Occupational disease: steps to be taken

Verified 25 October 2021 - Directorate for Legal and Administrative Information (Prime Minister)

If your attending physician considers that the deterioration of your health is linked to your work, it can be recognized as work-related. In this case, you must apply for recognition of your occupational disease from your social security body (CPAM: titleContent, MSA: titleContent,...). After reviewing your file, the organization informs you of its decision.

General case

Work can cause illness for employees (e.g. cancer related to the handling of materials such as asbestos). The largest number of these diseases are listed in a table of occupational diseases.

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, MSA: titleContent) and keep the 3e.

Who shall I contact

You must attach the following documents to this form:

  • 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 have 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.

If you have been diagnosed with your disease before being enrolled in the table of occupational diseases, you can then declare your disease within 3 months of its inclusion in the table.

If these deadlines are not respected, the declaration remains admissible (can be accepted) if it is made within 2 years which are:

  • either the date on which the sickness-related work ceases or, if later, the date on which you were informed by medical certificate of the possible link between your sickness and your professional activity,
  • either the date on which payment of your sickness benefits ceases, or
  • or the date on which your disease is entered in the lists of occupational diseases.

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.

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.

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.

Who shall I contact

When the occupational origin of the disease is recognized, you can then collect:

COVID-19

If you are infected with COVID-19 as part of your professional activity, you can benefit from a specific treatment for occupational diseases.

The COVID-19 occupational disease recognition procedure applies to you if you are in one of the following situations:

  • You are a health care professional and you have been infected in the course of your work
  • You don't work in the health sector, and you've been infected in the course of your work. Your application will be reviewed by a committee of medical experts.

CPAM

You must file a return online:

Online reporting of COVID-19-related occupational disease

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

MSA

You must file a return online:

Coronavirus: Declaring an occupational disease for a person attached to AMM

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

The recognition of COVID-19 as an occupational disease allows you to benefit from a reimbursement of care to 100% on the basis of the social security tariff.

You can also benefit of daily allowances more advantageous than during a regular sick leave.

For sequelae resulting in permanent disability, a life annuity can be assigned to you. This rent is calculated based on the severity of the after-effects and the income before the virus contracted.