Disability Benefits Under ESI or Employee State Insurance

Under Section 46, Subject to the provisions of this Act, the insured persons, their dependants or the persons hereinafter mentioned, as the case may be, shall be entitled to the following benefits, namely,-

1. Periodical payments to an insured person suffering from disablement as a result of an employment injury sustained as an employee under this Act and certified to be eligible for such payments by an authority specified in this behalf by the regulations (hereinafter referred to as disablement benefit);

Under Section of ESI Act 51, Subject to the provisions of this Act:-

1. A person who sustains temporary disablement for not less than three days (excluding the day of accident) shall be entitled to periodical payment at such rates and for such period and subject to such conditions as may be prescribed by the Central Government;
2. A person who sustains permanent disablement, whether total or partial, shall be entitled to periodical payment at such rates and for such period and subject to such conditions as may be prescribed by the Central Government :

Under Section of ESI Act 51 A, For the purposes of this Act, an accident arising in the course of an insured person's employment shall be presumed, in the absence of evidence to the contrary, also to have arisen out of that employment.

Under Section of ESI Act 51 B, An accident shall be deemed to arise out of and in the course of an insured person's employment notwithstanding that he is at the time of the accident acting in contravention of the provisions of any law applicable to him, or of any orders given by or on behalf of his employer or that he is acting without instructions from his employer, if

1. the accident would have been deemed so to have arisen had the act not been done in contravention as aforesaid or on without instructions from his employer, as the case may be; and
2. The act is done for the purpose of and in connection with the employer's trade or business.

Under Section of ESI Act 51 C, An accident happening while an insured person is, with the express or implied permission of his employer, travelling as a passenger by any vehicle to or from his place of work shall, notwithstanding that he is under no obligation to his employer to travel by that vehicle, be deemed to arise out of and in the course of his employment, if

1. the accident would have been deemed so to have arisen had he been under such obligation; and
2. at the time of the accident, the vehicle
   1. is being operated by or on behalf of his employer or some other person by whom it is provided in pursuance of arrangements made with his employer, and
   2. Is not being operated in the ordinary course of public transport service.
   3. In this Section of ESI Act "vehicle" includes a vessel and an aircraft.
   4. 
      

Under Section of ESI Act 51 D, An accident happening to an insured person in or about any premises at which he is for the time-being employed for the purpose of his employer's trade or business shall be deemed to arise out of and in the course of his employment, if it happens while he is taking steps, on an actual or supposed emergency at those premises, to rescue, succour or protect persons who are, or are thought to be or possibly to be, injured or imperilled, or to avert or minimise serious damage to property.

Under Rule 57, A person shall be qualified to claim disablement benefits

1. For temporary disablement for not less than three days (excluding the day of accident) for the period of such disablement sustained as an employee under the Act.
2. A person shall be qualified to claim periodical payment for permanent disablement sustained as an employee under the Act whether total or partial, for such disablement
3. Provided that where permanent disablement, whether total or partial, has been assessed provisionally for a limited period or finally, the benefit provided under this rule shall be payable for that limited period, or as the case may be, for life.
4. The daily rate of disablement benefit shall be ninety per cent. of the standard benefit rate in the contribution period corresponding to the benefit period in which the employment injury occurs, rounded to the next higher rupee.
5. Provided that where an employment injury occurs before the commencement of the first benefit period in respect of a person, the daily rate of disablement benefit shall be
   1. where a person sustains employment injury after the expiry of the first wage period in the contribution period in which the injury occurs, ninety per cent. of his average daily wages in that wage period, rounded to the next higher rupee ;
   2. where a person sustains employment injury before the expiry of the first wage period in the contribution period in which the injury occurs, ninety per cent. of his wages actually earned or which would have been earned, had he worked for a full day on the date of accident, rounded to the next higher rupee.
   3. Explanation. — The disablement benefit calculated as aforesaid shall be called the “ full rate ”.
   4. The disablement benefits shall be payable to the insured person as follows : —
      1. for temporary disablement, at the full rate ;
      2. for permanent total disablement, at the full rate ;
      3. for permanent partial disablement resulting from an injury specified, in Part II of the Second Schedule, at such percentage of the full rate which would have been payable in the case of permanent total disablement, as specified in the said schedule as being the percentage of the loss of earning capacity caused by the injury ;
      4. for permanent partial disablement resulting from an injury not specified in Part II of the Second Schedule, at such percentage of the full rate payable in the case of permanent total disablement as is proportionate to the loss of earning capacity permanently caused by the injury.
      5. Explanation. — Where more injuries than one are caused by the same accident, the rate of benefit payable under clauses (c) and (d) shall be aggregated but not so in any case as to exceed the full rate and in cases of disablement not covered by clauses (a), (b), (c) and (d) at such rate, not exceeding the full rate, as may be provided in the regulations.

 

ESI Contribution Rates, Rules, Procedure, Penalty and Related Matters

ESI CONTRIBUTION AND OTHER RELATED MATTER:-

Under Section 38, Subject to the provisions of this Act, all employees in factories or establishments to which this Act applies shall be insured in the manner provided by this Act.

Under Section 39, the contribution payable under this Act in respect of an employee

1. Shall comprise contribution payable by the employer hereinafter referred to as the employer's contribution and contribution payable by the employee hereinafter referred to as the employee's contribution and shall be paid to the Corporation.
2. The contributions shall be paid at such rates as may be prescribed by the Central Government:
3.  PROVIDED that the rates so prescribed shall not be more than the rates which were in force immediately before the commencement of the Employees’ State Insurance (Amendment) Act, 1989.
4. The wage period in relation to an employee shall be the unit in respect of which all contributions shall be payable under this Act.
5. The contributions payable in respect of each wage period shall ordinarily fall due on the last day of the wage period, and where an employee is employed for part of the wage period, or is employed under two or more employers during the same wage period, the contributions shall fall due on such days as may be specified in the regulations.
6. If any contribution payable under this Act is not paid by the principal employer on the date on which such contribution has become due, he shall be liable to pay simple interest at the rate of twelve per cent per annum or at such higher rate as may be specified in the regulations till the date of its actual payment.  PROVIDED that higher interest specified in the regulations shall not exceed the lending rate of interest charged by any scheduled bank. Any interest recoverable under this clause may be recovered as an arrear of land revenue or under sections 45C to 45-1.
   Explanation: In this sub-section, "scheduled bank" means a bank for the time being included in the Second Schedule to the Reserve Bank of India Act, 1934 (2 of 1934).

Under Section 40, THE PRINCIPAL EMPLOYER SHALL PAY IN RESPECT OF EVERY EMPLOYEE, WHETHER DIRECTLY EMPLOYED BY HIM OR BY OR THROUGH AN IMMEDIATE EMPLOYER, BOTH THE EMPLOYER'S CONTRIBUTION AND THE EMPLOYEE'S CONTRIBUTION.

1. Notwithstanding anything contained in any other enactment but subject to the provisions of this Act and the regulations, if any, made thereunder, the principal employer shall, in the case of an employee directly employed by him (not being an exempted employee), be entitled to recover from the employee the employee's contribution by deduction from his wages and not otherwise:
2. PROVIDED that no such deduction shall be made from any wages other than such as relate to the period or part of the period in respect of which the contribution is payable, or in excess of the sum representing the employee's contribution for the period.  
3. Notwithstanding any contract to the contrary, neither the principal employer nor the immediate employer shall be entitled to deduct the employer's contribution from any wages payable to an employee or otherwise to recover it from him.
4. Any sum deducted by the principal employer from wages under this Act shall be deemed to have been entrusted to him by the employee for the purpose of paying the contribution in respect of which it was deducted.
5. The principal employer shall bear the expenses of remitting the contributions to the Corporation.

Under Section 41, A principal employer, who has paid contribution in respect of an employee employed by or through an immediate employer, shall be entitled to recover the amount of the contribution so paid (that is to say the employer's contribution as well as the employee's contribution, if any) from the immediate employer, either by deduction from any amount payable to him by the principal employer under any contract, or as a debt payable by the immediate employer. The immediate employer shall maintain register of employees employed by or through him as provided in the regulations and submit the same to the principal employer before the settlement of any amount payable under this clause. In the case referred to in sub-section (1), the immediate employer shall be entitled to recover the employee's contribution from the employee employed by or through him by deduction from wages and not otherwise, subject to the conditions specified in the proviso to sub-section (2) of section 40.

Under Section 42, No employee's contribution shall be payable by or on behalf of an employee whose average daily wages during a wage period are below such wages as may be prescribed by the Central Government. The average daily wages of an employee shall be calculated in such manner as may be prescribed by the Central Government. Contribution (both the employer's contribution and the employee's contribution) shall be payable by the principal employer for each wage period in respect of the whole or part of which wages are payable to the employee and not otherwise.  

UNDER RULE 50 OF ESI RULES 1950, THE WAGE LIMIT FOR COVERAGE OF AN EMPLOYEE UNDER SUB-CLAUSE (B) OF CLAUSE (9) OF SECTION 2 OF THE ACT

1. SHALL BE FIFTEEN THOUSAND RUPEES A MONTH :
2.  PROVIDED THAT AN EMPLOYEE WHOSE WAGES (EXCLUDING REMUNERATION FOR OVERTIME WORK) EXCEED FIFTEEN THOUSAND RUPEES A MONTH AT ANY TIME AFTER AND NOT BEFORE THE BEGINNING OF THE CONTRIBUTION PERIOD, SHALL CONTINUE TO BE AN EMPLOYEE UNTIL THE END OF THAT PERIOD.
3. PROVIDED FURTHER THAT THE WAGE LIMIT FOR COVERAGE OF AN EMPLOYEE WHO IS A PERSON WITH DISABILITY UNDER THE PERSONS WITH DISABILITIES (EQUAL OPPORTUNITIES PROTECTION OF RIGHTS AND FULL PARTICIPATION) ACT, 1995 (1 OF 1996), AND UNDER THE NATIONAL TRUST FOR WELFARE OF PERSONS WITH AUTISM, CEREBRAL PALSY, MENTAL RETARDATION AND MULTIPLE DISABILITIES ACT, 1999 (44 OF 1999) RESPECTIVELY, SHALL BE TWENTY-FIVE THOUSAND RUPEES PER MONTH.
4. “ Contribution period ” means the period not exceeding six consecutive months, as may be specified in the regulations ; “ benefit period ” means the period not exceeding six consecutive months corresponding to the contribution period, as may be specified in the regulations.
5. Under Rule 4 of ESI General Rules,
   1. Contribution periods and the corresponding benefit periods shall be as under : — Contribution period                                           Corresponding benefit period
      1st April to 30th September                  1st January of the year following, to 30^th June.
      1st October to 31st March                     1st July to 31st December. the year following
      Provided that in the case of a person who becomes an employee within the meaning of the Act for the first time, the first contribution period shall commence from the date of such employment in the contribution period current on that day and the corresponding benefit period for him shall commence on the expiry of the period of 9 months from the date of such employment.

UNDER RULE 51, THE AMOUNT OF CONTRIBUTION FOR A WAGE PERIOD

1. SHALL BE IN RESPECT OF EMPLOYER’S CONTRIBUTION, A SUM (ROUNDED TO THE NEXT HIGHER RUPEE)
2. EQUAL TO FOUR AND THREE FOURTH (4.75) PER CENT. OF THE WAGES PAYABLE TO AN EMPLOYEE ; AND
3. EMPLOYEE’S CONTRIBUTION, A SUM (ROUNDED TO THE NEXT HIGHER RUPEE) EQUAL TO ONE AND THREE FOURTH (1.75) PER CENT. OF THE WAGES PAYABLE TO AN EMPLOYEE.

Under Rule 51 A, In respect of an employee who is a person with disability under the Persons with Disabilities (Equal Protection of Rights and Full  Participation) Act, 1995 (1 of 1996), and under the National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999 (44 of 1999), the employer shall not be required to pay employer’s share of contribution up to a maximum period of three years from the date of commencement of the contribution period. The employer’s share of contribution in respect of such employees and for such period under sub-section (1) shall be reimbursed to the Corporation by the Central Government

Under Section 44, every principal and immediate employer shall submit to the Corporation or to such officer of the Corporation as it may direct:

1. Such returns in such form and containing such particulars relating to persons employed by him or to any factory or establishment in respect of which he is the principal or immediate employer as may be specified in regulations made in this behalf.
2. Where in respect of any factory or establishment the Corporation has reason to believe that a return should have been submitted under sub-section (1) but has not been so submitted, the Corporation may require any person in charge of the factory or establishment to furnish such particulars as it may consider necessary for the purpose of enabling the Corporation to decide whether the factory or establishment is a factory or establishment to which this Act applies.
3. Every principal and immediate employer shall maintain such registers or records in respect of his factory or establishment as may be required by regulations made in this behalf.

Under section 45A, Where in respect of a factory or establishment

1. No returns, particulars, registers or records are submitted, furnished or maintained in accordance with the provisions of section 44 or
2. Any Inspector or other official of the Corporation referred to in sub-section 45 is prevented in any manner  by the principal or immediate employer or any other person, in exercising his functions or discharging his duties under section 45,
3. The Corporation may, on the basis of information available to it, by order, determine the amount of contributions payable in respect of the employees of that factory or establishment:
4. PROVIDED that no such order shall be passed by the Corporation unless the principal or immediate employer or the person in charge of the factory or establishment has been given a reasonable opportunity of being heard.

An order made by the Corporation under sub-section (1) shall be sufficient proof of the claim of the Corporation under section 75 or for recovery of the amount determined by such order as an arrear of land revenue under section 45B or the recovery under section 45C to section 45-I.