Formulaire

Application for recognition of the temporary invalidity status of officials (Form 16950*01)

Cerfa 16950*01

This form allows you to apply for the Temporary Invalidity Allowance (TIA) if you are a State, hospital or territorial official, temporarily physically unable to resume your duties at the end of your statutory leave entitlements for health reasons, and placed on compulsory standby for health reasons.

Your application is completed by your employer administration and then forwarded to the medical service of the Primary Health Insurance Fund to which you are affiliated.

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    For details, please use the practical information sheets :

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    Émetteur du formulaire administratif : Ministry of Public Service

    Verified 04 June 2024 - Directorate for Legal and Administrative Information (Prime Minister)