How to take benefits when you are injured?
If you are the victim of an accident at work, you can benefit from daily allowances from health insurance. If your accident at work leaves you with consequences, you can benefit from an accident at work pension. From the point of view of compensation rules, there is no difference between Injured on the job and commuting accidents. To qualify as an accident at work, three criteria must be met:
● The accident must have occurred within the framework of professional activity
● It must have a sudden and fortuitous origin
● The Injured on the job must have caused bodily or mental harm
This doctor will give you a medical certificate, in duplicate, on which he describes the lesions, the symptoms, and possibly the squeal. The doctor provides a copy directly to your CPAM and gives you the second certificate.
In addition, if necessary, the doctor will issue you a work stoppage certificate.
For his part, your employer, following your declaration, must give you a work accident form that allows you to benefit from free treatment related to this accident. You must therefore present this sheet at each consultation with a health professional. This sheet is valid for the entire duration of the treatment. You can then benefit from three types of workers’ compensation benefits:
● Daily allowances by your CPAM
● Additional compensation from your employer
● A disability pension
Daily allowances
The daily allowances are calculated based on the gross salary received by the employee the month preceding the accident. The CPAM will determine your basic daily salary, identify a net daily gain and apply a percentage of the basic daily wage.
The permanent disability pension
It will be paid to you if you are permanently incapacitated for work. You will be summoned by the medical service of your Social Security. In practice, the courts appoint an expert responsible for carrying out judicial medical expertise (the expert will thus be able to carry out a medical examination of the employee read his medical file and all documents allowing him to assess the damage suffered).
The expert’s report will allow the employee to quantify the sums they will claim as compensation for his damages. In the event of recognition of the inexcusable fault of the employer, it is the Primary Health Insurance Fund (CPAM). That advances all of the sums allocated to the employee. In addition to the sums paid for the pension’s increase (and revaluation).
The CPAM will then recover these sums from the employer. At each stage, the presence of a lawyer for victims experienced in defense of industrial accidents is essential, whether to obtain recognition of the inexcusable fault or to present a request to receive compensation. The lawyer will help you optimize your compensation as much as possible when you are injured on the job.
