Application for a disability pension for the widow or widower of a deceased employee (Form 11791*03)

National Health Insurance Fund (Cnam) - Cerfa n° 11791*03

Allows any person, widow or widower of a deceased employee, who is disabled and under the age of 55, to apply for a disability pension related to his or her situation.

The form shall contain an explanatory note specifying the supporting documents to be provided in support of the application.

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Verified 09 April 2024 - Directorate for Legal and Administrative Information (Prime Minister)

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