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Benefits

Sickness Benefit

Under the Act, it represents periodical payment of Cash Benefit made to the Insured Persons in respect

of sickness certified by I.M.O.s/I.M.P.s. The rate of Sickness Benefit corresponds to Standard Benefit

Rate and the rate at which, such benefit is payable, roughly works out to 66% of the average daily

wages at the maximum, which can be availed of by an employee for a maximum period of 91 days in

two consecutive benefit periods (one benefit period comprises 6 months normally). In order to beeligible for this benefit, an I.P. has to work for at least 78 days in the corresponding contribution period

(one contribution periods consists of 6 months normally).

Extended Sickness Benefit :This benefit is provided to an I.P. for any of the 34 listed specific

long-term diseases, like TB, Cancer and other malignant diseases requiring prolonged treatment. The

rate of Extended Sickness Benefit is 40% more than the Standard Benefit Rate, which works out to

about 80% of the average wages at the maximum, which is initially payable for a period of 124 days, in

addition to 91 days' of Sickness Benefit, which may be extended to 309 days. In fit cases, Extended

Sickness Benefit for an additional period of 330 days is also admissible, on recommendation of the

Special Medical Board. A few uncommon diseases, over and above 34 diseases listed, can also qualify

for the same benefit under discretion of the competent Medical Authority of E.S.I. Corporation, New

Delhi.

Maternity Benefit

This benefit also represents periodical payment in case of confinement/miscarriage/medical termination

of pregnancy and sickness arising out of pregnancy. The rate of benefit is double the standard benefit

rate, which works out to full average wages and more. The criteria for payment being that an Insured

Woman should have worked for 70 days in 2 consecutive contribution periods immediately preceding

the date of confinement, expected date of confinement etc. The maximum period for which this benefit

is admissible is 12 weeks, in case of confinement, 6 weeks, in case of mis-carriage. Additional period of

one month benefit is also admissible, in case, there is prolongation of sickness arising out of

pregnancy/confinement.

Disablement Benefit

Disablement Benefit consists of Temporary Disablement Benefit and Permanent Disablement

Benefit.

(a) Temporary Disablement Benefit : This benefit is admissible for temporary disablement,

arising out of Employment Injury, sustained by an employee in course of employment. There is

no limit of duration of this benefit, in as much as an employee can be entitled to this benefit for

the entire period he is certified incapacitated temporarily, as certified by Insurance Medical

Practitioner/I.M.O. etc.. No contributory condition is required to be fulfilled for this benefit. An

I.P., being an employee, can be entitled ; to this benefit, immediately on sustaining an E.I., even

on first day of, his Insurable Employment. The rate of Temporary Disablement Benefit is ; 40%

more than the Standard Benefit Rate equivalent to about 80% of the, average daily wages at

the maximum.

(b) Permanent Disablement Benefit : Permanent Disablement Benefit is of 2 category, aspermanent partial disablement benefit and permanent total disblement benefit. This benefit is

admissible to an I.P., who loses earning capacity partially or fully as a result of Employment

Injury sustained by him as an employee. The loss of earning capacity is assessed by a ;

duly-constituted Medical Board. This benefit is paid periodically till the death of an I.P. An I.P.

can, however, be entitled to lump sum payment of Permanent Disalement Benefit, in lieu of

periodic payment, which is called commutation of Permanent Disablement Benefit, subject to

the rate of such benefit being within Rs. 5.00 per day and/or the commuted value does not

exceed Rs. 30,000.00.

During the year 2006, 2,824 cases have been admitted for fresh payment of P.D.B., with this,

the total number of live P.D.B. beneficiaries at the end of 31.12.06, stands at 29,873.

Medical Benefits

Maternity BenefitsDependant Benefits

Sickness Benefits

Disablement Benefits

Funeral Expenses

Vocational Training

RGSKY Allowance

Medical Bonus

Money Order Facilities

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Dependants' Benefit

It is also periodic in nature, payable to the dependants of an I.P., in the event of death of an I.P. due to

Employment Injury sustained by him as an employee. The benefit is admissible to living widow(s),

dependent widowed mother and children upto the age of 18 years, among the first category of

dependants. Infirm children, who are dependent on the earning of the I.P. at the time of his death, are

also entitled to Dependants' Benefit, till the infirmity lasts. Where the I.P. is not svirvived by the widow,

children etc., the Dependants' Benefit is admissible to other dependants, viz., parents, grand parents,

minor brother(s), sister(s), hilly dependant on the earning of the deceased I.P. The rate of Dependants'

Benefit is equivalent to the rate of Temporary Disablement Benefit, which is about 80% of the average

daily wages of an I.P at the maximum. The full benefit rate of D.B. is now Rs. 420.00 at the minimum

and the maximvim is Rs. 8,190.00 per month. During the year, 2006, 56 death cases have been

admitted, with a total number of 134 dependants. As on 31.12.06, the total number of beneficiaries of

Dependants' Benefit stands at 4,309.

Funeral Expenses

Funeral Expenses are re-imbursements in lump sum in the event of death of an I.P., subject to the

decaeased person being entitled to any of the benefits provided under teh Act, at the time of his death.

The amount not exceeding Rs. 2,500.00 is reimbursed to the eldest surviving member of the deceased,

or the person, who had actually incurred the expenditure.

Vocational Training

Under the Scheme, an Insured Person can avail himself of vocational training, in the event of his

suffering permanent disability, to the extent of at least 40%. The vocational training provides for

know-how in different trades, under recognised Government Institutions to earn gainful employment in

future. As per the Scheme, the I.P. is entitled to receive cash allowance @ Rs. 45.00 per day, however,

it has been enhanced to Rs. 123.00 per day, w.e.f. 01.01.06. In addition, the I.P. is entitled to

rehabilitation allowance fro days on which, he remains admitted in artificial limb centre. Such benefit is

paid at the rate of Standard Benefit Rate.

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MB) Scheme, West Bengal http://esiwb.gov.in/htm/Benefits.html#ben_dis

7/3/2014