Le casse-tête de la gestion des AT/MP

 » L’administration hospitalière n’est globalement pas à son aise avec la procédure propre à la déclaration, à la reconnaissance et à la prise en charge des AT-MP « , a reconnu la commission chargée de remettre, tous les trois ans, au Gouvernement et au Parlement un rapport évaluant le coût réel pour la branche maladie de la sous-déclaration des accidents du travail et des maladies professionnelles, ainsi qu’en atteste le rapport remis en juillet 2008.

Et pour cause, les règles régissant la gestion des inaptitudes dues aux accidents du travail et aux maladies professionnelles dans la fonction publique sont difficiles à mettre en œuvre, tant par leur complexité que par les conséquences qu’elles emportent sur la situation individuelle des agents victimes ou qui se disent victimes d’une inaptitude. ((Parmi ces règles, on peut citer : les articles 71 à 75 de la loi n° 86-33 du 9 janvier 1986, le décret n° 86-442 du 14 mars 1986 relatif à la désignation des médecins agréés, à l’organisation des comités médicaux et des commissions de réforme, aux conditions d’aptitude physique pour l’admission aux emplois publics et au régime de congés de maladie  des fonctionnaires, le décret n° 88-386 du 19 avril 1988 relatif aux conditions d’aptitude physique et aux congés de maladie des agents de la fonction publique hospitalière, le décret n° 89-376 du 8 juin 1989 pris pour l’application de la loi n° 86-33 du 9 janvier 1986 portant dispositions statutaires relatives à la fonction publique hospitalière et relatif au reclassement des fonctionnaires pour raison de santé, l’arrêté du 4 août 2004 relatif  aux commissions de réforme des agents de la fonction publique territoriale et de la fonction publique hospitalière.))

Dérogation à l’obligation générale d’assiduité des fonctionnaires, l’absentéisme qui découle de cette situation paralyse les services, démotive les équipes, et représente un coût pour la collectivité, sans qu’il soit besoin d’évoquer les atteintes au principe de continuité du service public en général et à la permanence des soins en particulier. Ce sont en définitive l’employeur, le personnel présent et les usagers qui paient le prix de ce phénomène cyclique, qu’il soit justifié ou non.

Accidents de service : une définition et une typologie nécessaires

Pour appliquer les textes, encore faut-il s’entendre sur ce que recouvre la notion d’accident de service. Et c’est notamment là que le bât blesse. Aucune définition n’est donnée par les textes réglementaires. C’est à la jurisprudence qu’il est revenu de pallier cette carence. Il est possible de retenir la définition suivante : est considéré comme un accident du travail, quelle qu’en soit la cause l’accident survenu par le fait ou à l’occasion du travail à toute personne salariée ou travaillant à quelque titre ou en quelque lieu que ce soit, pour un ou plusieurs employeurs.

Il faut se reporter à une circulaire n° 1711-34/CMS-2B n° 9 du 30 janvier 1989 pour apprendre que, sans être défini, l’accident doit résulter de « l’action violente et soudaine d’une cause extérieure provoquant, au cours du travail ou du trajet, une lésion du corps humain. »

Cela dit, les juges administratifs ont élaboré une jurisprudence à partir de laquelle on peut – au prix d’un long travail de recoupements et de comparaisons – établir une typologie quasi-précise des évènements méritant ou non la qualification d’accident de service (et d’accident de trajet). ((Un aperçu de ce travail peut être consulté à l’article suivant : J-L. Pecchioli, L’accident survenu en service, Le processus d’imputation de l’accident au service, AJDA 2002, p. 393.))

Dysfonctionnements des commissions de réforme

La définition de l’accident de service n’est pas le seul élément posant difficulté. En effet, dans son rapport du 27 septembre 2005, la Cour des comptes a eu l’occasion de déplorer l’inutile encombrement des commissions de réforme chargées, faut-il le rappeler, de déterminer l’imputabilité au service d’une maladie ou d’un accident.

La lenteur avec laquelle ces commissions se réunissent conduisent à des situations humaines dramatiques, certains agents se trouvant privés de ressources, faute d’une réunion desdites commissions dans les délais impartis.

L’intervention de ces commissions n’est pourtant pas nécessaire dès lors que 90% des accidents de service ou des maladies professionnelles ne font l’objet d’aucune contestation de la part des employeurs publics ((Pour une illustration jurisprudentielle récente et caricaturale, cf. D. Jean-Pierre, Les méformes des commissions de réforme sous le contrôle du Conseil d’État, La Semaine Juridique Administrations et Collectivités territoriales n° 45, 3 nov. 2008, 2247.))

C’est ainsi que le Médiateur de la République se trouve régulièrement saisi de la question par les agents lésés dans leurs droits, ce qui le conduit à formuler des propositions d’amélioration dans le sens d’une plus grande lisibilité.

Quelle méthodologie pour le reclassement des agents inaptes ?

Les gestionnaires des ressources humaines hospitalières éprouvent de grandes difficultés à assurer l' »employabilité » des agents dont la santé, physique ou mentale, a été détériorée par les conditions de travail, lesquelles renvoient leur situation aux exigences réglementaires d’hygiène et de sécurité.

Le reclassement des agents doit faire l’objet d’une véritable réflexion en interne, chaque solution devant être adaptée à la situation rencontrée. Le principe général est que l’employeur public a l’obligation de rechercher un poste vacant et adapté au handicap de l’agent. ((CE, 2 octobre 2002, CCI de Meurthe-et-Moselle, AJFP 2002-6 p. 41 ; AJDA 2002, p. 1294.)) Il s’agit bien entendu d’une obligation de moyens et non d’une obligation de résultats, à l’impossible nul n’étant tenu, même l’employeur.

Le statut de l’agent importe peu au demeurant, qu’il s’agisse d’un titulaire, d’un stagiaire, ou d’un contractuel (CDD et CDI) : le principe général du droit sus-décrit s’applique indifféremment.

Les condamnations de centres hospitaliers ne sont pas rares. Il suffit de compulser les revues juridiques pour s’en convaincre. Telle direction n’aura pas recherché de reclassement préalable au placement d’une aide-soignante stagiaire en congé sans solde pour raison de santé. ((TA Dijon, 3ème chambre, 29 décembre 2005, n° 0401194.)) Telle autre n’aura pas mis l’agent considéré en mesure de demander la communication de son entier dossier individuel et pas uniquement de son dossier médical. ((CE, 9 mai 2005, M. Wardi X., n° 262288.)) Tel centre hospitalier se sera dispensé de veiller à ce que la procédure suivie devant le comité médical a it pu être contradictoire et régulière. ((CAA Nancy, 3ème chambre, 26 février 2004, Mme Fabrizi Bernier c/ CHR de Metz-Thionville, n° 00NC00956.))

Si rien n’a pu être trouvé pour offrir une seconde partie de carrière à l’agent invalide, les ressources du statut de la fonction publique hospitalière devront alors être exploitées, sans compter les astuces qu’il est possible de  découvrir à travers les nouveaux textes tels que celui relatif à la formation professionnelle tout au long de la vie (décret n° 2008-824 du 21 août 2008 dont le mécanisme a été expliqué ici-même.).

La timide mais nécessaire réforme des commissions de réforme

Nous avons vu que la réforme des commissions de réforme était nécessaire. C’est l’objet du décret n° 2008-1191 du 17 novembre 2008 qui a entendu les critiques récurrentes émises à l’encontre des dysfonctionnements répétés.

En effet, et c’est un point remarquable, la commission de réforme ne sera plus consultée lorsque l’imputabilité au service d’une maladie ou d’un accident sera reconnue par l’administration, ce qui devrait faire baisser automatiquement et mécaniquement le nombre de dossiers à traiter. L’équité et le bon sens commandaient également que l’information dont bénéficiaient le fonctionnaire d’Etat et le fonctionnaire hospitalier soit pleinement applicable au fonctionnaire territorial. C’est ainsi que le secrétariat du comité médical informera désormais également le fonctionnaire territorial :

  • de la date à laquelle son dossier sera examiné,
  • de ses droits concernant la communication de son dossier et de la possibilité de faire entendre le médecin de son choix,
  • des voies de recours possibles devant le comité médical supérieur.

La réforme s’avère toutefois timide dans la mesure où certaines questions délicates ont été passées sous silence, telles que les difficultés relatives au secret médical des médecins, à l’archivage des dossiers médicaux, et à l’absence de représentants du personnel.

Le décret susévoqué est une première étape.

Espérons qu’il puisse ouvrir la voie à une gestion plus saine et moins complexe des accidents du travail et des maladies professionnelles.

Omar YAHIA

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