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

The search query "list of 30 diseases recognised by the MDPH" appears frequently 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 that lie behind the search.

Direct answer: there is no official list of 30 diseases that automatically open rights with the MDPH. The MDPH assesses disability individually, on the basis of 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 sécurité sociale. ALD 30 concerns 100% healthcare cost coverage for serious chronic conditions — 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 sit within different institutions.

You can have an ALD without a RQTH, and vice versa. A cancer in active treatment with a good functional prognosis may open an ALD 30 without generating any significant MDPH incapacity rate. Conversely, severe psychiatric disorders or serious developmental conditions (the "dys" disorders) frequently lead to a RQTH without featuring on the ALD list at all.

The MDPH can assess any person whose pathology or disorder causes lasting functional limitations in daily or professional life. The guide-barème (scale guide) annexed to the Code de l'action sociale et des familles describes incapacity rate ranges across broad categories of situations — motor, sensory, intellectual, psychiatric, visceral or metabolic impairments. It does not list diseases by name.

Among the conditions most frequently seen in MDPH files processed in France:

• psychiatric disorders (severe depression, bipolar disorder, schizophrenia, chronic PTSD)
• autism spectrum conditions (ASD) and serious developmental disorders (dyspraxia, severe ADHD, dysphasia)
• multiple sclerosis and other neurodegenerative diseases (Parkinson's, ALS)
• sequelae of cerebrovascular accidents (stroke)
• severe epilepsy
• disabling osteoarticular diseases (rheumatoid arthritis, severe spondyloarthritis)
• profound sensory deficits (deafness, partial sight, blindness)
• serious chronic respiratory diseases (severe COPD, cystic fibrosis)
• severe chronic renal failure
• cancers with lasting disabling sequelae
• acquired or congenital motor disabilities

This list is neither exhaustive nor official. It simply reflects the statistical reality of files processed.

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

1. Disabling cerebrovascular accident
2. Medullary insufficiency and other chronic cytopenias
3. Chronic arteriopathy with ischaemic manifestations
4. Complicated bilharzia (schistosomiasis)
5. Severe cardiac failure, serious cardiac rhythm disorders, serious valvular heart disease, serious 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 runs through the GP, who drafts a care protocol submitted to the insurance medical adviser. It does not involve the MDPH.

The Commission des Droits et de l'Autonomie des Personnes Handicapées (CDAPH — Commission on the Rights and Autonomy of Disabled People) 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 a pathology
2. Restrictions on participation in social life: isolation, difficulty maintaining relationships, accessing leisure activities, healthcare or culture
3. Compensation needs: technical aids, human assistance, workplace adjustments, adapted transport
4. Overall situation: family environment, life project, current professional circumstances

The resulting incapacity rate follows the scale guide ranges. It is not an automatic calculation: two assessors can reach different rates for the same pathology depending on the real impact they observe. This is precisely why the quality of the documents submitted to the file is decisive.

Our reading: in the employer-side files we work with, we frequently see employees with a significant MDPH incapacity rate but no recognised ALD, and conversely people on ALD 30 whose MDPH file is pending or has never been opened. The two mechanisms can coexist, complement each other, or operate entirely independently.

The table below summarises the main entitlements by incapacity rate.

The AAH (Allocation aux adultes handicapés) was uprated on 1 April 2026 to 1,041.59 euros per month at full rate (source: monparcourshandicap.gouv.fr), replacing the previously cited figure of 1,016.08 euros.

The Reconnaissance de la Qualité de Travailleur Handicapé (RQTH — recognition of disabled worker status) is the most widely used MDPH entitlement in the professional sphere. It is not subject to any minimum incapacity rate — something many people do not realise. Any person whose professional capacity is reduced by a health condition can apply, whether currently employed or not.

For the employee, the RQTH opens:

• entitlement to workstation adjustments (ergonomics, working hours, specialist software)
• priority access to AGEFIPH training programmes and an enhanced CPF (personal training account) top-up
• access to sheltered employment structures (ESAT — établissements et services d'aide par le travail) and adapted companies
• maintained-employment support schemes with occupational health services

For employers with 20 or more employees, the stakes are direct. Every such establishment is required to maintain a 6% employment quota of BOETH beneficiaries (bénéficiaires de l'obligation d'emploi des travailleurs handicapés — workers covered by the disability employment obligation). An employee holding a RQTH counts towards this quota. Failing to reach the threshold triggers a contribution payable to AGEFIPH or FIPHFP, set in 2026 at 1,500 times the gross hourly minimum wage (SMIC), equating to 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 discretionary and confidential process. The employer cannot require disclosure or access the information without the employee's explicit consent.

In the payroll and HR support work we carry out for businesses, we observe a recurring pattern: the employee obtains their RQTH, sometimes after several months of procedure, but does not inform their employer — either through lack of information or out of concern about a negative reaction. The company continues paying the AGEFIPH contribution even though it could have reduced or eliminated that cost. On the other side, some HR managers do not realise that the BOETH headcount also includes employees holding a second or third category invalidity pension, an occupational accident/occupational disease (AT/MP) annuity of 10% or above, or a CMI card marked "invalidité".

An annual workforce review with the payroll manager avoids these gaps, in full compliance with the confidentiality of individual situations.

File quality is the determining factor. Five elements to focus on:

1. The medical certificate (Cerfa 15695*01): completed by a doctor who knows the patient's situation well. Every section must be filled in precisely, covering current treatments, past hospitalisations and the likely future course. A cursory certificate is the single most common cause of an undervalued incapacity rate.

2. The life project (projet de vie): the applicant describes their difficulties in their own words with concrete examples. This document is too often rushed or superficial. It carries as much weight as the medical certificate, because it illustrates the real day-to-day impact.

3. Supporting medical documents: hospital discharge reports, speech therapy, neuropsychological or psychiatric assessments, recent prescriptions, and relevant test results.

4. A detailed description of functional limitations: not simply "I cannot work". Specify which tasks are impossible or painful, how often, and what adjustments have already been attempted.

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

For matters relating to payroll and employment law, including absence management, sick leave and employer obligations, an accounting firm with HR expertise can save significant 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 without describing its 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, treatment still in progress)
• no summary of support already mobilised (previous RQTH, sick-leave record, workplace adjustments already in place)

Where the administration has not responded within four months of receiving a complete file, this constitutes an implied rejection. An amicable appeal before the CDAPH remains possible, followed by a contentious appeal before the civil court (tribunal judiciaire).

Updated 2026-05-26. This article is for information purposes and does not replace personalised advice. For your specific situation, consult a qualified professional: the MDPH itself, your doctor, or a chartered accountant (expert-comptable) registered with the Ordre des experts-comptables for employer-side matters.