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On July 5, 2024, a decree was published regarding the new rules for counter-visits of employees during their work stoppage. Here’s what you need to know.
If many of us think that the health insurance counter-visit in the event of work stoppage never happens, beware. Indeed, at the beginning of the summer a decree was published to inform about the new terms and conditions regarding this famous counter-visit. Here are the new rules to know to keep your benefits!
Reminder: what does a follow-up visit consist of during sick leave?
This is a visit to the employee to check that the employee is complying with the conditions of the sick leave prescribed for them. A doctor ensures that the employee is present at the address they have provided (home, chosen place of rest or doctor’s office), at the authorized exit times. This counter-visit can be carried out following the request of Social Security but also by the employer in the event that they pay additional compensation to the person concerned by the sick leave.
While the terms of this visit remained rather vague until now, they were clearly announced by the government in a decree of July 5, 2024. The latter then adds four new articles to the Labor Code. The goal? To make savings by limiting unjustified work stoppages. We present them to you.
The conditions to be respected
The employee must absolutely communicate his rest address
Whether at home or elsewhere, you are required to inform health insurance and your employer of the place where you are resting during this leave. You must send it at the beginning of this period, and add the times when the counter-visit can take place (outside your hours of going out).
A visit that can happen at any time
According to the decree in question, the doctor’s visit can occur at any time during the work stoppage and this “without any notice period being required”. If you have permission to go out at certain times, the doctor will come outside of these times that you have communicated.
What you risk in case of fraud
Early return to work
Once the doctor has carried out the counter-visit, two scenarios are possible. The first: you complied with the conditions of the stoppage and you were at home, then your work stoppage is justified to your employer. The second: you were not at home when you should have been, then your stoppage is unjustified and the doctor orders an early return to work on a date specified in his conclusions.
The removal of your additional benefits
In addition to an early return to work, employees who were not at their place of rest as agreed may see their additional benefits withdrawn. This occurs if they are unable to justify their absence to their employer. Also note that your benefits may disappear if you refuse the medical counter-examination.
Quick reminder, the daily allowances paid by Health Insurance correspond to 50% of the basic daily salary and are capped at €52.28 per day. According to its collective agreement, the employer pays a supplement to this amount to the employee in order to guarantee the partial or total maintenance of his salary. The allowances also depend on the employee’s seniority in the company.
However, while this counter-visit is applicable throughout France, this is not the case in the Alsace-Moselle region. Indeed, employers cannot require a counter-medical visit from their employees on sick leave.