S-2.1, r. 22 - Regulation respecting the implementation of the provisions relating to industrial accidents and occupational diseases contained in the Agreement on Social Security between the Gouvernement du Québec and the Government of the French Republic

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SCHEDULE 2
(S. 2)
ADMINISTRATIVE ARRANGEMENT FOR THE IMPLEMENTATION OF THE AGREEMENT ON SOCIAL SECURITY BETWEEN THE GOUVERNEMENT DU QUÉBEC AND THE GOVERNMENT OF THE FRENCH REPUBLIC
In accordance with Article 49 of the Agreement on Social Security signed on 17 December 2003 between the Gouvernement du Québec and the Government of the French Republic, hereafter called the “Agreement”, the competent authorities represented by
For Québec:
— Jean D. Ménard, head of the Service des ententes internationales, Ministère des Relations internationales;
For France:
— Florence Lianos, head of the Division des affaires communautaires et internationales, Direction de la sécurité sociale, Ministère des Affaires sociales, du Travail et de la Solidarité;
— Louis Ranvier, responsible for international matters, Direction Générale de la forêt et des affaires rurales, Ministère de l’Agriculture, de l’Alimentation, de la Pêche et des Affaires rurales;
CONSIDERING the desire of both Governments to implement the Agreement with a view to preserving the mobility of persons between Québec and France,
HAVE AGREED TO THE FOLLOWING PROVISIONS:
TITLE I
GENERAL
ARTICLE 1
DEFINITIONS
In this Administrative Arrangement, the terms used shall have the meaning assigned to them in Article 1 of the Agreement.
ARTICLE 2
PARTICULARS CONCERNING EQUALITY OF TREATMENT
For the purposes of Chapters 3 and 5 of Title III of the Agreement, as regards Québec statutes, workers temporarily working in Québec and staying legally in Québec without residing therein within the meaning of Article 1 of the Agreement shall receive, in that territory, treatment equal to the treatment given to persons residing therein, with regard to the benefits provided, in accordance with the provisions of Article 4 of the Agreement.
TITLE II
PROVISIONS RELATING TO APPLICABLE STATUTES
ARTICLE 3
CERTIFICATE OF COVERAGE
(1) In the cases referred to in Articles 7 to 13 of the Agreement, the institutions of the Party whose statutes remain applicable, that are designated below, shall establish, on application from the employer or an unsalaried worker, a “certificate of coverage” certifying that the worker concerned remains subject to the statutes.
The certificate is issued
(a) with respect to the Québec statutes,
by the Québec liaison agency;
(b) with respect to the French statutes,
by the worker’s Caisse or, with respect to salaried workers of the general plan, by the Caisse in the district in which the employer is located.
(2) For the purposes of paragraph 2 of Article 8 of the Agreement and, as regards a derogation concerning individual cases, of Article 13, an agreement prior to the issuance of a certificate of coverage must be requested
(a) for the maintenance of affiliation to the Québec statutes,
by the Québec liaison agency to France’s liaison agency;
(b) for the maintenance of affiliation to the French statutes,
— by France’s liaison agency, as regards insured persons under plans other than the seamen’s plan;
— by the Établissement national des invalides de la marine, as regards insured persons under the seamen’s plan;
to the Québec liaison agency, which is responsible for obtaining a decision from the competent Québec institutions
(3) A decision made by mutual agreement by both Parties shall be communicated to the interested affiliated organizations and to the worker, if need be through the worker’s employer.
(4) Liaison agencies may agree, if applicable, on common procedures to improve or clarify the management of certificates of coverage.
(5) For the purposes of Article 13 of the Agreement, the department responsible for social security, for France, and the liaison agency responsible for obtaining a decision from the competent institutions, for Québec, may, by common agreement, derogate from the applicable statutes with respect to a category of persons.
ARTICLE 4
PUBLIC SERVICE
(1) For the purposes of paragraph 1 of Article 12 of the Agreement, the following persons are deemed to be in the Public Service:
(a) for Québec,
the persons employed by the Gouvernement du Québec and governed by the Public Service Act;
(b) for France,
i. persons in government employment and military service and similar personnel;
ii. salaried personnel other than the personnel referred to in subparagraph i, working for a French public administration and who, assigned in the territory of Québec, remain subject to the French social security plan.
(2) For the purposes of paragraph 2 of Article 12 of the Agreement, the following persons are deemed to be in the Public Service:
(a) for Québec,
locally recruited persons;
(b) for France,
salaried personnel other than the personnel referred to in subparagraph ii of subparagraph b of paragraph 1 working for the French government.
TITRE III
PROVISIONS CONCERNING PENSIONS AND BENEFITS
CHAPTER 1
OLD AGE PENSIONS AND SURVIVORS BENEFITS
ARTICLE 5
FILING OF CLAIM
(1) For the purposes of Chapter 1 of Title III of the Agreement, a claim for a pension under the statutes of one Party shall be filed with the competent institution of that Party through the competent institution or liaison agency of the other Party, if the claimant resides in the territory of the latter Party. If the claimant resides in the territory of a third party state, the claim shall be filed with the competent institution of either Party.
(2) With respect to claims for pensions under the statutes of Québec, la Régie des rentes du Québec shall be the competent institution for any application relating to a person whose contributions have been paid into the Québec Pension Plan.
ARTICLE 6
PROCESSING OF THE CLAIM
(1) The competent institution or liaison agency through which the pension claim is filed shall send the claim to the competent institution of the other Party with the required supporting documents and a liaison form indicating the periods of insurance completed and the entitlement, if any, under the statutes of the first Party.
(2) For the purposes of Article 16 of the Agreement for the totalization of the periods of insurance, the competent institution of one Party shall request from the competent institution of the other Party a statement indicating the periods of insurance recognized under the statutes that the latter Party applies.
(3) The information on civil status entered on the claim form shall be certified by the institution or agency forwarding the claim, which exempts the institution or agency from sending the supporting documents.
(4) The competent institution shall notify the claimant as soon as it has made a decision under the statutes it applies indicating the remedies and time limits provided for in the statutes; the institution shall also notify the institution or agency of the other Party through which the claim was filed, using the liaison form.
CHAPTER 2
DISABILITY PENSIONS
ARTICLE 7
FILING AND PROCESSING OF CLAIM
(1) For the purposes of Article 21 of the Agreement, a claim for disability pensions must be filed with the institution to which the person concerned was affiliated at the time the disability occurred, according to the terms and conditions set out in the statutes to be applied by the institution.
(2) If the person resides in the territory of the other Party, the person may send the claim to an institution situated in that territory, according to the terms and conditions set out in the statutes of that Party. That institution shall send the claim along with the required medical documents or a medical report and a statement of the periods of insurance completed under the statutes it applies to the institution to which the person concerned was affiliated at the time the disability occurred.
ARTICLE 8
AMOUNT OF THE DISABILITY PENSION AND CALCULATION PROCEDURES OF THE RÉGIE DES RENTES DU QUÉBEC
For the purposes of paragraphs 2 and 6 of Article 21 of the Agreement, where a disability pension is paid by Québec, the amount of the pension payable to the contributor shall be equal to the sum of the total amount of the fixed portion and the amount of the part related to earnings established over the aggregate of the periods of insurance taken into account. The amount of the pension payable to the contributor’s children is the amount fixed by the statutes of Québec.
ARTICLE 9
EXAMINATION OF THE CLAIM BY THE INSTITUTION OF THE OTHER PARTY; CONSIDERATION OF THE PERIODS OF INSURANCE COMPLETED IN THE TERRITORY OF THE OTHER PARTY FOR THE CALCULATION OF DISABILITY PENSIONS AND APPORTIONMNET OF THE COST
(1) In the case referred to in paragraph 5 of Article 21 of the Agreement, the refusing institution shall send the claim to the institution of the other Party along with the medical documents it has or a medical report and the statement of the periods of insurance completed under the statutes it applies.
(2) For the purposes of paragraph 1 of the first sentence of Article 21 of the Agreement, in the case where the statutes applied by the institution to which the claim was sent requires a determined number of hours of activity for entitlement, a day of insurance shall be equivalent to 6 hours of work.
(3) In every case where the competent institution, as regards the provisions of paragraph 2 or paragraph 6 of Article 21 of the Agreement, awards a disability pension, the institution of the other Party may not, for any reason whatsoever, refuse the apportionment of the costs.
ARTICLE 10
EXCHANGE OF INFORMATION RELATING TO DISABILITY PENSIONS
(1) The institutions shall inform each other of the awarding of paid disability pensions in accordance with the provisions of paragraphs 1 to 4 or paragraph 6 of Article 21 of the Agreement, using the form provided for that purpose.
(2) For the purposes of paragraph 7 of Article 21 of the Agreement,
(a) the competent French institution shall inform the Régie des rentes du Québec of the granting of an old age pension in respect of a person receiving a shared-cost disability pension, in order to terminate the apportionment of the costs as of the date of entitlement to the old age pension;
(b) where a person who has reached the minimum age required for the granting of an old age pension under the French statutes submits a claim for a disability pension to the Régie des rentes du Québec, the Régie shall establish the amount of the pension owed, if any, without apportionment of the costs and shall call upon that person to assert the person’s entitlement to an old age pension under the French statutes;
(c) if, however, the person informs the Régie des rentes du Québec of the rejection or deferral of the claim for old age pension under the French statutes, the Régie, by common agreement with the competent French institution, shall review the amount of the disability pension, taking into account the periods of insurance completed under the French statutes and shall communicate to the latter institution the result of the review as provided in paragraph 1 of this Article.
(3) In the situations referred to in paragraphs 1 and 2 of Article 22 of the Agreement, the notices of suspension, termination or resumption of the benefits shall be communicated with the statements of account established for the claims for reimbursement.
CHAPTER 3
HEALTH AND MATERNITY BENEFITS
ARTICLE 11
DETERMINATION OF DEPENDENTS
(1) For the purposes of paragraphs 1 and 2 of Article 24 of the Agreement, dependents shall respectively be determined in accordance with the statutes applicable in the territory of work or residence.
(2) For the purposes of Articles 25, 26 and 28 of the Agreement, dependents shall be determined in accordance with the statutes applied by the institution paying the benefits.
ARTICLE 12
PROCEDURES RELATING TO ENTITLEMENT TO, MAINTENANCE OR RECOVERY OF BENEFITS
(1) For the purposes of Articles 23 and 24 of the Agreement, where it is necessary to resort to the totalization of the periods of insurance, the information on the periods completed previously shall be given by the institution of the Party under whose statutes the person was previously subject by means of a “certificate of periods of insurance related to employment or residence, as regards health insurance, maternity and death”. The certificate shall be issued at the request of the person concerned or at the request of the new competent institution.
(2) To receive benefits in kind in the territory of Québec, a person must register with the Régie de l’assurance maladie du Québec using the registration form and submitting the certificate referred to in paragraph 1 of this Article along with documents corresponding to the person’s immigrant status in Québec and, if applicable, proof of establishment of domicile. Entitlement to benefits shall be determined as soon as the form is received at the Régie de l’assurance maladie du Québec and be retroactive to the date of arrival of the person.
(3) To receive benefits in kind in the territory of France, a person must be registered, in compliance with the conditions set out in the French statutes according to the person’s situation, with the appropriate competent institution, and must justify as needed prior affiliation to the Régie de l’assurance maladie du Québec by submitting the certificate referred to in paragraph 1 of this Article. The benefits shall then be granted on the day of the person’s arrival in that territory.
(4) Where, for entitlement to the benefits in kind provided for in the French statutes, the competent institution must use the periods of employment in Québec as provided in paragraph 1 of Article 27, the insured person must submit any document attesting to the effective duration of the activity during the periods of employment.
ARTICLE 13
PROCEDURES IN CASE OF TEMPORARY STAY IN THE TERRITORY OF THE ORIGINAL PARTY
(1) For the purposes of paragraph 1 of Article 25 of the Agreement, the insured person or one of the person’s dependents shall submit to the institution of the place of stay a certificate of entitlement to health and maternity insurance benefits in kind. The certificate may be established for a period not exceeding three months.
The certificate shall be submitted in the case where the insured person or one of the person’s dependents applies for entitlement to benefits in kind:
(a) in Québec, at the Régie de l’assurance maladie du Québec so that the institution may register the person;
(b) in France, at the territorially competent Caisse primaire de l’assurance maladie with regards to the place where the care is received.
(2) If, at the time of registration or submission of the claim for benefits, a person does not have the form referred to in paragraph 1 of this Article, the person must request the form from the institution to which the person is affiliated. If the person has serious grounds for not making the request himself or herself, the request may be made through the institution of the place of stay. Entitlement to benefits shall be established with effect on the date the care commenced.
(3) The three-month period referred to in paragraph 3 of Article 25 shall commence on the initial date of care. If, on the expiry of the three-month period, the person’s health requires, in the opinion of the attending physician, that the benefits in kind be continued, the coverage may be extended for another three-month period provided that the competent institution has given a favourable opinion by renewing the certificate referred to in paragraph 1 of this Article.
ARTICLE 14
PROCEDURES IN THE CASE OF TRANSFER OF PLACE OF STAY DURING THE TREATMENT OR COMPENSATION
(1) For the purposes of paragraph 1 of Article 26 of the Agreement, the insured person or one of the person’s dependents shall be required to submit a certificate of entitlement to health and maternity insurance benefits in kind to the institution of the place of stay.
(2) The certificate shall be issued by the competent institution, on request from the person concerned before departure, and must include the period during which the benefits are provided within the initial three-month period. The initial period of validity of the certificate may exceptionally be longer than three months if the anticipated period of benefits so justifies. In the case of maternity, the certificate issued under the same conditions as in the case of health insurance is valid for the granting of benefits in kind until the end of the compensation period for maternity provided for in the statutes applied by the competent institution.
If the certificate is requested by an insured person under the French plan who, in accordance with the provisions of paragraph 2 of Article 27 of the Agreement, is entitled to benefits in kind, the certificate shall be issued after the consulting physician has agreed to the travel.
(3) In Québec, the certificate is submitted to the Régie de l’assurance maladie du Québec so that the agency may register the insured person or dependent.
In France, the certificate is submitted to the territorially competent Caisse primaire d’assurance maladie with regards to the place where the care is received.
(4) If, at the time of registration or submission of the claim, a person does not have the form referred to in paragraph 1 of this Article, the person must request the form from the institution to which the person is affiliated. When the person has serious grounds for not making the request himself or herself, the request may be made through the institution of the place of stay. Entitlement to benefits shall be established with effect on the date the place of stay has been transferred.
(5) If the health of the insured person or dependent requires an extension of care beyond the period anticipated originally in the certificate issued, the institution of the place of stay, on its own motion or on the request of the insured person, shall apply for the renewal of the certificate.
The competent institution shall grant the extension provided that entitlement to the benefits is maintained with regard to its statutes throughout the additional three-month period or a longer period in the case of an exceptionally serious illness. The institution may, if need be, request a medical verification from the institution of the place of stay and shall communicate the results to the institution.
In the case of a refusal of the extension, the reasons for the refusal and the remedies available shall be given to the person concerned and to the institution of the place of stay.
ARTICLE 15
PROCEDURES PRIOR TO ENTITLEMENT TO BENEFITS OF SECONDED WORKERS AND DEPENDENTS
(1) For the purposes of paragraphs 1 and 2 of Article 28 of the Agreement, a worker who chose to refer to the institution of the Party in whose territory the person is staying shall submit the “certificate of coverage” to the institution.
(2) In France, the certificate shall be filed with the Caisse primaire de l’assurance maladie of the place of stay. The Caisse that is the custodian of the certificate shall inform the Québec liaison agency by returning to the agency the card attached to the certificate of coverage that includes the name of the Caisse and the name of the worker.
(3) In Québec, the certificate shall be submitted to the Régie de l’assurance maladie du Québec that registers the insured person. At the time of registration, the person may become a member of the general prescription drug insurance plan without paying a premium if the person submits proof that the person has no access to a group insurance plan in Québec providing reimbursement of costs related to prescription drugs.
(4) The provisions of paragraphs 2 and 3 shall not apply by analogy to the worker’s dependents.
ARTICLE 16
SPECIAL PROVISIONS CONCERNING INSURED PERSONS UNDER THE FRENCH PLAN FOR BENEFITS IN KIND AND MEDICAL MONITORING IN CASE OF INTERRUPTION OF WORK
(1) To receive health and maternity insurance benefits in kind provided by French statutes, the insured person referred to in Articles 25 and 28 of the Agreement shall submit to the competent French institution, within a three-day period after the commencement of the work disability, except in the case of a force majeure, a notice of interruption of work or a work disability certificate issued by the attending physician.
(2) The provisions of paragraph 1 of this Article shall apply in case the interruption of work of the person referred to in Articles 25, 26 or 28 of the Agreement is extended. The competent institution shall examine the rights of the person concerned and inform the person directly of the decision, indicating the remedies and their time limits.
(3) The competent institution notified of an interruption of work may, at any time, and particularly in the case of an extension of a prior interruption of work, request from the Régie de l’assurance maladie du Québec a medical verification the results of which shall be communicated to the institution as soon as possible.
ARTICLE 17
FORMALITIES TO BE FOLLOWED BY DEPENDENTS RESIDING IN THE TERRITORY OF THE OTHER PARTY
The persons referred to in Article 29 of the Agreement shall receive the benefits provided by the institution of the place of residence under the following conditions.
In the case of a dependent who returns to reside in Québec, the provisions of paragraphs 1 and 2 of Article 12 of this Arrangement shall apply by analogy.
A dependent residing or returning to reside in France must register at the Caisse primaire de l’assurance maladie of the place of residence by submitting a form issued by the Régie de l’assurance maladie du Québec attesting to status as an insured person entitled to benefits. The form shall be issued on the request of the insured person or the Caisse primaire d’assurance maladie and shall be valid for a period of not more than twelve months, having a commencement date that may not precede the date of commencement of coverage of the insured person under the statutes of Québec.
ARTICLE 18
FORMALITIES TO BE FOLLOWED BY THE HOLDERS OF A PENSION OR ANNUITY
For the purposes of Article 30 of the Agreement, the provisions of paragraphs 1 to 3 of Article 12 of this Arrangement shall apply by analogy.
CHAPTER 4
NOT APPLICABLE
CHAPTER 5
BENEFITS IN CASE OF INDUSTRIAL ACCIDENT OR OCCUPATIONAL DISEASE
ARTICLE 19
DETERMINATION OF INSTITUTIONS
For the purposes of Articles 34 to 43 of the Agreement,
(a) affiliated institutions, as regards the statutes of Québec or France, are respectively the Commission de la santé et de la sécurité du travail, hereafter referred to as “CSST” and the Caisse de sécurité sociale to which the worker is affiliated;
(b) the institution of the place of stay or residence is, in Québec, the Commission de la santé et de la sécurité du travail, and in France, the Caisse of the place of stay or residence of the worker.
ARTICLE 20
CLAIM FOR BENEFITS UNDER THE STATUTES OF THE OTHER PARTY
(1) For the purposes of Article 34 of the Agreement,
(a) if the disease or accident occurs in France,
the institution of the place of stay shall send a case management claim, along with a medical certificate and a declaration describing the place and circumstances of the occurrence of the occupational injury, signed by the worker or the worker’s representative, to the affiliated institution;
(b) if the disease or accident occurs in Québec,
the CSST shall, when it receives a claim for a worker under French statutes, send the claim to the affiliated institution pursuant to the terms and conditions provided in subparagraph a of this paragraph.
(2) The affiliated institution that receives a claim for benefits shall immediately communicate its decision to the institution of the place of stay, on the basis of the information furnished by that institution, using the form provided to that effect. In the case of a negative decision, benefits shall be provided, in accordance with the general provisions applicable to the persons referred to in Article 28 of the Agreement.
(3) For entitlement to benefits in kind, a seconded worker or a self-employed worker insured voluntarily shall apply directly to the affiliated institution in accordance with the provisions of the statutes applied by that institution.
(4) Where a worker requests that the entitlement to benefits be extended beyond the period indicated in the form, the worker shall send the request with supporting medical documents to the affiliated institution either directly or through the institution of the place of stay.
(5) If the medical documents furnished do not permit the affiliated institution to make a decision, the institution shall request from the institution of the place of stay to have the person concerned examined, specifying the nature of the additional information required.
(6) The affiliated institution shall communicate its decision to a worker using a form indicating the entitlement extension period and the nature of the benefits granted or, if applicable, the reason for the refusal and the remedies available and their time limits.
ARTICLE 21
MAINTENANCE OF BENEFITS IN THE TERRITORY OF STAY OR OF NEW RESIDENCE
(1) A worker referred to in Article 35 of the Agreement is required to submit a form to the institution of the place of stay or of the new residence attesting that the affiliated institution authorizes the first institution to maintain entitlement to benefits in kind after the worker’s transfer of residence.
(2) When, for a serious reason, the form referred to in paragraph 1 could not be established prior to a worker’s transfer of residence, the affiliated institution may, on request from the worker or the institution of the place of stay or of the new residence, issue the form after the transfer of residence.
(3) When a worker requests an extension of benefit entitlement beyond the period provided for, the provisions of paragraphs 4, 5 and 6 of Article 20 shall apply.
ARTICLE 22
RELAPSE AFTER TRANSFER OF RESIDENCE
(1) To receive benefits in the case of relapse or aggravation, a worker referred to in Article 36 or 37 of the Agreement shall send a claim along with the required medical documents to the institution of the new place of residence, specifying that he or she has received benefits from the institution of the other Party following an industrial accident or an occupational disease.
(2) The institution of the place of stay shall send the claim along with the medical documents to the institution that recognized the industrial accident for a decision. The latter institution shall then proceed in accordance with the provisions of paragraphs 5 and 6 of Article 20 of this Arrangement.
(3) A claim sent directly to the institution that has recognized the industrial accident shall be admissible.
ARTICLE 23
GRANTING OF LARGE BENEFITS IN KING
(1) For the purposes of Article 40 of the Agreement, where the institution of the place of stay or residence grants prostheses, large devices or other large benefits in kind, the institution shall request that the affiliated institution send its decision concerning such granting on the form that will be sent to the worker. If the benefits have already been granted due to an emergency, the institution of the place of stay or residence shall so notify the affiliated institution and the acknowledgement of receipt of the notice shall serve as retroactive authorization.
(2) Benefits shall be provided under the conditions and according to the forms prescribed by the statutes of the institution of the place of stay, unless otherwise specified by the affiliated institution.
ARTICLE 24
ASSESSMENT OF THE DEGREE OF DISABILITY
For the purposes of Article 41 of the Agreement, a worker and the institution to which the worker was previously affiliated shall furnish to the institution processing the claim, on the request of that institution and to the extent where it is necessary for the processing of the claim, the information relating to industrial accidents or occupational diseases that occurred or were ascertained under the previously affiliated statutes.
ARTICLE 25
DOUBLE EXPOSURE TO THE SAME RISK
(1) Where the competent institution of the Party in whose territory a victim last carried on work likely to cause the occupational disease ascertains that the victim or the victim’s dependents do not satisfy the conditions of its statutes, having regard to the provisions of paragraphs 2 and 3 of Article 42 of the Agreement, the said institution shall
(a) immediately send to the institution of the other Party the decision and accompanying documents and a copy of the notice referred to below;
(b) notify at the same time the worker of its refusal, indicating the conditions that are not satisfied, the remedies available under the law and their time limits and that the declaration has been transmitted to the institution of the other Party.
(2) Where a remedy is exercised against the refusal of the institution of the Party in whose territory a victim last carried on work likely to cause the occupational disease, the institution is required to so inform the institution of the other Party and to make any final decision known to that institution.
ARTICLE 26
NOTICE IN CASE OF SHARED COST
For the purposes of paragraph 5 of Article 42 of the Agreement, the institution providing benefits shall send to the liaison agency of the other Party a first notice in which the institution shall indicate the amount of the benefits provided to a worker or the worker’s dependents, the period of work likely to cause the occupational disease performed in the territory of each Party and the amount of the share to be paid by each of the competent institutions.
ARTICLE 27
AGGRAVATION OF A COMPENSATED OCCUPATIONAL DISEASE
(1) For the purposes of Article 43 of the Agreement, a worker is required to furnish to the competent institution of the new place of residence the necessary information relating to previous benefits received for the occupational disease concerned. The said institution may contact the institution that provided the benefits to the worker to obtain any details.
(2) In the case referred to in subparagraph a of Article 43 of the Agreement, a copy of the decision of refusal notified to the worker by the institution of the worker’s new place of residence shall be forwarded to the competent institution of the other Party. Those institutions shall exchange any information useful to determine the worker’s health condition.
(3) In the case referred to in subparagraph b of Article 43 of the Agreement, the institution paying the amount of the supplement shall so inform the institution of the other Party.
CHAPTER 6
NOT APPLICABLE
CHAPTER 7
FAMILY BENEFITS
ARTICLE 28
FAMILY BENEFITS
The term “family benefits” means
(a) with respect to the Québec statutes, all benefits defined in the Act respecting family benefits;
(b) with respect to the French statutes, family allowances and allowance for infants in the portion paid up to three months of age.
ARTICLE 29
CLAIM FOR FAMILY BENEFITS
For the purposes of Article 47 of the Agreement, family benefits shall be payable in respect of dependent children as of the first day of the month following their arrival in the new territory of stay or residence provided that
(a) for Québec, the claim is made to the Régie des rentes du Québec, in accordance with the provisions of the statutes in force in that territory;
(b) for France, the beneficiary and the children justify the legality of their stay and that the claim for benefits be made to the Caisse d’allocations familiales of their place of stay or residence.
ARTICLE 30
NOTICE TO COMPETENT INSTITUTIONS
To obtain Québec family benefits, the persons referred to in Article 48 of the Agreement, going to France from Québec, shall furnish the certificate referred to in Article 3 of this Arrangement to the Régie des rentes du Québec. Persons going to Québec from France must so inform their Caisse d’allocations familiales.
TITLE IV
FINANCIAL AND MISCELLANEOUS
ARTICLE 31
LIAISON AGENCIES
In accordance with the provisions of paragraph 2 of Article 49 of the Agreement, each Party has designated the following liaison agencies:
(a) in Québec,
the Bureau des ententes de sécurité sociale of the Régie des rentes du Québec or any other agency that the competent Québec authority may designate later;
(b) in France,
the Centre des liaisons européennes et internationales de sécurité sociale.
ARTICLE 32
DATE OF RECEIPT OF CLAIM
The date of receipt of a claim for a pension, benefit or allowance by the competent institution or liaison agency of one Party is deemed to be the date of receipt by the competent institution of the other Party even if no pension, benefit or allowance is payable under the statutes of the first Party.
ARTICLE 33
MEDICAL EXAMINATION REPORTS AND VERIFICATIONS
(1) The competent institution of one Party that pays a pension or benefit to a person residing in the territory of the other Party may have that person examined by a physician of its choice in accordance with the conditions set out in its own statutes.
(2) If, following a request for verification by the institution paying the disability pension, it is observed that the beneficiary has resumed work in the territory of the other Party, a report shall be sent to the said institution by the institution of the place of residence of the beneficiary.
ARTICLE 34
REIMBURSEMENT BETWEEN INSTITUTIONS
(1) Benefits in kind provided for the purposes of Articles 25, 26 and 28 of the Agreement shall be reimbursed on the basis of the costs incurred by the institution of the place of stay as described in the individual statements of expenses that it submits and may include, for Québec, a percentage increase of the amount for consultations and medical examinations outside hospitalization billed on a fee basis to take into account the consultation and examinations that are not so billed. The rate is fixed at 15% and may increase by agreement between the competent authorities or agencies designated to that end, on the basis of the changes in the funding of medical acts in Québec. The amount of hospitalization expenses shall be established on the basis of daily prices.
(2) Benefits in kind provided pursuant to Article 39 of the Agreement shall be reimbursed on the basis of the expenses incurred by the institution at the place of stay as described in the individual statements of expenses that it submits.
(3) The statements of expenses established by the French institutions shall be consolidated by the French liaison agency and sent every six months with a summary report, including a duplicate, to the Régie de l’assurance maladie du Québec for expenses relating to health and to the Commission de la santé et de la sécurité du travail for expenses related to industrial accidents. Both agencies shall send quarterly statements of expenses, along with a summary report, established in Québec to the French liaison agency.
(4) For the purposes of paragraph 4 of Article 21 and paragraph 5 of Article 42 of the Agreement, at the end of every calendar year, the institution that provided the pensions and benefits shall send to the liaison agency of the first Party a statement of pensions and benefits provided indicating the amount paid and the portion payable by the institution of the other Party. The liaison agency of the first Party shall submit the billing to the other Party.
(5) For the purposes of Article 53 of the Agreement, at the end of every calendar year, the competent institution of each Party that performed the medical verifications or made the examination reports shall send individual statements of the costs incurred to the liaison agency. The liaison agency of that Party shall submit the statements to the liaison agency of the other Party for reimbursement.
(6) Each debtor institution shall pay the amounts owed to the other institution within six months following the date of receipt of the reimbursement claims sent in accordance with the provisions of paragraphs 3, 4 and 5 of this Article.
ARTICLE 35
CONTESTATION OF REIMBURSEMENT
(1) Where following the verification of the statements of expenses to be reimbursed referred to in Article 34 of this Arrangement, a Party contests certain amounts, the Party shall immediately reimburse the amounts with which the Party agrees, accompanied by a notice stating the reasons of the contestation of the other amounts.
(2) The Party receiving a contestation shall examine it and communicate its findings as soon as possible to the other Party. If the contestation is not justified, the claim shall be reinstated with supporting documents. The matter is settled when the next statement is submitted.
ARTICLE 36
CONTINUATION OF UNDUE PAYMENT
In the case of undue payment of a shared-cost pension or benefit, the institution that provided the payment shall be responsible for continuing the undue payment, the amount of which shall be apportioned between the institutions of both Parties in the proportion established for the payment of the pension or benefit concerned. If the amount cannot be recovered, the loss shall be charged to both institutions according to the same rule.
ARTICLE 37
FORMS
Forms and other documents required to implement the procedure provided for in the Administrative Arrangement shall be established by mutual agreement by the competent institutions and agencies responsible for the application of the Agreement for each Party. The forms and documents shall appear as schedules to a supplementary administrative arrangement.
ARTICLE 38
STATISTICAL DATA
The liaison agencies of both Parties shall exchange statistical data concerning the payment of pensions made during every calendar year to beneficiaries residing in the territory of the other Party. The data shall indicate the number of beneficiaries and the amount of the pensions for each category.
TITLE V
FINAL
ARTICLE 39
This Arrangement revokes and replaces the General Administrative Arrangement relating to the conditions of application of the Agreement on social security between the Gouvernement du Québec and the Government of the French Republic signed on 12 February 1979, the Arrangement signed on 15 May 1987 making the first amendment and the Arrangements signed on 21 December 1998 making the second and third amendments respectively to that General Administrative Arrangement.
This Administrative Arrangement comes into force on the same date as the Agreement signed on 17 December 2003.
Done in duplicate at Québec City, on 17 December 2003, and in Paris, on 30 December 2003.
For the competent authority For the competent authority of
of Québec the French Republic

________________________________________ ________________________________________
JEAN D. MÉNARD, FLORENCE LIANOS,
Head of the Service des Head of the Division
ententes internationales des Affaires communautaires
Ministère des Relations et internationales
internationales Ministère des Affaires
sociales du Travail et
de la Solidarité
________________________________________
LOUIS RANVIER,
Chargé des questions
internationales de
sécurité sociale
Ministère de l’Agriculture,
de l’Alimentation,
de la Pêche et
des Affaires rurales
O.C. 740-2006, Sch. 2.
From 1 January 2016, in accordance with section 237 of chapter 15 of the statutes of 2015, the words «Commission de la santé et de la sécurité du travail» mean in this Regulation «Commission des normes, de l’équité, de la santé et de la sécurité du travail»
SCHEDULE 2
(S. 2)
ADMINISTRATIVE ARRANGEMENT FOR THE IMPLEMENTATION OF THE AGREEMENT ON SOCIAL SECURITY BETWEEN THE GOUVERNEMENT DU QUÉBEC AND THE GOVERNMENT OF THE FRENCH REPUBLIC
In accordance with Article 49 of the Agreement on Social Security signed on 17 December 2003 between the Gouvernement du Québec and the Government of the French Republic, hereafter called the “Agreement”, the competent authorities represented by
For Québec:
— Jean D. Ménard, head of the Service des ententes internationales, Ministère des Relations internationales;
For France:
— Florence Lianos, head of the Division des affaires communautaires et internationales, Direction de la sécurité sociale, Ministère des Affaires sociales, du Travail et de la Solidarité;
— Louis Ranvier, responsible for international matters, Direction Générale de la forêt et des affaires rurales, Ministère de l’Agriculture, de l’Alimentation, de la Pêche et des Affaires rurales;
CONSIDERING the desire of both Governments to implement the Agreement with a view to preserving the mobility of persons between Québec and France,
HAVE AGREED TO THE FOLLOWING PROVISIONS:
TITLE I
GENERAL
ARTICLE 1
DEFINITIONS
In this Administrative Arrangement, the terms used shall have the meaning assigned to them in Article 1 of the Agreement.
ARTICLE 2
PARTICULARS CONCERNING EQUALITY OF TREATMENT
For the purposes of Chapters 3 and 5 of Title III of the Agreement, as regards Québec statutes, workers temporarily working in Québec and staying legally in Québec without residing therein within the meaning of Article 1 of the Agreement shall receive, in that territory, treatment equal to the treatment given to persons residing therein, with regard to the benefits provided, in accordance with the provisions of Article 4 of the Agreement.
TITLE II
PROVISIONS RELATING TO APPLICABLE STATUTES
ARTICLE 3
CERTIFICATE OF COVERAGE
(1) In the cases referred to in Articles 7 to 13 of the Agreement, the institutions of the Party whose statutes remain applicable, that are designated below, shall establish, on application from the employer or an unsalaried worker, a “certificate of coverage” certifying that the worker concerned remains subject to the statutes.
The certificate is issued
(a) with respect to the Québec statutes,
by the Québec liaison agency;
(b) with respect to the French statutes,
by the worker’s Caisse or, with respect to salaried workers of the general plan, by the Caisse in the district in which the employer is located.
(2) For the purposes of paragraph 2 of Article 8 of the Agreement and, as regards a derogation concerning individual cases, of Article 13, an agreement prior to the issuance of a certificate of coverage must be requested
(a) for the maintenance of affiliation to the Québec statutes,
by the Québec liaison agency to France’s liaison agency;
(b) for the maintenance of affiliation to the French statutes,
— by France’s liaison agency, as regards insured persons under plans other than the seamen’s plan;
— by the Établissement national des invalides de la marine, as regards insured persons under the seamen’s plan;
to the Québec liaison agency, which is responsible for obtaining a decision from the competent Québec institutions
(3) A decision made by mutual agreement by both Parties shall be communicated to the interested affiliated organizations and to the worker, if need be through the worker’s employer.
(4) Liaison agencies may agree, if applicable, on common procedures to improve or clarify the management of certificates of coverage.
(5) For the purposes of Article 13 of the Agreement, the department responsible for social security, for France, and the liaison agency responsible for obtaining a decision from the competent institutions, for Québec, may, by common agreement, derogate from the applicable statutes with respect to a category of persons.
ARTICLE 4
PUBLIC SERVICE
(1) For the purposes of paragraph 1 of Article 12 of the Agreement, the following persons are deemed to be in the Public Service:
(a) for Québec,
the persons employed by the Gouvernement du Québec and governed by the Public Service Act;
(b) for France,
i. persons in government employment and military service and similar personnel;
ii. salaried personnel other than the personnel referred to in subparagraph i, working for a French public administration and who, assigned in the territory of Québec, remain subject to the French social security plan.
(2) For the purposes of paragraph 2 of Article 12 of the Agreement, the following persons are deemed to be in the Public Service:
(a) for Québec,
locally recruited persons;
(b) for France,
salaried personnel other than the personnel referred to in subparagraph ii of subparagraph b of paragraph 1 working for the French government.
TITRE III
PROVISIONS CONCERNING PENSIONS AND BENEFITS
CHAPTER 1
OLD AGE PENSIONS AND SURVIVORS BENEFITS
ARTICLE 5
FILING OF CLAIM
(1) For the purposes of Chapter 1 of Title III of the Agreement, a claim for a pension under the statutes of one Party shall be filed with the competent institution of that Party through the competent institution or liaison agency of the other Party, if the claimant resides in the territory of the latter Party. If the claimant resides in the territory of a third party state, the claim shall be filed with the competent institution of either Party.
(2) With respect to claims for pensions under the statutes of Québec, la Régie des rentes du Québec shall be the competent institution for any application relating to a person whose contributions have been paid into the Québec Pension Plan.
ARTICLE 6
PROCESSING OF THE CLAIM
(1) The competent institution or liaison agency through which the pension claim is filed shall send the claim to the competent institution of the other Party with the required supporting documents and a liaison form indicating the periods of insurance completed and the entitlement, if any, under the statutes of the first Party.
(2) For the purposes of Article 16 of the Agreement for the totalization of the periods of insurance, the competent institution of one Party shall request from the competent institution of the other Party a statement indicating the periods of insurance recognized under the statutes that the latter Party applies.
(3) The information on civil status entered on the claim form shall be certified by the institution or agency forwarding the claim, which exempts the institution or agency from sending the supporting documents.
(4) The competent institution shall notify the claimant as soon as it has made a decision under the statutes it applies indicating the remedies and time limits provided for in the statutes; the institution shall also notify the institution or agency of the other Party through which the claim was filed, using the liaison form.
CHAPTER 2
DISABILITY PENSIONS
ARTICLE 7
FILING AND PROCESSING OF CLAIM
(1) For the purposes of Article 21 of the Agreement, a claim for disability pensions must be filed with the institution to which the person concerned was affiliated at the time the disability occurred, according to the terms and conditions set out in the statutes to be applied by the institution.
(2) If the person resides in the territory of the other Party, the person may send the claim to an institution situated in that territory, according to the terms and conditions set out in the statutes of that Party. That institution shall send the claim along with the required medical documents or a medical report and a statement of the periods of insurance completed under the statutes it applies to the institution to which the person concerned was affiliated at the time the disability occurred.
ARTICLE 8
AMOUNT OF THE DISABILITY PENSION AND CALCULATION PROCEDURES OF THE RÉGIE DES RENTES DU QUÉBEC
For the purposes of paragraphs 2 and 6 of Article 21 of the Agreement, where a disability pension is paid by Québec, the amount of the pension payable to the contributor shall be equal to the sum of the total amount of the fixed portion and the amount of the part related to earnings established over the aggregate of the periods of insurance taken into account. The amount of the pension payable to the contributor’s children is the amount fixed by the statutes of Québec.
ARTICLE 9
EXAMINATION OF THE CLAIM BY THE INSTITUTION OF THE OTHER PARTY; CONSIDERATION OF THE PERIODS OF INSURANCE COMPLETED IN THE TERRITORY OF THE OTHER PARTY FOR THE CALCULATION OF DISABILITY PENSIONS AND APPORTIONMNET OF THE COST
(1) In the case referred to in paragraph 5 of Article 21 of the Agreement, the refusing institution shall send the claim to the institution of the other Party along with the medical documents it has or a medical report and the statement of the periods of insurance completed under the statutes it applies.
(2) For the purposes of paragraph 1 of the first sentence of Article 21 of the Agreement, in the case where the statutes applied by the institution to which the claim was sent requires a determined number of hours of activity for entitlement, a day of insurance shall be equivalent to 6 hours of work.
(3) In every case where the competent institution, as regards the provisions of paragraph 2 or paragraph 6 of Article 21 of the Agreement, awards a disability pension, the institution of the other Party may not, for any reason whatsoever, refuse the apportionment of the costs.
ARTICLE 10
EXCHANGE OF INFORMATION RELATING TO DISABILITY PENSIONS
(1) The institutions shall inform each other of the awarding of paid disability pensions in accordance with the provisions of paragraphs 1 to 4 or paragraph 6 of Article 21 of the Agreement, using the form provided for that purpose.
(2) For the purposes of paragraph 7 of Article 21 of the Agreement,
(a) the competent French institution shall inform the Régie des rentes du Québec of the granting of an old age pension in respect of a person receiving a shared-cost disability pension, in order to terminate the apportionment of the costs as of the date of entitlement to the old age pension;
(b) where a person who has reached the minimum age required for the granting of an old age pension under the French statutes submits a claim for a disability pension to the Régie des rentes du Québec, the Régie shall establish the amount of the pension owed, if any, without apportionment of the costs and shall call upon that person to assert the person’s entitlement to an old age pension under the French statutes;
(c) if, however, the person informs the Régie des rentes du Québec of the rejection or deferral of the claim for old age pension under the French statutes, the Régie, by common agreement with the competent French institution, shall review the amount of the disability pension, taking into account the periods of insurance completed under the French statutes and shall communicate to the latter institution the result of the review as provided in paragraph 1 of this Article.
(3) In the situations referred to in paragraphs 1 and 2 of Article 22 of the Agreement, the notices of suspension, termination or resumption of the benefits shall be communicated with the statements of account established for the claims for reimbursement.
CHAPTER 3
HEALTH AND MATERNITY BENEFITS
ARTICLE 11
DETERMINATION OF DEPENDENTS
(1) For the purposes of paragraphs 1 and 2 of Article 24 of the Agreement, dependents shall respectively be determined in accordance with the statutes applicable in the territory of work or residence.
(2) For the purposes of Articles 25, 26 and 28 of the Agreement, dependents shall be determined in accordance with the statutes applied by the institution paying the benefits.
ARTICLE 12
PROCEDURES RELATING TO ENTITLEMENT TO, MAINTENANCE OR RECOVERY OF BENEFITS
(1) For the purposes of Articles 23 and 24 of the Agreement, where it is necessary to resort to the totalization of the periods of insurance, the information on the periods completed previously shall be given by the institution of the Party under whose statutes the person was previously subject by means of a “certificate of periods of insurance related to employment or residence, as regards health insurance, maternity and death”. The certificate shall be issued at the request of the person concerned or at the request of the new competent institution.
(2) To receive benefits in kind in the territory of Québec, a person must register with the Régie de l’assurance maladie du Québec using the registration form and submitting the certificate referred to in paragraph 1 of this Article along with documents corresponding to the person’s immigrant status in Québec and, if applicable, proof of establishment of domicile. Entitlement to benefits shall be determined as soon as the form is received at the Régie de l’assurance maladie du Québec and be retroactive to the date of arrival of the person.
(3) To receive benefits in kind in the territory of France, a person must be registered, in compliance with the conditions set out in the French statutes according to the person’s situation, with the appropriate competent institution, and must justify as needed prior affiliation to the Régie de l’assurance maladie du Québec by submitting the certificate referred to in paragraph 1 of this Article. The benefits shall then be granted on the day of the person’s arrival in that territory.
(4) Where, for entitlement to the benefits in kind provided for in the French statutes, the competent institution must use the periods of employment in Québec as provided in paragraph 1 of Article 27, the insured person must submit any document attesting to the effective duration of the activity during the periods of employment.
ARTICLE 13
PROCEDURES IN CASE OF TEMPORARY STAY IN THE TERRITORY OF THE ORIGINAL PARTY
(1) For the purposes of paragraph 1 of Article 25 of the Agreement, the insured person or one of the person’s dependents shall submit to the institution of the place of stay a certificate of entitlement to health and maternity insurance benefits in kind. The certificate may be established for a period not exceeding three months.
The certificate shall be submitted in the case where the insured person or one of the person’s dependents applies for entitlement to benefits in kind:
(a) in Québec, at the Régie de l’assurance maladie du Québec so that the institution may register the person;
(b) in France, at the territorially competent Caisse primaire de l’assurance maladie with regards to the place where the care is received.
(2) If, at the time of registration or submission of the claim for benefits, a person does not have the form referred to in paragraph 1 of this Article, the person must request the form from the institution to which the person is affiliated. If the person has serious grounds for not making the request himself or herself, the request may be made through the institution of the place of stay. Entitlement to benefits shall be established with effect on the date the care commenced.
(3) The three-month period referred to in paragraph 3 of Article 25 shall commence on the initial date of care. If, on the expiry of the three-month period, the person’s health requires, in the opinion of the attending physician, that the benefits in kind be continued, the coverage may be extended for another three-month period provided that the competent institution has given a favourable opinion by renewing the certificate referred to in paragraph 1 of this Article.
ARTICLE 14
PROCEDURES IN THE CASE OF TRANSFER OF PLACE OF STAY DURING THE TREATMENT OR COMPENSATION
(1) For the purposes of paragraph 1 of Article 26 of the Agreement, the insured person or one of the person’s dependents shall be required to submit a certificate of entitlement to health and maternity insurance benefits in kind to the institution of the place of stay.
(2) The certificate shall be issued by the competent institution, on request from the person concerned before departure, and must include the period during which the benefits are provided within the initial three-month period. The initial period of validity of the certificate may exceptionally be longer than three months if the anticipated period of benefits so justifies. In the case of maternity, the certificate issued under the same conditions as in the case of health insurance is valid for the granting of benefits in kind until the end of the compensation period for maternity provided for in the statutes applied by the competent institution.
If the certificate is requested by an insured person under the French plan who, in accordance with the provisions of paragraph 2 of Article 27 of the Agreement, is entitled to benefits in kind, the certificate shall be issued after the consulting physician has agreed to the travel.
(3) In Québec, the certificate is submitted to the Régie de l’assurance maladie du Québec so that the agency may register the insured person or dependent.
In France, the certificate is submitted to the territorially competent Caisse primaire d’assurance maladie with regards to the place where the care is received.
(4) If, at the time of registration or submission of the claim, a person does not have the form referred to in paragraph 1 of this Article, the person must request the form from the institution to which the person is affiliated. When the person has serious grounds for not making the request himself or herself, the request may be made through the institution of the place of stay. Entitlement to benefits shall be established with effect on the date the place of stay has been transferred.
(5) If the health of the insured person or dependent requires an extension of care beyond the period anticipated originally in the certificate issued, the institution of the place of stay, on its own motion or on the request of the insured person, shall apply for the renewal of the certificate.
The competent institution shall grant the extension provided that entitlement to the benefits is maintained with regard to its statutes throughout the additional three-month period or a longer period in the case of an exceptionally serious illness. The institution may, if need be, request a medical verification from the institution of the place of stay and shall communicate the results to the institution.
In the case of a refusal of the extension, the reasons for the refusal and the remedies available shall be given to the person concerned and to the institution of the place of stay.
ARTICLE 15
PROCEDURES PRIOR TO ENTITLEMENT TO BENEFITS OF SECONDED WORKERS AND DEPENDENTS
(1) For the purposes of paragraphs 1 and 2 of Article 28 of the Agreement, a worker who chose to refer to the institution of the Party in whose territory the person is staying shall submit the “certificate of coverage” to the institution.
(2) In France, the certificate shall be filed with the Caisse primaire de l’assurance maladie of the place of stay. The Caisse that is the custodian of the certificate shall inform the Québec liaison agency by returning to the agency the card attached to the certificate of coverage that includes the name of the Caisse and the name of the worker.
(3) In Québec, the certificate shall be submitted to the Régie de l’assurance maladie du Québec that registers the insured person. At the time of registration, the person may become a member of the general prescription drug insurance plan without paying a premium if the person submits proof that the person has no access to a group insurance plan in Québec providing reimbursement of costs related to prescription drugs.
(4) The provisions of paragraphs 2 and 3 shall not apply by analogy to the worker’s dependents.
ARTICLE 16
SPECIAL PROVISIONS CONCERNING INSURED PERSONS UNDER THE FRENCH PLAN FOR BENEFITS IN KIND AND MEDICAL MONITORING IN CASE OF INTERRUPTION OF WORK
(1) To receive health and maternity insurance benefits in kind provided by French statutes, the insured person referred to in Articles 25 and 28 of the Agreement shall submit to the competent French institution, within a three-day period after the commencement of the work disability, except in the case of a force majeure, a notice of interruption of work or a work disability certificate issued by the attending physician.
(2) The provisions of paragraph 1 of this Article shall apply in case the interruption of work of the person referred to in Articles 25, 26 or 28 of the Agreement is extended. The competent institution shall examine the rights of the person concerned and inform the person directly of the decision, indicating the remedies and their time limits.
(3) The competent institution notified of an interruption of work may, at any time, and particularly in the case of an extension of a prior interruption of work, request from the Régie de l’assurance maladie du Québec a medical verification the results of which shall be communicated to the institution as soon as possible.
ARTICLE 17
FORMALITIES TO BE FOLLOWED BY DEPENDENTS RESIDING IN THE TERRITORY OF THE OTHER PARTY
The persons referred to in Article 29 of the Agreement shall receive the benefits provided by the institution of the place of residence under the following conditions.
In the case of a dependent who returns to reside in Québec, the provisions of paragraphs 1 and 2 of Article 12 of this Arrangement shall apply by analogy.
A dependent residing or returning to reside in France must register at the Caisse primaire de l’assurance maladie of the place of residence by submitting a form issued by the Régie de l’assurance maladie du Québec attesting to status as an insured person entitled to benefits. The form shall be issued on the request of the insured person or the Caisse primaire d’assurance maladie and shall be valid for a period of not more than twelve months, having a commencement date that may not precede the date of commencement of coverage of the insured person under the statutes of Québec.
ARTICLE 18
FORMALITIES TO BE FOLLOWED BY THE HOLDERS OF A PENSION OR ANNUITY
For the purposes of Article 30 of the Agreement, the provisions of paragraphs 1 to 3 of Article 12 of this Arrangement shall apply by analogy.
CHAPTER 4
NOT APPLICABLE
CHAPTER 5
BENEFITS IN CASE OF INDUSTRIAL ACCIDENT OR OCCUPATIONAL DISEASE
ARTICLE 19
DETERMINATION OF INSTITUTIONS
For the purposes of Articles 34 to 43 of the Agreement,
(a) affiliated institutions, as regards the statutes of Québec or France, are respectively the Commission de la santé et de la sécurité du travail, hereafter referred to as “CSST” and the Caisse de sécurité sociale to which the worker is affiliated;
(b) the institution of the place of stay or residence is, in Québec, the Commission de la santé et de la sécurité du travail, and in France, the Caisse of the place of stay or residence of the worker.
ARTICLE 20
CLAIM FOR BENEFITS UNDER THE STATUTES OF THE OTHER PARTY
(1) For the purposes of Article 34 of the Agreement,
(a) if the disease or accident occurs in France,
the institution of the place of stay shall send a case management claim, along with a medical certificate and a declaration describing the place and circumstances of the occurrence of the occupational injury, signed by the worker or the worker’s representative, to the affiliated institution;
(b) if the disease or accident occurs in Québec,
the CSST shall, when it receives a claim for a worker under French statutes, send the claim to the affiliated institution pursuant to the terms and conditions provided in subparagraph a of this paragraph.
(2) The affiliated institution that receives a claim for benefits shall immediately communicate its decision to the institution of the place of stay, on the basis of the information furnished by that institution, using the form provided to that effect. In the case of a negative decision, benefits shall be provided, in accordance with the general provisions applicable to the persons referred to in Article 28 of the Agreement.
(3) For entitlement to benefits in kind, a seconded worker or a self-employed worker insured voluntarily shall apply directly to the affiliated institution in accordance with the provisions of the statutes applied by that institution.
(4) Where a worker requests that the entitlement to benefits be extended beyond the period indicated in the form, the worker shall send the request with supporting medical documents to the affiliated institution either directly or through the institution of the place of stay.
(5) If the medical documents furnished do not permit the affiliated institution to make a decision, the institution shall request from the institution of the place of stay to have the person concerned examined, specifying the nature of the additional information required.
(6) The affiliated institution shall communicate its decision to a worker using a form indicating the entitlement extension period and the nature of the benefits granted or, if applicable, the reason for the refusal and the remedies available and their time limits.
ARTICLE 21
MAINTENANCE OF BENEFITS IN THE TERRITORY OF STAY OR OF NEW RESIDENCE
(1) A worker referred to in Article 35 of the Agreement is required to submit a form to the institution of the place of stay or of the new residence attesting that the affiliated institution authorizes the first institution to maintain entitlement to benefits in kind after the worker’s transfer of residence.
(2) When, for a serious reason, the form referred to in paragraph 1 could not be established prior to a worker’s transfer of residence, the affiliated institution may, on request from the worker or the institution of the place of stay or of the new residence, issue the form after the transfer of residence.
(3) When a worker requests an extension of benefit entitlement beyond the period provided for, the provisions of paragraphs 4, 5 and 6 of Article 20 shall apply.
ARTICLE 22
RELAPSE AFTER TRANSFER OF RESIDENCE
(1) To receive benefits in the case of relapse or aggravation, a worker referred to in Article 36 or 37 of the Agreement shall send a claim along with the required medical documents to the institution of the new place of residence, specifying that he or she has received benefits from the institution of the other Party following an industrial accident or an occupational disease.
(2) The institution of the place of stay shall send the claim along with the medical documents to the institution that recognized the industrial accident for a decision. The latter institution shall then proceed in accordance with the provisions of paragraphs 5 and 6 of Article 20 of this Arrangement.
(3) A claim sent directly to the institution that has recognized the industrial accident shall be admissible.
ARTICLE 23
GRANTING OF LARGE BENEFITS IN KING
(1) For the purposes of Article 40 of the Agreement, where the institution of the place of stay or residence grants prostheses, large devices or other large benefits in kind, the institution shall request that the affiliated institution send its decision concerning such granting on the form that will be sent to the worker. If the benefits have already been granted due to an emergency, the institution of the place of stay or residence shall so notify the affiliated institution and the acknowledgement of receipt of the notice shall serve as retroactive authorization.
(2) Benefits shall be provided under the conditions and according to the forms prescribed by the statutes of the institution of the place of stay, unless otherwise specified by the affiliated institution.
ARTICLE 24
ASSESSMENT OF THE DEGREE OF DISABILITY
For the purposes of Article 41 of the Agreement, a worker and the institution to which the worker was previously affiliated shall furnish to the institution processing the claim, on the request of that institution and to the extent where it is necessary for the processing of the claim, the information relating to industrial accidents or occupational diseases that occurred or were ascertained under the previously affiliated statutes.
ARTICLE 25
DOUBLE EXPOSURE TO THE SAME RISK
(1) Where the competent institution of the Party in whose territory a victim last carried on work likely to cause the occupational disease ascertains that the victim or the victim’s dependents do not satisfy the conditions of its statutes, having regard to the provisions of paragraphs 2 and 3 of Article 42 of the Agreement, the said institution shall
(a) immediately send to the institution of the other Party the decision and accompanying documents and a copy of the notice referred to below;
(b) notify at the same time the worker of its refusal, indicating the conditions that are not satisfied, the remedies available under the law and their time limits and that the declaration has been transmitted to the institution of the other Party.
(2) Where a remedy is exercised against the refusal of the institution of the Party in whose territory a victim last carried on work likely to cause the occupational disease, the institution is required to so inform the institution of the other Party and to make any final decision known to that institution.
ARTICLE 26
NOTICE IN CASE OF SHARED COST
For the purposes of paragraph 5 of Article 42 of the Agreement, the institution providing benefits shall send to the liaison agency of the other Party a first notice in which the institution shall indicate the amount of the benefits provided to a worker or the worker’s dependents, the period of work likely to cause the occupational disease performed in the territory of each Party and the amount of the share to be paid by each of the competent institutions.
ARTICLE 27
AGGRAVATION OF A COMPENSATED OCCUPATIONAL DISEASE
(1) For the purposes of Article 43 of the Agreement, a worker is required to furnish to the competent institution of the new place of residence the necessary information relating to previous benefits received for the occupational disease concerned. The said institution may contact the institution that provided the benefits to the worker to obtain any details.
(2) In the case referred to in subparagraph a of Article 43 of the Agreement, a copy of the decision of refusal notified to the worker by the institution of the worker’s new place of residence shall be forwarded to the competent institution of the other Party. Those institutions shall exchange any information useful to determine the worker’s health condition.
(3) In the case referred to in subparagraph b of Article 43 of the Agreement, the institution paying the amount of the supplement shall so inform the institution of the other Party.
CHAPTER 6
NOT APPLICABLE
CHAPTER 7
FAMILY BENEFITS
ARTICLE 28
FAMILY BENEFITS
The term “family benefits” means
(a) with respect to the Québec statutes, all benefits defined in the Act respecting family benefits;
(b) with respect to the French statutes, family allowances and allowance for infants in the portion paid up to three months of age.
ARTICLE 29
CLAIM FOR FAMILY BENEFITS
For the purposes of Article 47 of the Agreement, family benefits shall be payable in respect of dependent children as of the first day of the month following their arrival in the new territory of stay or residence provided that
(a) for Québec, the claim is made to the Régie des rentes du Québec, in accordance with the provisions of the statutes in force in that territory;
(b) for France, the beneficiary and the children justify the legality of their stay and that the claim for benefits be made to the Caisse d’allocations familiales of their place of stay or residence.
ARTICLE 30
NOTICE TO COMPETENT INSTITUTIONS
To obtain Québec family benefits, the persons referred to in Article 48 of the Agreement, going to France from Québec, shall furnish the certificate referred to in Article 3 of this Arrangement to the Régie des rentes du Québec. Persons going to Québec from France must so inform their Caisse d’allocations familiales.
TITLE IV
FINANCIAL AND MISCELLANEOUS
ARTICLE 31
LIAISON AGENCIES
In accordance with the provisions of paragraph 2 of Article 49 of the Agreement, each Party has designated the following liaison agencies:
(a) in Québec,
the Bureau des ententes de sécurité sociale of the Régie des rentes du Québec or any other agency that the competent Québec authority may designate later;
(b) in France,
the Centre des liaisons européennes et internationales de sécurité sociale.
ARTICLE 32
DATE OF RECEIPT OF CLAIM
The date of receipt of a claim for a pension, benefit or allowance by the competent institution or liaison agency of one Party is deemed to be the date of receipt by the competent institution of the other Party even if no pension, benefit or allowance is payable under the statutes of the first Party.
ARTICLE 33
MEDICAL EXAMINATION REPORTS AND VERIFICATIONS
(1) The competent institution of one Party that pays a pension or benefit to a person residing in the territory of the other Party may have that person examined by a physician of its choice in accordance with the conditions set out in its own statutes.
(2) If, following a request for verification by the institution paying the disability pension, it is observed that the beneficiary has resumed work in the territory of the other Party, a report shall be sent to the said institution by the institution of the place of residence of the beneficiary.
ARTICLE 34
REIMBURSEMENT BETWEEN INSTITUTIONS
(1) Benefits in kind provided for the purposes of Articles 25, 26 and 28 of the Agreement shall be reimbursed on the basis of the costs incurred by the institution of the place of stay as described in the individual statements of expenses that it submits and may include, for Québec, a percentage increase of the amount for consultations and medical examinations outside hospitalization billed on a fee basis to take into account the consultation and examinations that are not so billed. The rate is fixed at 15% and may increase by agreement between the competent authorities or agencies designated to that end, on the basis of the changes in the funding of medical acts in Québec. The amount of hospitalization expenses shall be established on the basis of daily prices.
(2) Benefits in kind provided pursuant to Article 39 of the Agreement shall be reimbursed on the basis of the expenses incurred by the institution at the place of stay as described in the individual statements of expenses that it submits.
(3) The statements of expenses established by the French institutions shall be consolidated by the French liaison agency and sent every six months with a summary report, including a duplicate, to the Régie de l’assurance maladie du Québec for expenses relating to health and to the Commission de la santé et de la sécurité du travail for expenses related to industrial accidents. Both agencies shall send quarterly statements of expenses, along with a summary report, established in Québec to the French liaison agency.
(4) For the purposes of paragraph 4 of Article 21 and paragraph 5 of Article 42 of the Agreement, at the end of every calendar year, the institution that provided the pensions and benefits shall send to the liaison agency of the first Party a statement of pensions and benefits provided indicating the amount paid and the portion payable by the institution of the other Party. The liaison agency of the first Party shall submit the billing to the other Party.
(5) For the purposes of Article 53 of the Agreement, at the end of every calendar year, the competent institution of each Party that performed the medical verifications or made the examination reports shall send individual statements of the costs incurred to the liaison agency. The liaison agency of that Party shall submit the statements to the liaison agency of the other Party for reimbursement.
(6) Each debtor institution shall pay the amounts owed to the other institution within six months following the date of receipt of the reimbursement claims sent in accordance with the provisions of paragraphs 3, 4 and 5 of this Article.
ARTICLE 35
CONTESTATION OF REIMBURSEMENT
(1) Where following the verification of the statements of expenses to be reimbursed referred to in Article 34 of this Arrangement, a Party contests certain amounts, the Party shall immediately reimburse the amounts with which the Party agrees, accompanied by a notice stating the reasons of the contestation of the other amounts.
(2) The Party receiving a contestation shall examine it and communicate its findings as soon as possible to the other Party. If the contestation is not justified, the claim shall be reinstated with supporting documents. The matter is settled when the next statement is submitted.
ARTICLE 36
CONTINUATION OF UNDUE PAYMENT
In the case of undue payment of a shared-cost pension or benefit, the institution that provided the payment shall be responsible for continuing the undue payment, the amount of which shall be apportioned between the institutions of both Parties in the proportion established for the payment of the pension or benefit concerned. If the amount cannot be recovered, the loss shall be charged to both institutions according to the same rule.
ARTICLE 37
FORMS
Forms and other documents required to implement the procedure provided for in the Administrative Arrangement shall be established by mutual agreement by the competent institutions and agencies responsible for the application of the Agreement for each Party. The forms and documents shall appear as schedules to a supplementary administrative arrangement.
ARTICLE 38
STATISTICAL DATA
The liaison agencies of both Parties shall exchange statistical data concerning the payment of pensions made during every calendar year to beneficiaries residing in the territory of the other Party. The data shall indicate the number of beneficiaries and the amount of the pensions for each category.
TITLE V
FINAL
ARTICLE 39
This Arrangement revokes and replaces the General Administrative Arrangement relating to the conditions of application of the Agreement on social security between the Gouvernement du Québec and the Government of the French Republic signed on 12 February 1979, the Arrangement signed on 15 May 1987 making the first amendment and the Arrangements signed on 21 December 1998 making the second and third amendments respectively to that General Administrative Arrangement.
This Administrative Arrangement comes into force on the same date as the Agreement signed on 17 December 2003.
Done in duplicate at Québec City, on 17 December 2003, and in Paris, on 30 December 2003.
For the competent authority For the competent authority of
of Québec the French Republic

________________________________________ ________________________________________
JEAN D. MÉNARD, FLORENCE LIANOS,
Head of the Service des Head of the Division
ententes internationales des Affaires communautaires
Ministère des Relations et internationales
internationales Ministère des Affaires
sociales du Travail et
de la Solidarité
________________________________________
LOUIS RANVIER,
Chargé des questions
internationales de
sécurité sociale
Ministère de l’Agriculture,
de l’Alimentation,
de la Pêche et
des Affaires rurales
O.C. 740-2006, Sch. 2.