Occupational disease: compensation for permanent incapacity
Verified 01 April 2024 - Directorate for Legal and Administrative Information (Prime Minister)
Are you suffering from an occupational disease and would you like to know if you can receive compensation when your working capacity is permanently reduced due to that disease? Do you want to know if additional compensation can be paid to you in case of very serious (inexcusable) fault on the part of the employer? We present you with the information you need to know.
If you are suffering from an occupational disease, you may suffer a lasting decrease in your physical or mental capacity. In this case, your Social Security organization (CPAM: titleContent or MSA: titleContent) determines a rate of permanent disability (PPI)which allows you to receive compensation in the form of capital or life annuity.
Forecast Incapacity
You may be granted a projected disability rate if you meet the following 2 conditions:
- The recognition of the occupational nature of the disease cannot be done by referring to the tables of occupational diseases
- And your disease causes a PPI of at least 25%
This rate shall be fixed on a provisional basis, until the instruction to grant you a final PPI is complete.
Permanent permanent disability
The CPAM or MSA determines your final PPI based on the information collected. Your Social Security organization seeks the advice of its medical officer and, in some cases, the occupational physician (especially when permanent incapacity could make you unfit for work).
You and your employer are informed and can request the advice of the medical officer within 10 days following the notification of the decision.
Please note
the final PPI level may be adjusted as your health status changes.
Criteria used to determine the rate of disability
To determine your disability rate, the CPAM: titleContent or the MSA: titleContent is based on the following criteria:
- Nature of your disability
- Your overall health
- Your age
- Your physical and mental faculties
- Your professional skills and qualifications
Appeals
You and your employer may challenge the decision of the CPAM or the MSA to the Medical Amicable Appeals Board, within 2 months of its notification of the PPI rate.
Amount
The method of compensation by CPAM or MSA depends on the PPI rate:
- If your PPI level is below 10%, you receive a lump sum capital allowance paid in one installment.
- If your PPI level is equal to or greater than 10%, you get a life annuity until you die.
Warning
If you have an occupational disease related to asbestos, you will benefit from a specific compensation scheme.
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Disability rate below 10%
If the CPAM or MSA sets a PPI below 10%, you receive a capital allowance, the amount of which varies as follows:
Disability rate between 10% and 80%
You receive an annuity, the amount of which is calculated on the basis of your annual salary, multiplied by the disability rate.
Your annual salary is the total actual remuneration received in the 12 months preceding the work stoppage due to the accident or illness.
The annual reference salary taken into account shall be at least 20,971.05 and not more than €167,768.38.
To determine the amount of the annuity, your annual salary is taken into account within a certain limit. Beyond that, part of your remuneration is taken into account either partially or not at all. The proportion of salary taken into account or not shall be determined under the following conditions:
Your disability rate is determined by cutting it in half to 50% of incapacity and increasing it by half for the part of the rate exceeding 50%.
Example :
If your PPI is set to 75%, the rate used to calculate your annuity is 62.5% (i.e. (50:2) + (25 x 1,5)).
Disability rate from 80%
You receive an annuity, the amount of which is calculated on the basis of your annual salary, multiplied by the disability rate.
Your annual salary is the total actual remuneration received in the 12 months preceding the work stoppage due to the accident or illness.
The annual reference salary taken into account shall be at least 20,971.05 and not more than €167,768.38.
To determine the amount of the annuity, your annual salary is taken into account within a certain limit. Beyond that, part of your remuneration is taken into account either partially or not at all. The proportion of salary taken into account or not shall be determined under the following conditions:
Your disability rate is determined by cutting it in half to 50% of incapacity and increasing it by half for the part of the rate exceeding 50%.
Example :
If your PPI is set to 75%, the rate used to calculate your annuity is 62.5% (i.e. (50:2) + (25 x 1,5)).
If your medical condition requires you to have the assistance of a third person to perform the ordinary acts of everyday life (e.g. getting up, dressing, etc.), you are entitled to the payment of the Third Party Complementary Benefit (TPRB).
Payment of the annuity
The incapacity pension is paid quarterly (or monthly in the case of a PPI of at least 50%).
However, you can ask the CPAM for a portion of your annuity:
- is paid to you in the form of capital,
- and/or is used to constitute a life annuity that can be paid (for up to half) to your spouse in the event of death.
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You depend on CPAM
To request the conversion of the annuity, you must contact your CPAM: titleContent the following application form:
This request may be made at any time from the date of notification of the award of the annuity.
CPAM has 2 months to respond.
If no reply is received within this period, your request shall be deemed to have been accepted.
If you claim both the capital conversion and the benefit of the reversible annuity conversion, the 2 decisions taken by the fund must be the subject of separate notifications.
The conversion of your annuity into capital or a reversible annuity is final.
You depend on the MSA
To request the conversion of the annuity, you must contact your MSA: titleContent the following application form:
Your occupational disease may be the result of a so-called fault inexcusable from your employer.
Inexcusable fault is recognized when it is established that the employer was (or should have been) aware of the danger to which you were exposed and did not take the necessary measures to protect you from it. It's up to you to prove your employer's inexcusable fault.
If the inexcusable fault is recognized, it allows you to obtain:
- an increase in your permanent disability pension,
- full compensation for the damage suffered and not compensated by the annuity (e.g. physical and moral suffering, aesthetic and pleasure damage, damage resulting from the loss or reduction of your opportunities for professional promotion).
Claims for compensation and compensation for damage must be made to the CPAM or the MSA.
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You depend on CPAM
You depend on the MSA
Who can help me?
Find who can answer your questions in your region
If you are dependent on the general diet
Primary health insurance fund (CPAM)If you depend on the general regime: for any additional information, if you reside in a department of Ile-de-France, except the Seine-et-Marne
Ile-de-France Regional Health Insurance Fund (Cramif)If you depend on the MSA
Mutual Social Agricultural Organization (MSA)
General principles
PPI compensation
Additional compensation in the event of the employer's inexcusable misconduct
Amount of the capital allowance
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