Key Benefits:
Minister of Labour, Employment and Health and Minister of Budget, Public Accounts and State Reform, Government Spokesperson,
Vu le Social Security Codeincluding articles R. 376-1 and R. 454-1;
Having regard to the advice of the Board of the National Health Insurance Fund of Employees dated 20 December 2011;
Considering the referral of the Industrial Accidents and Occupational Diseases Commission dated 16 December 2011;
Considering the referral of the Central Board of Directors of the Agricultural Social Mutuality dated 16 December 2011,
Stop:
I. ― The lump-sum assessment of disability pension plans first paragraph of Article R. 376-1 of the Social Security Code is calculated in accordance with the scale set out in Appendix 1 to this Order.
II. ∙ The flat-rate evaluation first paragraph of Article R. 454-1 of the Social Security Code shall be made, for the expenses resulting from the payment of work and supply accident annuities, the repair and renewal of prosthetic and orthopaedic equipment in the case of work accidents attributable to a third party, in accordance with the following provisions:
1° The expenditure resulting from the payment of annuities to victims or persons entitled to the victims of industrial accidents shall be determined by the amount of the representative capital of those annuities calculated using the scale set out in I and II of Schedule 2 to this Order, taking into account the age reached by the beneficiaries on the date of the amicable payment agreement or the court decision ordering the payment.
Payments of annuities paid prior to that date are subject to a separate refund.
2° The expenditure resulting from the provision, repair and renewal of prosthetic and orthopaedic devices is fixed for each victim to the amount of the representative capital of a supposed life annuity payable under the same conditions as the annuity. This representative capital shall be calculated by means of the scale set out in I of Schedule 2 to the life annuities of this Order, taking into account the age reached by the recipient on the date of the amicable payment agreement or the court decision ordering that payment.
Annuity includes:
(a) The value of the supply, repairs and renewal of the main aircraft, at 50% of its price.
This proportion of 50% is increased to:
75% for the orthotics of the trunk referred to in Part II, Chapter 7, of the list referred to inArticle L. 165-1 of the Social Security Code ;
100% for small-scale equipment related to herniary bandages, orthopaedic belts and corsets, elastic and low-valour knees, probes, alkes, day and night urinals, eyeglasses and hearing aids referred to in Part II, Chapter 1, Part II, Chapter E, Chapter I, Chapter II, Chapter IArticle L. 165-1 of the Social Security Code ;
100% for eye prostheses referred to in Chapter II of the same list;
200 % for orthopaedic footwear listed under Part II, Chapter 6, of the same list.
It is reduced to 15% for dental equipment;
(b) The value of the incidental supplies, the travel expenses of the victim, the shipping costs of the aircraft, estimated at 50% of the value determined as above for the supply, repair and renewal of the main aircraft.
The cost of the main appliance as the basis for calculating the amount of annuity is the current price on the day of payment.
If the victim is entitled, because of multiple infirmities, to several main devices, their prices are added for the determination of the amount of annuity.
The equipment charges paid prior to the payment date are subject to a separate refund.
III. ― The lump-sum assessment of future third-party benefits and medical and paramedical costs provided for in the first paragraph of sections R. 376-1 and R. 454-1 shall be set, apart from the benefits referred to in I and 1° of II and subject to the provisions provided for in 2° of II of this section, to the amount of the representative capital of such benefits calculated on the terms defined in 1° of II of this section.
Orders of December 3, 1954 relating to the lump-sum assessment of work accident annuities and equipment costs resulting from work accidents attributable to a third party and November 23, 1962 setting out the scale to be used for the lump-sum assessment of disability annuities attributed to social insured persons in the event of an accident or injury caused by a third party are repealed.
The Director of Social Security and the Director of the Budget are responsible, each with respect to him, for the execution of this Order, which will be published in the Official Journal of the French Republic.
A N N E X E S
You can consult the table in the
JOn° 302 of 30/12/2011 text number 61
You can consult the table in the
JOn° 302 of 30/12/2011 text number 61
You can consult the table in the
JOn° 302 of 30/12/2011 text number 61
You can consult the table in the
JOn° 302 of 30/12/2011 text number 61
Done on 27 December 2011.
The Minister of Labour,
employment and health,
For the Minister and by delegation:
The Director of Social Security,
D. Libault
Minister of Budget, Public Accounts
and state reform,
Government spokesperson,
For the Minister and by delegation:
By preventing the Budget Director from:
The Deputy Director,
R. Gintz
