Employee's compensation computation and statement
A single format from the Employee's Compensation pack. s.76 and Sixth Schedule, Code on Social Security 2020 · death 50% and PTD 60% of monthly wages × relevant factor, or the amount notified, whichever is more.
- 10 pages
- 42
- Word, PDF and Excel
- 30 October 2026
- 30 October 2026
What it covers
- 1Employee's compensation computation and statements.76 and Sixth Schedule, Code on Social Security 2020 · death 50% and PTD 60% of monthly wages × relevant factor, or the amount notified, whichever is more
Not included
What you will still need outside this format:
- The OSH Code notice of the accident and the register of accidents: see OSH Formats (FV10-G11).
- The accident report for an insured person to the ESI Branch Office: see ESI Formats (FV10-D10).
- The medical assessment of loss of earning capacity by a qualified medical practitioner.
- Gratuity, provident fund, pension and EDLI claims on death: see Gratuity Formats (FV10-E6) and PF Formats (FV10-C13).
- The State's prescribed forms under the Code for the report and the deposit, where notified.
- Proceedings and appeals before the competent authority or the High Court, which need counsel, and the claim on the employer's liability insurer.
Read the opening
The first part of the format, as it downloads. Blanks are highlighted.
Working paper for the employer's file and the statement that goes with the payment or deposit. Do not use it for an insured person under Chapter IV: that claim lies with the Employees' State Insurance Corporation
Use this working paper when an employee is killed or disabled by an accident or an occupational disease arising out of and in the course of employment and the employee was not an insured person under the ESI chapter of the Code. Report and deposit with the "Report of an accident and deposit of compensation with the competent authority" in this pack. For the statutory notices of the accident itself, use the "Notice of accident or dangerous occurrence" and the "Register of accidents and dangerous occurrences" in the OSH formats, and for an insured person the "Accident report to the Branch Office" in the ESI formats. This format cites Chapter VII by subject; before quoting a section number in a filing, read the bare Code, because many commentaries still reproduce the clause numbers of the 2019 Bill.