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Occupational disease: daily allowances during work stoppage

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

If you are an employee who has stopped working because of an illness related to your work, you are entitled to daily allowances (IJ) paid by your health insurance scheme (CPAM: titleContent, MSA: titleContent,...). If your illness is recognized as being of occupational origin, the amount of the compensation and the conditions for payment differ from those provided for sickness. You can also receive additional compensation from your employer, subject to conditions.

You are concerned if you are an employee who is on work stoppage for an illness related to your professional activity. This is the case, for example, if you are a victim of pleural cancer that occurred during exposure to asbestos in the course of your work.

Thus, you are entitled to basic daily allowances as long as the professional nature of your illness is not recognized.

Once your illness is recognized by the CPAM: titleContent or the MSA: titleContent, your social security body will pay you increased daily subsistence allowances (DI).

Calculation formula

If you are an employee, paid monthly, your health insurance plan (CPAM: titleContent, MSA: titleContent) determines a reference daily wage.

This daily wage is calculated by dividing the amount of your gross salary received the month before the start of the sick leave by 30.42.

This reference daily wage may not exceed €366.89.

So if the result of the calculation is greater than that amount, it is €366.89 which is taken into account.

Your daily allowances (IJ) will be equal to a part (percentage) of the daily reference salary that has been calculated. This percentage varies according to the duration of your sick leave and within the limit of an amount called net daily gain (daily wage minus 21%). There is a cap on their amount.

Thus, the amount of the IJs is calculated differently between the 1er and 28e off day, then from 29e day.

FYI  

benefits in kind are normally included in the basic salary used to calculate the YI except if you are no longer entitled to it during your stop (example: food allowance).

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1st to 28th day off

Per diem is 60% your reference daily wage.

The net daily wage is 1/30.42 of your previous month's salary less a flat rate of 21%.

The daily allowances are, at most, €220.14.

Example :

For an employee who has won €1,800 gross, in the month preceding his work stoppage, the daily reference wage shall be €59.17 (1,800 / 30.42). The net daily gain is €46.75 (59.17 - 21%).

Thus, its IJ cannot exceed €46.75.

The IJ will rise to €35.50 (reference daily wage x 60%, i.e. 59.17 x 60%). This amount is less than the net daily gain that had been calculated (€46.75).

CSG (6.2%) and the CRDS (0.50%) shall then be deducted from the amount of the daily subsistence allowances due.

From the 29th day of arrest

Per diem is 80% of the daily reference wage for the work stoppage from 29eme day.

The net daily wage corresponds to 1/30,42 of the previous month's wage, less a flat rate of 21%.

Daily allowances shall be limited to €293.51.

Example :

For an employee who has won €1,800 gross, in the month preceding his work stoppage, the daily reference wage shall be €59.17 (1,800 / 30.42). The net daily gain is €46.75 (59.17 - 21%).

Thus, its IJ cannot exceed €46.75.

The IJ will rise to €35.50 (reference daily wage x 60% or 59.17 x 60%) for the first 28 days. This amount is well below the net daily gain that had been calculated (€46.75).

From 29e by day, the IJ will rise to €46.75 because the calculated IJ (59.17×80%) is equal to €47.34, which exceeds the net daily gain.

CSG (6.2%) and the CRDS (0.50%) shall then be deducted from the amount of the daily subsistence allowances due.

Upgrading

Since 1er July 2020, the possibility of increasing the value of daily allowances (IJ) has been removed.

However, following a work stoppage that started before 1er July 2020, the IJ can still benefit from an upgrade by ministerial order or by collective agreement.

In the event of an occupational disease, the daily subsistence allowance is paid to you by your social security body (CPAM: titleContent, MSA: titleContent) from 1er day after you stop work, without waiting period.

Daily allowances are paid throughout the period of incapacity for work, until the end of the judgment or the consolidation injury (or death).

If your injury is consolidated, a permanent disability rate (PPI) is set by your social security agency (CPAM: titleContent, MSA: titleContent) and entitles you to payment of a life annuity or a lump sum capital allowance.

Conditions

Your employer must pay you additional compensation during your work stoppage, if you complete all the following conditions:

  • You are not a homeworker, seasonal, intermittent or temporary (temporary) employee
  • You're justifying at least 1 year of service in the company (at 1er day of your absence)
  • You informed your employer within 48 hours and then submitted your medical certificate
  • You benefit from daily allowances paid by your social security body
  • You are being treated in France or one of the Member States of the European Economic Area (EEA)

Warning  

in return for the obligation to pay the compensation, your employer can use a counter-medical examination.

Amount

The amount of compensation paid by your employer is calculated, over 2 periods, as follows:

  • For the first 30 days of work stoppage, the amount shall be 90% the gross remuneration you would have received if you had worked.
  • From 31e on the day of cessation, this amount is only 2/3 (66.66%) the gross remuneration you would have received if you had worked.

The supplementary allowance paid by the employer is deducted from the IJ paid by the social security scheme and possibly from the sums paid by your supplementary pension scheme.

Of treaty provisions may provide for a higher amount.

FYI  

even if the IJs paid by the Social Security are reduced (for example, because of hospitalization or a penalty of the CPAM: titleContent for non-compliance with the procedure), the additional allowances paid by the employer shall remain calculated on the basis of the daily allowance before reduction.

Payment Start Date

The payment of additional compensation begins on your 1er day of absence. There is no waiting period (i.e. time during which you would not receive a salary).

Duration of payment

Your additional compensation is paid until the end of your work stoppage, taking into account the compensation you would have already received for an accident on the job in the last 12 months.

The length of time the employer pays the compensation varies according to your seniority in the company, as follows:

Tableau - Duration of payment of additional allowances according to your seniority

Length of service in the company

Maximum duration of payment of allowances in a 12-month period

1 to 5 years

60 days (30 days to 90% and 30 days at 66.66%)

6 to 10 years

80 days (40 days to 90% and 40 days at 66.66%)

11 to 15 years

100 days (50 days to 90% and 50 days at 66.66%)

From 16 to 20 years

120 days (60 days to 90% and 60 days at 66.66%)

21 to 25 years

140 days (70 days to 90% and 70 days at 66.66%)

26 to 30 years

160 days (80 days to 90% and 80 days at 66.66%)

31 years and older

180 days (90 days to 90% and 90 days at 66.66%)

The 12-month period for the payment of allowances shall be evaluated, for each day of work stoppage, from date to date. Every calendar days shall be taken into account.

If you have already received one or more periods of sickness benefit from the employer in the previous 12 months, this is taken into account when calculating the maximum allowable payment period.

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