Control of an employee on work stoppage: what are the rules?

Verified 06 August 2024 - Directorate for Legal and Administrative Information (Prime Minister)

While you are sick, you must follow the obligations (called prescriptions) that are set by your doctor. One inspection visit can be done at your home or at the initiative of the Social security, or at the request of your employer. In case of an unjustified sick leave or failure to comply with your obligations, you risk suspending the payment of daily allowances (IJ) and supplementary allowances. We're laying out the regulations for you.

By Social Security

If your Social Security organization (the CPAM: titleContent or the MSA: titleContent) must pay you allowances during your sick leave, he can take the initiative of a check.

This is to check that you are at home during the hours of exit ban (administrative control) and your medical condition justifies the prescribed work stoppage (medical examination).

FYI  

you do not receive a notice in advance, the check is done unexpectedly.

These checks can be carried out on the spot (at your home) or on file. In the latter case, the CPAM or MSA asks you to send him additional documents.

Administrative control

If the administrative control cannot take place because you are absent from your home, the social security body may suspend the payment of daily allowances (IJ). Financial penalties can be imposed in certain situations (false declaration, fraud...).

You can challenge the decision of the CPAM or the MSA in referring the matter to the Amicable Appeals Board (CRA).

If you don't agree with the CRA's decision, you can hire a litigation before the court of law (social center) of your domicile.

Medical examination

The medical check is carried out by the medical officer of the social security agency.

If he finds your work stoppage unjustified, you are informed immediately. The consulting doctor also informs your treating doctor.

You can challenge this decision under the same conditions as for administrative control.

The CPAM or the MSA confirms by mail your date of return to work and informs you of the end of payment of your allowances.

Warning  

If you have received compensation to which you were not entitled or no longer entitled (particularly in the case of fraud), these organizations may to request reimbursement of the sums received unduly (wrongly).

A copy of this letter is sent to your employer.

Your employer can also stop paying supplementary allowances.

The employer may request a check from Social Security.

FYI  

your (mutual) supplementary plan may also carry out checks, including by means of an investigation, under the contract between you and the insurer.

By the employer

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General case

If your employer has to pay you supplementary allowances while you are sick, they may have a counter-medical examination by the doctor of his choice. This doctor must be independent and have no private connection with your employer to ensure his impartiality.

That doctor shall decide whether the stoppage of work, including its duration, is justified. The counter-visit also makes it possible to check that you are present at your home or place of rest during the hours of exit ban.

Your employer must inform you of the possibility of a counter-medical examination when your work stoppage is declared. He or she should also explain the possible consequences if you refuse to appear or if you are unjustifiably absent at the time of the counter-visit.

Place and time of the counter-visit

It's the doctor who decide the place and time of the counter-visit. It may take place:

  • Either to your home or place of rest that you communicated in your work stoppage. You don't have advance notice. The counter-visit can take place at any time. However, it cannot intervene during the authorized hours of leave (you must stay at your home from 9 a.m. to 11 a.m. and from 2 p.m. to 4 p.m.) or the hours that you have communicated to your employer in the case of authorized free leave
  • Either at doctor's office, following a summons sent to you, specifying the date and time of the inspection. If you are unable to travel, particularly because of your medical condition, you must inform the doctor and specify the reasons.
Sending doctor's report to employer

After the counter-visit, the doctor informs your employer whether or not your work stoppage is justified.

He or she should also inform them if they were unable to carry out the check-up, in particular if you refused to attend the appointment following the summons to the office or if you were absent during the visit to your home or resting place.

Your employer shall forward this report to you without delay.

Warning  

In case the counter-visit could not be held due to your absence or your refusal of inspection, your employer can end of payment of supplementary allowances . However, if your absence is justified (for example, a medical appointment), your employer cannot suspend the payment of additional allowances.

It is up to your employer to provide proof that the counter-medical examination could not take place because of your absence or refusal.

Transmission of the doctor’s report to the CPAM or AMM medical officer

If the examining doctor has been unable to carry out the inspection, he shall inform the CPAM: titleContent or the MSA: titleContent, in writing, within 48 hours. The same applies if the doctor decides that your sick leave is not justified.

The social security organization may then:

  • Terminate the payment of per diems. Your employer is notified of the end of the payment
  • Or carry out a new examination by the doctor appointed by your employer. This re-examination is lawful if the doctor's report states that he was unable to carry out the counter-examination.

If the supervising physician considers that sickness leave is not justified and orders the return to work, you must return to work on the date specified in his conclusions.

If you refuse to return to work, the payment of additional benefits may be interrupted.

If you wish to challenge the conclusions of the examining doctor, you must ask for another counter-visit or seek the opinion of a forensic expert from the Labor Council (CPH).

Who shall I contact

Alsace-Moselle

The employer can't order counter-medical examination.