If you are an employee on sick leave due to an illness linked to your profession, you are entitled to daily allowances (IJ) paid by your health insurance plan. These financial benefits aim to compensate the insured for the loss of income. Recognition of an occupational illness allows the sick employee to benefit from better care.
Daily allowance (IJ): who is affected?
If your work stoppage is due to your professional activity, you can receive daily allowances (IJ). You are then entitled to basic daily allowances as long as the “professional nature” of your illness is not recognized. As soon as your illness is recognized as “work-related” by your social security organization (CPAM or MSA), the latter will pay you increased IJ.
The criteria that define an occupational disease
An illness can be recognized as occupational in three cases:
- The disease is designated in a table of occupational diseases and is contracted by the employee under the conditions set out in this table.
- The disease is designated in a table of occupational diseases, was not contracted by the employee under the conditions set out in this table, but its link with work is proven.
- The illness is not designated in a table of occupational illnesses, but has a direct link to the employee’s work and has caused work incapacity of at least 25%.
How to report an occupational illness?
If the doctor notices an alteration in the victim’s state of health which he considers to be linked to his work, he must then make a declaration to your social security organization to have the occupational origin of the illness recognized.
- This declaration must be made within 15 days following the cessation of work.
- It must be carried out by completing the occupational disease declaration form (Cerfa n° 60-3950). The victim must send the first four parts of the form to the CPAM and keep the fifth.
- She must attach the first two parts of the initial medical certificate drawn up by the doctor, which specifies the illness and the date of its first medical diagnosis, and keep the third part.
- The victim must also attach the salary certificate issued by the employer.
What is the amount of IJ?
To agree on the amount of your IJ, your health insurance plan determines a daily reference salary. It is calculated by dividing the amount of your gross salary received in the month preceding the start of the sick leave by 30.42 and cannot exceed €386.70. For example: an employee receives a monthly salary of €2,500 gross. His daily reference salary is €82.18, or 2,500/30.42.
THE amount of daily occupational illness compensation progresses over time. It amounts to the rates of:
- 60% of the daily reference salary: from the 1st to the 28th day of leave
- 80% of the daily reference salary: from the 29th day of sick leave
These daily allowances are paid to you by your social security organization from the first day following your cessation of work, without waiting periodand this, for the entire duration of your stop.
Additional compensation may be paid by the employer
Your employer must pay you additional compensation during your work stoppage, if you meet all of the following conditions :
- You are not a home worker, seasonal, intermittent or temporary (temporary) employee.
- You have at least 1 year of seniority in the company (on the first day of your absence).
- You have informed your employer within 48 hours, then sent your medical certificate.
- You benefit from daily allowances paid by your social security organization.
- You are receiving treatment in France or in one of the member states of the European Economic Area.
Source :
“Occupational illness: daily allowances during work stoppage“- Public service