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Occupational disease: procedures

Verified 15 September 2020 - Directorate for Legal and Administrative Information (Prime Minister)

If your doctor finds a deterioration in your health, which he considers to be linked to your work, it can be recognized as a professional. You must apply for recognition of your occupational disease at your primary health insurance fund (CPAM). At the end of the investigation, CPAM will inform you of its decision. A specific procedure is provided for workers suffering from Covid-19 in the course of their professional activity.

General case

If your doctor finds a deterioration in your health that he considers related to your work, you can request recognition of the occupational origin of your illness..

Within 15 days of leaving work, you must complete an online form:

Declaration of occupational disease or application for recognition of occupational disease

You must send the first 4 panes of the form to the CPAM: titleContent, and keep 5e..

You must attach the following documents to this form:

  • 2 first part of the initial medical certificate issued by your doctor, which specifies the disease and the date of its 1re medical finding (keep 3e pane
  • Wage certificate issued by your employer (unless the employer addresses it directly to your CPAM).

CPAM acknowledges receipt of your occupational health report.

Your CPAM will then investigate your case and decide whether or not your illness is professional.

You do not have to approach your employer. The CPAM sends him a copy of your declaration of professional illness. The employer may express reasoned reservations about the occupational nature of the disease.

Who shall I contact

Case of extension of time to make application

If your illness was found before you enrolled in occupational diseases , you can then report your illness within 3 months of its inclusion in the table.

If these time limits are not respected, the declaration shall remain admissible if it is made within 2 years which follow:

  • the date on which the work related to the illness is stopped or, if it is later, the date on which you have been informed by a medical certificate of the possible link between your illness and your professional activity,
  • the date on which your sickness benefits cease to be paid, or
  • the date your illness is listed in the occupational disease tables.

The CPAM has 3 months to decide on the professional nature of your illness, from the date on which it received the complete file. This includes the declaration of occupational disease incorporating the initial medical certificate and the result of supplementary medical examinations (if they have been prescribed).

Medical examination or further investigation

The CPAM carries out a questionnaire examination of the circumstances or cause of the illness, or a survey (mandatory in the event of the death of the employee) in the following cases:

  • in the presence of reasoned reservations by the employer as to the occupational nature of the disease,
  • or if the CPAM itself considers it necessary.

CPAM informs you (and your employer), by registered letter with acknowledgement of receipt, of this procedure before the expiry of the investigation period.

CPAM can also subject you to a medical examination by a consultant..

Opinion of the Regional Committee for the Recognition of Occupational Diseases (RCRD)

Recognition of occupational disease shall be subject to the opinion of the CRRMP in any of the following cases:

  • The disease is listed in the occupational disease table but has not been acquired under the conditions specified in these tables, and it is established that it is directly caused by your usual work.
  • The disease is not included in the occupational disease table, but it is established that it is primarily and directly caused by work and that it has resulted in a permanent disability of at least 25% (or death).

The CRRMP then has 4 months to give its reasoned opinion (plus an additional 2 months when a review or further investigation is necessary).

The CPAM investigation period is not extended because the CRRMP has been entered.

After receiving your declaration of occupational disease, CPAM will give you a sheet of occupational disease. It allows you to benefit from free care related to your illness.

You must present this sheet to each health professional (doctor, nurse, physiotherapist, pharmacist, etc.). It shall mention the acts performed.

This sheet is valid until the end of the processing.

At the end of the treatment or as soon as it is fully filled out, you send this sheet to your CPAM, who will issue you a new one if necessary.

At the end of the investigation, the CPAM notifies you of its reasoned decision (or the beneficiaries in the event of death), as well as the employer and your doctor.

This decision shall specify the remedies and time limits for appeal, if the occupational nature of the disease is not recognized.

If CPAM recognizes the occupational origin of the disease, you can then perceive:

Covid-19

If you are infected with Covid-19 in the course of your professional activity, you can benefit from a specific treatment in occupational disease.

The procedure for recognizing Covid-19 as an occupational disease concerns you if you are in one of the following situations:

  • You are a professional working in the health sector and you have been contaminated as part of your work
  • You do not work in the health sector and you have been contaminated as part of your work. Your request will be reviewed by a committee of medical experts.

You must complete an online return by completing the following form:

Online declaration of occupational disease related to COVID-19

Your request will be reviewed by CPAM: titleContent who will contact you to complete your file.

Covid-19's recognition as a professional disease entitles the patient to a reimbursement of 100% on the basis of the social security tariff.

You can also benefit per diem more advantageous than during a common illness.

In the event of sequelae causing permanent incapacity, life annuity can be assigned to you. This pension is calculated according to the severity of the sequelae and the income prior to the contraction of the virus.