Recognition procedure for occupational disease

Several criteria must be met cumulitavely to obtain the recognition of an occupational disease. Physicians of all specialities must know this procedure but it is always the victim who decides to declare or not the illness as an occupational disease.

Presumption of occupational origin 
The declaration of the occupational disease
Original medical certificate
Inquiry
Final medical certificate

Presumption of occupational origin

A disease can be recognised as an occupational disease if it is on the lists appended to the Social Security Code. There are currently 112 such tables of occupational diseases.

Any disease which meets the medical, occupational and administrative criteria given in the tables  is systematically presumed to be occupational in origin, without it having to be proven

 3 conditions must be met so that the illness  is recognised as occupational disease and the victim shall be compensated :

  • the disease is listed in one of the table of occupational disease,
  • the victim has been exposed to a risk,
  • the disease has been certified by a doctor within a set time limit ( specified in the table) : the starting point of this period is the end of the exposure to the risk.

 The declaration of the occupational disease

According to the French Social security Code article L. 461-5, it is the victim himself  who must declare the disease to the the Primary Sickness Insurance Fund (Caisse primaire d’assurance maladie) by sending in a copy of the medical certificate delivered by the practitioner.
The victim has to use a specific declaration form which must be forwaded to the Social Security within 15 days after cessation of work or initial detection

 Original medical certificate

The victims’s declaration be accompanied by an original medical certificate : the practitioner makes out and gives to the victim a medical certificate.

The practitioner has to use a specific certificate form Cerfa S 6909a ou 11139*01 

  • This medical certificate notifies  :
    • the nature of the disease,
    • the symptoms related to the hazard,
    • its likely consequences.
  • the medical certificate is in quadruplicate,
    • one copy of which contains no information concerning the disease and is to be given to the employer.

 Inquiry

The Social Security begins systematically a medical and administrative inquiry when a work-related illness is declared.
The investigator meet the victim, the employer and sometimes he shall obtain the opinion of the occupational doctor.

According to the French Social security Code (article R. 441-10 ), the Social security has 3 months to make its decision : disease is or is not occupational.
A period of further 3 months may be necessary to the Social security to make its decision : it shall inform the victim.

 Final medical certificate

When the victim has been cured or his condition stabilized, the practitioner write a final medical certificate that states the consequences of the disease. This certificate  is in quadruplicate.
In case of after-effects, caused by an occupational accident or an occupational disease,  the victim is entitled to receive a partial permanent disability.

It is the physician of Social Security who sets the rate for the partial permanent disability.

 Any doctor, in whatever position or function he may be practising his profession, is therefore concerned by the occupational disease declaration and compensation system : it is the doctor’s responsibility to enquire after the patient’s occupation and type of work, and what substances the patient handles.



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