{"id":22454,"date":"2018-06-05T00:30:37","date_gmt":"2018-06-04T22:30:37","guid":{"rendered":"https:\/\/valoxy.org\/blog\/?p=22454"},"modified":"2024-06-13T15:36:25","modified_gmt":"2024-06-13T13:36:25","slug":"comment-etre-sur-de-la-realite-dun-arret-maladie","status":"publish","type":"post","link":"https:\/\/valoxy.org\/blog\/comment-etre-sur-de-la-realite-dun-arret-maladie\/","title":{"rendered":"Comment \u00eatre s\u00fbr de la r\u00e9alit\u00e9 d\u2019un arr\u00eat maladie ?"},"content":{"rendered":"<p>Devant un arr\u00eat maladie qui se prolonge, des dates d\u2019absence\u00a0 \u00ab opportunistes \u00bb, ou parfois simplement pour dissiper un \u00ab doute \u00bb sur la r\u00e9alit\u00e9 ou l\u2019importance de la maladie, comment \u00eatre s\u00fbr de la r\u00e9alit\u00e9 d&rsquo;un arr\u00eat maladie ? Le chef d\u2019entreprise peut simplement organiser une <u>contre-visite m\u00e9dicale<\/u>.<\/p>\n<p>Valoxy, cabinet d\u2019expertise comptable dans les Hauts de France, vous en dit plus sur la r\u00e9alit\u00e9 d&rsquo;un arr\u00eat maladie.<\/p>\n<h4><u>Qu\u2019est-ce qu\u2019une contre-visite m\u00e9dicale ?<\/u><\/h4>\n<p>Une contre-visite, c\u2019est une v\u00e9rification de la r\u00e9alit\u00e9 d\u2019un arr\u00eat de travail prescrit. C&rsquo;est \u00e9galement la v\u00e9rification de la pertinence de sa dur\u00e9e. L&rsquo;incapacit\u00e9 temporaire totale de travailler du salari\u00e9 est elle justifi\u00e9e ? L\u2019arr\u00eat n\u2019a-t-il pas \u00e9t\u00e9 accord\u00e9 trop facilement ?<\/p>\n<p>Ce contr\u00f4le permet de v\u00e9rifier que\u00a0:<\/p>\n<ul>\n<li>le salari\u00e9 est chez lui pendant les heures d\u2019interdiction de sortie, fix\u00e9es par son m\u00e9decin<\/li>\n<li>l\u2019\u00e9tat de sant\u00e9 du salari\u00e9 justifie l&rsquo;arr\u00eat prescrit.<\/li>\n<\/ul>\n<p>La visite de contr\u00f4le peut \u00eatre effectu\u00e9e soit \u00e0 l&rsquo;initiative de la S\u00e9curit\u00e9 sociale, soit \u00e0 la demande de l\u2019employeur (contr\u00f4le m\u00e9dical patronal).<\/p>\n<p>En effet, le droit \u00e0 recourir \u00e0 une contre visite n\u2019est que la contrepartie de l\u2019obligation de la CPAM \u00e0 verser des indemnit\u00e9s journali\u00e8res, et de l\u2019obligation de l\u2019employeur au maintien du salaire (les indemnit\u00e9s journali\u00e8res compl\u00e9mentaires).<\/p>\n<p>La contre-visite est un acte m\u00e9dical par lequel un m\u00e9decin mandat\u00e9 par la S\u00e9curit\u00e9 sociale ou par l\u2019employeur v\u00e9rifie la r\u00e9alit\u00e9 de l\u2019incapacit\u00e9 de travail d\u2019un salari\u00e9.<\/p>\n<h4><u>Comment l\u2019entreprise peut elle organiser la contre-visite ?<\/u><\/h4>\n<p>Aucun motif particulier n\u2019est n\u00e9cessaire pour recourir \u00e0 une contre visite, \u00e0 partir du moment o\u00f9 l\u2019absence est sup\u00e9rieure ou \u00e9gale \u00e0 8 jours cons\u00e9cutifs ; l\u2019employeur peut vouloir v\u00e9rifier le bien fond\u00e9 de l\u2019arr\u00eat, la dur\u00e9e de celui-ci ou m\u00eame le respect des horaires de sortie autoris\u00e9s sur l\u2019arr\u00eat.<\/p>\n<p>L\u2019entreprise choisit le m\u00e9decin qu\u2019elle souhaite, qu\u2019il soit ind\u00e9pendant, ou qu\u2019il travaille avec une entreprise sp\u00e9cialis\u00e9e dans les contre-visites (Mediverif, S\u00e9curex, etc..). Certaines f\u00e9d\u00e9rations patronales ont aussi leur propre organisme de contr\u00f4le.<\/p>\n<p>Pour effectuer la contre-visite, le m\u00e9decin choisi peut convoquer le salari\u00e9, prendre rendez vous, ou encore se rendre au domicile du salari\u00e9 sans l\u2019avoir inform\u00e9 au\u00a0 pr\u00e9alable, notamment s\u2019il souhaite v\u00e9rifier le respect des heures de sortie.<\/p>\n<p>Le salari\u00e9 a l\u2019obligation de se soumettre \u00e0 la contre-visite, et ne peut exiger la pr\u00e9sence de son m\u00e9decin traitant pendant celle-ci.<\/p>\n<h4><u>Quelles sont les suites de la contre visite ?<\/u><\/h4>\n<p>L\u2019arr\u00eat de travail n\u2019est pas justifi\u00e9 :<\/p>\n<ul>\n<li>si le salari\u00e9 refuse de se soumettre \u00e0 la visite du m\u00e9decin contr\u00f4leur,<\/li>\n<li>lorsque le salari\u00e9 est absent de son domicile (en dehors des horaires de sortie autoris\u00e9s),<\/li>\n<li>si le m\u00e9decin contr\u00f4leur ne voit aucune justification m\u00e9dicale \u00e0 l\u2019arr\u00eat<\/li>\n<\/ul>\n<p>Les cons\u00e9quences de l\u2019arr\u00eat de travail (les indemnit\u00e9s journali\u00e8res) peuvent aussi \u00eatre remises en cause si l\u2019adresse est erron\u00e9e ou que le m\u00e9decin n\u2019a pu acc\u00e9der au domicile.<\/p>\n<h4><u>ATTENTION AUX HEURES DE SORTIE !<\/u><\/h4>\n<p class=\"p1\"><span class=\"s1\"><div class=\"encadre-style\">Le m\u00e9decin qui d\u00e9livre l&rsquo;arr\u00eat de travail pour maladie doit pr\u00e9ciser si le salari\u00e9 a l&rsquo;autorisation ou non de sortir de son domicile. Cependant, m\u00eame en cas de sortie autoris\u00e9e, le salari\u00e9 doit \u00eatre \u00e0 son domicile entre 9h et 11h et entre 14h et 16h, sauf en cas d\u2019examens m\u00e9dicaux ext\u00e9rieurs.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Les horaires de sortie autoris\u00e9s ne peuvent exc\u00e9der trois heures cons\u00e9cutives. Les horaires de sortie sont aussi valables pour les week-ends et jours f\u00e9ri\u00e9s. Tout manquement \u00e0 cette r\u00e8gle peut voir r\u00e9duites ou suspendues le versement des indemnit\u00e9s journali\u00e8res.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Le m\u00e9decin peut \u00e9galement autoriser des sorties totalement libres sous r\u00e9serve de les justifier.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Dans tous les cas, le salari\u00e9 doit obtenir l&rsquo;autorisation de la CPAM s&rsquo;il quitte le d\u00e9partement pendant son arr\u00eat. Il doit \u00e9galement lui communiquer son adresse provisoire. <\/div><\/span><\/p>\n<p>S\u2019il conclut \u00e0 l\u2019absence de justification de l\u2019arr\u00eat, le m\u00e9decin contr\u00f4leur transmet un rapport de sa visite au service du contr\u00f4le m\u00e9dical de la Caisse. Et ce, qu\u2019il ait \u00e9t\u00e9 mandat\u00e9 par la CPAM ou par l\u2019entreprise.<\/p>\n<p>Au vu de ce rapport, ce service :<\/p>\n<ul>\n<li>demande \u00e0 la caisse de suspendre les indemnit\u00e9s journali\u00e8res (IJSS).<\/li>\n<li>ou proc\u00e8de \u00e0 nouvel examen de la situation de l&rsquo;assur\u00e9 (notamment si le m\u00e9decin contr\u00f4leur n&rsquo;a pas vu l&rsquo;assur\u00e9).<\/li>\n<\/ul>\n<p>L\u2019employeur peut alors cesser de verser le compl\u00e9ment employeur pour la dur\u00e9e de l\u2019arr\u00eat restant \u00e0 courir \u00e0 compter du jour du contr\u00f4le (mais sans effet r\u00e9troactif). <em>Cependant, l\u2019employeur ne peut sanctionner le salari\u00e9 en l\u2019absence de justification de l\u2019arr\u00eat.<\/em><\/p>\n<h4><u>Conclusion<\/u><\/h4>\n<p>Les arr\u00eats maladie frauduleux ou abusifs sont un r\u00e9el probl\u00e8me d\u2019absent\u00e9isme pour les entreprises. Ils ne repr\u00e9sentent cependant qu\u2019un pourcentage tr\u00e8s faible du total des arr\u00eats.<\/p>\n<p>Loin du cas d\u2019\u00e9cole rarissime de l\u2019employ\u00e9 travaillant chez un concurrent pendant son\/ses arr\u00eats maladie. Loin de l\u2019image fantasm\u00e9e de salari\u00e9s toujours fraudeurs ou fain\u00e9ants. Mais aussi loin de m\u00e9decins toujours aveugles ou complaisants, la contre-visite n\u2019est qu\u2019un moyen, parmi d\u2019autres, de lutter contre l\u2019absent\u00e9isme. Utilis\u00e9e \u00e0 bon escient, de mani\u00e8re mod\u00e9r\u00e9e, elle peut m\u00eame avoir un effet positif sur le taux d\u2019absent\u00e9isme de l\u2019entreprise.<\/p>\n<p>L\u2019attention aux \u00ab arr\u00eats \u00e0 r\u00e9p\u00e9tition \u00bb fera en g\u00e9n\u00e9ral appara\u00eetre les v\u00e9ritables raisons du malaise d\u2019un salari\u00e9.\u00a0 L&rsquo;entreprise doit \u00e9galement suivre les \u00ab prolongations permanentes \u00bb d&rsquo;un arr\u00eat. Que les raisons soient personnelles (famille, alcoolisme, \u00e9tat d\u00e9pressif, etc.) ou li\u00e9es au travail (organisation, m\u00e9sentente, etc.). Coupl\u00e9e \u00e0 une bonne relation avec le M\u00e9decin du Travail, le fonctionnement de l&rsquo;entreprise en sera am\u00e9lior\u00e9.<\/p>\n<p>Pour plus d\u2019informations sur les arr\u00eats maladie, retrouvez nos articles sur le blog de Valoxy :<\/p>\n<ul>\n<li><a href=\"https:\/\/valoxy.org\/blog\/arret-de-travail-complement-de-salaire-indemnites-journalieres\/\">Arr\u00eat de travail, compl\u00e9ment de salaire et indemnit\u00e9s journali\u00e8res<\/a><\/li>\n<li><a href=\"https:\/\/valoxy.org\/blog\/quest-ce-que-la-garantie-arret-de-travail\/\">Qu\u2019est ce que la garantie arr\u00eat de travail<\/a><\/li>\n<li><a href=\"https:\/\/valoxy.org\/blog\/medecin-du-travail\/\">Le m\u00e9decin du travail<\/a><\/li>\n<li><a href=\"https:\/\/valoxy.org\/blog\/visite-medicale-reprise\/\">Les obligations de l\u2019employeur en mati\u00e8re de visite m\u00e9dicale de reprise.<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Devant un arr\u00eat maladie qui se prolonge, des dates d\u2019absence\u00a0 \u00ab opportunistes \u00bb, ou parfois simplement pour dissiper un \u00ab doute \u00bb sur la r\u00e9alit\u00e9 ou l\u2019importance de la maladie, comment \u00eatre s\u00fbr de la r\u00e9alit\u00e9 d&rsquo;un arr\u00eat maladie ?&#8230;<\/p>\n","protected":false},"author":1,"featured_media":22460,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-22454","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-social-rh"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Comment \u00eatre s\u00fbr de la r\u00e9alit\u00e9 d\u2019un arr\u00eat maladie ? | Valoxy<\/title>\n<meta name=\"description\" content=\"Un arr\u00eat maladie qui se prolonge, des dates d\u2019absence\u00a0 \u00ab\u00a0opportunistes\u00a0\u00bb, ou un \u00ab\u00a0doute\u00a0\u00bb sur la r\u00e9alit\u00e9 de la maladie ? 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