OD FLASH | Autonomy of labor court judges in relation to French Social Security Fund (CPAM) coverage decisions: the debate continues

The French Supreme Court, Sept. 10, 2025, No. 24-12.900; 23-19.841

The overlap between labor law and social security law continues to fuel case law. It is clear that each has significant consequences for the other.; the occurrence of an occupational risk covered by the CPAM during the performance of the employment contract gives rise to (i) protection prohibiting any dismissal except in cases of serious misconduct or where it is impossible to maintain the contract, and (ii) the conditions under which compensation will be paid for dismissal on grounds of incapacity and impossibility of redeployment if the employee’s state of health deteriorates to the point where they can no longer perform their duties.

The operational and legal stakes are therefore high when an employee claims to have suffered an accident at work or an occupational illness and the employer disputes the validity of the claim. On this point, it is the CPAM which, chronologically and given her jurisdiction, will be the first to decide on the matter. The question remains whether the labor court judge is bound by the decision of the fund when he must indirectly address this issue under labor law.

In its rulings of September 10, 2025, the social chamber answered in the negative and reiterated that the labor court judge is not legally bound by the CPAM’s decisions (1), which allows them to form their own opinion on the occupational nature of the condition in question based on all the evidence presented (2).

1. The principle of the autonomy of the labor court judge in relation to the decisions of the CPAM

The autonomy of labor law in relation to social security law is an established legal principle. The French Supreme Court applied this principle in a landmark ruling in 1996 (The French Supreme Court, May 23, 1996, No. 93-41.940). Since then, case law has been consistent: decisions by the CPAM, the CRA or the social division of the judicial court are merely indicative; the labor court judge must form their own opinion, most often in the context of litigation relating to the origin of the incapacity, in light of all the evidence presented (In this sense: The French Supreme Court, Nov. 22, 2017, No. 16-12.729; The French Supreme Court, April 10, 2019, No. 17-24.091).

However, a recent ruling has changed the situation, as the French Supreme Court held that it was not for the labor court judge to assess the occupational nature of an accident or illness when the CPAM had covered these conditions and its decision had not been challenged (The French Supreme Court, Sept. 18, 2024, No. 22-22.782).

In its September 2025 rulings, the French Supreme Court appears to have adopted a much more nuanced position, considering that it is up to the labor court judge to form an opinion based on all the evidence submitted to them, as the mere decision to cover sick leave under occupational risk legislation does not in itself constitute proof of the occupational origin of the accident. A genuine reversal or simply a clarification?

2. The discretion of the labor court judge still needs to be clarified

In response to the question raised, the French Supreme Court seems to have opted for articulation, but it will in any case have to be clearer on the assessment that the labor court judge is likely to make of a decision by the CPAM to cover the costs.

In the first case (24-12.900), the French Supreme Court admitted that the trial judges could disregard the application of Article L. 1226-9 of the Labor Code, since the origin of the suspension of the employment contract, the , during which the contractual relationship had been broken, was not sufficiently established: the medical and factual evidence relating to the occupational nature of the initial accident, which had been covered by the CPAM (French social security) but was subsequently declared unenforceable against the employer, was insufficient to prove that it had occurred.

In the second case (23-19.841), the French Supreme Court, this time accepted that the trial judges could dismiss the occupational origin of the incapacity: it did not result from an occupational disease, even though the claim, which had been submitted by the employee, had been covered by the CPAM before finally being declared unenforceable against the employer due to the late diagnosis and the employee’s lack of actual exposure.

In other words, in both cases, the employer had challenged the fund’s coverage of the work-related accident and occupational illness in its dealings with the fund, obtaining a ruling that it was unenforceable. This is very different from the 2024 ruling, in which the occupational accident was covered by the fund without this decision being subsequently challenged. 

Accordingly, these decisions illustrate the full role of the labor court judge, who is competent to review, step by step, the stages of (pre-)litigation in social security matters and to form his or her own opinion based on all the elements brought to his or her attention, mainly (and exclusively) when the initial decision to grant coverage has been challenged through an appeal lodged by the employer or the employee.

In short, (three) two rulings that establish the principle of the autonomy of the labor court judge in relation to the assertiveness shown by the parties in their respective dealings with the social security fund.