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The recognition of an occupational disease goes through a tedious administrative procedure. – IStock / City Presse
The saying that “work is health” is far from true. According to health insurance statistics, 655,715 accidents at work occurred in 2019, or a frequency of 33.5 accidents per 1,000 employees, as well as 50,392 occupational diseases, 88% of which were related to musculoskeletal disorders.
But what exactly are we talking about?
A complex definition
The question is whether or not the worker’s poor health is related to his occupation. In the event of an injury, you must prove that the accidental event occurred in the course of your professional activity, i.e. when you were under the authority of your employer, and that it resulted in the sudden appearance of any injury. From cuts to heart disease, muscle aches or emotional shocks following a corporate assault, the impact can be physical or psychological.
The demonstration, on the other hand, is less evident for an affect, since the latter develops over time. Social security has therefore drawn up tables of diseases that are presumed to be of occupational origin when they are contracted under certain conditions. This is for example the case of sciatica caused by handling heavy loads, or even ailments related to exposure to lead or coal. For each pathology, the time of taking responsibility is specified and a list of the types of work that can cause the disorder.
As soon as you don’t get in trouble, the deal gets complicated. If all the criteria are not met, it is necessary to establish that the pathology was directly caused by the employee’s usual work. And if the illness does not appear in one of these tables, it will also be necessary to prove that it resulted in a permanent disability of at least 25% or the death of the employee in order for it to be considered of professional origin.
What is the procedure?
This recognition of the impact of work on health is a major financial challenge, as it entitles you to free treatment related to your injury or illness, but also to higher daily allowances in the event of sick leave and specific allowance in the event of permanent incapacity. .
In the event of an accident, you have in principle 24 hours to inform your employer on the spot or by registered mail. The latter then has 48 hours to declare it to the Primary Health Insurance Fund (CPAM). For your part, you must have your condition detected by a doctor, who will draw up a medical certificate describing the injuries suffered and send it to the CPAM. Unless there is further demand, the health insurance is split within 30 days.
If your doctor believes that your pathology is related to your work, it is instead up to you to ask for recognition of your professional origin by sending the appropriate form to the CPAM (available on Ameli.fr), accompanied by the medical certificate and ” a certificate salary. The Fund has three months to govern. During this time, he will conduct his investigation by asking you to complete a questionnaire about your working conditions and by requiring further medical examinations. Also, if your condition does not meet the conditions required by the social security tables or does not appear there, your case will be submitted to the Regional Committee for the Recognition of Occupational Diseases (CRRMP).
Covid-19 recognized
Decree published in Official newspaper of 15 September 2020 created new tables of occupational diseases related to “Acute respiratory diseases linked to SARS-CoV2 infection”. Healthcare professionals can therefore automatically benefit from this recognition if they have contracted a severe form of the coronavirus. For liberal professionals and people not working in the health sector, the file is reviewed by a committee of independent experts.
You can make your application online at Declare-maladiepro.ameli.fr, attaching a medical certificate, a hospitalization report certifying the severity of your condition, proof of professional activity and a certificate from the employer on your periods of work in 2020.
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