obligations of the employer and the employee
It is an accident occurring, whatever the cause, by the fact or on the occasion of work. It must intervene suddenly and during the performance of the employment contract, at a time and in a place where the employee is under the authority of his employer. A link must exist between the accident and the injuries suffered by the employee. article L.411-1 of the Social Security Code
This is an accident that occurs during the normal outward and return journey made by the employee between:
- the place of his main residence (or his secondary residence if it is stable) or a place of residence where the person concerned usually goes for family reasons;
- the workplace and the place where he usually takes his meals (restaurant, canteen, etc.).
The notion of “normal route” does not necessarily imply the most direct route. On the other hand, it requires that the journey be made during the normal journey time, taking into account the employee’s usual working hours and the requirements of the job he occupies.
The journey must in principle have a direct link with the provision of work. Finally, an accident occurring during a detour or an interruption of the journey can be qualified as a commuting accident, if the detour or the interruption is motivated by the necessities of everyday life (accompanying a child, medical care …) or employment (particularly carpooling).
The commuting accident is considered a work accident.Please note: an accident occurring during the suspension of the employment contract (strike, leave, etc.) is not considered work-related.
All employers are subject to the regulations applicable to work or commuting accidents.
- any employee, regardless of the nature of the employment contract and even if he is on assignment outside his company;
- the continuing vocational training trainee;
- the trainees.
Articles L.412-2 and L.412-8 of the Social Security Code
The employee who is the victim of a workplace or commuting accident has 24 hours to notify his employer, except in cases of force majeure.
It must specify the place, the circumstances of the accident and the identity of any witnesses. He must quickly consult a doctor who draws up an initial medical certificate in view of the injuries observed.
He must then send parts 1 and 2 of this certificate to the health insurance fund and keep part 3. In the event of sick leave, he sends part 4, entitled “work stoppage certificate” to his employer.
The employer is required to declare any work or commuting accident 48 hours at the latest (not including Sundays and public holidays or non-working days) after becoming aware of it, except in cases of force majeure, to the primary insurance fund. disease (CPAM) on which the victim depends.
In addition, a medical certificate must be drawn up by a doctor (form S6909). It indicates the state of the victim, the injuries observed, the possible consequences of the accident as well as the necessary care and, in the event of a work interruption, its probable duration or, from 1 November 2021, the notice stop.
In the event of work stoppage, the employer must also declare it via the Nominative Social Declaration (DSN) to trigger the payment of daily social security allowances.
Please note: the 48-hour period runs from the moment the employer becomes aware of the accident.
The employer does not have to take into account the seriousness of the injuries suffered by the employee and must declare any accident, even if it does not lead to a work stoppage or even if the employer doubts its professional character.
In the event of non-declaration by the employer, the declaration to the fund can be made by the victim, or his representatives, until the end of the 2nd year following the accident.
Please note: if the declaration is made after the deadline, the CPAM may request reimbursement of the services from the employer, except in the event of force majeure. The absence of a declaration or a declaration out of time is punishable by a fine (maximum of €750 for a natural person or €3,750 for a legal person).
Articles L.114-17-1, L.471-1 and R.471-3 of the Social Security Code
The employer can carry out a DAT:
- either directly online on the website www.net-entreprises.fr;
- or by mail by sending the first 3 sections of the special form to the fund by registered letter with acknowledgment of receipt, the 4th section must be kept by the employer for 5 years (cerfa n° 14463*03). This form is either provided by the fund or can be downloaded from the website Ameli Where service-public.fr.
The employer has a period of 10 days to issue to the fund, by any means, reasoned reservations on the circumstances of place, time or on the existence of a cause totally unrelated to the work.
The primary health insurance fund, on which the employee and the employer depend, has 30 days from receipt of the DAT to rule on the professional nature of the accident.
In the event of sick leave, the employer must also send to the primary health insurance fund, at the same time as the declaration of accident or during the sick leave if later, a salary certificate for the payment of daily allowances.
The salary certificate is mandatory for any work stoppage, whatever the reason. It is on the basis of this certificate that the fund examines the employee’s right to daily allowances and calculates the amount.
The employer must specify whether the salary is maintained (in part or in full). If this is the case, and if the conditions for wage subrogation are met, it is the employer who receives the daily allowances.
Note that the gradual implementation of the DSN tends to replace the salary certificate.
The employer must also give an accident form to the employee who is the victim of the accident at work in paper form or in electronic version (online DAT).
The employee must systematically present it to the practitioner, to the hospital providing the care, to the medical assistant, to the pharmacist in order to benefit from third-party payment, i.e. 100% reimbursement of the medical costs related to accident at work without upfront costs, and free healthcare, within the limits of conventional rates.
Within 48 hours of the accident (not including Sundays and public holidays), the employer can make a simple entry in a specific register, called the infirmary register or the register of minor accidents, intended to replace the declaration of accident. , if the following conditions are met:
- the accident does not lead to work stoppage or medical care;
- permanent presence of a doctor, pharmacist or nurse;
- existence of an emergency aid station;
- the employer informs the CHSCT of any registration;
- the register is signed by the victim of the accident.
Since May 1, 2021, the register of minor accidents can be kept by the employer without authorization, after simple information from the Pension and Occupational Health Insurance Fund (CARSAT).
Articles L.441-4 and R.441-1 and following of the Social Security Code
The entry in the register, which must be countersigned by the victim, must mention:
- the name of the victim;
- the date, place and circumstances of the accident;
- the nature and location of the lesions, with the visa of the person who provided treatment.
Daily allowances are paid to the victim of the accident at work by the primary health insurance fund from the first day following the work stoppage following the accident. The working day during which the accident occurred remains the responsibility of the employer.
The daily compensation for accidents at work is equal to:
- 60% of the basic daily salary during the first 28 days of work stoppage with a maximum amount of €205.84 per day on January 1, 2021;
- 80% of the basic daily salary from the 29th day with a maximum amount of €274.46 per day on January 1, 2021.
When the stoppage of work extends beyond 3 months and, in the event of a general increase in wages after the accident, the amount of daily allowances may be increased according to a coefficient of increase fixed by ministerial decree and in the limit of the ceiling provided for by law. However, another method of calculation provided for by the collective agreement may be used if it proves to be more favorable for the employee.
Please refer to the applicable collective agreement to find out the specifics.
The employer is entitled to request a counter medical examination in the event of doubt about the justification for a work stoppage.