Problem Statement. Despite significant media coverage of asbestos-related issues, 40% of patients with mesothelioma reportedly do not file a claim for occupational disease, even though they were exposed to asbestos in the workplace. The objective of this study is therefore to identify the various factors in the patient’s care pathway that influence the filing of a claim for occupational disease (DMP). In particular, to test the hypothesis that ODD is linked to social class and educational level. Method. A quantitative study based on the registry of the National Mesothelioma Surveillance Program (PNSM) analyzed the social determinants of underreporting. A qualitative study was then conducted in the same department: ten patients with potential mesothelioma were interviewed. The collected data underwent thematic content analysis to elucidate individual motivations, barriers, and factors promoting the reporting of occupational diseases. Results. Statistical analyses show that the lower the level of education, the more likely patients are to report their occupational disease. Thus, manual laborers are more likely to report their illness than managers. Interviews with patients diagnosed with mesothelioma may help suggest possible explanations for these results. The physician is often the driving force behind the occupational disease reporting process: they inform patients about the possible link to their previous occupation, explain the procedure to follow, and motivate patients who are battling their illness and rarely wish to be recognized as victims. The physician plays a key role in encouraging patients to file claims regardless of their social background and may be more likely to identify an occupational disease among manual laborers. Conclusion. These results help put into perspective the complexity of the reporting process or patients’ low educational levels as the main causes of underreporting of occupational diseases. The physician’s identification of potential occupational diseases and the provision of appropriate information to all affected patients would make it possible to combat disparities in underreporting more effectively.