Declaration of incapacity for work

I am only using this form to digitally submit my certificate of incapacity for work to the CNS.

I send my certificate of incapacity for work to the CNS

Fields marked with an asterisk (*) are mandatory.

Name*

Firstname*

Type of declaration (IMPORTANT to choose the right option!) *

13-digit identification number*

Child's 13-digit identification number (sick child/leave for family reasons)

E-mail address (example : info@public.lu)*

Start date of the certificate of incapacity*

End date of the certificate of incapacity*

Country of doctor's practice *

Certificate of incapacity in PDF format (max. 5 MB) * No file chosen

I am aware that by using this form to send my certificate of incapacity for work, I am not sending my certificate by post at the same time. *

To send my certificate of incapacity for work to the CNS in just a few clicks, I fill in ALL the fields on this page and then click on PREVIEW. On the summary page, I check the information provided and confirm by clicking SEND.

Important
The file I send to the CNS using the form on this page must be clearly legible and correctly cropped, have a maximum size of 5 MB and be in PDF format.
I am only using this form to digitally submit my certificate of incapacity for work to the CNS.

Please note! By completing this process, I agree that my personal data will be processed as part of my request. I click here for more information on the CNS data privacy policy.

Everything I need to know about my incapacity for work

While I'm on sick leave, I have rights and obligations towards my employer and the CNS.

I check the SICK LEAVE section for information

Contact us

By phone

Our agents are available Monday to Friday from 08:00 to 16:30 to answer your questions by telephone.

(+352) 2757 - 1
By mail

If, for any reason, I am unable to send my certificate of incapacity for work using this online form, I will send it by post to:

Caisse nationale de santé
Indemnités pécuniaires
L-2980 Luxembourg

Last update 11.12.2024