Accident at work in the event of permanent incapacity

Verified 01 April 2023 - Legal and Administrative Information Directorate (Prime Minister)

Accident at work Are you a victim of an accident and would you like to know if you can receive compensation if your working capacity is permanently reduced as a result of this accident?

Do you want to know if additional compensation can be paid to you in case of (very serious or intentional) fault on the part of your employer, or fault on the part of a person outside the company)?

We present you with the information you need to know.

Accident at work If you are the victim of a procedure, you may have a long-term physical or mental impairment. In this case, your social security organization (CPAM: titleContent or MSA: titleContent) determines a permanent disability rate (PPI) that allows you to receive compensation. Depending on your PPI rate, this allowance is paid as a capital or life annuity.

Procedure

The CPAM or AMM sets your final PPI based on the information collected. Your social security body seeks the advice of its medical officer and, in some cases, the occupational physician (especially when permanent incapacity could make you unfit for work).

You and your employer are informed and can request the opinion of the medical officer within 10 days of notification of the decision.

Please note

the final PPI level may be adjusted as your health status changes.

Criteria used to determine the rate of disability

To determine your PPI level, the CPAM or AMM is based on the following criteria:

  • Nature of your disability
  • Your overall health
  • Your age
  • Your physical and mental faculties
  • Your professional skills and qualifications

Appeals

You and your employer can challenge the decision of your social security organization with the Medical Amicable Appeals Board, in 2 months that follow its notification of the PPI level.

Amount

Disability rate below 10%

If the CPAM or MSA sets a PPI below 10%, you receive a lump sum payment.

The amount varies under the following conditions:

Tableau - Amount of the paid capital allowance based on your disability rate

Rate of permanent disability

Amount of the capital allowance

1%

€450.83

2%

€732.77

3%

€1,070.78

4%

€1,690.06

5%

€2,141.01

6%

€2,648.07

7%

€3,211.25

8%

€3,831.24

9%

€4,507.29

Between 10% and 80%

You receive a life annuity until your death.

It is calculated on the basis of your annual salary, multiplied by the disability rate.

Your annual salary is the total actual remuneration received in the 12 months preceding the work stoppage due to the accident or illness.

The annual reference salary taken into account shall be at least 20,048.80 and not more than €160,390.42.

To determine the amount of the annuity, your annual salary is taken into account within a certain limit. Beyond that, part of your remuneration is taken into account either partially or not at all. The proportion of salary taken into account or not shall be determined under the following conditions:

Tableau - Fraction taken into account according to your annual salary

Annual salary

Wage fraction taken into account

Salary less than €40,097.60

Full consideration

Salary between €40,097.60 and €160,390.42

Consideration by a third party

Salary above €160,390.42

No account taken

Your disability rate is determined by cutting it in half to 50% of incapacity and increasing it by half for the part of the rate exceeding 50%.

Example :

If your PPI is set to 75%, the rate used to calculate your annuity is 62.5% (i.e. (50:2) + (25 x 1,5)).

From 80%

You receive a life annuity until your death.

It is calculated on the basis of your annual salary, multiplied by the disability rate.

Your annual salary is the total actual remuneration received in the 12 months preceding the work stoppage due to the accident or illness.

The annual reference salary taken into account shall be at least 20,048.80 and not more than €160,390.42.

To determine the amount of the annuity, your annual salary is taken into account within a certain limit. Beyond that, part of your remuneration is taken into account either partially or not at all. The proportion of salary taken into account or not shall be determined under the following conditions:

Tableau - Fraction taken into account according to your annual salary

Annual salary

Wage fraction taken into account

Salary less than €40,097.60

Full consideration

Salary between €40,097.60 and €160,390.42

Consideration by a third party

Salary above €160,390.42

No account taken

Your disability rate is determined by cutting it in half to 50% of incapacity and increasing it by half for the part of the rate exceeding 50%.

Example :

Example 1

Let's say, for the purposes of calculating your disability pension, that your salary over the last 12 months is €35,000 and your PPI rate is 20%:

  • Your salary will be taken into account in full, since it is less than €37,299.82 (basic minimum wage).
  • The PPI rate used to calculate your annuity will be 10% (20:2), because PPI rates below 50% are cut in half.

Your pension will be calculated as follows: 35,000 x 10%. Your disability pension will then be €3,500.

Example 2

Let's say, for the purposes of calculating your disability pension, that your salary over the last 12 months is €45,000 and your PPI rate is 75%:

  • Your salary will be taken into account in full until €37,299.82 (basic minimum wage).
  • The fraction exceeding €37,299.82, or €7,700.18 (45,000 - 37,299.82) will be taken into account at a rate of 1/3. So they are €2,566.73 in addition to the 37,299.82 €39,866.55.
  • The PPI rate used to calculate your annuity will be 62.5% (either (50: 2) because PPI rates below 50% are reduced by half + (25 x 1.5) because the fraction of PPI above 50% must be increased by half, or x 1.5).

Your pension will be calculated as follows: €39,866.55 (37 299.82 + 2 566.73) x 62.5% [50: 2 + (25 x 1.5) i.e. 25 + 37.5].

Your disability pension will then be €24,916.59.

If your medical condition requires you to seek the assistance of a third party, you are entitled to the payment of the Third Party Complementary Benefit (TPRB). This person helps you perform the ordinary acts of everyday life (example: getting up, going to bed, dressing,...).

Payment of the annuity

The incapacity pension is paid quarterly (or monthly in the case of a PPI of at least 50%).

You can request that a portion of your life annuity be repaid (for up to half) to your spouse or Civil partnership partner in the event of death.

The application procedure varies depending on whether you are covered by the general scheme (CPAM) or the general agricultural scheme (MSA).

You depend on CPAM

To request the conversion of the annuity, you must contact your CPAM: titleContent the following application form:

Application for conversion of a permanent incapacity pension into a capital or a reversible annuity on the head of the spouse (general scheme)

Who shall I contact

This request may be made at any time from the date of notification of the award of the annuity.

CPAM has 2 months to respond.

If no reply is received within this period, your request shall be deemed to have been accepted.

The conversion of your annuity into a reversible annuity (i.e. income that will be paid back to your spouse upon your death) is final.

You depend on the MSA

In order to request the conversion of the annuity, you must apply to your pension fund MSA: titleContent the following application form:

Application for conversion of a permanent incapacity pension into a capital pension or a reversible pension on the head of the spouse, partner of the Civil partnership or common-law partner (agricultural scheme)

Who shall I contact

Very serious (inexcusable) fault of the employer

Your accident may be the result of a so-called fault inexcusable from your employer. This fault is recognized if it is established that the employer was (or should have been) aware of the danger to which you were exposed and did not take the necessary measures to protect you from it. It is up to you to prove the existence of damage and that your employer has not implemented the means to ensure your safety.

If the inexcusable fault is recognized, it allows you to get an increase in your permanent disability pension. It also allows you to obtain full compensation for damages suffered and not compensated by the annuity.

Example :

physical and mental suffering, loss of appearance and pleasure, loss resulting from the loss or reduction of your opportunities for professional promotion.

You must make the claim for compensation and compensation of damages to CPAM or MSA.

Répondez aux questions successives et les réponses s’afficheront automatiquement

You depend on CPAM

Who shall I contact

You depend on the MSA

Who shall I contact

Willful misconduct of the employer

If the employer intentionally sought to cause injury (e.g. physical abuse), you can have the employer's willful misconduct acknowledged to the employer. correctional court. You can get compensation for this mistake.

If your accident was caused by someone outside the company, you can request compensation for the damage caused from the correctional court (unless the damage is already compensated by the incapacity pension).

Who can help me?

Find who can answer your questions in your region