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Sick leave: restrictions ill-founded

Monitoring of sick leave is being further reinforced as part of a drive to clamp down on "abuses". And yet there are no absolute medical rules on the ideal amount of time off work for illness.

Several laws and decrees have recently led to increased sick leave monitoring, both of prescribers and of patients. Although a crackdown on abuse and fraud is welcome in principle, its implementation should not penalise the vast majority of patients who are neither abusers nor cheats. A report by the ANAES (French health accreditation and evaluation agency, now part of the HAS (France's National Authority for Health) concludes that international scientific literature provides no valid data to determine the ideal period of sick leave for a particular illness. In practice, the decision to put a patient on sick leave seems above all to depend upon the attitude of the patient (with socio-cultural differences between patients), and of the doctor (whose willingness to approve sick leave depends upon his/her own work ethic, and often his or her knowledge of the patient's job). The data gathered by the ANAES show that sick leave depends on working conditions (the perceived difficulty), the employee's age and the economic circumstances. Protecting the interests of the Social Security system should not come at the expense of employees' health.

©Prescrire November 2005

Source: "Arrêt de travail : nouvelles étapes dans le renforcement des contrôles" Rev Prescrire 2005 ; 25 (266) : 783-785.

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