Benefit payments for periods of work interruption due to illness are designed to provide a replacement income for employees who are forced to stop working as a result.
- The employee must therefore prove a loss of wages as a result of stopping work (which is not the case for example, in the event of unpaid leave or a period of inactivity not covered by Unemployment Insurance).
- The employee must also meet the same working period condition as that stipulated for the reimbursement of medical expenses (see the Basic conditions section).
Within 48 hours of the medical statement to stop work, you must send the letter card with the medical statement from your treating physician to the CCSS after completing and signing it.
If you live in Italy and you are of Monegasque or Italian nationality, you must send this letter card to the Italian social services (I.N.P.S.) within the first 6 months of your work interruption. After this period, documents relating to the extension of the work interruption should be sent to the C.C.S.S.
If this deadline of 48 hours is not met, you may be refused daily allowances.
Send us a certificate of absence completed by your employer, ensuring that it clearly states:
- the work cessation date and, where applicable, the work resumption date,
- the information appearing on the payslips for the three months prior to the month during which you stopped work (gross salary amounts and number of working hours).
This document, which determines the payment, must be submitted:
- when you resume work in the case of a short-term work interruption,
- every fifteen days or every month, on a fixed date, in the case of a long-term work interruption (the weekly submission of certificates of absence increases the complexity of the statements and does not speed up payments).
The employee must:
- comply with the set times for leaving the house (between 4.00pm and 6.00pm),
- provide their place of residence and telephone number when they stop work,
- not spend time outside the place of residence without the prior permission of the Medical Examinations Department.
Failing this, the payment of daily allowances is likely to be refused.
Special cases of work stoppages prescribed during a secondment outside France or Italy.
Calculating the daily allowance
- The amount of the daily sickness benefit is equal to half the average gross daily salary received by the insured over the 12 previous months. However, it cannot be greater than half the C.C.S.S. upper contributions limit recalculated on a daily basis from the October 1, 2023: €155.00
- When the employee has three or more dependent children, as described in the legislation on family benefits, the daily allowance amount is increased to 2/3 of the average daily salary from the 31st continuous day of work interruption, but cannot exceed one 45th of the C.C.S.S. monthly upper contributions limit.
The first three days of the initial work stoppage are not subject to benefit payments.
Given this waiting time, the benefit is calculated by multiplying the daily allowance amount by the number of days of work interruption subject to benefit payments.
Revision of the daily allowance
The daily allowance amount can be revised in two different ways:
- From the start of the fourth month of work interruption, the employee can request that the daily allowance amount be revised in proportion to the general salary increases in the company under a legal or regulatory text, or agreements reached within the profession.
- If no such request is made or the measurement was less favourable, there is a revision after a continuous six-month work interruption, by application of the coefficients established by the Ministerial Decrees published subsequent to this six-month deadline. In this case, the employee does not have to do anything.