ESIC Services

Extended Sickness Benefit (ESB)

IPs suffering from long term diseases were experiencing great hardship on expiry of 91 days Sickness benefit. Often they, though not fit for duty, pressed for a Final certificate. Hence, a provision for paying Sickness Benefit for an extended period (Extended Sickness Benefit)of upto 2 years in a ESB period of 3 years.

1. 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

  5. II Neoplasms
  6. Malignant Diseases

  7. III Endocrine, Nutritional and Metabolic Disorders
  8. Diabetes Mellitus-with proliferative retinopathy/diabetic foot/nephropathy.

  9. IV Disorders of Nervous System
  10. Monoplegia
  11. Hemiplegia
  12. Paraplegia
  13. Hemiparesis
  14. Intracranial Space Occupying Lesion
  15. Spinal Cord Compression
  16. Parkinson's disease
  17. Myasthenia Gravis/Neuromuscular Dystrophies

  18. V Disease of Eye
  19. Immature Cataract with vision 6/60 or less
  20. Detachment of Retina
  21. Glaucoma

  22. VI Diseases of Cardiovascular System
  23. Coronary Artery Disease:- (a) Unstable Angina
    (b) Myocardial infraction with ejection less than 45%
  24. Congestive Heart Failure- Left , Right
  25. Cardiac Valvular Diseases with failure/complications
  26. Cardiomyopathies
  27. Heart disease with surgical intervention alongwith complications

  28. VII Chest Diseases
  29. Bronchiectasis
  30. Interstitial Lung Disease
  31. Chronic Obstructive Lung Diseases (COPD) with congestive heart failure (Cor Pulmonale)

  32. VIII Diseases of the Digestive System
  33. Cirrhosis of liver with ascities/chronic active hepatitis

  34. IX Orthopaedic Diseases
  35. Dislocation of vertebra/prolapse of intervertebral disc
  36. Non union or delayed union of fracture
  37. Post Traumatic Surgical amputation of lower extremity
  38. Compound fracture with chronic osteomyelitis

  39. X Psychoses
  40. Sub-group under this head are listed for clarification (a) Schizophrenia
    (a) Endogenous depression
    (a) Manic Depressive Psychosis (MDP)
    (a) Dementia

  41. XI Others
  42. More than 20% burns with infection/complication
  43. Chronic Renal Failure
  44. Reynaud's disease/Burger's disease.
  1. 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.
  2. 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.
  3. 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).