Know how to book medical expertise in My INSS

Insured persons of the INSS (National Institute of Social Service) who need to undergo a medical examination to receive the benefit for temporary incapacity, former sick pay, can schedule the exam without leaving home. The queue to be attended by an expert totals more than 1 million, after a strike by the category, which was ended.

Scheduling is done by phone, at Central 135, or through the Meu INSS app or website, where it is also possible to consult the expert’s analysis to find out if the request was granted or denied. Result consultation and expertise scheduling services are among the ten most sought after services on Meu INSS.

Welfare wants to return the aid with the sending of a certificate

According to information from the Ministry of Social Security and Labor, one of the measures to reduce the impact of the experts’ reversal is the implementation of the release of the benefit for temporary incapacity with the sending of the certificate by Meu INSS, as has already been done in the pandeia.

This and two other measures were announced by the agency in a plan that provides for reducing the queue of expertise in 90 days after the implementation of actions. In the agreement after the end of the strike, the medical experts undertook to replace the days off and work to reduce the stock of expertise not carried out as a result of the strike.

The category must carry out extraordinary expertise, upon payment of a bonus of R$ 61.72, in addition to joint efforts to serve the population. Regarding the implementation of expertise with document analysis, the intention is to serve places where there are few or no experts, or where the waiting time for medical expertise is more than 30 days.

Who can apply for sick pay?

The insured person who suffers an accident or has an illness that leaves him temporarily unable to work is entitled to receive sick pay, provided he meets certain rules.

According to the INSS, any type of insured person (employee, individual contributor or optional insured) who is linked to Social Security and who has contributed for at least 12 months can apply for the benefit. Serious illnesses exempt the insured from the grace period.

Also according to the agency, the benefit is granted to a person considered incapable of work or usual activity for more than 15 consecutive days.

The insured does not specifically apply for sick pay. He must schedule a medical expertise and who defines the type of benefit is the expert. On the day of the consultation, it is necessary to prove that the disability arose during the period in which he was already insured by the INSS — there are cases in which, even without paying, the worker is still entitled to benefits, in the so-called grace period.

Otherwise, the request will be denied, explains social security lawyer and president of Ieprev (Institute of Social Security Studies), Roberto de Carvalho Santos. “Often, the insured starts contributing after he is incapacitated, which will lead to the denial. It’s like auto insurance, the insurance company doesn’t pay the indemnity if you take out the insurance only after the crash.”

How to schedule the expertise through My INSS

1. Access the My INSS app or website
2. Enter CPF and password; then click on the “Schedule expertise” button or search for the term in the “What do you need” field
3. Select the “Initial Skill” option
4. Fill in the fields requesting phone number and other data
5. Choose whether it is “Employed” or “Non-Employed”. If you choose the “Employee” option, you must fill in the CNPJ of the company you work for. Then click “Next”
6. Inform the “CEP” so that the system presents the nearest branch and click “Next”
7. You will be redirected to the Dataprev website
8. Confirm the city name and choose the date and time available for the exam

NECESSARY DOCUMENTATION FOR SERVICE

• Original documents with photo (RG, CNH or CTPS)
• Original medical documents (exams, reports, prescriptions)
• Power of attorney or term of legal representation (guardianship, trusteeship, term of custody), if any
• Photo identification document (RG, CNH or CTPS) and CPF of the attorney or representative, if any

HOW TO CHECK OUT THE RESULT

The consultation of the expert’s analysis to find out if the request was granted or denied can also be carried out by Meu INSS. See how to do it:

1. Enter the My INSS app or website
2. Click on the “Check Orders” button
3. Find your process in the list;
4. To see more details, click on “Details”
5. The expert’s answer to your medical examination will appear

What to bring on exam day

On the day and time set for the examination, the insured must go to the INSS agency with identification documents and all the original reports and exams.

The lawyer advises the insured to gather as many documents as possible to minimize the chances of rejection at the time of medical examination. One of these documents is the medical certificate itself or a specialist’s report.

“It’s not enough just to say at the time of the expertise that you have the right to help, you need to have a medical certificate or report to show that that disease brings risks and makes it impossible to perform the activity”, he says.

Santos also points out that the expert is responsible for carrying out the assessment, but, in some specific cases, he may not have the same perception as a specialist in the insured’s illness, such as, for example, a psychiatrist evaluating a health case. mental.

When the benefit is granted, the expert determines a date for it to be discontinued. According to Santos, 15 days before the benefit ends, the insured is notified. If he is still unable to return to activities, it is necessary to make a request for an extension. If he misses the deadline, he will have to apply for sick pay again.

What to do if sick pay is denied?

If the benefit is denied, the insured can file an appeal. After the expert’s rejection, he has a period of 30 days to appeal and request a new medical evaluation.

The request will be analyzed by a sector formed by medical experts. “If they do not accept, the possibilities in the administrative route are over. Then it is necessary to file a lawsuit”, says the specialist.

(With Cristiane Gercina)