Should an accident at work report be made when the circumstances around a reported accident seem doubtful or unlikely? Or when the employee who was involved in an alleged accident does not seem to show any injuries and does not provide a medical certificate? Or when the employee’s injuries seem likely to be attributable to a previous pathology?  

Many employers ask themselves these questions when they are informed that an accident affecting their employees has occurred. 

Although there are many factual scenarios, the answer is clear: the employer is not required to prejudge the nature of the accident observed or reported, and must report to the primary health insurance fund (CPAM) any accident occurring during work of which it is personally aware or through the report of the victim or a third party. The report must be made by way of a standard declaration form. 

The Social Security Code defines an accident at work as an accident occurring: 

• by the fact or on the occasion of work, 

• whatever the cause, 

• to any person employed or working in any capacity or in any place for one or more employers,  

• regardless of the amount and nature of their remuneration, the form, nature or validity of their contract, or their job status. 

Indeed, even if the employer is convinced that the accident did not occur in the circumstances described, or that the causes of the accident are unrelated to the work activity, or that the injuries are minimal, the employer cannot escape the reporting obligation. 

The accident must be reported within 48 hours of becoming aware of it, otherwise financial penalties and possible civil and criminal sanctions may be imposed. 

Therefore, as soon as the employer is informed of a workplace accident and/or the employee explicitly asks it to prepare an accident declaration, the employer must do so. 

For example, the declaration must be made even if: 

• the employee requests that an accident declaration be prepared several months after the occurrence of the alleged accident; or 

• the employee communicates a work stoppage for an accident following a preliminary interview which would be, according to the employee, the cause of psychological trauma. 

In these cases, and more generally when the employer has doubts about the very existence of an alleged accident, its circumstances (e.g. time and place), or whether the accident had an occupational origin, it is appropriate to draft reasoned reservations about the accident. The reasoned reservations must be submitted to the CPAM within ten  ‘clear days’ following the accident declaration (i.e. ten complete days not including the day of the declaration).    

The reservations should highlight any inconsistencies between the employee’s declaration and their working conditions, or facts indicating the absence of an accident or injury. In any case, the reservations will force the CPAM to examine the file more closely and with a more critical eye. While the form of the reservation letter is fairly free, its content must comply with a strict framework. 

The terms used by the employer in its accident declaration to the CPAM are important. For example, the employer is advised: 

• to use conditional language when it did not directly witness the facts giving rise to the declaration;  

• not to check the ‘observed’ (but instead the ‘reported’) box on the form when it did not visually witness the circumstances of the incident; and 

• to use general terms rather than medical terms to describe the injuries. 

These precautions, which may seem trivial at first glance, will make any subsequent appeals of a coverage decision by the CPAM easier.