When an employee is forced to interrupt their professional activity for health reasons, the sick leave (arrêt de travail) prescribed by a doctor temporarily suspends the performance of their employment contract. However, this period of inactivity is not synonymous with total freedom. The employer, who maintains all or part of the salary, as well as the Caisse primaire d'assurance maladie (CPAM - the local state health insurance office), which pays daily allowances, have a strict right to monitor the reality of the employee's state of health and compliance with their obligations. Understanding how a medical check-up (contrôle médical) works during sick leave, its limits, and its consequences is essential to avoid heavy financial and disciplinary sanctions.
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Inspections during sick leave are based on a dual mechanism: administrative and medical checks by the Social Security on one hand, and employer-initiated medical counter-examinations (contre-visite médicale patronale) on the other. These two procedures respond to strict rules defined by the Code de la sécurité sociale (French Social Security Code) and the Code du travail (French Labour Code).
The CPAM's mission is to ensure the proper use of public funds. As such, it can initiate inspections at any time during the sick leave, starting from the very first day.
As long as the employer pays supplementary benefits in addition to the daily social security allowances (indemnités journalières de la Sécurité sociale or IJSS) pursuant to Article L. 1226-1 of the Code du travail or a collective agreement (convention collective), they have the right to have a medical counter-examination of the employee carried out by the doctor of their choice.
This right is governed by Decree No. 2024-692 of July 5, 2024, which specified the procedures for carrying out this counter-examination. The employer mandates an independent doctor (who is not the company's occupational physician, the médecin du travail) to verify whether the employee's state of health still justifies the sick leave and whether its duration is consistent.
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For the sick leave to proceed smoothly, the employee must scrupulously respect several fundamental obligations from the moment their leave is prescribed.
The prescribing doctor indicates on the sick leave certificate (avis d'arrêt de travail) whether outings are authorised or not. Three situations are possible:
The employee is obliged to spend their convalescence at the address indicated on their sick leave certificate. If they wish to stay outside their department of residence (for example, with relatives to receive help), they must imperatively:
During sick leave, as the contract is suspended, the employee must not engage in any professional activity, whether paid or unpaid (volunteering, auto-entrepreneurship, regular help in a spouse's business). Even working remotely from home (teleworking) is strictly prohibited and subject to sanctions.
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Here is how the two types of inspections an employee may face actually take place.
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[Employer's Mandate] ➔ [Surprise Visit or Summons] ➔ [Medical Exam] ➔ [Submission of Findings]
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1. The employer's initiative: The employer mandates a doctor of their choice. They do not have to warn the employee in advance of the day and time of the visit if it takes place at the home.
2. The home visit or summons:
3. The medical examination: The mandated doctor verifies the employee's identity and performs a clinical examination. The employee cannot invoke medical secrecy to refuse the examination, but they are not obliged to hand over their personal medical reports (although this is highly recommended to justify their condition).
4. Submission of findings: Following the examination, the inspecting doctor writes a report. They immediately inform the employer and the CPAM of their conclusions: leave medically justified, leave unjustified, or impossibility to conduct the inspection due to the employee's actions.
1. The summons: The CPAM medical service sends a summons to the employee by post or via their personal Ameli online account. Attending this summons is mandatory.
2. The medical interview: The médecin-conseil assesses the employee's fitness to return to work.
3. The decision: If the médecin-conseil considers that the leave is no longer justified, they set a date for returning to work. Their decision is binding on both the employee and the employer.
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To better understand the financial impact of these rules, here are two practical cases based on current legislation.
Thomas is a maintenance technician. His gross monthly salary is €2,400. On sick leave for lower back pain, he receives:
His employer mandates a doctor for a counter-examination. The doctor arrives at Thomas's home at 11:00 AM, but Thomas is absent (out doing non-urgent shopping). The doctor notes the impossibility of conducting the inspection due to the employee's absence.
Financial consequences:
The employer is entitled to immediately suspend the payment of the supplementary benefits (the €960 per month) for the remaining period of the leave starting from the date the absence was recorded. Thomas only keeps his IJSS paid by the CPAM, suffering a net loss of €960 for the month.
Sofia, an accountant, is on sick leave for burnout. She receives €50 in IJSS per day. The CPAM initiates an administrative check at her home at 3:15 PM. Sofia is absent and cannot provide any medical justification (such as an appointment with a specialist).
Financial consequences:
The CPAM suspends the payment of the IJSS. In addition, the health insurance fund can impose an administrative financial penalty equivalent to 10% of the amount of benefits unduly received, in addition to the reimbursement of sums paid since the day of the missed inspection. If the leave was to last another 20 days, Sofia loses €1,000 in daily allowances.
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No, the report of the inspecting doctor mandated by the employer does not allow for a dismissal for misconduct or for real and serious cause (cause réelle et réelle). The only direct consequence is the suspension of the payment of supplementary salary benefits by the employer. However, if the CPAM medical advisor confirms your fitness and you refuse to return to work, you expose yourself to a dismissal procedure for unjustified absence.
If the inspecting doctor arrives during mandatory presence hours while you are at the physiotherapist or your treating doctor, you must imperatively obtain a written and dated proof of attendance (with the time of the visit) from this healthcare professional. Send this document within 48 hours to your employer and the CPAM to contest the recorded absence.
Absolutely not. The doctor mandated by the employer has no therapeutic power. They can neither modify your prescription, nor prescribe new medications, nor forbid you from following the recommendations of your treating doctor. Their role is strictly advisory and evaluative on behalf of the employer.
Yes. If the doctor mandated by the employer concludes that you are fit to return to work but your treating doctor maintains their diagnosis of temporary unfitness, you can request a medical expertise. To do this, you must refer the matter to the Conseil de prud'hommes under summary proceedings (référé) to request the appointment of a court-appointed medical expert.
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