Occupational disease: how is it recognised and reported? The table, the exposure and 48 hours

At Tannerie Niger-Cuir, Bakary has handled the tanning baths for eight years. For some months, his hands have been covered in sores that will not heal. The doctor at the inter-company medical centre mentions an occupational disease. The workshop foreman shrugs: “It’s not an accident, there’s nothing to report.” Wrong: an occupational disease is reported like a workplace accident, within 48 hours, and failing to do so costs the employer dearly.

1. What exactly are we talking about?

Tannerie Niger-Cuir is a fictitious company with 55 employees in Bamako: its name, Bakary’s and their situation are used purely as an example.

An occupational disease is an illness caused by habitual exposure to a work risk: a chemical, dust, a posture, an infected environment. Unlike an accident, it does not happen all at once: it develops over time.

The Social Security Code (SSC) applies the whole workplace accident scheme to occupational diseases: reporting, medical care, daily allowances, annuities (article 138). The scheme is run by the National Social Security Institute (INPS).

Why this scheme? Because an employee should not pay for the risks of a job with their health and then with their money. In return for the employer’s contributions, the INPS covers the victim’s care and income.

“An accident strikes in a day. An occupational disease sets in. Both are reported within 48 hours.”

2. How a disease is recognised: the system of tables

Recognition is based on tables of occupational diseases. Each table covers a harmful agent, an infection or a type of work; it lists the diseases presumed to be of occupational origin in workers habitually exposed, and sets the period of cover after exposure ends (Social Security Code, article 139).

Presumed means the victim does not have to prove the link between their work and their illness. Three conditions are enough:

1. the disease appears in a table;
2. the employee was habitually exposed to the agent or work covered by that table;
3. the disease is diagnosed within the period of cover set by the table.

A table of recognised occupational diseases is annexed to the Code, and it is supplemented by decree adopted in the Council of Ministers, after consulting the Higher Labour Council (article 139). For Bakary, the question is therefore simple: do his condition and his exposure to tanning products appear in a table in force?

The most common mistake

Waiting for “certain” medical proof before reporting. The report is not an admission of liability: it is the INPS that investigates and decides, on the basis of the medical certificate and, if necessary, an inquiry.

What you need to do

• Obtain the occupational disease tables in force from the INPS.
• Identify, job by job, the harmful agents and types of work covered by those tables.
• Keep a record of exposures: jobs held, products handled, durations.

3. Reporting: who, when, how

Even before any disease: declaring risky processes

Any employer using work processes liable to cause occupational diseases must, on pain of a fine, declare them before work begins, by registered letter, to the labour inspector and the INPS (Social Security Code, article 140). Tannerie Niger-Cuir should have done so when its tanning workshops opened.

When the disease is diagnosed

The employer notifies the labour inspector within 48 hours of any occupational disease found in the company (Labour Code, article L.176). The Social Security Code organises this report: within 48 hours, on the official INPS forms, in four copies, one for the INPS, two for the regional labour inspectorate and one for the employer’s records (Social Security Code, article 71).

The Code distinguishes two cases (Social Security Code, article 141):

Situation	Who reports, and when	Text
Disease detected by the company doctor or the inter-company medicalcentre at the annual check-up	The employer, within 48 hours, as for a workplace accident	SSC 141 and 71
Other cases, compensation claimed by the victim	The victim or their representatives, within 15 days after stoppingwork; the employer may report on their behalf	SSC 141

In every case, a medical certificate accompanies the report: it states the nature of the disease, the symptoms listed in the tables that were observed, and the likely consequences (article 141). The occupational doctor, for their part, must inform the employer of every case of occupational disease they know of (article 49).

What an oversight costs

Failing to notify the inspector is punishable by a fine of 20,000 to 50,000 XOF, and 50,000 to 200,000 XOF for a repeat offence (article L.326). Under the Social Security Code, an employer who fails to report within the deadline faces a fine of 20,000 XOF and must bear the temporary incapacity benefits, medical care and daily allowances; only annuities remain payable by the INPS (Social Security Code, article 239). The wording of article 239 refers to the “deadline provided for in article 70”, whereas the 48-hour deadline is in article 71.

Example. Bakary earned 150,000 XOF in the month before stopping work; he is off for 45 days and no report was made:

Daily allowance (1/30 of the previous month’s salary): 150,000 ÷ 30 =
5,000 XOF
For 45 days off: 45 × 5,000 = 225,000 XOF
Payable by the employer, on top of medical care and the fine,
instead of the INPS

What you need to do

• Report any occupational disease found to the INPS and the inspectorate within 48 hours.
• Use the official INPS forms, in four copies, and keep proof of sending.
• Help the employee report within 15 days where the disease was not detected at a check-up.

4. During and after sick leave: what the employer must do

The employee’s contract is suspended until recovery or consolidation, that is, the stabilisation of their condition (Social Security Code, article 112; Labour Code, article L.34). The day on which the stoppage begins is paid by the employer; after that, the INPS pays a daily allowance equal to one thirtieth of the salary for the calendar month before the stoppage, for a monthly-paid employee (articles 114 and 115).

On return, a medical examination is compulsory after any absence for occupational disease: it assesses whether the employee can go back to their former job or needs rehabilitation (article 45).

If the employee is left with an incapacity making them unfit for their former job, the employer must try to redeploy them to a suitable post. If the employer states it has no such post, dismissal requires the prior opinion of the labour inspector, given within fifteen days; if disputed, the labour court must be seized within fifteen days, and the employee cannot be dismissed before its decision (article 112).

The most common mistake

Putting the employee back in their former job, in contact with the same product, without medical advice. The return-to-work examination is compulsory, and the occupational doctor’s opinion must be taken into account (article 48).

What you need to do

• Arrange the return-to-work medical examination before any return to the job.
• Look for a suitable redeployment post if the former job is medically ruled out.
• Only dismiss for unfitness after the labour inspector’s opinion.

5. Prevention: monitoring exposed employees

Every employee has a medical examination at least once a year; employees exposed to dangerous work are under special monitoring, whose frequency the doctor decides (article 44). Additional tests needed to detect occupational diseases are paid for by the employer (article 46).

If the disease results from the employer’s inexcusable fault, the victim’s benefits are increased, the INPS recovers the increase through an additional contribution, and the employer may not insure against this risk (article 68). In establishments with a health and safety committee, the committee investigates any serious occupational disease: see Health and safety committee: from what headcount, and how to run it?

For an overview of the scheme, see Workplace accidents and occupational diseases and Occupational doctor in Mali: what the employer must organise, and what to do with it.

A closer look: two misconceptions imported from France

First misconception: only the employee reports their occupational disease. That is the French rule. In Mali, the employer must notify the inspector within 48 hours of any occupational disease found in the company, and it is the employer who reports a disease detected at the annual check-up.

Second misconception: a disease not listed in the tables can be recognised by a panel of experts. This “off-table” route exists in French law. The Malian Social Security Code does not provide for it: it refers to the tables, which only a decree can supplement (article 139).

Key takeaways in 6 points

1. Declare to the inspector and the INPS, before starting, any work processes exposing staff to an occupational disease.
2. Report any occupational disease found within 48 hours, on INPS forms, in four copies.
3. Check whether the disease, the exposure and the timing match a table in force.
4. Arrange the return-to-work examination and look for redeployment before any dismissal for unfitness.
5. Put exposed employees under enhanced medical monitoring, paid for by the company.
6. Remember that failing to report shifts medical care and daily allowances onto the employer.