What is the legal framework?
After suffering from a heart incident or heart rhythm disorder, the vast majority of people will return to work. The sick leave prescribed by the physician may vary in duration, depending on the severity of the heart incident and the resulting after-effects, as well as the general health of the person concerned and the nature of their job. In the event of a heart attack with no complications, for instance, sick leave generally lasts four weeks for sedentary jobs and eight weeks for physical jobs. If the sick leave exceeds a month, a medical examination upon work resumption is obligatory within eight days.
In any case, the professional opinion of a cardiologist is essential before resuming a professional activity.
It should be noted that the law does not require you to inform your employer of your health issues. Any sick leave they receive does not specify them. In practice, a healthy discussion with your employer may facilitate your return to work. If this is not possible, it is a good idea to inform a colleague you trust, ideally a health and safety representative, who is likely to know the action to be taken in the event of a recurrence.
For people fitted with defibrillators
Nothing prevents you from returning to work with an implantable cardioverter-defibrillator, as long as the symptoms of your heart issue which led to it be being fitted have disappeared. This decision is therefore to be made in agreement with doctors.
Required tests
To evaluate the ability of a person suffering from a heart rhythm disorder to return to work, a certain number of clinical exams and tests will be carried out.
The first consists of a clinical exam. Symptoms such as chest pain, shortness of breath and fainting must have completely disappeared. The heart must have returned to a normal rhythm.
Then there are the practical tests, particularly stress tests, and more specifically, exams to evaluate a person’s ability to withstand the physical and emotional stress linked to resuming work.
Finally, in some cases, certain prescribed medication which can affect vigilance may need to be adjusted. The physician is in charge of adjusting the treatment, if possible.
Returning to work
Returning to work after a heart rhythm disorder or heart incident may of course be a financial necessity, but it is also an important step to return to as normal a life as possible.
However, it is important not to overlook the difficulty. Depending on the symptoms, 67 to 93% of patients return to work within three months. However, according to a study published in 2019 by the European Journal of Preventive Cardiology, a quarter of them resign within one year.
This figure highlights how it is important to not overlook the need to think ahead before returning to work. This must be done in consultation with the employer as much as possible since in certain cases, it will be necessary to adapt working conditions or hours, and even equipment. Depending on the job, it may also be preferable to return gradually and to increase the workload little by little.
Meditation, breathing, concentration and mindfulness exercises are highly recommended to try to prevent any potential stress linked to the return to work. Mindfulness meditation also helps to protect the heart since it improves well-being and reduces stress and anxiety. More generally, relaxation techniques are particularly beneficial in the months following a heart problem.
Beyond the mandatory medical visit, regular check-ups with your cardiologist must be carried out to ensure that your return to work hasn’t had any harmful effects.
To go back to work in the best possible conditions, lifestyle changes are often recommended.
These include resuming physical activity, as well as changing your diet and avoiding tobacco and alcohol in some cases.
Associations dedicated to helping people suffering from heart rhythm disorders (see box) may provide support on all subjects related to returning to work. Support groups in particular can help people share their experiences.
Early retirement
Having a heart incident does not automatically make you eligible for early retirement, even in the case of a heart attack, for instance. However, sometimes the after-effects are so great, or the risk of recurrence is so high that you can ask for early retirement on two counts. Those eligible include employees in hardship positions, from 60 years old for a disability with at least 20% impairment, or two years before retirement age for impairments between 10 and 20%. In both cases, a full pension can be claimed. Lastly, it is also possible to request retirement on grounds of incapacity if you are aged 62 and over, on the advice of a physician appointed by your pension fund, or if you receive an incapacity benefit or adult disability allowance (Allocation aux adultes handicapés – AAH), or are able to justify an incapacity of at least 50%.
Dedicated associations
A certain number of specialized associations support people suffering from heart issues, as well as their loved ones. Among them is the Alliance du coeur, which brings together various associations across France. More specialized associations include the, Association des porteurs de dispositifs électriques cardiaques (APODEC), the l’Association pour les patients insuffisants cardiaques et leurs proches (ASPIC), and Coeur des Mamans Priorité Prévention, not forgetting the Association vie et coeur avec insuffisance cardiaque (AVEC), created for patients and their loved ones.
