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

Verified 11 August 2023 - Legal and Administrative Information Directorate (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. You want to know how it goes, and if you are notified in advance? We give you the facts to know.

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 check cannot be carried out because you are absent from your home, the social security body may suspend payment of daily allowances (IJ). Financial penalties may be imposed in certain situations (false declaration, fraud, etc.).

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 shall be carried out by the medical officer of the social security body.

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 can arrange for a second visit to your home by the doctor of their choice.

He doesn't have to warn you in advance.

This check will ensure that you are at home during hours of exit ban and your medical condition justifies the prescribed work stoppage.

Warning  

When the doctor was unable to perform the check-up because you were absent or in case of 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.

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 body may then:

  • Terminate the daily allowance payment (your employer is notified that the payment has been terminated)
  • 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.