The occupational accidents and diseases branch of the Social Security covers employees who have been victims of an accident at their place of work or the journey that leads to it, as well as an illness caused by work.
In health insurance: reimbursement and support
The recognition of an accident or an occupational disease entitles to specific compensation, free care, daily allowances in case of work stoppage, annuity when the working capacity is reduced. This wide coverage concerns all employees, including during their probationary period. Here the Work comp attorney can be your best guide.
Accidents at work and occupational disease: the definitions
An illness or an accident occurring in a professional setting gives rise to rights to take charge of it and to compensation for the damage resulting therefrom. As a result, their recognition responds to a specific context.
An accident at work is defined as that which occurs during work (including breaks) and at the workplace while the employee is under the authority of the employer. It can occur on the premises of the company (car park, canteen), or when the employee is on a business trip at the request of the employer. The accident must have caused a bodily or psychological injury (some cases of nervous breakdown is recognized). All employees benefit, regardless of their employment contract (permanent contract, fixed-term contract, temporary work).
The commuting accident occurs to an employee during the round trip between his primary or secondary residence and his place of work, or between the company and the usual place where he takes his meals. If the trip is interrupted or modified for a reason related to the necessities of everyday life (purchase of food, medication, administrative procedures), the employee remains protected if he is the victim of an accident. On the other hand, he is not so anymore if he turns away from his trip for a personal reason (to visit a friend). Accidents that occur as part of a regular carpool meet the definition of commuting accidents.
The disease listed in one of the tables listing these diseases is presumed to be occupational. The employee must justify that he has been habitually exposed to the risk of the disease. An illness can also be recognized as professional by the use of an individual expertise, entrusted to a Regional Committee for the Recognition of Occupational Diseases, under two hypotheses: the illness complained of by the employee appears in a table, but it does not meet all the conditions described; the illness is not designated in a table, but it was directly and mainly caused by the employee’s usual work and resulted in death or permanent incapacity for work of at least 25%. Regularly updated, these tables appear in the appendix of the Social Security Code.