Therapeutic part-time work in 2026: advantages, disadvantages and payroll errors to avoid

Temps partiel thérapeutique — therapeutic part-time — allows an employee to return to work progressively while receiving daily sickness benefits (indemnités journalières de la Sécurité sociale, IJSS) from the health insurance fund to offset the income lost through reduced working hours. It is a genuine employment-retention tool, but one that concentrates recurring payroll errors on the employer's side: wrong attestation type, inconsistent DSN filings, payslips mis-configured on hours.

For a business owner or HR manager, the subject is never purely medical. It touches payroll processing, monthly declaration obligations, work organisation and HR file documentation simultaneously. A properly framed file from the outset prevents most emergency corrections and the tension that arises between employee and employer over the payslip amount.

The key is simple: three parties must be aligned before the first reduced working day — the treating physician, the health insurance fund's medical adviser, and the employer. Without that alignment, the arrangement has no legal force and benefits may be refused or recovered retroactively.

Three cumulative conditions must be met, as confirmed by ameli.fr and Article L323-3 of the Code de la sécurité sociale.

Prescription from the treating physician. The treating physician prescribes or validates the principle of a progressive return. The physician specifies the envisaged work percentage — the return can be set at any level between 20% and 80% of the employee's usual hours — and the expected duration. Since the 2019 reform, there is no legally defined minimum or maximum duration; it is the medical situation that determines the length, as assessed by the fund's medical adviser.

Employer agreement. The employer is not obliged to accept. A refusal is permitted if therapeutic part-time is genuinely incompatible with the post's organisation, production constraints or the nature of the duties. Any refusal must be clearly motivated and recorded in writing, since it may be examined later if the employee contests it. A poorly handled refusal can accelerate a formal incapacity declaration by the occupational physician, triggering redeployment obligations that are far more burdensome.

Medical adviser approval from the fund. The health insurance fund evaluates whether the medical situation justifies maintaining daily benefit payments during the partial return. Without this approval, the employee will not receive the supplementary IJSS. This third link is the one most frequently missing in poorly constructed files.

Since 1 January 2019, therapeutic part-time no longer needs to be preceded by a full certified sick leave. The arrangement can be put in place directly, without any prior stoppage, which has broadened its scope of application. The two situations — with or without a prior stoppage — call for different attestation formats.

For the broader HR compliance context, see Social management, payroll and remuneration: guide 2026 and HR and payroll: employer obligations in 2026.

The employee in therapeutic part-time receives two income streams simultaneously.

The salary, paid by the employer, is proportional to hours actually worked. If the employee works at 60% of their usual time, they receive 60% of their reference salary.

The daily sickness benefits (IJSS), paid directly by the fund to the employee or to the employer in the event of subrogation, compensate for the income lost through the reduced activity. They are calculated on the basis of the daily reference salary, itself determined by the last three complete months of salary before the stoppage or the partial return.

The combination cap is firm: total income — partial salary plus IJSS — must not, in principle, exceed the employee's usual full-time salary. The fund monitors this on the basis of the attestation data provided by the employer. Any inconsistency in the attestation produces either an overpayment (recovered later) or an underpayment (felt immediately by the employee).

This is the most frequent source of error we observe in files. Ameli identifies two attestation types depending on the starting situation, and the data fields differ materially.

Case 1: return to therapeutic part-time following a full sick leave. The monthly attestation must show the three complete salary months preceding the initial stoppage, together with the monthly salary loss during the therapeutic part-time period — that is, the difference between the usual salary and the partial salary actually paid. It is the loss that must be declared, not the total gross salary.

Case 2: return to therapeutic part-time without a prior sick leave (available since 2019). The attestation must show the three complete salary months preceding the partial return, plus the monthly salary loss calculated on the same basis.

Case 3: interruption of the therapeutic part-time by a new sick leave. The attestation requires two distinct dates: the last day worked before the second stoppage, and the last day worked before the original initial stoppage. This case is consistently mis-filed in every file we review.

The attestation is not a one-off document submitted at the start of the arrangement. It must be transmitted every month via Net-Entreprises, in arrears, for as long as the therapeutic part-time is active. Missing one month delays that month's IJSS payment.

For the employee#

A progressive return reduces the risk of relapse after a long absence. It maintains the link with the team and professional routines — a significant psychological factor, particularly in absences linked to burnout or anxiety. The financial loss is partially offset by the IJSS, making the transition economically viable for the employee.

The employee may work between 20% and 80% of their usual hours, with a possible step-up each week based on the physician's assessment. This flexibility is real and documented by ameli.fr.

For the employer#

The arrangement allows recovery of a valued skill without waiting for a full return — which after a long absence is often uncertain. It reduces the risk of a formal incapacity declaration by the occupational physician, which generates heavy redeployment obligations. It fosters better coordination with the occupational medicine service and can prevent prolonged disorganisation of the team or department.

The direct employer cost is limited to salary proportional to hours worked. IJSS are paid by the fund, not by the employer — unless a collective agreement imposes a salary maintenance obligation or subrogation has been elected.

Summary table: advantages and watch points#

Coordination is demanding. The treating physician, occupational physician, medical adviser, line manager, payroll manager and health insurance fund all need to be informed and aligned. A single weak link — for example, a manager who overloads the employee or a payroll officer who omits the attestation — creates inconsistencies that feed through to the payslip and affect entitlements.

The monthly attestation is a genuine operational burden. It is not automatic. It requires the payroll team to act each month, with the correct data in the correct format. One missed month or one error on the salary loss figure delays that month's IJSS payment to the employee.

The effects on ancillary benefits are rarely anticipated. Meal vouchers, attendance bonuses, commuting allowances, holiday pay accrual, profit-sharing: each element of pay has its own rules in a part-time situation. Approximate configuration generates anomalies across several months.

Management can handle expectations poorly. An employee on therapeutic part-time is not available part-time in an arbitrary or flexible way. Working hours must be defined, stable and respected. If the line manager adjusts the workload to suit operational needs without regard for the medical constraints, the arrangement loses its purpose and the fund may withdraw it.

The under-estimated risk: the fund can stop IJSS payments without notice if the attestation is incorrect or if the data transmitted is inconsistent with the payslip. The employee then loses their benefits retroactively. The employer may face liability if the error originates from the payroll function.

In the therapeutic part-time files we process, the same errors recur.

1. Choosing the wrong attestation type — using the "with prior sick leave" model for a return without a prior stoppage, or vice versa. IJSS are miscalculated from the outset.
2. Recording the wrong last-day-worked date — an error particularly frequent when a new sick leave interrupts the arrangement and two separate dates must be filed.
3. Declaring total salary instead of salary loss — that is, the difference between the usual salary and the partial salary. The fund calculates IJSS on the loss, not on the total gross salary.
4. Missing the monthly attestation — the attestation is monthly, not a one-off. One missed month delays the employee's IJSS for that month.
5. Not adjusting ancillary benefit parameters — meal vouchers, attendance bonuses, commuting allowances, holiday pay accrual, profit-sharing: all must be reviewed against hours actually worked.

An HR assistant returns after a three-month absence following severe burnout. The treating physician prescribes a return at 60% for six weeks, then at 80% until full return.

Here is how the file is structured in our practice:

1. The prescription is shared with the payroll manager and the line manager before the first reduced working day.
2. Working hours are agreed in writing with the manager: Monday, Tuesday, Thursday (full days) and Friday morning.
3. The employer's agreement is formalised in a dated and signed letter.
4. The fund's medical adviser approval is obtained and filed in the HR file before the first payslip is issued.
5. The salary attestation is submitted via Net-Entreprises at the end of each month of reduced work, with the salary loss calculated month by month — 40% of the usual salary declared as loss for the 60% return period.
6. The payslip is configured on hours actually worked, with a separate line for the partial salary and a note on the IJSS.
7. After six weeks, transition to 80%: new prescription, new attestation, updated payslip configuration.

This structure prevents retroactive corrections and removes uncertainty over the payslip amount.

Before the return:

• Obtain the treating physician's prescription stating the work percentage and expected duration.
• Consult the occupational physician on fitness for the specific post envisaged.
• Formalise the employer's agreement in writing, with agreed hours and a start date.
• Brief the payroll team before the first affected payslip.

During the arrangement:

• Submit the salary attestation every month via Net-Entreprises, declaring the salary loss.
• Verify that each payslip reflects actual hours worked, not contractual hours.
• Check DSN consistency each month.
• Reassess at each prescription renewal.

If interrupted by a new sick leave:

• Notify the payroll team immediately with the last-day-worked date.
• Submit a revised attestation, including both required dates if applicable.

In the payroll files we manage, poorly handled therapeutic part-time arrangements share the same starting point: payroll received the information late, without the prescription and without confirmation of the employer's agreement. The first payslip was produced without an attestation, or with an incorrect one. The employee received no IJSS the following month, called to complain, and the retroactive correction took three weeks.

The opposite pattern — a file properly structured from the prescription stage — runs as routine, with no urgency and no tension.

We help employers configure payroll for planned returns, produce the correct attestations and maintain DSN consistency month by month. Secure your social management and payroll

See also Therapeutic part-time and RQTH: how these two arrangements combine and Payroll outsourcing: what actually changes.

Up to date as of 2026-05-26. This article is for information only and does not substitute for personalised professional advice. The conditions for therapeutic part-time derive from Article L323-3 of the Code de la sécurité sociale, as confirmed by ameli.fr guidance. The absence of a legally defined minimum or maximum duration applies since the 1 January 2019 reform. Attestation rules and the salary-IJSS combination cap must be verified with the relevant health insurance fund for each individual file. For your specific situation, consult a chartered accountant (expert-comptable) registered with the Ordre des experts-comptables.