Definition of 'Sickness' Under the Act
Section 2(20) of the Act defines 'sickness' as "a condition which requires medical treatment and attendance and necessitates abstention from work on medical grounds."
So, a condition which requires medical treatment and attendance alone but not abstention from work on medical grounds, and a condition which necessitates abstention from work on medical grounds but does not require medical treatment and attendance, is not deemed 'sickness,' and sickness benefit is not payable.
ESI Compensation and Employee Rights
Only 50% of salary may be received by an employee as ESI compensation. If he receives a claim from ESIC, you should mark ESIC treatment for him.
Your organization is smartly manipulating this definition. The number of leaves your company allows and the types of leaves your organization offers also establish the rights of employees.
Choice of Medical Aid and Its Implications
It may also depend on the employee at the time of treatment whether he uses ESI medical aid or an outside medical practitioner. If he chooses the second option, he may claim SL, and ESIC is not liable to pay the sickness benefit.
Regards,
Manish Bali