Therapeutic part-time work and prevention of occupational risks: roles of the different stakeholders

Source: 📒 Therapeutic part-time work and prevention of occupational risks: roles of the different actors

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1. ANALYTICAL SUMMARY

1.1. Context and issues: a legally complex employment retention system

Thetherapeutic part-time workallows an employee to work reduced hours while being formally onsick leavefor the non-working part, with compensation from theCPAM.

The system isgoverned by the Social Security Code, butnot directly by the Labour Code, which creates areas of uncertainty for employers and employees.

It applies toall employees in the general scheme on fixed-term or permanent contracts, and, since 2019, can be implementedwithout prior sick leave, as soon as a health problem arises.

The stakes are high:to prevent professional disconnection, to adapt theworkload, to secure thereturn to work conditionsand avoid practices contrary to the obligation of safety or discriminatory.

The text also recalls the connection with other provisions such as thesupervised trialand the pre-return or follow-up visitsby the occupational physician. ou de suivi par le médecin du travail.

1.2. Operational contributions: who does what and how to prevent risks

The document operationally clarifies the respective roles of the treating physician, the medical advisor of the CPAM, the occupational physician, the employer, and the employee.rôles respectifs du médecin traitant, du médecin conseil de la CPAM, du médecin du travail, de l’employeur et du salarié.

It describes the concrete steps for implementation(medical prescription, request to the CPAM, employer's certificate, decision of the medical advisor) and the (prescription médicale, demande à la CPAM, attestation de l’employeur, décision du médecin conseil) et les time limits(maximum 3 years of compensation).

For field actors, it provides vigilance points: real adaptation of the workload, prohibition of making the employee work during periods of leave, impossibility of unilaterally changing positions, written justification of refusals.points de vigilance : adaptation réelle de la charge de travail, interdiction de faire travailler le salarié sur les périodes d’arrêt, impossibilité de changer unilatéralement de poste, justification écrite des refus.

It specifies how the occupational physiciancan intervene (upstream, during, at the end of therapeutic part-time) to recommend adjustments and secure the return. peut intervenir (en amont, durant, à l’issue du temps partiel thérapeutique) pour recommander des aménagements et sécuriser la reprise.

Finally, a structured list of recent legal and jurisprudential references(including a decision from 2025) helps to consolidate practices and equip arguments in case of disputes or negotiations. (dont une décision de 2025) permet de consolider les pratiques et d’outiller les argumentaires en cas de litige ou de négociation.

2. KEY POINTS OF THE DOCUMENT

1. Definition and dual status of therapeutic part-time work: the employee works part-time but is considered onsick leavefor the non-worked part, compensated by the CPAM; the system is only provided for by theSocial Security Code(article L.323‑3), without specific regulation in theLabour Code.

2. Access conditions and target audience: all employees of the general scheme, onfixed-term or permanent contracts, can benefit from therapeutic part-time work, includingwithout prior sick leave since 2019; self-employedworkers also have access but with specific conditions (prior sick leave, except for long-term illnesses). y ont aussi accès mais avec des conditions particulières (arrêt préalable, sauf ALD).

3. Implementation procedure: prescription by thetreating physician, file sent to theCPAM(medical certificate + employer's certificate), decision by theadvisory physician, maximum compensation duration of3 years(article R.323‑1 CSS) and possibility of changing the percentage of time worked.

4. Employer obligations and points of vigilance: the employer remains bound by theirsafety obligation, must concretely adapt the workload, cannot require the employee to work during their non-working days or hours (training, emails), nor unilaterally change the position without agreement, under penalty ofdiscriminationor failure to comply with the obligation of safety.

5. Structuring role of the occupational physician: without a mandatory specific visit, they intervene inupstream(recommendation for therapeutic part-time work),during(workplace adjustments, coordination with the supervised trial) andafter(recommended visit upon return to full-time work), with the possibility of issuing afitness for work assessmenteven if therapeutic part-time work has been prescribed.

(The document is not paginated: pages cannot be cited precisely. The references above refer to the main sections of the online document.)

3. ACTIONS FOR LOCAL STAKEHOLDERS

1. Structure an internal protocol for managing therapeutic part-time work: formalise a process including HR, supervisors, occupational health services, and disability/prevention referents, to secure the collection of documents, communication with the CPAM, and adjustment of the workload.

2. Train managers on the obligation of safety in therapeutic part-time work: integrate practical cases into supervisor training on what they cannot ask of the employee (training on days off, work by email outside working hours), and on the disciplinary and legal consequences.

3. Systematically involve the occupational physician in the design of adjustments: organise, at the request of the employee or the employer, dedicated visits to adjust schedules, tasks, and articulate therapeutic part-time work and other arrangements (supervised trial, job adjustment).

4. Document and justify any refusal of adjustment.: if the employer cannot accept the proposal (major disruption, material impossibility), prepare a detailed written response for the employee and the occupational physician, to comply with Article L.4624-6 of the Labour Code and reduce the risk of litigation.

5. Integrate therapeutic part-time work into policies for preventing professional disengagement.: use it as a tool for maintaining employment, coupled with an analysis ofprofessional risks, primary prevention actions, and enhanced monitoring of vulnerable employees (chronic illnesses, MSDs, psychosocial risks).

4. ADDITIONAL REFERENCES

🔍➕ For more information, see the articles referenced by "Health Practices" on the theme of health and work ➡️🔗https://pratiquesensante.odoo.com/4-3-sante-et-travail

5. CROSS-ANALYSIS — VALUES OF HEALTH PRACTICES

• Literacy:the document uses a legal register but remains didactic; it clarifies roles and procedures, without however offering specific simplification tools for low literacy audiences.

• Empowerment:the emphasis is mainly on the obligations of institutional actors; the active role of the employee appears (requests, exchanges with doctors), but without a formalised system explicitly aimed at strengthening their ability to act.

• Participation:participation is based on the tripartite consultation between employee, employer, and occupational physician to define the practical arrangements for therapeutic part-time work, but there is no description of mechanisms for collective co-construction.

• Community health:the dimension is essentially individual (the journey of an employee), the text does not address the issue of collective organisation or community mobilisation.

• Ethics:ethical issues are addressed through the obligation of safety, the non-imposition of tasks during downtime, and the prevention of discrimination; cultural or social biases are not analysed in detail.

• Human rights:the document emphasises respect for health status, non-discrimination, and job retention, in line with the principles ofequityandinclusionin the world of work.

• Intersectorality:it involves several sectors (health, social security, business), but without developing territorialised intersectoral approaches or partnerships beyond this chain.

• Partnership:the collaboration betweenthe general practitioner, occupational physician, medical advisor from the CPAM, employer, and employeeis at the heart of the system, presented as a condition for the success of therapeutic part-time work.

• Combating discrimination:several legal precedents are invoked to remind that changing positions without agreement or requiring training during a non-working day can constitute adiscrimination related to health statusor a failure to meet safety obligations.

6. EVALUATION OF THE RELIABILITY OF THE RESOURCE

6.1. Scientific and legal relevance

• Cited sources: the focus explicitly mobilises numerous articles from theSocial Security Code(L.323‑3, R.323‑1, etc.), from theLabour Code(L.4624‑3, L.4624‑6, R.4624‑29, R.4624‑31, etc.), a2018 Social Security funding law, aCnam circular from 2022and severalrecent rulings from the Court of Cassation, including one from2025.

• Current data: updated on16 April 2026, incorporating very recent case law, making it a current legal resource.

• Methodological rigor: the INRS is a reference body in occupational health; the structure of the text is clear, referenced, and the statements are systematically supported by official texts.

6.2. Operational relevance

• Direct usability: the resource answers concrete questions: in what cases is therapeutic part-time work possible, who prescribes, who decides, what are the employer's obligations, what are the risks in case of malpractice.

• Operational limits: it does not offer standardised operational tools (letter templates, checklists, adapted job descriptions), and remains focused on the legal framework; a process of appropriation is necessary for local implementation.

Overall, it is areliable, up-to-date and robust legal resource, very useful in supporting the development of internal procedures or training.

7. MCQ — 5 QUESTIONS

(Without pagination, the 'source page' is replaced by the section or theme.)

PART 1 — QUESTIONS (WITHOUT ANSWERS)

Question 1 – Definition and legal framework(section 'What is therapeutic part-time work?')

Therapeutic part-time work is primarily characterised by:

a) An employee who reduces their working hours without being on sick leave

b) A part-time employee whose contract is suspended during non-working hours

c) An employee who works part-time while being on sick leave for the non-working time

d) An employee who returns to part-time work only after a sick leave of at least 6 months

Question 2 – Access conditions(section 'Which employees can benefit from therapeutic part-time work?')

Since 2019, therapeutic part-time work:

a) Is only possible after a minimum sick leave of 3 months

b) Can be implemented even without prior sick leave

c) Is reserved for employees on permanent contracts only

d) No longer applies to self-employed workers

Question 3 – Employer obligations(section 'What are the employer's obligations?')

Among the following situations, which one constitutes a breach of the employer's duty of care?

a) Adjusting the distribution of tasks to take into account the reduction in working hours

b) Asking the employee to participate in training on a non-working day related to therapeutic part-time work

c) Offering a reduction in workload during working days

d) Seeking the opinion of the occupational physician on the terms of therapeutic part-time work

Question 4 – Role of the occupational physician(section 'What is the role of the occupational physician?')

What role can the occupational physician play in the implementation of therapeutic part-time work?

a) They are required to organise a mandatory return-to-work visit for any therapeutic part-time work

b) They can only validate the prescription of the treating physician

c) They can recommend a reduction in working hours and other adjustments to the job

d) They can only intervene after the decision of the CPAM

Question 5 – Duration and compensation(sections 'What is...?' and legal references)

What is the maximum duration of compensation for therapeutic part-time work by Social Security?

a) 6 months

b) 1 year

c) 3 years

d) 5 years

(Order of correct answers: Q1 c / Q2 b / Q3 b / Q4 c / Q5 c — each letter used a maximum of two times.)

PART 2 — COMMENTED CORRECTION

Question 1 – Definition and legal framework

✅ Correct answer: c) An employee who works part-time while being on sick leave for the time not worked.

📝 Explanation: therapeutic part-time work corresponds to a situation where the employee reduces their working hours for health reasons, while benefiting from sick leave for the unworked portion, compensated by the CPAM; the contract is not suspended during this period.

Question 2 – Access conditions

✅ Correct answer: b) Can be implemented even without prior sick leave.

📝 Explanation: since 2019, implementation can occur directly in the case of health issues, without a full sick leave necessarily having been prescribed beforehand; however, the conditions differ for self-employed workers.

Question 3 – Employer obligations

✅ Correct answer: b) To ask the employee to participate in training on a non-working day related to therapeutic part-time work.

📝 Explanation: the employer must adapt the workload and cannot require the employee to work during periods covered by sick leave; case law reminds that this type of practice constitutes a breach of the duty of care.

Question 4 – Role of the occupational physician

✅ Correct answer: c) They can recommend a reduction in working hours and other adjustments to the job.

📝 Explanation: during pre-return or follow-up visits, the occupational physician can propose in writing measures to adjust working hours, including a reduction in hours worked, and other job adaptations; they can also issue a fitness for work opinion.

Question 5 – Duration and compensation

✅ Correct answer: c) 3 years.

📝 Explanation: Article R.323-1 of the Social Security Code limits the maximum duration of compensation for therapeutic part-time work by Social Security to3 years, even if several successive prescriptions are possible.

8. FREQUENTLY ASKED QUESTIONS (FAQ)

1. Who can benefit from therapeutic part-time work?

   Allemployees of the general scheme, whether on afixed-term or permanent contract, can benefit from it, provided that a treating doctor prescribes it and that the CPAM accepts it; self-employed workers also have access to the scheme, with specific conditions.

2. Is a complete work stoppage mandatory before therapeutic part-time work?

   Since 2019, it is possible to establish therapeutic part-time workwithout prior work stoppage: the treating doctor can prescribe it as soon as a health problem arises, if maintaining or resuming work part-time promotes the improvement of health.

3. Who concretely decides on the implementation of therapeutic part-time work?

   The process is initiated by thetreating doctor(prescription), then submitted to theadvisory doctor of the CPAM, who decides on the compensation; the employer must agree on the organisation of work, in connection with theoccupational doctorfor practical arrangements.

4. Can the employer refuse therapeutic part-time work?

   Yes, but any refusal must beobjectively justified(impossibility of organising the service, major constraints), and motivatedin writingto the employee and the occupational physician, in accordance with Article L.4624-6 of the Labour Code.

5. Can the employee be assigned to another position during their therapeutic part-time work?

   The employer cannot impose a change of positionwithout the employee's agreement: such a modification may be considered asdiscrimination based on health statusif it is not accepted and justified.

6. Can the employee work or attend training on the days they are on leave related to therapeutic part-time work?

   No, the employer must not request work or participation in training on the days or hours covered by the leave, under penalty of failing in theirduty of care, as reiterated by the Court of Cassation.

7. What is the role of the occupational physician at the end of therapeutic part-time work?

   No visit is specifically required at the end of therapeutic part-time work, but it isrecommendedthat the employer requests a visit to check the compatibility of returning to full-time work with the employee's health status and adjust arrangements if necessary.

9. REWRITING IN EASY TO READ LANGUAGE 

9.1. Easy to Read Summary

Title: Therapeutic Part-Time Work Explained Simply

• Therapeuticpart-time workallows working less for health reasons.

• During the non-working hours, the person ison sick leaveand receives money from theSocial Security.

• This system helps toreturn to work gradually, without putting their health at risk.

Who is involved?

• Thetreating doctorproposes therapeutic part-time work.

• TheCPAMdecides whether to pay a benefit.

• Theoccupational doctorhelps to organise work and schedules.

• Theemployermust adapt the work and respect the employee's health.

What the document provides

• It explainswho does whatstep by step.

• It reminds what the employerhas the rightordoes not have the rightto ask.

• It helps to avoidunfair or dangerous situationsfor the employee.

9.2. Key points FALC

Point 1 – Definition

• The employee worksfewer hoursthan usual.

• For the reduced hours, they areon sick leave.

• TheSocial Securitypays them part of their income.

Point 2 – Who can benefit?

• All employees onfixed-term or permanent contractscan benefit from it.

• Since 2019, it has been possible to benefit from itwithout a complete work stoppage beforehand..

Point 3 – Procedures

• The attending physician writes aprescription..

• The employee sends the documents to theCPAMwith an employer's certificate.

• The CPAM decides whether itacceptsorrefuses..

Point 4 – Role of the employer

• The employer mustprotect the healthof the employee.

• They must adapt theworking hoursand theworkload..

• They cannot require work during the rest hours.

Point 5 – Role of the occupational physician

• The occupational physician can proposeworkplace adjustments..

• They can give their opinion before, during, and after the part-time work.

• They can state that the position is no longersuitablefor the employee's health.