MODALITIES AND PROCEDURES OF MEDICAL EXAMINATION AND MEDICAL EXPERTISE

By Decree N° 78-480 of 8 November 1978,  medical examination and the medical expertise concern:
– The determination of either the occupational nature of the accident or the disease or the rate of partial or total permanent disability;
– The assessment by a doctor of the victim’s state of health and his or her capacity to work;
– The duration of the temporary incapacity and the date of consolidation, recovery, or return to work;
– The finding of abuse in terms of care and the pricing of medical and surgical procedures;
– The need for functional re-education, rehabilitation, and professional reclassification.
They may also take place in the event of a dispute at the initiative of the National Social Insurance Fund or the victim, or in the absence of a final medical certificate. MEDICAL EXAMINATION
The medical examination of victims of accidents at work or occupational diseases is carried out under the responsibility of the National Social Insurance Fund by its medical advisers or doctors approved by it,
– at the time of discovery or at the time of the declaration of the accident at work or the occupational disease;
– during the period of incapacity;
– in the event of a relapse or worsening of the victim’s condition;
– at the time of resumption of work, consolidation, or recovery of the injury.
Except in cases of force majeure, the victim is obliged to report to any
requisition of the doctor appointed by the National Social Insurance Fund, and to bring with them the complete medical file relating to the accident or occupational disease.
In the event of an unjustified refusal, allowances and benefits may be withdrawn for the period during which the inspection was made impossible, by a decision notified to the person concerned by registered letter or against a receipt.
However, where a certificate of resumption of work, consolidation, or recovery has been issued, a medical examination may be carried out only by the prescriptions of the attending physician, or in the absence of such prescriptions, by the provisions of the Convention.
A medical examination may be carried out only by the prescriptions of the attending physician or, failing that, once a year at the most.
For all medical examinations, the victim has the right to be assisted by his or her doctor or a doctor of his or her choice, who will provide the doctor of the National Social Insurance Fund with all the documents or information he or she needs.
After examining the victim, the National Social Insurance Fund’s doctor’s conclusions shall be brought to the attention of the victim within eight (8) clear days.

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