ESI: card, treatment and benefits

1Your situation

A few questions. We show only the documents and steps your answers need.

Your answers stay on this phone.

Each step below says who it is for. Confirm yours at the office, then change your answer here.

2Documents you need

Tick the ones you have. They are kept in this browser.

• e-Pehchan card (or the ESI insurance number)original · The e-Pehchan card; for treatment before it comes, the employer's Certificate of Employment (Form 86)If you don't have it: Download it from the IP portal, the UMANG app or DigiLocker; if it is lost, you can also ask your employer.Have itNeed it
• Aadhaar of yourself and your family membersoriginalHave itNeed it
• Photos of you and your family members (to paste on the card)originalHave itNeed it
• Bank account detailscopyHave itNeed it
• The employer's abstention verification reportoriginalHave itNeed it
• ABVKY claim form (AB-1)originalIf you don't have it: ESIC Branch Offices give forms free.Have itNeed it
• Affidavit (for ABVKY)originalHave itNeed it
• Photocopy of your Aadhaar cardcopyHave itNeed it
• Proof of why the job ended: certificate of closure, retrenchment, or permanent invalidity of 40% or more; the employer's certificate; a life certificateoriginalHave itNeed it
• Funeral expenses claim form (Form 22)originalIf you don't have it: ESIC Branch Offices give forms free.Have itNeed it
• Death certificateoriginalHave itNeed it
• Identity proof of the person claimingcopyHave itNeed it

Nothing to get ready before these steps.

3Your steps

· Do them in order. Tick each one when it is done.

1. Do this now

   Ask your employer to register you with ESIC.

   Every covered employee must be registered on the day they join and given the e-Pehchan card. You are covered if you work in a factory or establishment covered by ESI and earn up to ₹21,000 a month (up to ₹25,000 for a person with disability).

   Where

   Your employer

   Sources: 7, 6, 1

   I have done this step
2. Do this now

   Until the card comes, ask your employer for a Certificate of Employment (Form 86) to get treatment.

   It is valid for 3 months and can be renewed for up to 3 more.

   Where

   Your employer

   Sources: 6

   I have done this step
3. Do this now

   Download your e-Pehchan card from the IP portal or the UMANG app; it is also in DigiLocker.

   In the ESIC Health Connect app, log in with your IP number and an OTP, open "IP Details", choose your employer code and download it.

   Where

   Online

   Open the official page

   Sources: 6, 7, 8, 9

   I have done this step
4. Do this now

   Paste the photos of yourself and your family on the downloaded card, and have it countersigned by your employer or the ESIC Branch Manager.

   Always keep one copy certified by your employer with you.

   Where

   Your employer, or the ESIC Branch Office

   Sources: 7, 6

   I have done this step
5. Do this now

   Check your family members' details.

   Link (seed) Aadhaar for yourself and each family member: on the IP portal or in the ESIC Health Connect app, with an OTP sent to the mobile number registered with Aadhaar, or by face authentication; your employer or the Branch Office can also do it. After a marriage, birth or death, ask for the family details to be changed.

   Where

   Online

   Open the official page

   Sources: 6, 8, 7

   I have done this step
6. Do this now

   Go to your ESI dispensary with your e-Pehchan card.

   From your first day in insured work, you and your family get full medical care with no upper limit on its cost, and medicines are free. You can see a doctor and get medicines at any ESI dispensary or hospital in India. You can change your dispensary on the IP portal.

   Where

   Your ESI dispensary (the list of Andhra Pradesh dispensaries is on esic.gov.in; they are run by the State's ESI scheme)

   Open the official page

   Sources: 3, 6, 10, 13

   I have done this step
7. Do this now

   If you like, book an appointment at the dispensary or an ESI hospital in the ESIC Health Connect app, and check in from the app on the day.

   Otherwise, take an OPD number at the registration counter.

   Where

   You do this yourself

   Sources: 8

   I have done this step
8. Do this now

   For a specialist or a hospital stay, the dispensary refers you to an ESI hospital; except in an emergency, go through the referral.

   Where

   An ESI hospital. In Andhra Pradesh: ESIC Hospital, Kakinada (run by ESIC); ESIS Hospitals at Rajamahendravaram, Tirupati, Vijayawada and Visakhapatnam (run by the State)

   Sources: 6, 3, 12, 13

   I have done this step
9. Do this now

   Get a medical certificate from your ESI dispensary doctor for the days you cannot work.

   Sickness or maternity benefit is not paid for a day you worked and were paid.

   Where

   Your ESI dispensary

   Sources: 2, 6

   I have done this step
10. Do this now

    Ask your employer whether they have sent ESIC the accident report (Form 12).

    A claim for the injury needs that report, accepted by ESIC.

    Where

    Your employer

    Sources: 7, 6

    I have done this step
11. Do this now

    Claim sickness benefit online on the IP portal, where you can also see its status.

    It is 70% of your wages, for up to 91 days in a year, if contributions were paid for 78 days in the matching contribution period. For 34 long-term diseases it can continue for up to two years at 80%. If in doubt, ask your Branch Manager.

    Where

    Online

    Time limit

    7 days, by ESIC's charter.

    Open the official page

    Sources: 2, 6, 9

    I have done this step
12. Do this now

    Claim maternity benefit online on the IP portal; you need not go to the Branch Office.

    It is your full wage for 26 weeks (one more month if a doctor advises), if contributions were paid for 70 days in the two previous contribution periods. It needs the medical certificate, the employer's report and your bank details.

    Where

    Online

    Time limit

    14 days, by ESIC's charter.

    Open the official page

    Sources: 2, 6, 9

    I have done this step
13. Do this now

    Claim temporary disablement benefit on the IP portal: 90% of your wages for as long as you cannot work, from your first day in insured work, with no contribution condition.

    If the disablement is permanent, a Medical Board decides how much earning capacity you lost, and you are paid monthly accordingly; apply for the Medical Board examination as soon as the temporary benefit ends.

    Where

    Online

    Time limit

    30 days, by ESIC's charter.

    Open the official page

    Sources: 2, 6, 9

    I have done this step
14. Do this now

    Claim relief under the Atal Beemit Vyakti Kalyan Yojana (ABVKY): 50% of your wages for up to 90 days, once in your life.

    You need at least one year of insured work just before the job ended, and contributions for at least 78 days in the completed contribution period within the 12 months before. The relief becomes payable 30 days after the job ended. Claim online, and give the paper claim (AB-1), an affidavit, a photocopy of your Aadhaar and your bank details at the Branch Office, in person or by post. The scheme runs until 30 June 2027.

    Where

    Your ESIC Branch Office (in Andhra Pradesh, for example Vijayawada, Visakhapatnam, Rajahmundry, Kakinada, Eluru, Guntur, Nellore, Ongole, Kurnool, Kadapa, Anantapuramu; the full list is on esic.gov.in)

    Time limit

    15 days, by ESIC's charter.

    Not confirmed: For the online claim, the ESIC page gives an old address (www.esic.in); ask the Branch Office where to claim online.

    Sources: 4, 5, 6, 11

    I have done this step
15. Do this now

    If the job ended because the establishment closed, because of retrenchment, or because of a permanent invalidity of 40% or more from an injury not at work, and you were insured for two years or more: claim the unemployment allowance under the Rajiv Gandhi Shramik Kalyan Yojana.

    It is 50% of your wages for the first 12 months and 25% for the next 12, once in your life, with medical care for your family meanwhile.

    Where

    Your ESIC Branch Office (in Andhra Pradesh, for example Vijayawada, Visakhapatnam, Rajahmundry, Kakinada, Eluru, Guntur, Nellore, Ongole, Kurnool, Kadapa, Anantapuramu; the full list is on esic.gov.in)

    Time limit

    30 days, by ESIC's charter.

    Sources: 4, 6, 11

    I have done this step
16. Do this now

    The eldest surviving family member (or whoever paid for the funeral, if the worker had no family or did not live with it) claims funeral expenses at the nearest ESIC Branch Office with Form 22: the amount actually spent, up to ₹20,000.

    It is paid whatever the cause of death.

    Where

    Your ESIC Branch Office (in Andhra Pradesh, for example Vijayawada, Visakhapatnam, Rajahmundry, Kakinada, Eluru, Guntur, Nellore, Ongole, Kurnool, Kadapa, Anantapuramu; the full list is on esic.gov.in)

    Time limit

    15 days, by ESIC's charter.

    Sources: 2, 6, 11

    I have done this step
17. Do this now

    If the death was caused by an injury at work or an occupational disease, the dependants can claim dependants' benefit: together at most 90% of the worker's wages, every month.

    Claim at the Branch Office with the employer's accident report as accepted by ESIC, and each dependant's bank account number.

    Where

    Your ESIC Branch Office (in Andhra Pradesh, for example Vijayawada, Visakhapatnam, Rajahmundry, Kakinada, Eluru, Guntur, Nellore, Ongole, Kurnool, Kadapa, Anantapuramu; the full list is on esic.gov.in)

    Time limit

    90 days, by ESIC's charter.

    Sources: 2, 6, 11

    I have done this step