: Support for recovery from employment-related injuries.

 Key Government Schemes Linked to ESIC:

  1. Rajiv Gandhi Shramik Kalyan Yojana
    • Unemployment Allowance: 50% of wages for up to 2 years for workers laid off due to closure, retrenchment, or invalidity.
    • Includes medical care and vocational training during unemployment.
  2. Atal Beemit Vyakti Kalyan Yojana (ABVKY)
    • Relief Payment: 50% of wages for up to 90 days (one-time benefit).
    • Eligibility: 1 year of employment with at least 78 days of contributions in the prior 12 months.
    • Claims: Can be processed online or in-person at ESIC offices.

Incentives for Employers Hiring Persons with Disabilities:

  • Wage Limit: Rs. 25,000 for ESIC benefits eligibility.
  • Contribution: Employer’s contribution is paid by the government for 3 years.

Contributory and Cash Benefit Features:

  • Contributions are wage-based, while benefits are need-based.
  • Cash benefits are disbursed through ESIC Branch/Pay Offices following contribution conditions.

This comprehensive structure ensures social security for insured workers, addressing medical, financial, and employment-related needs.

For more information or assistance, visit your nearest ESIC office or check the official website: www.esic.nic.in.