gms | German Medical Science

Background: Work disability prevention (WDP) in France sits at the crossroads of the social security system, employers, the occupational health system, and the healthcare system. Numerous codes, laws and regulations create a very complex system for all stakeholders involved. This presentation is derived from a chapter in The Science and Politics of Work Disability Prevention [1].

Aim:

1.

To describe the role and responsibilities in WDP/occupational rehabilitation of different actors in the French system;

2.

to describe current measures for WDP with a focus on the legal status “disabled worker”.

Method: Document study of policy documents and legal analysis of regulatory frameworks in France. This presentation will address only the general social security scheme that covers 18 million private-sector, salaried workers.

Results/findings: In France, the social-insurance physicians, the occupational physicians (OPs), and the treating physicians have specific roles in WDP. Only the OPs are entitled to communicate with the employers for job accommodation. There is no better incentive for employers to provide job accommodation than disabled-worker status. Rehabilitation services are loosely connected with WDP actors, with a few notable exceptions.

Discussion and conclusions: WDP in France is hampered by the complexity of the social legislation, the scattering of actors, and the uneven collaboration between rehabilitation and occupational health services. The viability of the system is challenged by the significant increase of workers with the “disabled worker” status.