Struggling to Access ESI Medical Facilities Due to Salary Increase – What Can I Do?

We are unable to access the ESI medical facility because our salary exceeds ₹21,000/- since October 2022 due to an increase in VDA. As a result, we cannot avail of the medical facility. I am working as a service contract laborer. Please help me understand how to obtain medical facilities.

Hi, If the wage of an employee exceeds the wage limit of Rs. 21,000 after April or October for the respective contribution periods, then the employee continues to be covered under ESI until the end of that contribution period. Please check with your contractor whether a group mediclaim policy facility is available.

If your salary had crossed Rs. 21,000 in October 2022, then you would be out of ESI from that October itself. At the same time, if your salary remained less than Rs. 21,000 in October but the increase took place from November onwards, then you should have contributed to ESI till March 2023. From April 2023 onwards, only then would you exit from ESI.

If you have contributed till September 2022, you should get the medical benefits until the benefit period is over. The benefit period corresponding to the contribution period April to September (2022) is January 2023 to June 2023. That means medical benefits should be available, subject to contribution conditions, till June 2023 even though you had exited from ESI in October 2022.

If you are still contributing or if your salary crossed Rs. 21,000 in November or December and thereby you have to contribute till March 2023, then you will continue to get medical benefits from ESI till December 2023, i.e., till the end of the benefit period (July to December) corresponding to your last contribution period, October 2022 to March 2023.