Confused About the ESIC Eligibility Form? Here's How to Get It from Your Employer

I have submitted Form 12 to the ESIC office, and now they are asking for the Eligibility Form from the employer's side.

Sir, please guide me on what this form is and how I can obtain it.

Form 12 is an accident report and has to be submitted by the employer ONLINE.

Accident reports are to be filed by the employer online at esic.in portal, and a copy should be provided to the panel doctor/dispensary with signature and seal. Ask your employer to submit it online.

Seniors,

Please guide over the Eligibility Form - what it is and how we can obtain it?

Aside, Gangadhar: Accidental report (Form 12) is mandatory to be filled by the employer to avail the benefits.

Understanding the Eligibility Form for ESIC

Now that online procedures have been introduced in ESIC, identifying the correct form can be confusing. Previously, there was FORM ESIC 37, used by employers to certify employee eligibility and required submission to the ESIC Branch Office for employees to claim benefits.

If FORM ESIC-37 is still applicable, it might be available in printed form at the ESIC Branch Office. You can obtain it there and submit it to the appropriate branch so the employee can receive benefits. Additionally, there is an online link to a form called ESIC MED-37, which might be the same. Please confirm this with your ESIC Branch Office Manager.

http://esic.nic.in/downloadableforms...employment.pdf

Regards

The question you are asking about is "eligibility form." But the answers you got are irrelevant. The eligibility form is required in case you are approaching a dispensary which is not actually your dispensary. Suppose your dispensary is at one location/city (e.g., HYD), but your dependent's dispensary is at another location/city (e.g., Pune). If your dependent also visited the same dispensary which is HYD, in this case, you are asked to submit the eligibility form. The same form is asked of you if you also visit another dispensary (e.g., Pune). You can download this form at the link below: [ESIC-105 Certificate of Entitlement](http://www.esic.nic.in/downloadableforms/ESIC-105%20Certificate%20of%20Entitlement.pdf)

Dear Friends,

Our learned friend Danush is correct in answering about the eligibility certificate. I will provide some additional information.

This certificate is requested by the dispensary or hospital when you, i.e. an Insured Person (IP), approach them for any special treatment or operation, etc. The certificate is issued by the Branch Office.

Currently, this certificate is available on the ESI portal for the IP. However, the dispensary or hospital will not accept it unless it is signed and stamped by the Branch Office.

Thank you.