You hired your first employee in France, you manage the company from London, New York, Dubai or Singapore, and one morning the email arrives: your employee is on sick leave. The arrêt de travail (the medical certificate that stops work) is attached, the absence may last two weeks or six months, and you have no HR department on site. What do you pay, to whom, and for how long? How do you check that the absence is genuine when you are 5,000 kilometres away? Can you hire a replacement, and what happens on the day your employee returns? French law answers each of these questions with precise mechanisms, strict deadlines and traps that cost foreign employers dearly before the labour courts (conseil de prud’hommes, the court that hears employment disputes). This guide explains the full sequence in plain English: the daily benefits paid by the French health insurance system, the salary top-up you owe as employer, the 48-hour rule, the medical counter-visit you can order, the fixed-term replacement contract, the prohibition on dismissing a sick employee and the mandatory return-to-work examination. Every French acronym is explained, every decisive rule is sourced, and every practical step is adapted to a director who lives abroad.
I. Sick Leave in France: What Your First Employee Receives and What You Must Pay From Abroad
A. Daily Allowances From the State: the 48-Hour Rule, the Three Waiting Days and Half Pay
When your employee falls ill, two payers share the burden: the French social security system first, then you as employer. Understanding the order matters, because the state benefits (IJSS, indemnités journalières de Sécurité sociale, the daily sickness benefits) are the base on which your own obligation is calculated.
The statute opens the scheme in broad terms: Article L.321-1 of the Social Security Code states that “L’assurance maladie assure le versement d’indemnités journalières à l’assuré qui se trouve dans l’incapacité physique constatée par le médecin” (the health insurance pays daily allowances to the insured person who is physically unable to work, as certified by the doctor). Three practical consequences follow for a foreign employer.
First, the 48-hour rule. Your employee must send parts 1 and 2 of the sick note to the local health insurance fund (CPAM, caisse primaire d’assurance maladie, the local fund that pays the benefits) within 48 hours, and part 3 to you, the employer, within the same 48 hours. Article L.1226-1 of the Labour Code makes this a condition of your own top-up duty, and late notice is the most common reason the CPAM reduces or refuses benefits. Tell your employee this rule on day one, in writing, because an employee who posts the certificate a week late creates a file you will spend months fixing.
Second, the three waiting days (délai de carence). The state pays nothing for the first three days of absence. Article R.323-1 of the Social Security Code provides that “le point de départ de l’indemnité journalière définie par de l’article L. 321-1 est le quatrième jour de l’incapacité de travail” (daily benefits start on the fourth day of incapacity). Whether you cover those three days depends on your sector collective agreement (convention collective, the industry-wide agreement that sets minimum employment terms): many agreements neutralise the waiting period entirely, so check yours before telling the employee that three days are unpaid.
Third, the amount. The CPAM pays roughly 50 percent of the basic daily wage, capped by reference to the social security ceiling (plafond de la Sécurité sociale, the annually set cap on covered earnings, 47,100 euros per year in 2025). Your employee therefore loses about half their income unless you top it up, which is exactly why the employer top-up exists. To trigger payment, you must file the salary certificate (attestation de salaire) through the single payroll reporting channel (DSN, déclaration sociale nominative, the monthly electronic payroll return every French employer files). From abroad, this is done by your payroll provider or accountant (expert-comptable); without that certificate, the CPAM cannot compute or pay the benefits, and the employee will turn to you for the missing money. You may also opt for subrogation, a mechanism in which the CPAM pays the state benefits directly to you while you advance the full salary to the employee, which simplifies the employee’s cash flow and your bookkeeping.
One warning for the first hire in particular: the employee must be treated on French territory or in the European Union or European Economic Area to keep the benefits, and seasonal, home-based or temporary staff follow different rules. If your first recruit works remotely from outside Europe while claiming French sick leave, the file will collapse, and so will your top-up obligation with it.
B. Your Top-Up as Employer: One Year of Seniority, 90 Percent of Gross Pay and the Payroll Mechanics
Once the state benefits are flowing, your own obligation begins, and it surprises many foreign founders by its generosity. Article L.1226-1 of the Labour Code grants every employee with one year of seniority a top-up payment in addition to the state daily allowance during an absence justified by a medically certified incapacity, subject to a counter-visit where applicable. Three conditions attach: the 48-hour notice described above, coverage by social security, and treatment in France, the European Union or the European Economic Area.
The seniority threshold is the first trap for a young company. If your first employee falls ill during their first year with you, the statutory top-up does not apply, although your collective agreement may impose one from day one, and many do. Check the agreement before you refuse anything: refusing a top-up that the agreement grants is a wage claim your employee wins automatically, with interest, before the labour court.
The calculation method is the second trap, and the Court of Cassation (Cour de cassation, France’s supreme court for labour and civil matters) settled it recently. In a decision of 14 May 2025 (Cass. soc., 14 May 2025, No. 23-23.734), the Court recalled that “Pendant les trente premiers jours, 90 % de la rémunération brute que le salarié aurait perçue s’il avait continué à travailler” (during the first thirty days, 90 percent of the gross pay the employee would have earned if they had kept working), adding that “Pendant les trente jours suivants, deux tiers de cette même rémunération” (during the next thirty days, two thirds of that same pay). Two lessons for a director abroad: the base is gross pay (salaire brut), never net pay, so a payroll computed “to guarantee the net” that ends up below 90 percent of gross is unlawful; and from that top-up you deduct only the state daily allowances and the employer-funded share of any supplementary provident benefits (prévoyance, the employer-funded insurance that covers disability and death). Deducting the employee-funded share of provident benefits is an underpayment the courts rectify with back pay.
The duration of your top-up grows with seniority: thirty days at 90 percent then thirty days at two thirds as a starting point, extended by ten days per five-year seniority band up to ninety days for each period. Your sector agreement frequently improves these floors, sometimes removing the one-year condition or raising the percentages, which is why the agreement, not the statute alone, is your true pay scale.
In practice, from abroad, organise three things. First, mandate your payroll provider to file the salary certificate through the DSN immediately upon receiving part 3 of the sick note, and to compute the top-up on gross pay with the correct deductions. Second, decide on subrogation so the employee receives one clean payment from you rather than two partial payments from two bodies. Third, keep paying the employer’s share of social contributions (charges patronales, collected by URSSAF, the agency that collects social security contributions) on the top-up, because the top-up is salary for contribution purposes, and an URSSAF audit two years later will reclassify any shortcut with penalties. Our companion guide on URSSAF audits for companies run from abroad explains how those controls unfold. If the numbers look wrong, our hub guide for foreign founders setting up in France shows how payroll, bank account and registration fit together from day one.
II. Managing the Absence From Abroad: Checks, Replacement and the Return to Work
A. Counter-Visits, Health Insurance Checks and How to Contest an Abusive Sick Leave
You cannot fly to Paris to knock on the door, but French law gives you two organised verification channels: your own medical counter-visit and the health insurance fund’s checks. Using them correctly is the difference between paying what you owe and paying for an abuse.
Your channel is the employer counter-visit (contre-visite patronale). You appoint a doctor, at your expense, who examines the employee, usually at home, and reports whether the absence is medically justified. The official English guidance on service-public.fr states the key principle: the counter-visit ordered by the employer governs only the salary top-up paid by the employer. In other words, an unfavourable counter-visit allows you to suspend your top-up, but it does not stop the state daily allowances, which only the CPAM’s own medical officer can interrupt. Never present a counter-visit as cancelling the whole sick leave: the employee keeps the state benefits and will challenge your suspension before the labour court, where the judge reviews the medical file, not your suspicion.
The CPAM’s channel runs in parallel and is often more effective. The fund can order an administrative check (is the employee home during the mandatory presence hours, or does a medical appointment justify the absence?) and a medical check (does the health condition justify stopping work?). The checks happen without warning. If the employee is absent without justification, the fund suspends the daily allowances and can add financial penalties for misrepresentation or fraud. The employee is informed in writing and can appeal to the friendly appeals commission (CRA, commission de recours amiable, the internal appeals board of the fund) within two months, then to the social chamber of the judicial court within a further two months. As employer, you cannot trigger the CPAM check directly, but you can report facts that suggest fraud, and your counter-visit report feeds the file usefully.
Three discipline points protect you. First, organise the counter-visit through a local provider or your lawyer’s network in France; a letter from abroad asking the employee to “prove they are really ill” has no legal value and poisons the relationship. Second, respect the restricted exit hours shown on the sick note: outside authorised outing slots, the employee must be reachable at the declared address, and that is what controllers verify. Third, never draw conclusions from social media alone. Photos of a weekend outing do not overturn a medical certificate; only a doctor’s opinion does, and judges punish employers who suspend pay on gossip.
The heaviest mistake is dismissing the employee because they are ill. Article L.1132-1 of the Labour Code prohibits any dismissal based on health, and Article L.1132-4 punishes the breach with nullity: the dismissal is treated as if it never happened, with reinstatement or heavy damages. The Court of Cassation applied this to the most fragile moment of a first hire, the trial period (période d’essai, the initial weeks during which either party can end the contract quickly). On 25 June 2025 (Cass. soc., 25 June 2025, No. 23-17.999), ruling on an employee whose trial period was ended shortly after she disclosed a serious illness, the Court held that “Selon les articles L. 1132-1 et L. 1132-4 du code du travail, toute rupture du contrat de travail prononcée à l’égard d’un salarié en raison de son état de santé est nulle” (any termination of the employment contract pronounced against an employee because of their state of health is void). Ending your first hire’s trial period because the sick leave annoys you is therefore not a shortcut; it is a void act that buys a lawsuit. Our guide on ending the trial period lawfully from abroad details the valid procedure.
B. Replacing Your Employee on a Fixed-Term Contract, Lawful Dismissal Routes and the Mandatory Return Visit
While the absence lasts, the business must continue, and French law lets you hire a replacement, but only in the right contractual frame. Article L.1242-2 of the Labour Code provides that “un contrat de travail à durée déterminée ne peut être conclu que pour l’exécution d’une tâche précise et temporaire” (a fixed-term contract, CDD, contrat à durée déterminée, may only cover a precise and temporary task), and expressly lists the “Remplacement d’un salarié en cas : a) D’absence” (replacement of an employee during absence) as a valid case. The replacement contract must name the absent employee and state the reason, and it can run without a fixed end date until the employee returns. What you must not do is hire the replacement permanently “just in case” while the sick employee is still under contract: a permanent hire (CDI, contrat à durée indéterminée) alongside the suspended contract signals that you treated the illness as an exit, and the labour court reads that signal against you.
If the absence stretches over many months and genuinely disorganises the company, dismissal becomes possible, but the conditions are demanding, especially for a one-person team where every absence hurts. Dismissal for prolonged absence requires two cumulative proofs: an objective disruption of the business and the need for a definitive replacement, with the dismissal letter stating both. The Court of Cassation enforces this strictly. On 17 November 2021 (Cass. soc., 17 Nov. 2021, No. 20-14.848), it approved judges who had found that “l’existence d’une désorganisation d’un service essentiel de l’entreprise n’était pas établie par l’employeur, en sorte que le licenciement était dépourvu de cause réelle et sérieuse” (the employer had not established disruption of an essential company service, so the dismissal lacked real and serious cause). With a single employee, document the disruption concretely: lost contracts, unanswered clients, closed activity, the replacement’s payslips. Feelings are not proof.
Before any dismissal, open your sector collective agreement, because it may add a mandatory step or a job guarantee that blocks you. Two recent rulings show why. On 11 June 2025 (Cass. soc., 11 June 2025, No. 24-16.350), the Court applied a wholesale-trade agreement under which “l’employeur peut mettre l’intéressé en demeure, par lettre recommandée, de reprendre son travail dans les dix jours francs suivant l’envoi de ladite lettre” (the employer may formally require the employee, by registered letter, to return to work within ten clear days of sending): skipping that formal demand voids the dismissal procedure in that sector. On 18 December 2019 (Cass. soc., 18 Dec. 2019, No. 18-18.864), the Court enforced a medical-practices agreement providing that “les absences justifiées par la maladie ou l’accident dans un délai maximum d’un an n’entraînent pas une rupture du contrat de travail” (absences justified by illness or accident for up to one year cannot end the contract): dismissing within the guaranteed year, even for genuine disruption, violates the agreement. Identify your agreement on the hiring day, not the dismissal day.
The return to work closes the sequence with an examination you must organise. Article R.4624-31 of the Labour Code grants that “Le travailleur bénéficie d’un examen de reprise du travail par le médecin du travail : […] 4° Après une absence d’au moins soixante jours pour cause de maladie ou d’accident non professionnel” (the worker undergoes a return examination by the occupational doctor, including after any absence of at least sixty days for non-occupational illness or accident). As soon as you know the end date of the sick leave, you must contact the occupational health service (SPST, service de prévention et de santé au travail, the accredited body that monitors employee health), which “organise l’examen de reprise le jour de la reprise effective du travail par le travailleur, et au plus tard dans un délai de huit jours qui suivent cette reprise” (organises the examination on the actual return day, at the latest within eight days after the return). Skipping this visit exposes you to damages, and the visit alone decides fitness: only the occupational doctor can declare the employee fit, fit with adjustments, or unfit (inapte).
Unfitness opens a final strict procedure. Article L.1226-2 of the Labour Code requires you to offer the unfit employee another suitable position in the company or group, based on the doctor’s written conclusions, after consulting the staff committee where one exists. If no reclassification is possible, dismissal for unfitness follows its own procedure with specific compensation. And Article L.1226-4 adds a costly clock: “Lorsque, à l’issue d’un délai d’un mois à compter de la date de l’examen médical de reprise du travail, le salarié déclaré inapte n’est pas reclassé dans l’entreprise ou s’il n’est pas licencié, l’employeur lui verse, dès l’expiration de ce délai, le salaire correspondant à l’emploi que celui-ci occupait avant la suspension de son contrat de travail” (if, one month after the return examination, the unfit employee is neither reclassified nor dismissed, the employer resumes paying the full previous salary). A director abroad who lets the file sleep pays a full salary for nothing, so diary the one-month deadline the day the unfitness is declared.
Conclusion
A sick leave in a one-employee French company is a management exercise with five reflexes. Collect part 3 of the sick note within 48 hours and have your payroll provider file the salary certificate through the DSN so the state daily allowances start on day four. Compute your top-up on gross pay at 90 percent then two thirds, after checking whether your collective agreement removes the one-year seniority condition or improves the rates. Order a medical counter-visit through a local doctor when the absence looks doubtful, remembering it suspends only your top-up while the CPAM’s own checks govern the state benefits. Replace on a fixed-term contract that names the absent employee, and dismiss for prolonged absence only with documented disruption of an essential activity, a definitive replacement need and the formal steps of your collective agreement. Finally, organise the occupational doctor’s return examination within eight days of return and diary the one-month reclassification clock if unfitness is declared. Run from abroad with these reflexes, a first sick leave stays an administrative episode; improvised, it becomes a void dismissal, back pay and damages. Keep this article’s checklist with the employment file, and call on counsel at the first doubtful certificate rather than after the labour court summons.