Occupational disease: steps to be taken
Verified 17 October 2023 - Directorate for Legal and Administrative Information (Prime Minister)
Your attending doctor notes that the deterioration of your health is linked to your work and you want to know how to do so that it can be recognized of professional origin? We present the process to be carried out.
A disease can be considered an occupational disease when it is contracted as a result of your work.
The disease may be of occupational origin whether or not it appears in the table of occupational diseases.
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The disease is listed in the table
The diseases listed in the table of occupational diseases are presumed to have been contracted in the course of your work.
The table specifies the following:
- Diseases concerned
- Time to take over (and, in some cases, time to exposure)
- Indicative list of the main works that may cause these diseases
However, if one or more conditions relating to the time taken over, the duration of exposure or the indicative list of works are not fulfilled, recognition of the occupational disease remains possible.
In this case, the CPAM: titleContent (or the MSA: titleContent if you are dependent on the agricultural system) can recognize the occupational origin of the disease if the latter is caused directly through your usual work.
To obtain care, it is necessary to follow the specific recognition procedure.
Once the recognition has been made, you may be entitled to the following allowances:
- In case of work stoppage, social security benefits and supplementary compensation paid by the employer
- In the event of permanent incapacity for work, compensation specific, and additional compensation in the event of serious misconduct on the part of the employer
Please note
with the exception of health professionals, there is specific occupational disease care for workers infected with COVID-19 in the course of their professional activity. This point is developed in the 2nd situation: COVID-19
Other diseases
A disease not listed in the table of occupational diseases is not presumed to have been contracted in the course of your work.
However, if the following 2 conditions are met, a disease not listed in the table may be recognized as being of occupational origin:
- The disease is essentially and directly caused by your usual work
- It results in either death or permanent disability of at least 25%
To obtain care, it is necessary to follow the specific recognition procedure.
Once the recognition has been made, you may be entitled to the following allowances:
- In case of work stoppage, social security benefits and supplementary compensation paid by the employer
- In the event of permanent incapacity for work, compensation specific and additional compensation in the event of serious misconduct on the part of the employer
You can request recognition of the occupational origin of your disease if your treating doctor observes that your work-related condition is deteriorating.
To do this, you must complete a form in the 15 days after your work stoppage begins:
Declaration of an occupational disease or application for recognition of an occupational disease
You must send the first 2 parts of the form to your social security organization ( CPAM: titleContent or MSA: titleContent) and keep the 3e.
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You depend on the general diet
You depend on the agricultural system
You must attach the following documents to this form:
- The first 2 parts of the initial medical certificate drawn up by your doctor, which specifies the illness and the date of its 1re medical report (you keep the 3e flap)
- Proof of salary issued by your employer (unless the employer sends it directly to your CPAM or MSA).
The complete file must include the declaration of occupational disease including the initial medical certificate and the result of the additional medical examinations (if prescribed).
You don't to approach your employer.
Your social security body sends him a copy of your declaration of occupational disease.
At that point, the employer may express reservations about whether the illness is occupational or not.
The CPAM or the MSA acknowledges receipt of your declaration of occupational disease.
She then reviews your file and decides whether or not your illness is professional.
The CPAM or MSA shall have a period of 120 days to make a decision. This period shall start from the date on which your complete file has been received by your social security organization.
Medical examination or further investigation
The CPAM or the MSA shall carry out a questionnaire examination of the circumstances or cause of the disease, or a survey (mandatory in the event of the death of the employee) in any of the following cases:
- Presence of reasoned reservations on the part of the employer as to the occupational nature of the illness
- The CPAM or the AMM itself considers this necessary
Your social security agency (and your employer as well) informs you (by registered letter with acknowledgement of receipt) of this procedure before the expiry of the investigation period.
The CPAM or the MSA may also submit you to a medical examination by a medical officer.
Opinion of the Regional Committee for the Recognition of Occupational Diseases (CRRMP)
The recognition of the occupational disease shall be subject to the opinion of the CRRMP in one of the following cases:
- The disease is listed in the table of occupational diseases but was not contracted under the conditions specified in those tables, and it is established that it is directly caused by your usual work.
- The disease is not listed in the table of occupational diseases, but it is established that it is primarily and directly caused by work and that it has resulted in a permanent incapacity of at least 25% (or death).
The CRRMP then has 4 months to deliver its reasoned opinion (more 2 additional months where further investigation or examination is necessary).
The time limit for the CPAM or the MSA’s investigation shall not be extended as a result of the referral to the CRRMP. The time limit shall be suspended until the CRRMP delivers its opinion.
At the end of the examination of your file, the CPAM or the MSA sends you its decision with the explanations justifying it (or to the beneficiaries in case of death). The organization also sends it to your employer and your doctor.
That decision shall specify the remedies and time-limits for bringing an action if the occupational nature of the occupational disease is not recognized.
In the event that professional character is recognized, the employer may challenge this decision.
When the occupational origin of the disease is recognized, you can then collect:
- of daily allowances higher than in the case of non-occupational disease,
- one specific compensation related to your permanent disability.
After receiving your declaration of occupational disease, the CPAM or the MSA will provide you with an occupational disease sheet. This allows you to benefit from the free treatment related to your illness.
You must present this sheet to each healthcare professional (doctor, nurse, physiotherapist, pharmacist, etc.). He mentions the acts carried out.
This sheet is valid until the end of the treatment.
At the end of the treatment or when it is completely filled in, you must send this sheet to your CPAM or MSA, who will issue you a new one if necessary.
Who can help me?
Find who can answer your questions in your region
If you are dependent on the general diet
Primary health insurance fund (CPAM)If you are dependent on the farm plan
Mutual Social Agricultural Organization (MSA)
Steps taken by the employee
Recognition of the professional nature of the accident
Steps taken by the employee
List of diseases in the table of occupational diseases
Recognition in occupational diseases of pathologies linked to the inhalation of asbestos dust
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