Key Benefits:
Minister of Defence,
Vu le Defence codeincluding articles R. 3233-1 to R. 3233-4;
Vu le Labour code ;
Vu le Decree No. 82-453 of 28 May 1982 amended on occupational health and safety and on medical prevention in the public service;
Vu le Decree No. 2008-429 of 2 May 2008 amended on schools and training of the military health service;
In view of Decree No. 2008-967 of 7 September 2008, setting out rules of ethics for armed practitioners;
Vu le Decree No. 2012-422 of 29 March 2012 Health and Safety at Work in the Ministry of Defence;
In view of the decision of 7 January 1983 setting the conditions for the inspection of occupational medicine in the armed forces;
Having regard to the Order of 9 August 2012 setting out the specific modalities for organizing occupational risk prevention in the Ministry of Defence, including Article 5;
In view of the decision of 3 September 2012 on the organization of the Military Staff setting out the list of authorities and agencies directly subordinated to the Chief of Staff of the Armed Forces;
Having regard to the decision of 9 November 2012 on the organization of the military health service;
Having regard to the decision of 20 December 2012 on the determination and control of medical fitness for military personnel;
Considering the opinion of the Joint Prevention Commission of 13 February 2013,
Stop it!
This Order fixes, pursuant toarticle 47 of the decree of 29 March 2012 referred to abovethe organizational and operational arrangements for the practice of preventive medicine for military personnel assigned to the Ministry of Defence when carrying out activities similar to those entrusted to civilian personnel.
Prevention medicine for the benefit of the military personnel concerned is an integrated service in the exercise of military medicine organized for all military personnel by the military health service, in accordance with the rules of ethics established by the decree of September 7, 2008 referred to above.
For the purposes of this Order, "medical centre of the armed health service" means any medical structure in which one or more of the armed, active or reserve doctors operate, regardless of the site hosting the training, the national navy building or the settlement area.
The military health service sets out the rules for the organization and operation of the preventive medicine exercise for military personnel assigned to the Ministry of Defence.
The Central Director of the Armed Health Service is consulted on the occupational health and safety regulations in the Ministry of Defence as long as they contain provisions that have medical implications or impacts on the organization and conditions of the preventive medicine for the benefit of military personnel.
In accordance witharticle 38 of the Decree of 29 March 2012 referred to above, the Central Director of the Armed Health Service designates a skilled practitioner in occupational medicine, known as the National Coordinator of Prevention Medicine of the Ministry, to provide his technical advice and expertise to the sub-director in charge of the implementation and management of military medicine to the central management of the military health service.
This practitioner centralizes and operates the annual summary data and reports transmitted by the regional or joint branches of the armed health service regarding the exercise of preventive medicine for military personnel. The encrypted synthesis is transmitted to the inspector of preventive medicine in the armies.
The Regional Director of the Armed Health Service has a skilled worker in occupational medicine, appointed by the Central Directorate of the Armed Health Service, to serve as a regional advisor and expert in the exercise of preventive medicine for the benefit of military personnel assigned to the Ministry of Defence.
The regional counselor and expert in preventive medicine operates the annual reports of preventive medicine prepared by the doctors of the armed forces in charge of the practice of the medicine for the prevention of military personnel assigned to the Ministry of Defence. It proposes a synthesis of these reports to the regional director of the military health service. This synthesis is forwarded to the Central Directorate of the Armed Health Service and the Inspector of Prevention Medicine in the Armed Forces.
The regional adviser and expert in preventive medicine is responsible, under the authority of the Regional Director, for the organization of ongoing training in preventive medicine for the doctors of the armies carrying out this activity. This training is placed under the educational authority of the school of Val-de-Grâce.
The regional advisor and expert in preventive medicine transmits to the medical practitioners in the field of preventive medicine the technical guidelines from the central branch of the armed health service.
In addition to his advice, expertise and training activities, the regional advisor and expert in preventive medicine organizes and coordinates the supervision of the preventive medicine activity carried out by the medical practitioners of the concerned armies.
Medical doctors in the armed medical centres of the military health service are responsible for the exercise of preventive medicine for the benefit of military personnel assigned to the Ministry of Defence, whose medical support they provide.
The Regional Director of the Health Service is among the physicians who report to his technical authority to the medical officers responsible for the prevention of military personnel, known as Assistant Doctors for Prevention Medicine.
These armed doctors are given priority training under Article 6 of this Order.
They are responsible, each with respect to it, for the drafting of the annual report on preventive medicine referred to in Article 6 of this Order.
They contribute to the harmonization of medical practices in the particular field of prevention medicine by ensuring, among other things, the dissemination among other doctors of the medical centre of the military health service, the guidelines developed by the central management or the regional management of the related health service.
For the exercise of activities related to preventive medicine, armed physicians are supervised by a doctor who supervises preventive medicine. This physician is designated by the Regional Director for each geographic area proposed by the Regional Advisor and Expert.
This skilled practitioner in occupational medicine, assigned to the Department of Defence's Prevention Medicine Service referred to in Article 37 of the Decree of 29 March 2012, provides his assistance and advice to the medical practitioners of the sector for which he was appointed. He conducts supervisory visits in which he ensures, inter alia, compliance with the recommendations of good practices in the field of occupational medicine. Assistant physicians in charge of military prevention medicine are the attached correspondents of the supervisory doctor.
The control of medical fitness to serve military personnel is the exercise of military medicine under the above-mentioned Order of 20 December 2012 and can only be carried out by the military doctors under the military health service.
During the medical visits provided for by the above-mentioned order, the medical practitioner, whether or not he is an assistant in charge of preventive medicine, determines the particular aptitude for the conditions of employment that warrant enhanced medical supervision, in accordance with the conditions of employment provisions of the third paragraph of Article R. 4624-18 of the Labour Code, or appropriate monitoring, in accordance witharticle 7 of the decree of 29 March 2012 referred to above.
The data collected during fitness visits are recorded in the medical and medico-administrative documents mentioned in the above-mentioned Order 20 December 2012.
Proposals to adapt or develop workstations that take into account the state of health of the member examined are, as appropriate, mentioned on the medical-administrative certificate established after medical visits.
With the exception of military personnel classified With respect to ionizing radiation that benefit from monitoring their state of health according to the periodicity provided for in theArticle R. 4451-84 of the Labour Code, enhanced medical supervision includes the completion of a periodic medical visit at least every twenty-four months.
During these visits, the medical doctor of the armed forces conducting medical supervision of military personnel may prescribe, in the context of preventive medicine, any additional examination or specialized consultation necessary:
– the determination of the fitness for the job position;
― the screening of a disease related to occupational exposures;
- the screening of hazardous diseases for the surge in the workplace.
These additional examinations and consultations are handled by the armed health service. The member goes there as part of a mission for which transportation expenses and related mission allowances are the responsibility of the employment authority.
The determination of the suitability of the military under enhanced medical supervision is mandatory and prior to the effective assignment to the position of work.
Under the authority of the Assistant Physician for Prevention Medicine, and after the agreement of the Regional Director for the Health Service of the Armed Forces of which he reports, special medical supervision procedures that take into account the cooperation between health professionals can be established, without derogating from the two-year periodicity.
Between scheduled visits, military personnel under the provisions of Article 10 may, at their request, benefit from a medical examination or supervisory authority to re-evaluate their ability.
Assistant doctors in charge of preventive medicine have free access to workplaces to carry out workplace activities related to military personnel in the Ministry of Defence. These practitioners analyze the relevant workstations and report in writing to the heads of agencies the serious malfunctions that they may see and, where appropriate, make motivated proposals to remedy them.
In application of thearticle 45 of the decree of 29 March 2012 referred to above, they may also ask the heads of organizations to carry out expertise, sampling or workplace measures.
Assistant physicians in charge of preventive medicine, or in the event of an incapacity of another medical officer, participate in meetings of the advisory boards of hygiene and accident prevention provided for in thearticle 30 of the decree of 29 March 2012 referred to above.
Medical conclusions of suitability or incapacity, to be served or to be employed, partial or total, may be appealed under the terms referred to in the above-mentioned Order of 20 December 2012.
The heads of agencies are responsible for the management of the summons and follow-up of medical visits in consultation with the head doctor or commander of the medical centre of the military health service.
The visits mentioned in articles 10 and 12 are mandatory for all military personnel in situations of activity. The heads of agencies ensure compliance with this obligation.
A new visit must be caused by the employment authority prior to the regulatory deadline for military personnel undergoing a change of activity requiring different enhanced medical supervision.
During the visits to determine the adequacy of the state of health with the imperatives of the military occupations, the member summoned shall give the examining physician the record mentioned in the Order of 20 December 2012 provided by the employment authority as well as any other document put in place by the Ministry of Defence and describing occupational or environmental exposures in relation to the conditions of employment of the member.
The organization and operation of preventive medicine for the benefit of military personnel engaged in operational or combat training activities are subject to special provisions, if necessary, developed by the military health service.
The provisions of this Order apply to military personnel assigned to organizations not returning under Article 1 but technically supported by the military health service, without prejudice to the specific provisions that may be the subject of a contractual document between the military health service and the employment authorities concerned.
The Central Director of the Armed Health Service shall specify by ministerial circular the conditions for the application of this Order.
The Central Director of the Armed Health Service is responsible for the execution of this Order, which will be published in the Official Journal of the French Republic.
Done on 30 April 2013.
Jean-Yves Le Drian
