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Disablement Benefits

Eligibility: should be an employee on the date of the accident.

Benefit: Temporary disablement benefit is payable till temporary disablement lasts and is duly certified by authorized insurance medical officer/practitioner.
In case of permanent disablement, the cash benefit is payable for life. Amount payable is worked out on the basis of loss of earning capacity determined by a Medical Board.

Disablement benefit is payable within one month of submission of the complete claim papers.

Rate: In case of Temporary Disablement Benefit, above 88% of wages approx. In case of Permanent Disablement Benefit, PDB rate depending upon the percentage of loss of earning capacity as assessed by the duly constituted Medical Board, maximum 88% of wages, i.e. TDB rate. … see rates

Claim procedure:

for Temporary Disablement Benefit:

  • Procedure regarding submission of Regulation Certificate and claiming the benefit remains the same as shown above against Sickness Benefit.
  • In addition, an Insured Person who sustains employment injury to give a notice of such injury to the employer immediately either in writing or orally and also ensure that the employer has given the accident report to the concerned Branch Office well in time in the prescribed form-Form 16.

For Permanent Disablement Benefit:

  • An Insured Person should submit an application for reference to the Medical Board on plain paper to the Branch Office Manager after the termination of temporary disablement benefit. This may be done at the time of submitting the final certificate, or within twelve months from the termination of temporary disablement.
  • He should ensure that he also gives his age proof to the Branch Office Manager alongwith the application.
  • Form B.l (a) indicating residual incapacity will be issued by the I.M.O./I.M.l.at the time of final certificate. It is required to be submitted alongwith an application for appearing before a Medical Board. If it has not been obtained at the time of issue of final certificate it should be obtained at the time of applying for Medical Board.
  • The Medical Board sends its decision to the ESIC Regional Office directly or through Branch Office as the case may be and the Regional Office issues the sanction for periodical payments of P.D.B. One copy of the sanction order is endorsed to the Insured Person also. After receipt of this sanction the Insured person should submit the claims form in the Branch Office for payment of P.D.B. This payment will be made to him every month as long as he is alive.
  • In case his rate of P.D.B. is Rs. 5/- per day or less an insured person can apply for lump sum commutation of the payment provided that the total commuted value does not exceed Rs. 30,000/-.
  • n a period of six months from the date of possible option. Then only the Branch office Manager shall be able to send the request to Regional Office immediately. Otherwise the Insured Person will be referred to the Medical Referee for certifying normal expectancy of life, and only after such certificate is obtained, the Insured Person's case will be processed for sanction of commutation.
  • The original sanction order of commutation is sent to the Insured Person with a copy to the Branch Office. The Insured person should produce the original copy at the Branch Office at the time of payment.