Sick leave

Can one receive daily allowances from the Social Security during a stay abroad?

Publié le 11 juillet 2025 - Directorate of Legal and Administrative Information (Prime Minister)

The Primary Health Insurance Fund informed an insured person that she had received a payment that she should not have received, in respect of daily health insurance benefits received during a stay abroad. The insured person takes legal action. Was she entitled to receive her daily allowances while she was outside France?

An insured woman on sick leave goes to Tunisia, with the agreement of her attending doctor, to visit her seriously ill mother. During this period, she receives daily social security allowances (IJSS) from her primary health insurance fund (CPAM). The Commission then asks the applicant to reimburse the amount of those allowances paid in error.

Was the insured person entitled to her daily social security benefits during her stay abroad?

Service-Public.fr replies:

The Court of Cassation recalls the Social Security Code and the fact that the insured must remain able to "comply with all his legal obligations". The first of these obligations is the fact that: submit to the controls organized by the medical control service » (Article L. 323-6).

While the court had initially found the departure of this insured compatible with her state of health, the Court of Cassation held that the displacement had the effect of removing the insured from any control by the CPAM.

There is currently no specific mechanism for the Health Insurance to mandate a medical examination in a foreigner country. If travel makes this impossible, the payment of compensation may be suspended.

An employee on sick leave who temporarily stays outside France cannot receive the daily allowances of the primary health insurance fund during this stay, unless he first ensures that the conditions of control can be respected, the Court of Cassation ruled.

Please note

If the agreement of the attending physician constitutes an element of assessment, only the medical service of the CPAM is competent to monitor the incapacity for work and compliance with the conditions of compensation. The opinion of the attending physician does not relieve the insured of his legal obligations, in particular that of remaining available to the CPAM for a check, recalls the Court of Cassation.

FYI  

Until 2024, the CPAM could require the insured person on sick leave to obtain their “prior authorization” for travel outside their constituency, under penalty of suspension of the IJSS. In 2024, the Council of State ruled that prior authorization had no legal basis to justify the sanction.

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