In the event of an accident at work or an occupational disease of the employee, the employer does not always know what the financial consequences are for him. Explanations: you are informed by the primary health insurance fund that your employee is still suffering from the consequences of his work accident or his occupational disease, and that consequently a permanent partial disability rate is attributed to him in order to compensate for his injury. When and how does compensation come into play?
Often, the employer neglects this type of decision of the fund, which can have significant financial consequences for the company because of its impact on it’s at premium rate. Here is a reminder of the applicable rules. The hiring of the work comp lawyer for this work is essential now.
When can the employee be assigned a permanent partial disability rate?
The attribution to the employee of a partial permanent incapacity rate takes effect on the date of his consolidation, that is to say when his state of health has stopped deteriorating and has stabilized, and that he preserves after-effects related to his work accident or his occupational disease.
In practice, the employee whose state of health has been consolidated is summoned by the Caisse’s medical examination department to be examined by the medical adviser. The latter will determine whether the employee’s legacy justifies the attribution of a partial permanent disability rate and thereby a financial compensation.
Indeed, the role of the medical adviser of the primary fund is to assess the permanent partial disability suffered by the employee by using the indicative scale of disability (occupational accidents) annexed to the Social Security Code which determines the method of calculating permanent partial disability.
To do this, the medical adviser of the primary fund must take into account:
- the nature of the employee’s disability
- of his general condition
- about his age
- of his physical and mental faculties
- Professional skills and qualifications
A medical permanent partial disability rate will therefore be determined based on the first four items. The last item is a medico-social element that is filled by the medical adviser when the consequences of the accident or occupational disease appear to him to result in a change in the employee’s employment status or a change of job. In this case, this will enable the primary fund to determine whether a socio-professional coefficient should be added to the medical rate.
At the end of this process, the employee will be notified by the primary fund, by registered with RA, as the employer, his decision to assign a partial permanent disability rate to compensate him for the consequences he retains in respect of his accident at work or occupational disease.
The financial impact of this decision, for both the employee and the employer, will vary according to the rate of partial permanent disability that has been allocated by the primary fund.