|
|
IPs suffering from long term diseases experienced great
hardship on expiry of 91 days sickness benefit. Often they
are pressed for a final certificate, though not fit for
duty. Hence, a provision for paying Sickness Benefit for
an extended period (Extended Sickness Benefit [ESB]) of up
to two years and in the case of Extended Sickness Benefit
for a period of three years. |
|
|
An IP suffering from certain long-term diseases is
entitled to ESB only after exhausting Sickness Benefit to
which he may be eligible. |
|
|
A common list of these long-term diseases for which ESB
is payable is reviewed by the corporation from time to
time. |
|
|
The list was last reviewed on 5.12.99 and revised
provisions of ESB became effective from 1.1.2000 and at
present this list includes 34 diseases which are grouped
in 11 groups as per international classification of
diseases and the names of many existing diseases have been
changed as under: |
|
1 |
Infectious Diseases |
|
|
1 |
Tuberculosis |
|
|
2 |
Leprosy |
|
|
3 |
Chronic Empyema |
|
|
4 |
AIDS |
|
2 |
Neoplasms |
|
|
5 |
Malignant Diseases |
|
3 |
Endocrine, Nutritional and Metabolic Disorders |
|
|
6 |
Diabetes Mellitus-with proliferative
retinopathy/diabetic foot/nephropathy. |
|
4 |
Disorders of Nervous System |
|
|
1 |
Monoplegia |
|
|
2 |
Hemiplegia |
|
|
3 |
Paraplegia |
|
|
4 |
Hemiparesis |
|
|
5 |
Hemiparesis |
|
|
6 |
Intracranial Space Occupying Lesion |
|
|
7 |
Spinal Cord Compression |
|
|
8 |
Parkinson’s disease |
|
|
9 |
Myasthenia Gravis/Neuromuscular Dystrophies |
|
5 |
|
Others |
|
|
1 |
More than 20 per cent burns with infection/complication |
|
|
2 |
Chronic renal failure |
|
|
3 |
Reynaud’s disease/Burger’s disease. |
|
1 |
In addition to the above list, the Director
General/Medical Commissioner are authorised to sanction
ESB for a maximum period up to 730 in cases of rare but
treatable diseases or under special circumstances, such as
adverse reaction to drugs which have not been included in
the above list, depending on the merits of each case, on
the recommendations of RDMC/AMO or either authorised
officers running the medical scheme. |
|
2 |
To be entitled to the Extended Sickness Benefit an
insured person should have been in continuous employment
for two years or more at the beginning of a spell of
sickness in which the disease is diagnosed and should also
satisfy other contributory conditions. |
