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HEALTH

‘Arrêt de maladie’: Why you’ll need a sick note in France – and how to get one

If you fall ill in France, you will likely need an 'arrêt de maladie' to justify your absence from university or work. Here is how that works and what you can expect from sick leave in France.

'Arrêt de maladie': Why you'll need a sick note in France - and how to get one
Getting a sick note in France (Photo by PHILIPPE HUGUEN / AFP)

In France, if you are sick and need to miss work or school, you will need a doctor’s note. 

Failing to provide one can have consequences. For employees, your absence may be considered not justified and this could result in disciplinary action from your employer. For students, depending on the university’s policy, an unjustified absence could leave you unable to make up work.

Most of the time, getting a doctor’s note can be pretty simple – it involves making an appointment with either a doctor or a midwife, both of whom are qualified to give an ‘arrêt de travail’ (sanctioned sick leave).

Specifically, if you are deemed ill enough to warrant time off work or school, then the doctor or midwife will give you an arrêt de maladie, which is a type of arrêt de travail. This is justified by a ‘certificat médical’.

Will I be paid if I am on sick leave?

In France, statutory sick pay can vary depending on how long you’ve been ill. And it’s important to note that the amount you are paid if you are off sick will depend on company policy, which in turn will be most likely be based on a collective agreement of some kind. 

Basic legal cover means when workers are off sick they have to go without pay for the first three days – increasingly, however, companies will continue to pay staff for their first three days of absence – but you are generally required to have a doctor’s note confirming their illness from day one. 

After those initial three days, statutory sick pay rules kick in, and a worker’s salary will be covered by social security, up to a maximum daily rate of €51.70 before tax.

When does payment arrive?

Payment starts on the fourth day of illness. After processing the file you should receive a payment every 14 days on average covering the duration of your arrêt de travail. Processing times depend on the primary health insurance fund and reimbursement statements can be viewed in your ameli account.

Are there exceptions to the waiting period?

Yes. If you are absent due to a work accident or occupational illness; if you have suffered a recurrence of your incapacity after trying to go back to work; or if your absence is because of a long-term condition and your arrêt is renewed.

How do the steps work?

Let’s say you’ve fallen ill, phoned in sick, and made an appointment with your doctor, who has ordered you to take a break from work for health reasons. So far so normal – here’s what happens next.

I have been given an arrêt de travail 

You’ll notice that the arrêt is in three parts. Send parts 1 and 2 of the form to your primary health insurance fund (CPAM), and part 3 to your employer.

You have 48 hours to do this.

No – my doctor did it online… 

In that case, parts 1 and 2 have been done for you. Your doctor will have given you part 3, which you need to send to your employer within 48 hours.

I’m unemployed

If you are unemployed and in receipt of benefits, send the following supporting documents to your primary health insurance fund, along with parts 1 and 2 of the arrêt from your doctor:

  • your last 3 pay slips prior to unemployment – or 4 if the last month is incomplete (if you have a seasonal or discontinuous activity, send your pay slips for the last 12 months).

If you do not receive unemployment benefits, send the following supporting documents:

  • your last 3 pay slips prior to unemployment – or 4 if the last month is incomplete (if you have a seasonal or discontinuous activity, send your pay slips for the last 12 months);
  • a sworn statement in which you specify the date of cessation of your salaried activity.

During this period, you are not considered to be looking for work, and will not receive unemployment benefits, but will receive sickness benefits instead.

Can I leave home when I’m off ill?

That’s up to your doctor, who will indicate on your sick leave notice whether you are authorised to leave your home during your sick leave. Your doctor may also limit the times you are allowed outside.

Staff at your primary health insurance fund can check that you are present at home for the duration of your sick period, including Saturdays, Sundays and public holidays.

Can I go back to work while on an arrêt de travail?

Officially you are not allowed to go back to work until the end date on your ârret de maladie, although the reality is workers, eager to get back on full pay, likely do it. The law states you must refrain from any activity not authorised by your doctor for the amount of time specified in the arrêt de travail

This also includes working from home, according to the French government. So the best thing would be to see your doctor to ask to change the date of your arrêt de travail.

Technically, if you work during the days you are meant to be off sick, then you could be required to pay back CPAM for the statutory sick pay that was provided. 

An employer that tries to force their employee to return before the end of their arrêt de travail can be convicted of undeclared work, according to the French legal site Axiome Avocats.

Can I get the sick leave extended?

If you are still too ill to work, then before the end of your current arrêt de travail, you must make another appointment with either the doctor who prescribed your initial arrêt de travail or with your GP (médecin traitant) to get an extension.

What happens when I go back to work?

After the last day of your arrêt, you are expected to go back to work as normal. Your sick payments will stop, and you will receive your salary as usual, minus any days you were off work.

If you are unemployed, you are reinstated at Pôle Emploi and start receiving your benefits again. 

Your unemployment benefit period will be extended by the number of days that were compensated by Health Insurance for the illness. This means that if you have received daily health insurance benefits for 10 days, you will receive your unemployment benefits for an additional 10 days compared to the end date of rights which was notified to you.

Taxes

Remember, daily allowances are part of the income that you must declare to the tax authorities. To complete your tax return, you will need to download your daily allowance payment certificate from your Ameli account.

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MOVING TO FRANCE

Moving to France: Language tests, new immigration law and jobs for non French-speakers

Moving to France - a country famous for its complicated bureaucracy - can be a daunting task. Fortunately, our new newsletter is here to answer your questions - this month we're looking at new immigration plans, acquiring language skills and healthcare.

Moving to France: Language tests, new immigration law and jobs for non French-speakers

Here at The Local we’re an Anglo-American team living in France – which means all of us have been through the simultaneously exciting and terrifying process of moving countries.

Our new newsletter is aimed at people who are in the process of moving, have recently moved and are still grappling with the paperwork or perhaps are just thinking about it – and we’ll share a monthly selection of practical tips. Our team is also available to answer questions from subscribers to The Local.

Let’s start with some news that I know has been worrying people who plan to move to France some day – the new French immigration bill.

The bill is currently making its way through parliament, with a lot of accompanying political drama and some very headline-grabbing amendments from Senators (most of which have now been scrapped).

This seems to be one of those cases where the political drama is in inverse proportion to the actual content of the bill – because it really doesn’t contain a lot that would affect people moving to France. We’ve done a complete breakdown HERE.

It won’t immediately affect new arrivals – but one thing that the bill does contain is a proposal for compulsory language tests in order to gain the long-term residency card (which usually happens after four or five years of residency, depending on your personal situation). We have a guide on exactly what language level would be required and a quiz so you can test yourself against the required standard. 

Language skills

I’m often asked how easy it is to move to France if you don’t speak any French at all. Ideally you would do some studying before arriving, but sometimes circumstances dictate a move while your French is still at a basic level (full disclosure – my French was extremely rudimentary when I first arrived).

Here’s a look at how easy it is to move to France if you don’t speak French – and what jobs you could do while you learn. 

Staying healthy

The other big concern for many people is healthcare – specifically how to access care in France, and whether you need to pay for expensive health insurance in order to move.

In good news, the French system is pretty generous – you can register in the French public health system after three months of residency and the state covers around 70 percent of medical costs, depending on circumstances. It’s worth pointing out, however, that the registration process itself can be lengthy – it’s not unusual to wait a year for your first carte vitale health card.

What you do in the meantime – and what health cover you need in order to get a visa – depends on your country of origin. 

Brits can use their EHIC or GHIC European health card as proof of medical cover, although it’s advised to get a short private health insurance policy too as there are things not covered by the European health card.

If you’re moving from an EU country you would be covered by the reciprocal EU health agreements between member states, but if you’re moving from the USA you will need private cover for your first few months in France (and not all American health insurance covers treatments outside of the US). 

Questions

The Local’s Reader Questions section covers questions our members have asked us and is a treasure trove of useful info on all kinds of practical matters. If you can’t find the answer you’re looking for, head here to leave us your questions.

Bon courage !

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