Occupational diseases in self-employed workers in France

Abstract

Abstract Background In France, self- employed workers receive disability benefits, but are outside of the specific legislation protecting employees from occupational accident and diseases. Physicians are generally not aware of this shortcoming and ask for occupational diseases benefits, as they do for salaried employees. The health fund of independent workers (HFIW ), dismiss the application, which is uphold by law, but can be a threat to the patient, if it shutters hope for other available benefits. Our aim was to see if the request for occupational diseases was related to significant disability in self-employed workers, and if such a disability could be handled by available benefits from HFIW. This survey could be instructive for countries without occupational diseases frame for self-employed workers. Methods A prospective study was conducted on self-employed claimants applying for occupational disease, from June 2015 to September 2017, with an 18 month period follow-up, in the Ile- de- France region. A questionnaire was sent to the claimant and the data were completed through a phone call or appointment. The main outcome was the number of claimants qualifying for disability benefit available at the HFIW. Results 148 claimants were identified and 141 (95%) matched with the occupational diseases legal setting. The causative agents were close to those observed in employed workers: musculoskeletal, asbestosis. Disability allowance, complete or partial, could be provided by the HFIW because his criteria were met in 38 claimants(27%);benefits for asbestosis exposure were possible through a specialized body in 16 claimants(11%). Conclusions The occupational disease request from self-employed workers matched with medical conditions granted by the HFIW, or external social bodies. This screening should be routinely implemented by nurses or any insurance officer. Key messages Self-employed workers are outside of the specific legislation protecting employees from occupational accident and diseases but 27% of them may apply for other disability benefits. The occupational disease request from self-employed workers dismiss an application but match with available disability benefits from the Independent health fund and should be routinely screened.