What is the ESIC letter about mandatory annual health check-up of employees above 40?

ESIC Sub-Regional Offices are sending establishment-specific letters under the Occupational Safety, Health and Working Conditions Code, 2020 and the Rules framed thereunder, directing employers to arrange annual health check-ups for employees above 40 years of age. The letter usually encloses a list of eligible employees drawn from ESIC records and asks the employer to extend required support, such as leave and coordination with the designated hospital.

What does IP/IW mean in the ESIC letter?

IP stands for Insured Person and IW stands for Insured Worker — both refer to employees registered under the Employees' State Insurance scheme whose wages are within the ESI wage ceiling and for whom ESI contributions are being deposited. The letter uses IP/IW to refer to the employees named in the enclosed list who must attend the health check-up.

Who counts as an 'eligible employee' for this check-up?

Eligible employees are those named in the list enclosed with the letter — typically all employees above 40 years of age who are registered as Insured Persons (IP) under ESIC for that establishment. If an employee above 40 is not on the list, check whether their ESI registration or wage records are up to date with the Sub-Regional Office.

Does this letter apply to my sector even if I'm not in dock work, mining, or construction?

The Occupational Safety, Health and Working Conditions (Central) Rules, 2026 formally limit the specific check-up mandate to dock work and building or other construction work. In practice, ESIC Sub-Regional Offices appear to be issuing this letter to all their registered establishments, regardless of sector, since it is linked to ESIC's own beneficiary health programme. If your establishment has received the letter with a named employee list, treat it as applicable and comply; seek written clarification from the Sub-Regional Office only if you want formal confirmation.

What exact law is cited for penalty in these letters?

Some letters cite Section 6 read with Section 104 of the OSH Code, 2020 specifically for penal consequences. Others use more general wording such as 'penal action under the relevant provisions of the Code.' Both refer to the same underlying risk: non-compliance with the Section 6 health-examination duty can attract penalty under the Code's general penalty provisions.

Who pays for the annual health check-up — employer or ESIC?

For eligible ESIC beneficiaries, the check-up conducted at an ESIC Hospital or Dispensary is free of cost. The employer's obligation is to arrange and facilitate the check-up — releasing employees, coordinating with the hospital, and covering transport where required — not to pay a medical fee, since the OSH Code duty is fulfilled through the free ESIC facility.

What should the employer do after receiving this letter?

Cross-check the enclosed employee list against current staff records, note the designated hospital/dispensary and schedule, inform employees to carry their e-pehchan card and come on an empty stomach, arrange special or paid leave and transport where needed, keep a compliance file, and send a written acknowledgment to the Branch Manager.

What happens if an employee refuses to attend?

The statutory obligation is on the employer to arrange and facilitate the check-up, not to force attendance. Employers should document that the employee was informed, offered leave and support, and given the opportunity to attend, and should follow up in writing if an employee declines, since the compliance record protects the employer in case of an audit.

What if an employee above 40 is not on the ESIC list?

This usually means their ESI registration, e-pehchan card, or contribution records are not current with the Sub-Regional Office. Employers should verify the employee's ESIC registration status and raise a correction request with the Branch Manager rather than assuming the employee is excluded from the requirement.

Why are employees asked to come with an empty stomach?

Fasting is required because the panel typically includes blood tests such as fasting blood sugar, which need the employee not to have eaten for several hours beforehand for an accurate result.

What is an e-pehchan card and why is it needed at the check-up?

The e-pehchan card is the ESIC identity card issued to Insured Persons, used to verify the employee's ESIC registration and access benefits, including this check-up, at the ESIC Hospital or Dispensary.

How should an employer reply to the ESIC Branch Manager after this letter?

A short written acknowledgment confirming receipt of the list, the intended date of compliance, and a point of contact is good practice. It creates a compliance record and signals cooperation, even though the letter does not always mandate a formal reply.

Is this a one-time requirement or does it recur every year?

The underlying OSH Code obligation is for an annual health examination, so employers should expect a similar letter and process each year for employees above 40, not a one-time exercise.

ESIC Letter on Mandatory Annual Health Check-Up for Employees Above 40: Complete Employer Guide — Labour Code Advisor

ESIC Letter on Mandatory Annual Health Check-Up: The Complete Employer Guide

In one line: If ESIC has sent your establishment a letter — with or without a named Section 104 citation — enclosing a list of employees above 40 and asking you to arrange their annual health check-up, this is a real, recurring compliance obligation, not a one-off notice. Here is everything an HR or compliance owner needs, in one place.

Employers across sectors — factories, trusts, hospitals, shops and establishments, IT and service firms — are opening near-identical letters from their ESIC Sub-Regional Office this year. The wording varies slightly between offices, but the ask is the same: identify the named employees above 40, get them to an ESIC facility for a free check-up, and keep proof that you did.

Two versions of the letter, side by side

Different Sub-Regional Offices are phrasing this slightly differently. Both are asking for the same compliance action.

Version A — specific citation: Invokes Section 6 of the OSH Code, 2020, encloses an Annexure of eligible employees, names a designated ESIC Hospital/Dispensary with a fixed date and time, and warns of penal action specifically under Section 6 read with Section 104 of the OSH Code, 2020.

Version B — general citation: States that the communication is issued “under the provisions of the Occupational Safety, Health and Working Conditions Code, 2020 and Rules framed thereunder,” asks the employer to “ensure necessary compliance by arranging annual health check-ups for eligible employees and extending required support… as applicable,” instructs that employees be sent with their e-pehchan card and on an empty stomach, warns of “penal action under the relevant provisions of the Code,” and closes with “this may be treated as important.”

If your letter looks like Version B, it is not a lesser or informal version of Version A — it is the same legal obligation, worded more generally. Employers should not read the absence of a specific section number as reduced urgency; the “may be treated as important” line is doing that job instead.

Decoding the letter, line by line

“Communication regarding mandatory annual health check-up… under the provisions of the OSH Code, 2020 and Rules framed thereunder” — this is the legal basis: Section 6(1)(c) of the OSH Code, operationalised through the Occupational Safety, Health and Working Conditions (Central) Rules, 2026, notified 8 May 2026 and currently in force.
“Ensure necessary compliance by arranging annual health check-ups for eligible employees” — “eligible employees” means those named in the enclosed list: employees above 40 registered as Insured Persons under ESIC for your establishment. See the eligibility section below if someone above 40 is missing from the list.
“Extending required support for the same, as applicable” — this covers releasing employees for the visit, granting leave where needed, and arranging transport to the designated facility where distance or timing makes it necessary.
“Employees are advised to come with his/her e-pehchan card” — the e-pehchan card is the ESIC identity document; without it, verification at the hospital counter can be delayed or refused.
“Send your IP/IW with empty stomach” — IP (Insured Person) and IW (Insured Worker) both refer to ESIC-registered employees; fasting is needed for accurate blood sugar and related test results.
“Non-compliance… may attract penal action under the relevant provisions of the Code” — the relevant provision is Section 104 of the OSH Code, the general penalty section, read with the Section 6 duty.
“This may be treated as important” — a standard government-letter phrase signalling this is not routine correspondence to file away; it expects action and, implicitly, a compliance trail.

Legal basis, precisely

Section 6(1)(c) of the OSH Code, 2020 requires every employer to provide free annual health examinations to employees “of such age or such class of employees or establishments… as may be prescribed by the appropriate Government.”

This has been operationalised through the Occupational Safety, Health and Working Conditions (Central) Rules, 2026, notified on 8 May 2026 and now in force. The notified Central Rules currently limit this specific check-up mandate to employees aged 40 and above in dock work and building or other construction work; an earlier draft had proposed including factories, but the final rules narrowed the scope.

Section 104 of the OSH Code is the general penalty provision for contravention of duties under the Code, and is the section — sometimes named explicitly, sometimes referred to only as “relevant provisions” — behind the penalty warning in these letters.

Why your establishment may have received this letter regardless of sector

This is the single most-searched question behind this topic, so it deserves a direct answer: the ESIC letter’s claimed scope is broader in practice than what the notified Central Rules mandate on paper. The Central Rules, read strictly, cover dock work and construction work. But ESIC Sub-Regional Offices appear to be issuing this letter to all establishments registered with them under the ESI framework — trusts, hospitals, shops, service companies — independent of that narrower sector list, because the letter is tied to ESIC’s own preventive health check-up programme for its insured beneficiaries as much as to the OSH Code duty itself.

Practical takeaway: if the letter names your employees, comply. Sector-based arguments about the Central Rules’ narrower wording are unlikely to be a useful compliance strategy once ESIC has already identified your establishment and listed your people by name.

Who counts as an “eligible employee”

“Eligible employees” in these letters means the individuals named in the enclosed list — not every employee above 40 in your establishment automatically. That list is built from ESIC’s own registration and contribution records. Two common mismatches to check:

Employee above 40 but not on the list: usually an ESI registration or wage-record gap. Raise it with the Branch Manager rather than assuming exclusion.
Employee on the list who has since left or crossed the wage ceiling: flag it back to ESIC in your reply so the record is corrected for future cycles.

Employer action checklist

Cross-check the enclosed list against current employment records — active status, correct age, correct establishment code.
Note the designated ESIC Hospital/Dispensary, and the visit date and time if specified.
Inform employees individually, not just via a notice board — this is a compliance record, not just an FYI.
Tell them to carry their e-pehchan card and, if fasting tests are indicated, to come on an empty stomach.
Sanction special or paid leave for the visit so attendance isn’t left to an employee’s discretion or personal leave balance.
Arrange transport to the facility if required by distance, shift timing, or the letter itself.
Send a written acknowledgment to the Branch Manager confirming receipt and your compliance timeline — see the sample below.
Maintain a compliance file: the letter, the employee list, attendance or consent records for the visit, and any report or certificate the hospital issues.
Repeat annually — this is not a one-time exercise; expect a similar letter each year.

Employee-facing instructions (keep this separate and simple)

Carry your e-pehchan card to the ESIC Hospital/Dispensary.
Come on an empty stomach if informed that fasting tests are part of the panel.
Confirm the exact date, time, and location with HR before the visit.
Report any change in your ESIC registration status (new employer, wage change) to HR so your record stays current.

Sample reply/acknowledgment letter to the Branch Manager

Employers can adapt the following short acknowledgment. It is not mandated by the letter, but it creates a paper trail and shows good-faith compliance intent.

To,
The Branch Manager,
ESIC Branch Office, [Branch Name]

Subject: Acknowledgment and compliance action on annual health check-up
of employees above 40 years — [Your Establishment Name], Code No. [___]

Sir/Madam,

This is to acknowledge receipt of your letter dated [___] regarding the
mandatory annual health check-up of employees above 40 years of age
under the OSH Code, 2020 and Rules framed thereunder.

We confirm that we are arranging the check-up for the employees named
in the enclosed list at [ESIC Hospital/Dispensary name], and will
extend the required support, including leave and coordination, to
ensure their attendance on [date/schedule, if fixed].

We will share proof of compliance/attendance on completion. Kindly
note the following queries/corrections to the enclosed list, if any:
[list discrepancies, if applicable].

Thanking you,
For [Establishment Name]
[Authorized Signatory, Designation, Contact Number]

Record-keeping: what “proof of compliance” should include

The original ESIC letter and any enclosed employee list.
Your written acknowledgment/reply, if sent.
Internal communication to employees (email/notice) informing them of the schedule.
Leave sanction records for the visit, where applicable.
Attendance confirmation or any report/certificate issued by the hospital after the check-up.

Keeping this file matters not just for this cycle but for the recurring annual obligation — auditors and future ESIC correspondence will expect a consistent trail year over year.

Penalty and risk — what “relevant provisions” actually means

Whether your letter names Section 104 explicitly or only refers to “relevant provisions of the Code,” the underlying risk is the same: non-compliance with the Section 6 health-examination duty can attract penal action under the OSH Code’s general penalty framework. Treat both wordings as carrying equal weight — the general phrasing is not a softer warning, just a shorter one.

Verified against live ESIC Sub-Regional Office letters (two wording variants observed). Last updated: 14 July 2026.