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MANAGEMENT OF AFTER- EFFECTS OF AN ACCIDENT AT WORK OR AN OCCUPATIONNAL DISEASE IN THE FRENCH LEGISLATION
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The nature of the resulting injury becomes permanent The date of consolidation is determined by : The general practitioner The medical adviser of the National Health Insurance This date does not necessarily coincide with the resumption of professional activity Concept of consolidation
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This rate is evaluated : By the medical adviser of the National Health Insurance From an official indicative scale providing average rates The evaluation of this rate is based on the reduction of capacity resulting from the loss or alterations of body organs or functions The medical adviser writes a detailed report containing in particular : The account of his clinical examination The justification for the fixed rate Determination of the rate of permanent disability
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The medical adviser writes a detailed report containing in particular : The account of his clinical examination The justification for the fixed rate Determination of the rate of permanent disability
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Dominant sideNon dominant side Shoulder blocking, frozen shoulder blade55% 45% Shoulder blocking, with mobile shoulder blade 40%30% Average limitation of all movements20%15% Slight limitation of all movements10 to 15 %8 to 10 % Example of rates
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The medical adviser must take into account when evaluating the rate of permanent disability The general condition of the victim The age The physical and mental faculties The skills and professional qualification
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The injuries caused by the accident are the only ones to be compensated The aggravation of a previous state by accident at work or an occupational disease is compensated The assigned rate is increased in case of an injury of a limb or an organ on a subject with the homologous member previously destroyed. The previous state
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Applicable in case of multiple infirmities resulting from the same accident The first infirmity is evaluated according to the total capacity (e.g 20/100 = 20 %) The second infirmity is evaluated according to the remaining capacity (e.g 10 % of 80 % resulting from the first infirmity = 8 %) Etc. Formula Balthazard
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Indexed to the salary of the victim Up to 9 % of Permanent Disability, the financial compensation paid in capital From 10 %, paid as a lifetime annuity Terms of the financial compensation
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A revision is appropriate if the state of the victim improves or worsens The death of the victim as a result of consequences of an accident at work or an occupational disease leads to a new setting of a compensation allocated to potential rights holders. Revision of a Permanent Disability rate
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The rate of permanent disability may be contested by the victim or employer The legal remedy is a specialized court The National Health Insurance defends its position against the judge (legal department and medical service) Contestation
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When the medical adviser of the National Health Insurance detects a risk of difficulty in the recovery of professional activity and of professional exclusion, he/she contacts : Prevention of professional exclusion The general practitioner of the victim The occupational physician to request an early pre-covery visit The social service to assist the victim in mobilization actions or occupational reclassification
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Training Modules of prevention Tools for risk’s diagnostics Financial support to businesses for implementing prevention action Preventive actions taken by the National Health Insurance towards businesses
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Thank you very much for your attention Crédit photos-Fotolia-Giovanni Cancemi
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