Key Benefits:
The Prime Minister,
On the report of the Minister of Defence,
Considering the Code of Military Disability Pensions and War Victims;
Considering the advice of the Central Joint Technical Committee to the Director of the National Veterans' Office on June 17, 2009;
Considering the deliberation of the Board of Directors of the National Veterans and War Victims Office of June 23, 2009,
Decrete:
Title I of Book I of the Code of Military Disability Pensions and War Victims is amended as follows:
1° Section D. 4 bis is repealed.
2° In the first paragraph of section D. 11, the words "interdepartmental or departmental department of the Ministry of Veterans and War Victims entitled to receive the application" are replaced by the words "or body designated by the Minister for Veterans and War Victims".
3° In the third paragraph of section D. 11, the words: "Interdepartmental Director or Departmental Director of Veterans and War Victims who, by virtue of his delegation to the Minister of Veterans and War Victims, makes a decision granting or refusing compensation" are replaced by the words: "service or agency designated by the Minister responsible for Veterans and War Victims. The Minister shall forward the record of care allowance to the appropriate department of the Minister responsible for the budget that proceeds to the liquidation and concession of the Minister. "
4° In the last paragraph of section D. 14, the words: "the Interdepartmental Director or Departmental Director of Veterans and War Victims" are replaced by the words: "the service or agency designated by the Minister for Veterans and War Victims".
5° In the third paragraph of section D. 15, the words: "directly from the interdepartmental or departmental director" are replaced by the words: "from the decision of the service or agency designated by the Minister for Veterans and War Victims".
6° In section D. 18, the words "to the interdepartmental leadership of which they belong" are remarked by the words: "to the service or agency designated by the Minister for Veterans and War Victims".
Chapters I to III of Title VII of Book I of the Code of Military Disability Pensions and War Victims are replaced by the following provisions:
“Chapter I
“Free Care
“Section 1
« Admission to free care
"Art.D. 53.-Any pensionable under this Code that benefits from the provisions of Article L. 115 shall be included in the special list provided for inArticle 1 of Decree No. 59-328 of 20 February 1959 amended to provide for free care under Article L. 115 of the Code of Military Disability Pensions and War Victims.
"This list is established, updated and controlled by the Human Resources Directorate of the Ministry of Defence.
"An identification number is assigned to each registered person.
"Art.D. 54.-Registration on the list follows the fate of the pension.
"If a pension entitlement is denied, the pensioner loses the benefit of the provisions of Article L. 115.
"Deletion decisions of the special list must be notified to the interested parties by the service referred to in Article D. 53.
"Art.D. 55.-Any recipient of section L. 115 receives a certificate of right to free medical care that is transmitted to him by the service referred to in section D. 53.
"He is only authorized to use it.
"In the event of a temporary pension, the expiry date of the right to free medical care is mentioned on the legal certificate.
"The pensioners, as well as health professionals and institutions, are required to comply with the provisions mentioned in this certificate of law.
“Section 2
“External care
"Art.D. 56.- Pensioners who are beneficiaries of Article L. 115 have the free choice of health professionals among those legally authorized to practise their profession.
"However, health professionals who benefit from section L. 115 cannot apply for the care that they would have given themselves. The beneficiaries of Article L. 115 may only appeal to medical assistants on medical prescription and for the execution of the acts in the general nomenclature of the professional acts in force in respect of social security.
"Art.D. 57.-When making a visit to the home of a beneficiary under section L. 115, in respect of the condition for which he or she is pensioned, the physician must indicate the reasons that prevented the person concerned from consulting his or her medical office.
"Art.D. 58.-Previously for the performance of certain acts or treatments, the practitioner in charge of the care to be given to a beneficiary under Article L. 115, for the affection for which he is a pensioner, must apply for their confidential treatment to the physician in charge of the control of free care.
These acts or treatments are those contained in the common classification of medical acts, the general nomenclature of the professional acts of doctors, dental surgeons, midwives and medical assistants or the nomenclature of medical biology acts and which are subject to social security to the formality of the prior agreement.
"In the event of an emergency, this request must be addressed as soon as possible, and no later than forty-eight hours after the day the act was performed or, for serial acts, on the day of the first sitting.
"Requests for care for these acts or treatments must specify the exact nature of the condition requiring care.
"Art.D. 59.- Upon receipt of requests under section D. 58, the medical officer responsible for the control of free care shall offer to the Director of the service referred to in section D. 53, to whom the decision is made, whether or not to authorize the care under section L. 115 of the acts in question. The pensioner notifies his decision.
"It may also, after control, terminate any authorization to take charge of serial acts, by duly reasoned decision, notified to the pensioner and to the caregivers; in this case, only the costs incurred until the date of notification of this decision are paid to the pensioner, except in the event of a marked fraud.
"Art.D. 60.-Health institutions are empowered to consult and provide external care to the beneficiaries of this chapter. The applicable rates are those that are covered by health insurance.
"Health facilities may not, in respect of external consultations and care, apply to the regulation by the service referred to in Article D. 53 of the care provided to beneficiaries of free care only if the requirements of Articles D. 58 and D. 59 were observed.
"Art.D. 61.-In addition to the care of the thermal treatments, pensioners performing a spa treatment under Article L. 115 are entitled, under conditions defined by decree, to the payment of a flat-rate accommodation allowance and to the reimbursement of their transportation expenses, unless they are domiciled in the thermal station. The amount of the lump-sum accommodation allowance is determined by joint order of the Budget Minister and the Minister for Veterans and War Victims.
"Transport costs are covered, regardless of the means of transport used, on the basis of the most cost-effective tariff, taking into account the reductions to which the persons concerned may benefit in their personal capacity. However, where, in the opinion of the doctor responsible for the control of free medical care, the pensioner did not choose the approved thermal establishment, appropriate to his or her case, the closest to his or her home or temporary residence, the reimbursement of transportation costs is calculated against the route that would have been made if the nearest establishment had been chosen.
"Art.D. 62.- Dental surgeons may, under the benefits referred to in section L. 115, make and lay dental prosthetic devices under the conditions and rates in effect for social security, provided that this benefit is subject to a request for care addressed to the doctor responsible for the control of free care. The application, which must be accompanied by an encrypted quotation, is subject to a decision of acceptance or refusal under the same conditions as that set out in section D. 59.
“Section 3
« Hospitalizations
"Art.D. 63.-If a hospitalization for a pensioned condition is deemed necessary, the care practitioner must apply for the care, at least six days in advance, in confidence, to the doctor responsible for the control of free care. In the event of an emergency, hospitalization takes place without delay. The request for care, which includes the reasons for emergency hospitalization, is then addressed no later than 48 hours after its occurrence. In all cases, the practitioner must also mention the health establishment chosen by the pensioner who must be, except for reasons, the qualified establishment closest to his or her home or temporary residence.
"Art.D. 64.-The head of the health care institution, where a pensioner was admitted under section L. 115, shall, in any case and not later than six days after his or her admission, notify the physician responsible for the control of free care. This information must be accompanied by the indication, written in confidence by the physician in charge of the care of the pensioner, the date of entry and medical reasons justifying his hospitalization.
"The head of the institution must also, within 48 hours, notify the physician responsible for the control of the free care of the outgoing pensioner.
"Art.D. 65.- Upon receipt of requests for care provided for in section D. 63, the physician responsible for the control of free care offers to the Director of the service referred to in section D. 53, who is the responsibility of the decision, whether or not to authorize the care of the hospital under section L. 115. The latter notifies its decision to the pensioner and the health care provider.
"Art.D. 66.-Hospitalization, fees and residence fees are, for each of the categories of health establishments considered, those determined under the conditions prescribed by the Social Security Code and its texts of application.
"Art.D. 67.-The transportation costs required by hospitalization are the responsibility of the State. This care is calculated on the basis of the less expensive route and means of transportation, compatible with the health condition of the pensioner and limited to the distance between the qualified health facility closest to the home or temporary residence of the pensioner.
"By derogation from the previous paragraph, on the advice of the doctor responsible for the control of free care, the charge of transportation costs is carried out, regardless of the means of transport used, on the basis of the most economical rate, taking into account the reductions that may be enjoyed by the individual concerned.
"The care of transportation costs for external care may only take place after prior agreement of the Director of the service referred to in section D. 53, taken on the advice of the physician responsible for the control of free care.
"Art.D. 68.-In the event of death in a hospital under Article L. 115 and following, the transfer of the body, from the health establishment to the place of the home, shall be the responsibility of the State.
“Section 4
"Care monitoring and control
"Art.D. 69.-The National Military Social Security Fund, as a body designated by the Minister of Defence, may be entrusted with the management of the free medical care benefits referred to in section L. 115 of this Code.
"Art.D. 70.-The Director of Service referred to in Article D. 53 shall be assisted by one or more physicians responsible for the control of free care in the exercise of the powers entrusted to him under the provisions of this chapter.
"These doctors are responsible for monitoring and monitoring the care provided to the beneficiaries of Article L. 115. They ensure that the benefits due under this article are delivered in accordance with the rules of a proper and fair exercise of medicine and pharmacy, and apply exclusively to the therapy of pensionable infirmities. They perform all required parts or on-site controls.
"The functions of a doctor responsible for the control of free care may, as necessary, be entrusted to a doctor under the authority of the Minister of Defence in whole or in part.
"Health institutions and professionals, as well as the beneficiaries of section L. 115, are required to communicate in confidence and personal form to the physician responsible for the control of free medical care, any information and medical documents that may be requested by the physician for the performance of his or her duties.
“Section 5
“General provisions
“paragraph 1
“Rules of costs incurred
free medical care
"Art.D. 71.-The care provided to the beneficiaries of Article L. 115 shall be paid to health care institutions and professionals on the one hand, of electronic or paper-based documents, referred to in Articles R. 161-40 and following of the Social Security Code, recognizing the acts performed and the benefits provided, on the other hand, of the order of the prescriptor, if any.
"Art.D. 72.-The conditions under which the travel expenses advanced by the pensioners are paid, the advances made to the pensioners for their travel expenses and the transportation costs of the deceased pensioners in a hospital under section L. 115 are determined by joint orders of the Minister for War Veterans and the Minister for Budget.
"Art.D. 73.- Unduly borne expenses, either by State medical assistance or by health insurance organizations, or by third parties or the persons concerned themselves, on the occasion of care that should have been covered by the provisions of Article L. 115, are reimbursed under the conditions set by joint instructions of ministers responsible for war veterans and victims of war, social security and the budget.
"The unduly borne expenditure by the State under Article L. 115 shall be refunded to it under the same conditions.
“Paragraph 2
“Procedure and remedies
"Art.D. 74.-The Director of the Service referred to in section D. 53 may, by a duly reasoned and notified decision to the stakeholders, refuse to pay for the provision of care benefits, in the event of non-compliance with the terms of care provided for in this chapter.
"Art.D. 75.- Notwithstanding any authorization given, or any payment already made, and without prejudice to any criminal proceedings, the Director of the service referred to in Article D. 53 may refer to the departmental pension courts any record that reveals either a fraudulent act or a marked abuse.
"Art.D. 76.- Appeals against decisions taken by the Director of the Service or the body designated by the Minister of Defence or by the Minister of Defence for the purposes of this chapter shall be brought before the pension court within six months of their notification to the participating party or agency concerned.
"The Departmental Court of Appeals and Judges in First Instance according to the procedure provided by the Decree No. 59-327 of 20 February 1959 amended on pension courts.
"Art.D. 77.-Interested parties, including the organizations referred to in Article D. 73, where the charge of the costs may subsequently be borne by them, may take on-site communication of their files. They may request to appear in person and make their oral submissions or make them appear before the court.
“Paragraph 3
“Special provisions for nationals
resident abroad
"Art.D. 78.-The provisions of Article L. 115 of the Code of Military Disability Pensions and War Victims, with respect to pensioners residing outside France, are subject to specific terms of application determined by instruction of the Minister for Veterans and War Victims, in accordance with the Ministers concerned.
“Chapter II
“Interned
"Art.D. 79.- Pensioners, interned under Article L. 124 of this Code, are in the same situation as other persons hospitalized in an establishment provided for inArticle L. 3222-1 of the Public Health Code.
"They can benefit from a daily allowance whose calculation methods are defined by decree of ministers responsible for veterans and victims of war, budget and health.
“Chapter III
« Apparatus
"Art.D. 80.-The Minister of Defence may entrust to any of the services or organizations that he or she has designated the management of the equipment benefits referred to in section L. 128 of this Code. »
The first three paragraphs of Article D. 232 of the Code of Military Disability Pensions and War Victims are replaced by the following:
"People with infirmities contracted or aggravated by the fact or on the occasion of the service during the completion of their compulsory internship at the youth yards may, if they have not been offered on an ex officio basis, assert their disability pension rights under the conditions set out below.
The persons referred to in the first paragraph shall apply to the Human Resources Directorate of the Ministry of Defence. After conducting the investigation of the file under the conditions set out in sections R. 8 et seq., this service shall forward the file to the appropriate department of the Minister responsible for the budget that proceeds to the liquidation and concession of the pension. »
Chapter II of Book IV of the Code of Military Disability Pensions and War Victims is amended as follows:
1° In Article D. 410, the words: "the overseas countries" are replaced by the words: "the overseas communities, New Caledonia".
2° In the fourth paragraph of section D. 413, the words "from the Minister of War Veterans and Victims of War and the Minister of Defence" are replaced by the words "from the Minister of Defence and the Minister responsible for the budget. »
3° Section D. 416 is replaced by the following provisions:
"The repatriation of the bodies, currently buried in the overseas departments, communities and in New Caledonia, or to be buried in those territories, are carried out under the conditions established by a joint decree of the Minister for War Veterans and War Victims and the Minister for Overseas. »
4° In section D. 418, the words: " Veterans and War Victims and the Minister of Economy and Finance" are replaced by the words: "Defendant and Budget Minister".
5° In section D. 419, the words: " Veterans and War Victims and the Minister of Economy and Finance" are replaced by the words: "Defendant and Budget Minister".
Chapter III of Book IV of the Code of Military Disability Pensions and War Victims is amended as follows:
6° Section D. 425 is replaced by the following provisions:
"The maintenance of national military cemeteries is provided by officers under the National Veterans' Office. It can also be entrusted by the private sector to companies.”
7° Section D. 426 is repealed.
8° In the second and third paragraphs of section D. 427, the words "the Director of General Administration" are replaced by the words "the Director General of the National Veterans' Office".
9° In the second paragraph of section D. 428, the words "The Minister of Veterans and War Victims" are replaced by the words "The Minister of Defence".
Article D. 432 of the Code of Military Disability Pensions and War Victims is supplemented by the following paragraph:
"The national office is responsible for the instruction of the reserved job applications of the beneficiaries of the 1st of Article L. 394 who are no longer in operation, from 2nd to 6th of the same article and articles L. 395 and L. 396. »
The Minister of Budget, Public Accounts, Public Service and State Reform, the Minister of Defence and the Secretary of State for Defence and Veterans Affairs are responsible, each with respect to him, for the implementation of this decree, which will be published in the Official Journal of the French Republic.
Done on 30 December 2009.
François Fillon
By the Prime Minister:
Minister of Defence,
Hervé Morin
Minister of Budget, Public Accounts,
Civil Service
and state reform,
Eric Woerth
Secretary of State for Defence
and Veterans,
Hubert Falco
