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Extended Sickness Benefit


An IP suffering from certain long term diseases is entitled to ESB, only after exhausting Sickness Benefit to which he may be eligible. A common list of these long term diseases for which ESB is payable, is reviewed by the Corporation from time to time. The list was last reviewed on 5.12.99 and revised provisions of ESB became effective from 1.1.2000 and at present this list includes 34 diseases which are grouped in 11 groups as per International Classification of diseases and theo names of many existing diseases have been changed as under :-

I Infectious Diseases

  1. Tuberculosis
  2. Leprosy
  3. Chronic Empyema
  4. AIDS

II Neoplasms

  1. Malignant Diseases

III Endocrine, Nutritional and Metabolic Disorders

  1. Diabetes Mellitus-with proliferative retinopathy/diabetic foot/nephropathy.

IV Disorders of Nervous System

  1. Monoplegia
  2. Hemiplegia
  3. Paraplegia
  4. Hemiparesis
  5. Intracranial Space Occupying Lesion
  6. Spinal Cord Compression
  7. Parkinson's disease
  8. Myasthenia Gravis/Neuromuscular Dystrophies

V Disease of Eye

  1. Immature Cataract with vision 6/60 or less
  2. Detachment of Retina
  3. Glaucoma

VI Diseases of Cardiovascular System

  1. Coronary Artery Disease:- (a)Unstable Angina  (b) Myocardial infraction with ejection less than 45%
  2. Congestive Heart Failure- Left , Right
  3. Cardiac Valvular Diseases with failure/complications
  4. Cardiomyopathies
  5. Heart disease with surgical intervention alongwith complications

VII Chest Diseases

  1. Bronchiectasis
  2. Interstitial Lung Disease
  3. Chronic Obstructive Lung Diseases (COPD) with congestive heart failure (Cor Pulmonale)

VIII Diseases of the Digestive System

  1. Cirrhosis of liver with ascities/chronic active hepatitis

IX Orthopaedic Diseases

  1. Dislocation of vertebra/prolapse of intervertebral disc
  2. Non union or delayed union of fracture
  3. Post Traumatic Surgical amputation of lower extremity
  4. Compound fracture with chronic osteomyelitis

X Psychoses

  1. Sub-group under this head are listed for clarification (a) Schizophrenia
    (b) Endogenous depression
    (c) Manic Depressive Psychosis (MDP)
    (d) Dementia

XI Others

  1. More than 20% burns with infection/complication
  2. Chronic Renal Failure
  3. Reynaud's disease/Burger's disease.

In addition to the above list, Director General/Medical Commissioner are authorised to sanction ESB for a maximum period upto 730 in cases of rare but treatable diseases or under special circumstances, such as, adverse reaction to drugs which have not been included in the above list, depending on the merits of each case, on the recommendations of RDMC/AMO or either authorised officers runniong the medical scheme.

To be entitled to the Extended Sickness Benefit an Insured Persons should have been in continuous employment for 2 years or more at the beginning of a spell of sickness in which the disease is diagnosed and should also satisfy other contributory conditions.

ESB shall be payable for a period of 124 days initially and may be extended up to 309 days in chronic suitable cases by Regional Dy. Medical Commissioner/Medical Referee/Administrative Medical Officer/Chief Executive of the E.S.I. Scheme in the State or his nominee on the report of the specialist(s).

The duration of ESB may be enhanced beyond 400 days(91 days of sickness benefit plus 309 days of extended sickness benefit) to a maximum period of two years in deserving cases duly certified by a medical board. However, this facility would be available upto the date on which the insured person attain the age of 60 years.

 

 

Last updated / Reviewed : 2024-07-02

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निर्देश

आपको CPGRAM वेबसाइट पर निर्देशित किया जा रहा है। यदि आप पहले से पंजीकृत नहीं हैं, तो आपको CPGRAM पर पंजीकरण के लिए कहा जाएगा। पंजीकृत उपयोगकर्ता सीधे अपने CPGRAM यूजर आईडी और पासवर्ड का उपयोग करके लॉगिन कर सकते हैं।

  • 1. CPGRAM में लॉग इन करें
  • 2. "Grievance Detail"के तहत "Others/Not Listed/Not Known" का चयन करें
  • 3. "Ministry/Department" ड्रॉपडाउन में ESIC चयन करें
  • 4. "Subordinate Department/Office" में क्षेत्रीय कार्यालय का चयन करें
  • 5. शिकायत का विवरण दें .

Instructions

You are being directed to CPGRAM website. You would be asked to Register with CPGRAM if not already registered. Registered users can login directly using their CPGRAM user ID and password.

  • 1. Login into CPGRAM
  • 2. In section "Grievance Detail" select "Others/Not Listed/Not Known"
  • 3. In the "Ministry/Department" Drop Down Select ESIC
  • 4. In "Subordinate Department/Office" select the Regional Office
  • 5. Provide details of the complaint

Proceed