Asbestos Workers Allowance Application - Professional Dockworkers and Port Personnel Handling (Form 11688*02)

1. Complete, date and sign the form (it can be completed online, then downloaded and printed)
2. Send the requested form and supporting documents by post to the South-East pension and occupational health insurance fund (Carsat Sud-Est) if you reside in the Provence-Alpes-Côte d'Azur, Corsica, Occitanie and Rhône-Alpes regions or to the Ile de France regional health insurance fund (Cramif) if you reside in the other regions and overseas departments

If you are professional dockworker or port personnel handling :

• Work certificates or attestations issued by your employers or by the compensation fund or attestations of remuneration during the period concerned or any other document likely to prove your activity in these ports
• Proof of civil status: photocopy of your family record book, national identity card, passport or residence permit, birth certificate extract (especially if you live abroad)
• Paper certificate accompanying your Vitale card
• Photocopies of your pay slips for the last 12 months of paid employment or, in the case of discontinuous paid employment, photocopies of your pay slips covering the last 365 days of paid employment

If you are recognized employee or former employee with an occupational disease :

• Photocopy of the notification of recognition of an occupational disease sent to you by the primary health insurance fund
• Proof of civil status: photocopy of your family record book, national identity card, passport or residence permit, birth certificate extract (especially if you live abroad)
• Paper certificate accompanying your Vitale card
• Photocopies of your pay slips for the last 12 months of paid employment or, in the case of discontinuous paid employment, photocopies of your pay slips covering the last 365 days of paid employment