Off Work Ill in France: The Arrêt Maladie Steps for Employees

This guide is for employees who have recently moved to France and need to take time off work because of illness. By the end, you will know who can sign your sick note, which parts go to your employer and to the health insurance fund, the deadlines that apply, and how late sending can affect your daily allowances.

• The doctor’s certificate
• Telling your employer
• The 48-hour deadline for the CPAM
• Waiting days, daily allowances and late sending
• During the leave and extensions
• FAQ

The doctor’s certificate

Everything starts with an arrêt de travail (a doctor’s certificate stopping you from working), usually called an arrêt maladie (sick leave). According to the official Service Public page on the employee’s steps, any doctor can prescribe it, not only your médecin traitant (the GP you have registered with). That includes an emergency doctor, a specialist or a doctor on call. In some cases, a sage-femme (midwife) or a dental surgeon can also issue one within their own field.

The certificate has three parts, called feuillets or volets. Parts 1 and 2 are for your health insurance fund, and part 3 is for your employer. When the certificate is on paper, the fund only accepts the secure form, cerfa n°10170*08, which carries a holographic label and other security features. Since 1 September 2025, old paper forms, photocopies and scans have not been accepted.

New limits on length have applied since 1 September 2026. When the leave gives a right to daily allowances, a first prescription cannot exceed 31 days, unless the doctor writes down why a longer period is needed. This is a limit for each prescription, not for the total length of your leave. Sick leave prescribed during a téléconsultation (video consultation) is in principle only paid for up to 3 days. Exceptions exist, in particular when the consultation is with your médecin traitant, their replacement or your named midwife.

Telling your employer

You must inform your employer without delay, by any means: a phone call, an email or a text message. Your convention collective (the collective agreement for your sector) or an accord d’entreprise (company agreement) may set a deadline. Where neither does, the usual practice is to inform the employer within 48 hours of the start of your leave.

You then back this up by sending part 3 of the certificate, which shows the dates and the reason for the stoppage. If you work for several employers and the doctor has decided you cannot carry out any of your jobs, you must inform each of them and send each a photocopy of part 3.

Skipping this step has consequences. An employee who does not inform the employer and send the document risks disciplinary action, up to licenciement (dismissal). The page states that an unjustified absence can be a genuine and serious reason for dismissal.

The 48-hour deadline for the CPAM

Most employees are covered by the CPAM (Caisse primaire d’assurance maladie, the local health insurance office). Agricultural workers are covered by the MSA (Mutualité sociale agricole, the farm sector’s social security scheme). You have 48 hours to inform this body. When the doctor gives you all three parts, you send parts 1 and 2 to the fund.

In many cases, and especially after a video consultation, the doctor sends parts 1 and 2 to the fund electronically. You then receive only part 3, which you pass on to your employer yourself. After a video consultation, part 3 may arrive by email, through the consultation platform or in your Ameli account (the online Assurance Maladie account).

Sending the certificate on time is what allows the Sécurité sociale to pay you, and your employer to pay you too if you are entitled to employer payments. The page does not set out who is entitled to employer payments; that depends on your situation and on the rules your employer applies.

Waiting days, daily allowances and late sending

The payments made during sick leave are called indemnités journalières (daily allowances). The Service Public page used for this guide does not give the amount of these allowances, how they are calculated, or the number of jours de carence (waiting days before payment starts). The health insurance fund decides your entitlement, and your employer or your collective agreement determines any top-up from the employer.

What the page does cover is what happens when you send the certificate late. If the fund receives it after 48 hours, it tells you about the delay and warns you of the consequences of another late sending. If you send late again within 2 years, your daily allowances can be cut by 50% for the period between the date of the prescription and the date you sent it. Further delays can lead to a bigger cut. Since 1 January 2026, when the fund receives the certificate after the prescribed period has already ended, the allowances can be cut by 100% for the whole period.

No cut applies if you can show that you were in hospital or that you could not send the certificate within 48 hours.

During the leave and extensions

While on sick leave, you must follow your doctor’s instructions and accept medical checks arranged by your employer, the Sécurité sociale or both. You must also respect any ban on going out or the permitted times for going out, and avoid any activity unless your médecin traitant has authorised it. If you do not, your daily allowances are suspended. Paid work that your médecin traitant has not authorised can also lead to a financial penalty.

An extension, or prolongation, follows the same steps: parts 1 and 2 go to the fund and part 3 to your employer. The usual practice is to tell your employer within 48 hours of the extension. Since 1 September 2026, each extension giving a right to daily allowances is limited to 62 days, unless the health professional writes down why a longer period is needed. Several extensions are possible. When an extension lasts more than 3 months, the professional can ask for the opinion of the Assurance Maladie’s service du contrôle médical (medical review service).

In principle, only your médecin traitant or the doctor who signed the first certificate can extend it. As an exception, their replacements, a specialist you see at your médecin traitant‘s request, or a doctor treating you in hospital can also extend it.

FAQ

Can I get a sick note if I do not have a médecin traitant yet?

Yes. The official page states that any doctor can prescribe sick leave, including an emergency doctor, a specialist or a doctor on call. The registered GP rule mainly matters for extensions and for video consultations lasting more than 3 days.

Can an extension be prescribed by video consultation?

Yes, if the doctor is your médecin traitant, the doctor who signed the first certificate, a replacement for either of them, a specialist you were referred to, or a doctor treating you in hospital. For the leave to be paid, the doctor must also have seen you in person within the last 12 months, unless there is an emergency or you cannot get access to care. The consultation must take place on an approved, secure platform.

How many waiting days apply before allowances start?

The Service Public page used here does not state the number of waiting days or the amount of the allowances. The CPAM or MSA decides your entitlement, and any employer payment depends on your employer and your collective agreement.

Does sick leave affect my titre de séjour (residence permit)?

The page on sick leave steps does not cover residence permits. For a question about your own residence status, contact your prefecture or a migration advice service.

Sources: service-public.fr

Last verified: 6 November 2026 against the pages linked above. Rules and fees change; the responsible authority always has the final word.

This is general information, not legal or immigration advice. For your own situation, ask the prefecture of your département, a recognised migration advice service or a lawyer (avocat).