Occupational Accident Declaration Form (HS50)

https://cern.ch/service-procedures/AdminMan/Forms/HS50E.doc

• It must be completed within 10 working days of the date on which the accident occurred (§ 29.2.1), unless the person concerned is materially unable to meet this deadline.

• The completed formula must be accompanied by a medical certificate giving details of any bodily injuries resulting from the accident (Annex 1, § 5). The medical certificate must be obtained from the doctor who has been consulted for that purpose.

Medical treatment will cease to be reimbursed under the occupational scheme in the event of cure (defined in § 15 as the certified end to the impairment of the patient’s state of health caused by the illness or accident), or consolidation (defined in § 14 as certification that no further improvement in the patient’s state of health can be expected from appropriate medical treatment). The right to such reimbursement shall resume only in the event of a relapse. (§ 43)

by HR Department