Incapacity benefit pensions and cover
Those who lost 100% incapacity level of cover in France when they became OAPs can now challenge the decision
HEALTH campaigners are looking for people who have successfully kept their incapacity level of reimbursements and cover on their E121 after they became eligible for an old age pension.
A ruling by European social security watchdog Cleiss has said the French health service should treat all disabled pensioners equally regardless of their country of origin.
As a result anyone who saw their reimbursements drop from the 100% of tarif de convention (the level for those registered disabled) once they became pensioners should be able to challenge this.
Exclusive Healthcare would like anyone who has successfully overturned this decision to get in touch so the group can build up a legal case file to help future appeals.
The problem originates with people on long term incapacity benefit who are issued with an E121 with the incapacity box ticked.
It is issued regardless of age and provides the same cover with regard to the holder and dependant beneficiaries as the E121 for retired people.
On top of this, it provides the holder with much improved care from the French health service covering most types of treatment at 100% of the tarif de convention (the government agreed list of medical pricing).
When both a French citizen and a UK citizen resident in France reach pension age the state retirement pension replaces the incapacity benefit.
The UK authority issues a new E121 without the incapacity box ticked, with the result that the much improved care provided with the incapacity benefit are lost as a result of the change in pension type.
A French citizen suffers no such loss.
Cleiss has ruled that the loss of 100% cover in the case of a UK citizen when incapacity benefit is replaced by the retirement pension was iniquitous and illegal under EU law as it does not apply to French citizens.
Instructions have been issued to Cpam branches that each loss of cover on change of pension type should be examined and judged on its merits.
If you are in a position in which you may be affected by the change of pension type mentioned above you should contact your Cpam branch before you reach your official retirement age.
Cpam reserve the right to conduct their own medical exams to determine the extent of your invalidity but you should continue to receive disability cover inline with the law for French citizens.
