In what situation can I claim?
As an employee of the private sector, if you fall ill and if you satisfy the conditions, you are entitled to daily sickness allowances.
Depending on certain conditions, you may also claim for additional compensation paid by your employer. For this, you need to declare your illness.
In case of an inability to work, a sick leave note must be written by the doctor. The daily allowance is only payable from the 4th day of sick leave.
What conditions do I need to meet?
Sick leave for a maximum of 6 months
On the day he stops working, the employee must satisfy the following conditions:
- having worked for at least 150 hours over the 3 calendar months or 90 days before stopping work;
- or having received a salary totalling at least 1,015 times the amount of the hourly Smic over the 6 calendar months before stopping work.
After the 6th month of sick leave
The employee has to satisfy the following conditions:
- on the date that work was stopped, prove 12 months payments into the sickness benefits scheme;
- and have worked for at least 600 hours during the 12 calendar months or the 365 days before the date of stopping work;
- or have received an income totalling at least 2,030 times the hourly Smic over the 12 calendar months (or 365 days) prior to stopping work.
What am I entitled to and how can I claim?
The daily allowance is equal to 50% of the daily basic wage and 66.66% from the 31st day after work was stopped when the beneficiary has at least 3 dependent children.
The gross reference wage is limited to €2,697.24 per month. Therefore, the daily allowance paid cannot exceed a certain total, which varies depending on the following conditions:
Payment period of daily allowances
Maximum gross total
The employee has less than 3 dependent children
From the 4th day after stopping work, until the 360th day of compensation, or until the end of the 3 years of compensation in the event of a long-term illness
The employee has 3 or more dependent children
From the 4th to the 30th day of stopped work
From the 31st day of stopped work until the 360th day of compensation (or until 3 years of compensation for a long-term illness)
When the sick leave exceeds 3 months, the daily allowance may be reassessed (up to the maximum gross amount) in the event of a general increase in income.
Maintenance of all or part of the income by the employer
The employment contract or the joint agreement that are applicable may include conditions of compensation that are more favourable than those defined by social security. These may go up to the complete repayment of income (this is the case for short-term sick leave in Alsace-Moselle).
Unless there are more favourable provisions, the employee who has worked at the company for at least one year, benefits from supplementary compensation, the amount of which is calculated so that:
- for the first 30 days of compensation, the employee receives 90% of the gross amount which he would have received if he had continued working (including daily allowance);
- for the next 30 days, 2/3 of this same remuneration (including daily allowance).
Each period of 30 days is increased by 10 days per additional 5 years of seniority. The maximum duration of compensation is set at 180 days (90 days at 90% and 90 days at 2/3 of the previous salary).
The additional compensation is paid from the 8th day of absence due to illness.
Unless there are more favourable collective (or contractual) agreements, the daily allowances are made after a waiting period of 3 days. This delay applies to every work stoppage, apart from in the following cases:
- a return to work between 2 work stoppages that does not exceed 48 hours;
- successive sick leave, owing to a long-term sickness (LTS or ALD).
Note: in Alsace-Moselle, the salary is maintained by the employer as of the first day off work.
The daily allowances are due for each calendar day not worked.
Frequency of payments
The Primary health insurance fund pays daily allowances every 14 days. It sends a summary at the same time.
Maximum duration of payment
At most, the Primary health insurance fund pays 360 daily allowances per period of 3 consecutive years (irrespective of the number of illnesses), without taking into account the compensations paid for a LTS.
If the employee suffers from an LTS, the daily allowances are paid, without limitation in the number, for 3 years. Another period of 3 years may apply if the employee has resumed work for at least 1 year without interruption.
- Smic: French Minimum Interprofessional Guaranteed Wage. The gross hourly Smic is €9.88 gross as at 1st January 2018.
- Primary health insurance fund: Primary health insurance fund. Guarantees the reception of public at a local level, administers membership for insured persons and their entitlement to sickness insurance, ensures sickness/maternity and occupational accident benefits are paid.
- LTS (or ALD): Long Term Condition. Disease that features on a list established by decree, or pathology resulting in absence from work or treatment for a period of more than 6 months.
Know your rights
The following links provide further information about your rights. These sites are not the responsibility of the European Commission and therefore do not represent its viewpoints:
- The French administration's website in the private sector.
- The French administration's website in the public sector.
- Centre of European and international social security matters (Cleiss) page on health insurance in France.
Commission publication and websites:
Who do you need to contact?
or find the nearest primary health insurance fund to where you live on the dedicated page of the sickness benefits website.