Arrêt Maladie in France: Employment Rights, Dismissal Limits and Leave

An arrêt maladie touches two separate systems at the same time, and most people looking for answers only find one of them. The Assurance Maladie side, the indemnités journalières, is well documented on ameli.fr and is where questions about waiting days, daily rates and payment dates belong. The employment side is different, and it is the part that decides what happens to the job.

This page deals with that second system: what the salarié owes the employer and within what délai, what happens to the contract while it is suspended, the limits on dismissing someone who is off sick, the congés payés that now build up during the absence, and the medical visit that governs the return. For the benefit calculation itself, ameli.fr remains the authoritative source and nothing here is intended to replace it.

Information last verified on 21 July 2026. This page presents general legal information, not legal advice.

The Contract Is Suspended, Not Ended

The starting point is straightforward and often reassuring. An arrêt maladie suspends the performance of the contrat de travail. It does not terminate it. The post remains and the terms of the contract are unchanged when the employee comes back. Seniority is treated differently depending on the cause: where the absence results from an accident du travail or a maladie professionnelle, article L1226-7 counts the suspension towards all legal and conventional seniority-based entitlements, whereas a non-professional arrêt is not counted towards ancienneté unless the convention collective provides for it.

Suspension does not mean every obligation disappears. The duty of loyalty continues throughout the absence, which is why activity that competes with the employer, or conduct incompatible with the stated incapacity, is analysed on the misconduct track rather than the illness track.

The 48 Hour Rule and What the Employee Owes the Employer

The practical obligation that trips people up most often is the notification deadline. Article L1226-1 of the Code du travail makes the employer's complementary pay conditional on the employee justifying the incapacity within 48 hours. The 48 hour condition does not apply to salariés covered by article L169-1 of the code de la sécurité sociale, who are victims of an act of terrorism.

The paper arrêt de travail is issued in parts, with the sections carrying the medical information going to the Caisse primaire d'assurance maladie and the remaining section, which carries only the dates, going to the employer. In most cases the arrêt is transmitted electronically by the doctor straight to the Assurance Maladie, which leaves the employer copy as the employee's remaining task.

Two recent changes are worth knowing. Since 1 July 2025 a paper arrêt must be issued on a new secured Cerfa form carrying seven authentication features, and since 1 September 2025 the Assurance Maladie rejects arrêts submitted on the older unsecured form. Photocopies and scans of the paper form are not accepted; a non-secured form is rejected and returned to the prescribing doctor, and the patient is asked to send the replacement without delay.

A convention collective or the contract itself may set a shorter or more detailed notification requirement, and where it does, that is the one that governs the employment relationship.

Employer Top-Up Pay Under Article L1226-1

Separately from the indemnités journalières paid by the CPAM, article L1226-1 provides for an indemnité complémentaire paid by the employer. It is not automatic and it is not universal.

The conditions in the article are cumulative. The employee must have one year of seniority with the employer, must have justified the incapacity within 48 hours, must be covered by French social security, and must be receiving care in France or in another Member State of the European Union or the European Economic Area.

The same article excludes certain categories from the legal top-up, including salariés travaillant à domicile (home workers, a distinct statutory category and not employees working remotely), seasonal workers, intermittent workers and temporary workers, and it does not apply where fraud in obtaining the benefit is established. Rates and timing are set by décret, and many collective agreements provide more generous terms than the legal minimum, so the applicable convention collective is usually the document that answers the practical question.

The Employer's Counter-Visit

An employer that pays the complément may have the incapacity checked by a doctor it mandates. The procedure was set out by decree number 2024-692 of 5 July 2024.

Article R1226-10 requires the employee to inform the employer, from the beginning of the arrêt and at each change, of their place of rest where it differs from their home address, and where the arrêt carries the sortie libre mention, of the hours during which the counter-visit can be carried out.

Article R1226-11 allows the mandated doctor either to attend the address communicated, without prior notice outside authorised exit hours or at the hours communicated, or to summon the employee to the doctor's own consulting rooms. Under article R1226-12 the doctor then tells the employer whether the arrêt is justified, whether it is not, or whether the examination was impossible because the employee refused to attend or was absent, and the employer must transmit that information to the employee without delay. The consequence attaches to the employer's complementary pay. It is not a medical decision that brings the arrêt itself to an end.

Dismissal While Off Sick: What Is and Is Not Allowed

Illness is never a lawful ground for dismissal in France. A dismissal based on the employee's state of health is discrimination and the termination is null, which pulls it into the same category discussed on the workplace harassment page: where a dismissal is null, article L1235-3-1 disapplies the capped compensation scale entirely and sets a floor of the last six months of salary with no ceiling. Where the dismissal is null the salarié may first ask to be reinstated. Article L1235-3-1's floor of six months' salary applies where reinstatement is not sought or is impossible.

What the law does permit is a dismissal founded on something other than the illness. Four routes exist in practice.

The first is absence that disrupts the functioning of the company. This requires two cumulative conditions: the prolonged or repeated absence must cause genuine disorganisation, and the employer must be obliged to replace the employee definitively by hiring on a permanent contract. Both have to be established and stated, and a temporary replacement does not satisfy the second.

The second is economic dismissal, which follows its own procedure and is addressed on the economic dismissal page. The third is misconduct unconnected with the illness, judged on ordinary disciplinary principles. The fourth is inaptitude, a finding of unfitness by the médecin du travail after the return, which triggers a redeployment obligation before any dismissal can be considered.

Two further protections are worth flagging. Many collective agreements contain a garantie d'emploi clause that prohibits any illness related dismissal for a defined period, commonly three, six or twelve months. And where the absence results from an accident du travail or a maladie professionnelle, the Code du travail gives markedly stronger protection during the suspension, permitting termination only for faute grave or for a proven impossibility of maintaining the contract for a reason unconnected with the accident or illness.

Paid Leave Now Accrues During Sick Leave

This is the biggest change of the past few years in the law on congés payés, and it is retroactive.

The law of 22 April 2024 aligned French law with European Union law by adding, at point 7 of article L3141-5, the periods during which the contract is suspended for a non-professional arrêt de travail to the list of periods counted as effective work for calculating congés payés entitlement.

Article L3141-5-1 sets the rate for those periods: two working days per month, within a limit of 24 working days per reference period. That is deliberately lower than the ordinary two and a half working days per month. Absence caused by a work accident or an occupational illness sits at point 5 of the same article and accrues on the ordinary basis.

Where the employee could not take the leave because of the absence, a carry-over period of 15 months applies. Article L3141-19-3 then imposes a concrete duty on the employer: within the month following the return to work, and by any means giving a certain date of receipt including the payslip, it must tell the employee how many days of leave they hold and the date until which those days may be taken. The 15 month clock is tied to that information being given.

One deadline has now passed. The 2024 law applied its rules retroactively to leave rights from 1 December 2009, but it gave employees still in post a window of two years from 24 April 2024 to bring a claim for that historic entitlement. That window closed in April 2026, two years after the law came into force on 24 April 2024. The forward-looking accrual rules continue to apply in full; it is the special retroactive claim route that is no longer available. The forclusion bites only on an action en exécution du contrat de travail, so it catches employees still in post. Someone whose contract has ended falls back on the ordinary three year salary prescription instead. Ordinary leave rules are covered on the paid leave page.

Coming Back: Visite de Reprise and Visite de Pré-Reprise

The return is regulated, and the trigger is the length of the absence.

Article R4624-31 makes a visite de reprise compulsory after maternity leave, after an absence for an occupational illness, after an absence of at least 30 days caused by an accident du travail, and after an absence of at least 60 days caused by a non-professional illness or accident. The employer must arrange it on the day of the actual return to work and at the latest within the eight days that follow.

Article R4624-31 adds one derogation. The visite de reprise is not required where the salarié had a visite de préreprise in the thirty days before the effective return and the médecin du travail concluded at that visit that no individual adjustment of the post or of working time was needed, unless the médecin du travail, the employer or the salarié asks for it anyway.

The examination checks whether the employee is fit to resume, whether the post is compatible with their state of health, and what adjustments or redeployment may be needed, and it is where an inaptitude finding is issued by the médecin du travail if one is warranted.

A visite de pré-reprise is available for absences of more than 30 days and takes place before the arrêt ends, so that adjustments can be prepared in advance. A separate and optional rendez-vous de liaison, which is not a medical appointment, can be requested by either side for absences of more than 30 days to discuss the conditions of the return.

Where the Benefit Side Lives

Everything above concerns the employment relationship. The money paid by the Assurance Maladie is a different system with its own rules on waiting days, the reference salary, the ceiling applied to the daily rate and the maximum duration of payment, and those rules have moved more than once in recent years.

That side is documented directly by the Assurance Maladie on ameli.fr, which is the source to use for a current figure. Reproducing a benefit calculation on a third party page is how outdated numbers spread, and this page deliberately does not do it.

For what happens when the contract does end, see the pages on wrongful dismissal and dismissal for gross misconduct, or the full list of topics on the France employment law hub.

Frequently Asked Questions

How quickly does the arrêt de travail have to reach the employer and the CPAM?

Forty eight hours is the operative figure on both sides. Article L1226-1 of the Code du travail makes the employer's complementary pay conditional on the employee justifying the incapacity within 48 hours, and the CPAM applies the same 48 hour expectation to the parts of the form that go to it. In roughly eight cases out of ten the doctor transmits the arrêt electronically to the Assurance Maladie directly, in which case the employee's remaining task is the employer copy. Since 1 July 2025 any paper arrêt must be issued on the new secured Cerfa form, and since 1 September 2025 the Assurance Maladie rejects arrêts sent on the old unsecured form. Photocopies and scans of the paper form are not accepted.

Can an employer dismiss someone while they are on sick leave?

Not because they are ill. A dismissal grounded on the employee's state of health is health discrimination and is null. What French law does allow is a dismissal for a reason that is distinct from the illness. The recognised routes are prolonged or repeated absence that disorganises the company where the employer is also obliged to replace the employee definitively on a permanent contract, and those two conditions are cumulative and both must be established. Beyond that there are economic dismissal, misconduct unconnected with the illness, and unfitness declared after a visite de reprise. Many collective agreements add a garantie d'emploi clause barring any illness related dismissal for a fixed period such as three, six or twelve months.

Does paid leave build up while off sick?

Yes, and this changed in 2024. The law of 22 April 2024 added non-professional sick leave to the list of periods treated as effective work in article L3141-5. Accrual during a non-professional arrêt runs at two working days per month, capped at 24 working days per reference period, under article L3141-5-1. Absence caused by a work accident or an occupational illness is treated more generously and accrues on the ordinary basis. Where the employee could not take the leave because of the absence, a 15 month carry-over period applies, and article L3141-19-3 requires the employer to tell the employee, within one month of the return to work, how many days they hold and the date until which those days can be taken.

What is the visite de reprise and when is it compulsory?

It is a medical examination by the médecin du travail on returning from an absence. Article R4624-31 of the Code du travail makes it compulsory after maternity leave, after any absence for an occupational illness, after an absence of at least 30 days caused by a work accident, and after an absence of at least 60 days caused by a non-professional illness or accident. The employer must arrange it on the day of the actual return and at the latest within the eight days that follow, subject to one derogation where a visite de préreprise in the previous thirty days concluded that no adjustment was needed. Its purpose is to check fitness for the post, examine any adjustments proposed, and issue an unfitness finding where that is warranted. A separate visite de pré-reprise is available for absences of more than 30 days and takes place before the arrêt ends.

Can the employer send its own doctor to check the arrêt?

Yes, and the procedure was formalised by decree number 2024-692 of 5 July 2024. Under article R1226-10 the employee must tell the employer, from the start of the arrêt and at each change, their place of rest where it differs from their home, and where the arrêt allows free exit, the hours at which a counter-visit can take place. The mandated doctor can attend the address given without prior notice outside authorised exit hours, or summon the employee to their consulting rooms. Article R1226-12 requires the doctor to report to the employer whether the arrêt is justified, unjustified, or whether the examination proved impossible because of the employee, and the employer must pass that information on to the employee without delay. The relevant consequence is to the employer's complementary pay; it is not a medical decision that ends the arrêt.