Declaration of occupational disease linked to Covid-19

EXPERT ARTICLE - By Samia Benmahrez, Consultant HR performance, at GAC Group

Your employee has contracted an illness related to COVID-19 as part of his professional activity?

An online service " declare-maladiepro.ameli.fr »Is made available to employees (or beneficiaries) who wish to apply for recognition of occupational disease. Objective: to benefit from support under professional legislation.

Which employees are affected?

  • Employees who do not work in the health sector can apply for recognition as an occupational disease under 2 conditions:
    • If they contracted Covid-19 in the course of their work
    • What if the disease has resulted in serious illness.

A committee of medical experts will examine their request.

  • Employees working in the health sector may benefit from recognition under the following conditions:
    • Their contamination with Covid-19 took place in the course of their work
    • Their contamination with Covid-19 has also led to a serious respiratory disease with recourse to oxygen therapy or any other form of respiratory assistance.

If it is a serious condition other than respiratory, a committee of medical experts will first examine their request for recognition.

 

What is the support?

The recognition as an occupational disease allows compensation for care at 100% rates reimbursable by social security. It also allows daily allowances more advantageous than sickness for employees.

In the event of sequelae causing permanent disability, the employee may receive an annuity. These are the seriousness of the sequelae and the income prior to the contraction of the virus allow its calculation. .

For your information, the beneficiaries of an employee who died due to the COVID-19 disease can also apply on the dedicated platform and benefit from an annuity.

 

What are the documents to provide?

To make their request online, the employee must provide:

  • A " initial medical certificate»(CMI) established by his attending physician. He makes the diagnosis of COVID-19 and mentions the clinical elements or examinations that led him to make this diagnosis.
  • A hospital report which mentions the use of oxygen therapy and the COVD-19 diagnosis. If the oxygen therapy was performed outside a hospital setting, the attending physician should include this information in the CMI.
  • Be a proof of professional activity be one employer's certificate. These must mention the job, the periods of absence in 2020 and attesting to contact with the public.
  • For the beneficiaries of the employee who died due to the COVID-19 infection, in addition to the documents requested above, it will be necessary to provide a copy of the family record book of the deceased.

 

It is important to remember that the statements made on the online service do not constitute recognition of the professional nature of the Covid-19 infection. This is done after verification by the Caisse Primaire d'Assurance Maladie (CPAM) services in accordance with the legislation in force on occupational risk.

Upon receipt of the request, the CPAM will study it and discuss it with the employee to complete his file.

At the end of this procedure, the CPAM will send the employee a registered letter. The latter informing him of the completion and start of the examination phase of his file and of the stages of the procedure to come.

The CPAM must also inform the employer of the examination of the occupational disease file.

 

Please do not hesitate to contact us if you have any questions on the subject.

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