Administrative control
The National Health Fund (CNS) may carry out an administrative control for people on sick leave due to illness or accident. This control may take place both during the period when the employer continues to pay the compensation (Lohnfortzahlung) and when the CNS takes over the financial compensation. These controls may be initiated by the CNS itself or at the request of the employer.
Everything you need to know
- Reasons for the request
- Application form
- Control and result
- Sanctions pronounced
Verification of compliance with the sick leave scheme
The administrative control involves verifying that the insured person is at home, ensuring that the hours of leave are respected. It is essential to emphasise that the state of health of the insured person is NOT checked during this process.
If you have any doubts about the validity of the medical certificate provided by your employee, you have the right to request a counter-examination by a doctor of your choice.
For information on the procedures for this counter-examination, we recommend that you contact the Inspectorate of Labour and Mines (Inspection du travail et des mines-ITM), as this falls under labour law.
The National Health Fund (CNS) cannot process requests for administrative control based on medical motives.
Administrative control procedure
Administrative control involves a visit to the home or place of residence of the insured person who is unable to work.
If the person being controlled is not present at their address at the time of the visit, they are presumed to be in breach of the CNS statutes. In this case, the controller will leave a notification at the address of the insured person, accompanied by a reply envelope, inviting them to justify their absence in writing within a deadline of three days. The date of sending will be considered as proof of receipt.
Home controls will only be carried out when the insured person, absent from work due to illness or accident, is deemed to be at home without authorisation to leave. Controls may also be carried out in public places.
Results of the administrative control
When the presumption of a breach of the statutes is confirmed by the absence of valid justification, the employer will be informed of the results of the control after the expiry of the deadline granted to the insured person to justify their absence.
The CNS services will examine the validity of the justifications provided. In case of doubt, the file will be investigated in more detail by the CNS.
In addition, if the control reveals other violations, such as the practice of sports, outings during the first five days of illness, or travel outside authorised hours or places, these findings will be recorded in the report drawn up by the controller.
Sanctions in the event of non-compliance with the statutes
The President of the CNS may impose administrative fines in the event of non-compliance with the statutes. In the event of a repeat offence, more severe fines may be applied.
Sanction decisions issued by the Council of administration may be the subject of an objection or an appeal before the social courts.
Record of sanctions
Employers in dispute with an employee over alleged unjustified absenteeism, as well as the labour or social courts concerned, may request from the CNS a statement of the definitive sanctions related to unjustified absenteeism of an insured person.
These statements do not contain any medical data and are limited to the list of sanctions definitively pronounced or which have become final within the 12 months preceding the request.
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