MDPH disability assessment and ALD 30: what you need to know

A search for "list of 30 diseases recognised by the MDPH" is common in France. It reflects a genuine confusion between two distinct mechanisms within the French social protection system. This article addresses that confusion directly and answers the practical questions behind the search.

Direct answer: there is no official list of 30 diseases automatically opening rights with the MDPH. The MDPH assesses disability individually, using an incapacity rate and functional limitations, not a diagnosis. The real "list of 30" is the ALD 30 list published by French health insurance (Assurance Maladie) under article D160-4 of the Code de la securite sociale. ALD 30 concerns 100% healthcare coverage for serious chronic conditions, which is a medical entitlement entirely separate from disability recognition.

This is the central confusion, and it is widespread. The two schemes operate under different logic and different institutions.

You can have an ALD without a RQTH, and vice versa. A cancer in active treatment may open an ALD 30 without generating a significant MDPH incapacity rate once functional prognosis is good. Conversely, severe psychiatric or developmental disorders often lead to a RQTH without featuring prominently on the ALD list.

The 30 categories listed in the annex to article D160-4 CSS (source: Legifrance) are as follows. Note: entry 12 (severe arterial hypertension) was removed by decree in 2011; the designation "ALD 30" is kept by convention, but there are 29 active categories.

1. Disabling cerebrovascular accident
2. Medullary insufficiency and other chronic cytopenias
3. Chronic arteriopathy with ischaemic events
4. Complicated bilharzia (schistosomiasis)
5. Severe cardiac failure, serious rhythm disorders, serious valvular and congenital heart disease
6. Chronic active liver diseases and cirrhosis
7. Severe primary immunodeficiency requiring prolonged treatment; HIV infection
8. Type 1 and type 2 diabetes
9. Severe neurological and muscular disorders (including myopathy), severe epilepsy
10. Haemoglobinopathies, severe constitutional and acquired chronic haemolyses
11. Haemophilia and serious constitutional haemostasis disorders
12. (Removed - severe arterial hypertension)
13. Coronary artery disease
14. Severe chronic respiratory insufficiency
15. Alzheimer's disease and other dementias
16. Parkinson's disease
17. Hereditary metabolic diseases requiring prolonged specialist treatment
18. Cystic fibrosis
19. Severe chronic nephropathy and primary or idiopathic nephrotic syndrome
20. Paraplegia
21. Vasculitis, systemic lupus erythematosus, systemic scleroderma
22. Evolving rheumatoid arthritis
23. Long-term psychiatric disorders
24. Evolving ulcerative colitis and Crohn's disease
25. Multiple sclerosis
26. Evolving structural idiopathic scoliosis
27. Severe spondyloarthritis
28. Following organ transplantation
29. Active tuberculosis, leprosy
30. Malignant tumour, malignant disease of lymphatic or haematopoietic tissue

These conditions entitle the patient to full reimbursement of healthcare costs directly related to the pathology. The process goes through the GP and the insurance medical adviser. It does not involve the MDPH.

The Commission on the Rights and Autonomy of Disabled People (CDAPH) never decides in isolation. A multidisciplinary MDPH team, comprising doctors, psychologists, occupational therapists and social workers, evaluates each file across four dimensions:

1. Activity limitations: what the person can no longer do, or does with difficulty, compared to someone of the same age without the condition
2. Restrictions on participation in social life: isolation, difficulty maintaining relationships, accessing leisure, healthcare or culture
3. Compensation needs: technical and human support, workplace adjustments, adapted transport
4. Overall situation: family environment, life project, current professional situation

The resulting incapacity rate follows the scale guide annexed to the Social Action and Families Code. It is not an automatic calculation. Two assessors can reach different rates for the same pathology depending on the observed real-world impact. This is why the quality of the documents submitted is decisive.

The Reconnaissance de la Qualite de Travailleur Handicape (RQTH) is the most widely used MDPH entitlement in the workplace. It is not subject to any minimum incapacity rate, which many people do not realise. Any person whose professional capacity is reduced by a health condition can apply, whether employed or not.

For the employee, the RQTH opens:

• entitlement to workstation adaptations (ergonomics, hours, specialist software)
• priority access to AGEFIPH training schemes and enhanced CPF training credit
• access to sheltered employment (ESAT) and adapted companies
• maintained-employment support from occupational health services

For employers with 20 or more employees, the stakes are direct. Every such establishment must maintain a 6% quota of BOETH beneficiaries (disabled workers under employment obligation). An employee holding a RQTH counts towards this quota. Failing to reach the threshold triggers a contribution payable to AGEFIPH or FIPHFP. In 2026, this contribution is set at 1,500 times the gross hourly minimum wage, equating to approximately 17,820 euros per year for obligations arising from 2025 (source: service-public.gouv.fr).

The RQTH is disclosed to the employer voluntarily by the employee. It is a confidential process. The employer cannot require it or access the information without the employee's explicit consent.

The AAH was uprated on 1 April 2026 to 1,041.59 euros per month at full rate (source: monparcourshandicap.gouv.fr). The previously cited figure of 1,016.08 euros applied before this revaluation.

Quality of documentation is the determining factor. Five elements to prioritise:

1. Medical certificate (Cerfa 15695*01): completed by a doctor who knows the patient well, with precise information on treatments, past hospitalisations and expected progression. A cursory certificate is the single most common cause of an undervalued incapacity rate.

2. Life project: the applicant describes daily difficulties in their own words with concrete examples. This document is too often rushed or skimmed. It carries as much weight as the medical certificate, because it illustrates the real impact on daily life.

3. Supporting medical documents: hospital reports, speech therapy, psychomotor or neuropsychological assessments, recent prescriptions.

4. Detailed functional limitations: not simply "I cannot work". Specify which tasks are impossible or painful, how often, and what adjustments have already been tried.

5. Professional supporting documents: pay slips if still employed, employer statement on adjustments already made, record of sick leave.

For matters relating to payroll and employment law, including absence management and employer obligations, an accounting firm with HR expertise can save time and prevent costly errors.

Further reading: therapeutic part-time work, sick leave for temporary workers, payroll and social remuneration, and workplace wellbeing regulation.

Recurring issues in rejected or undervalued files:

• a medical certificate that names the diagnosis but does not describe functional consequences
• a life project written in medical terminology rather than lived experience
• missing professional documents in RQTH applications
• a rapidly evolving situation that is poorly documented (recent diagnosis, ongoing treatment)
• no summary of support already mobilised (previous RQTH, sick leave record, adjustments)

On the timing side, the statutory instruction period is four months from the date of receipt of a complete file (article R. 241-31 of the Code de l'action sociale et des familles). In practice, actual processing times vary widely between departments: three to four months in well-resourced MDPHs, six to nine months elsewhere, and over twelve months for complex cases. It is worth submitting a complete file from the outset rather than adding documents piecemeal, as each new submission can reset the clock.

If the administration has not responded within four months, this constitutes an implied rejection. An amicable appeal before the CDAPH is possible, followed by a contentious appeal before the civil court.

Updated 2026-05-26. This article informs and does not replace personalised advice. For your specific situation, consult a qualified professional: MDPH, your doctor, or a registered expert-comptable for the employer-side matters.