Key Benefits:
The Prime Minister,
On the report of the Minister of Solidarity, Health and the Family;
Considering the Social Security Code, including Article L. 162-4-4;
Having regard to the advice of the Board of the National Health Insurance Fund of Employees dated 10 December 2004;
Having regard to the advice of the Council of the National Health Insurance Union dated 17 December 2004;
The State Council (Social Section) heard,
Decrete:
Section I-1 of Chapter 2 of Title VI of Book I of the Social Security Code is supplemented by an article R. 162-1-9-1 as follows:
"Art. R. 162-1-9-1. - Pursuant to section L. 162-4-4, the extension of a work stop, which is not prescribed by the doctor prescribing to the initial order or by the attending physician, is compensable in the following cases:
1° When the extension of work stop is prescribed by a specialist physician consulted at the request of the attending physician;
2° When the extension of work stop is prescribed by the doctor replacing the doctor prescribing to the initial order or the doctor replacing the attending physician;
3° When the extension of work stop is prescribed on the occasion of hospitalization.
Apart from the above cases, where the extension of a work stop has not been prescribed by the doctor prescribing the initial order or the attending physician, the insured person must justify the impossibility for any of these doctors to prescribe this extension. It provides proof by any means to the request of the health insurance organization.
In all cases, the insured person or health professional under the responsibility of the insured person indicates on the notice of termination of employment the reason why the physician prescribing the extension is not the doctor prescribing to the initial order or the attending physician. »
The Minister of Solidarity, Health and the Family, the Minister of Agriculture, Food, Fisheries and Rural Affairs and the Secretary of State for Health Insurance are responsible, each with respect to him, for the execution of this decree, which will be published in the Official Journal of the French Republic.
Done in Paris, December 23, 2004.
Jean-Pierre Raffarin
By the Prime Minister:
The Minister of Solidarity,
health and family,
Philippe Douste-Blazy
Minister of Agriculture, Food,
fisheries and rurality,
Dominic Bussereau
State Secretary for Health Insurance,
Xavier Bertrand
