Therapeutic part-time work in 2026: conditions, employer obligations and payroll errors to avoid

Therapeutic part-time work — temps partiel thérapeutique in French — allows an employee to return to work gradually after a sick leave, combining a partial salary paid by the employer with daily sickness benefits (IJSS) from the health insurance fund. For employers operating in France, the arrangement is useful for retaining staff and avoiding a declaration of permanent incapacity, but it generates persistent payroll errors: wrong attestation type, incorrect DSN filings, and payslip parameters that do not reflect hours actually worked.

The topic is never purely medical. It simultaneously involves payroll processing, monthly declaration obligations, work organisation and HR documentation. A well-structured file from day one prevents most emergency corrections.

Direct answer: therapeutic part-time requires three parties to agree before the first reduced working day — the treating physician, the health insurance fund's medical adviser, and the employer. Without that three-way alignment, the arrangement cannot be enforced 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 gradual return. The work percentage can range from around 20% to 80% of the employee's usual working time, adjusted as health improves. Since the January 2019 reform, there is no legally defined minimum or maximum duration — the medical adviser from the fund assesses duration based on the individual's situation.

Employer agreement. The employer is not obliged to accept. A refusal is permitted if the arrangement is genuinely incompatible with the post's requirements or operational constraints. Any refusal must be clearly motivated and documented in writing, since it may be reviewed in subsequent proceedings. A poorly handled refusal can accelerate a formal incapacity declaration by the occupational physician, which triggers more complex redeployment obligations.

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 is the element most frequently missing from poorly constructed files.

Since 1 January 2019, therapeutic part-time no longer needs to be preceded by a complete certified sick leave. The arrangement can be introduced directly, without a prior full-time stoppage. This broadened the scheme's practical application but also added a second attestation format — one for cases with a prior stoppage, one for those without.

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

The employee receives two income streams simultaneously.

The salary, paid by the employer, is proportional to hours actually worked. At 60% working time, the employee receives 60% of their reference salary.

The daily sickness benefits (IJSS), paid by the fund directly to the employee (or to the employer if subrogation is in place), compensate for the income lost due to 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 rule is firm: total income — partial salary plus IJSS — must not exceed the employee's usual full-time salary. The fund monitors this on the basis of the employer's attestation data. Any inconsistency in the attestation produces either an overpayment (recovered later) or an underpayment (felt immediately by the employee).

The attestation de salaire is the document through which the employer informs the fund of the salary data used to calculate IJSS. Ameli identifies two distinct formats depending on the starting situation, and the fields to complete differ materially.

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

Case 2 — without a prior sick leave (available since 2019). The attestation must show the three complete salary months preceding the start of the partial return, plus the monthly salary loss calculated on the same basis.

Case 3 — interruption by a new sick leave. The attestation requires two distinct "last day worked" dates: the day before the new stoppage, and the day before the original initial stoppage. This case is consistently the most frequently mis-filed in the files 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, at the end of each period. Missing one month delays that month's IJSS for the employee.

For the employee#

A progressive return reduces the risk of relapse after a long absence. It maintains professional continuity — particularly important in absences linked to burnout or anxiety disorders. The financial loss is partially covered by IJSS, making the transition economically viable.

For the employer#

The arrangement allows recovery of a key skill without waiting for a full return of uncertain timing. It reduces the risk of a formal incapacity declaration, which triggers mandatory redeployment obligations that are far more disruptive. It supports better coordination with the occupational physician and can prevent prolonged team disorganisation.

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

Summary: advantages and watch points#

1. Wrong attestation type — using the "with prior stoppage" model for a return without a prior sick leave, or vice versa. IJSS are miscalculated from the start.
2. Incorrect last-day-worked date — particularly when a new stoppage interrupts the arrangement and two separate dates are required.
3. Declaring total salary instead of salary loss — the fund calculates IJSS on the difference between usual and actual salary, not on the total gross.
4. Missing a monthly attestation — the attestation is submitted every month, not once. One missed month delays that month's IJSS.
5. Not adjusting ancillary benefit parameters — meal vouchers, attendance bonuses, transport allowances and holiday pay all have their own rules in part-time situations and must be reviewed individually.

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

How we structure the file:

1. The prescription is shared with the payroll manager and the direct 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. Employer agreement is formalised in a dated letter.
4. The fund's medical adviser approval is received and filed before the first payslip.
5. The monthly salary attestation is submitted via Net-Entreprises at the end of each month, with the salary loss declared — 40% of usual salary for the 60% return period.
6. The payslip reflects actual hours worked, with a separate line for the partial salary and a note on IJSS.
7. After six weeks: transition to 80%, new prescription, new attestation, updated payslip parameters.

This structure avoids retroactive corrections and prevents disputes over the payslip.

Before the return:

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

During the arrangement:

• Submit the salary attestation monthly via Net-Entreprises, declaring the salary loss.
• Verify 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 payroll immediately with the last-day-worked date.
• Submit a revised attestation with both required dates.

In the files we take over, poorly managed 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 — a file structured from the prescription stage — runs as routine, with no urgency and no tension.

We support employers in configuring payroll for planned returns, producing the correct attestations, and ensuring DSN consistency month by month. Secure your social management and payroll

For the combination with RQTH, see RQTH: advantages and disadvantages. For payroll outsourcing, see 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 and ameli.fr guidance. The absence of a legally defined minimum or maximum duration applies since the January 2019 reform. Attestation rules and the salary-IJSS combination cap must be verified with the relevant health insurance fund for each individual file. Consult a registered expert-comptable for your specific situation.