Medical Certificates and Labor Regulations

Various types of medical documents are required following the incident. It is important not to confuse them.

The Initial Medical Certificate

Immediately, it is urgent to obtain an Initial Medical Certificate and to initiate a workers’ compensation claim if applicable.

The Initial Medical Certificate (CMI) is issued by a doctor to a victim of violence—whether intentional or unintentional, physical or psychological—and documents and describes the event’s impact on the victim’s physical and psychological health. This document must be prepared as soon as possible, in accordance with specific guidelines (HAS recommendations), and you must keep it. Do not hesitate to ask the doctor who examines you for it.

This CMI will allow the victim to be recognized as such. It is an essential document for subsequent proceedings, including criminal proceedings, compensation proceedings (for example, before the Guarantee Fund for Victims of Terrorism and Crimes), and proceedings with the Health Insurance system.
This CMI can be issued at the victim’s own request or in response to a court order. It may also be proposed by the doctor. It is given to the victim. Doctors may determine a period of total incapacity for work (ITT) that assesses the duration of significant impairment in daily activities. However, a CMI may also be issued even without specifying the ITT (which is then deferred to a subsequent examination). The duration of ITT has legal significance, as it determines the course of the legal proceedings; however, it is a completely different concept from the prescription of a sick leave (in the sense of an interruption of professional activity), which can be issued separately on a health insurance form.
The CMI can be issued early on by a physician working in an emergency setting, at a CUMP, by the patient’s primary care physician, etc. The judicial authority may request a new remote examination to be conducted by a medical expert.
In practice, the systematic issuance of CMIs by CUMPs is often difficult (logistical challenges, lack of administrative support, low doctor-to-psychologist-to-nurse ratio).

If the incident occurred in the course of your professional activities or during your commute between work and home, it may be considered a work-related injury, which entitles you to specific rights (see work-related injury), but it is up to you (or your family and friends) to take the initiative by notifying your employer within 24 hours.

In other cases, a doctor may prescribe sick leave; you then have 48 hours to submit the document to the Health Insurance Office. However, do not forget to have the initial medical certificate issued as soon as possible.

Finally, medical evaluations fall under a very specific framework that does not apply to emergencies.

Workplace Accident Procedure

In the event of a workplace accident, the key step is to initiate the procedure within 24 hours. If the incident occurred while you were at work or on your commute between work and home, you must initiate the workplace accident procedure within 24 hours.
To do this, you must inform (or have someone inform) your employer. Your employer will report the workplace accident to the health insurance provider.
At the same time, your doctor must issue you a “Certificate of Workplace Accident or Occupational Illness” (Cerfa 11138.04), of which you must submit certain pages to your health insurance provider and another page to your employer, while making sure to keep a photocopy for yourself. Any doctor can complete this form (an emergency room doctor, your primary care physician, etc.).
A work-related accident entitles you to the following benefits: 100% coverage of medical costs at the social security rate, daily benefits in the event of a work stoppage, and a disability pension in the event of permanent disability.
Reporting a workplace accident is important, particularly for those with psychological injuries, even if they feel they can cope and do not want to stop working. In some people, symptoms may not appear until later, and it will be very difficult to link them to the workplace accident if the report was not filed.

References: Initial
Medical Certificate, Recommendations from the High Authority for Health (2011), Workplace
Accident (Ameli.fr), Sick
Leave (Ameli.fr), “Workplace
Accident” section on the Health Insurance website (Ameli.fr)
, “I had an accident at my workplace or on my way to work ” (Ameli.fr) Workplace Accident
and Occupational Illness Certificate (Cerfa 11138.04)

Legal Support for Victims of Terrorism

From the Single List of Victims to the Shared List

The ministerial directive of October 6, 2008 [1] established the concept of a “single list of victims,” which became a shared list in 2017 [2].

The shared list has several objectives:

• to identify deceased individuals in order to notify their beneficiaries,

• to determine which individuals are eligible for compensation from the FGTI,

• to assist victims located near the site of the attack,

• effectively refer victims to the appropriate contacts.

Compilation of the shared list:

• the Public Prosecutor’s Office compiles a list of deceased and unconscious injured persons,

• the FGTI compiles a list of direct victims—those injured and/or traumatized—eligible for an initial advance payment (persons “who were at the scene of the incident at the time of the terrorist act and who, having been exposed to the risk, subsequently suffered physical or psychological harm directly related to the incident [3]”). Defining the scope of who is recognized as a victim and potentially eligible for compensation is sometimes contentious, particularly when the locations are “outside city limits,” as in Nice, for example;

• the SADJAV (Ministry of Justice’s Legal Access and Victim Assistance Service) makes this list available to ministries and victim assistance organizations. It is responsible for monitoring and updating this list.

In conclusion, it is important for any victim who comes forward after a terrorist act, or for unregistered victims of psychological trauma, to file a complaint and submit an application to the FGTI in order to be included on this shared list, provided they meet the criteria defined above.

The Judicial Process

Criminal proceedings consist of the actions taken by various actors (police, judges) from the time a complaint is filed or an offense is identified, through referral to a judge, until a final decision is reached (handed down during a trial hearing).

The primary objective of the investigation conducted by the police is to establish the facts of the case by gathering evidence. In the specific case of a terrorist act, given the gravity of the situation, one or more investigating judges will be assigned to open a judicial inquiry. This judicial inquiry is an investigation conducted by the investigating judge. Its purpose is to prosecute the co-perpetrators and accomplices of the attack, with the aim of identifying them and bringing them to criminal trial. A National Anti-Terrorism Prosecutor’s Office (PNAT) was established on July 1, 2019, to handle these cases specifically. Victims have the option to participate in this proceeding by bringing a civil action.

At the conclusion of this phase, the judge may order the referral of the person(s) under investigation to a trial hearing (criminal court, assize court). The trial before the Assize Court takes place before a specially constituted panel (there is no jury, only judges) at the Paris Regional Court or the Paris Court of Appeal. Victims may receive psychological support throughout the trial.

Compensation for Victims of Terrorist Attacks

The Guarantee Fund (FGTI) compensates all victims who have suffered physical or psychological injury, as well as the beneficiaries (children, parents, grandparents, grandchildren, siblings, etc.) of deceased victims.

The victim has 10 years from the date of the terrorist act to file a claim.

If the claim is accepted, the Guarantee Fund pays an initial advance, to be applied toward the final compensation for damages, within a maximum of one month from the date of the request. Subsequently, further advance payments may be made depending on the victim’s medical and personal circumstances, until their condition stabilizes—that is, until there is no further significant change despite ongoing care. The victim’s condition is stable.

The principle is that of full compensation for damages, whether physical, psychological, or economic (as opposed to compensation based on a fixed scale). The FGTI may rely on expert assessments that evaluate the various categories of damages based on the Dintilhac classification. For victims of acts of terrorism, the following are added: the exceptional specific permanent injury to victims of terrorism (PESVT), the injury of fear of imminent death, and the injury of waiting and anxiety experienced by relatives.

The counter-assessment, initiated by the Guarantee Fund, is conducted by an expert who performs a clinical examination and discusses the various categories of damages with the victim, their medical advisor, and their attorney. This is why support from a medical advisor and an attorney can be essential [4].

Disputes regarding compensation are handled by the JIVAT (Judge for the Compensation of Victims of Acts of Terrorism).

To learn more about the Guarantee Fund for Victims of Terrorism and Other Crimes, click here.

The National Office for Veterans and Civilian War Victims (ONACVG)

Direct victims of terrorism may apply to the ONACVG for pension benefits, rights and benefits ancillary to the pension (e.g., prosthetics, free medical care, etc.), social security provisions, access to reserved employment opportunities, benefits from the National Institute for the Disabled, and the status of member of the National Office for Veterans and Civilian War Victims. Victims under the age of 21 and the children of victims may be adopted by the State (status of ward of the State), which entitles them to additional benefits.

The Attorney

In criminal proceedings, the lawyer advises and represents the victim throughout the criminal process, up to and including the trial. This same lawyer, or another lawyer specializing in compensation for bodily injury, may also assist and advise a victim during negotiations with the Guarantee Fund regarding the amount of compensation and the various categories of damages assessed.

The victim may request to sign a fee agreement. In addition to a fixed fee, the lawyer may request a variable fee, that is, a percentage of the final compensation obtained (often in the range of 10 to 15%).
A legal advisor from a victim support organization can assist the victim in completing an application for legal aid (which is available to victims of terrorism for criminal proceedings but not for compensation proceedings before the FGTI) or in activating the legal protection or defense/recourse coverage under their home insurance policy to request coverage of attorney fees.

The Paris Bar Association has organized a “contact group” of lawyers specializing in the defense of victims of acts of terrorism. There is also a list of lawyers who are members of the National Association of Lawyers for Victims of Bodily Injury (ANADAVI). Finally, the Paris Bar Association offers a free consultation service with specialized lawyers at the Information and Support Center for Victims of Terrorism (EIA de Paris) located at 18 Rue Poliveau in the 5th arrondissement on Tuesday and Thursday afternoons (see the “Paris Victim Assistance” fact sheet).

The medical consultant for victims, known as the “recourse” doctor

Lawyers can effectively refer the victim to a medical consultant so that they can be supported during the medical evaluation phase. Victims can also consult lists of medical consultants, particularly those provided by ANAMEVA.

Assistance from a medical consultant is essential to assert one’s rights. Unlike a unilateral medical examination, a cross-examination with the assistance of a medical consultant allows for a genuine discussion of the various items of damage. Meeting with the medical consultant before the examination will help the victim better understand what is at stake and prepare more effectively. Moreover, when there is no medical consultant, the victim must provide proof of all physical and psychological injuries sustained. They must bring all relevant documents to the assessment, such as medical certificates and reports written by psychologists.

After the medical examination, the medical consultant may draft their findings in the form of a “report” and submit it to the physician designated by the Guarantee Fund through the attorney.

References:
[1] Interministerial Directive on the Care of Victims of Acts of Terrorism No. 860/SGDN/PSE/PPS of October 6, 2008
[2] Interministerial Directive on the Care of Victims of Acts of Terrorism of March 2017
[3] Interministerial Directive on the Care of Victims of Acts of Terrorism dated April 13, 2016
[4] Guide for the Compensation of Victims of Acts of Terrorism – FGTI