Sick workers who need to pass the expertise of the INSS (National Social Security Institute) to obtain the disability benefit may have to wait until 2023 for care. This is the deadline that many policyholders encounter when making an appointment at Meu INSS or by calling 135.
The queue, which reached 1 million forensics dammed in May, is a reflection of a series of factors, such as the medical experts’ strike, which lasted 52 days, the closure of agencies in the Covid-19 pandemic and the lack of servers. For experts, waiting longer than 45 days violates the legislation and the agreement signed with the Federal Supreme Court (STF) in June 2021, valid until next year.
In a note, the Ministry of Labor and Welfare stated that the Federal Medical Expertise carries out several actions to reduce the wait of the insured. “The main one is the anticipation of skills whenever possible.”
The agency also said that it will soon start releasing social security and assistance benefits without the need for in-person expertise, only with the delivery of documents, as has already occurred in the Covid-19 pandemic.
“It is also planned to pay bonuses for extraordinary investigations carried out – which should increase the operational capacity of medical expertise. discussion in the National Congress”, the text reported.
On Twitter, there are reports of investigations scheduled only for January, February or March 2023. In one of the reports, the insured says that she accompanied her son to the forensic examination and, after waiting for two hours, was unable to receive care. The exam has been rescheduled for January 2023, she says.
Another worker reports that she tried to schedule the forensic examination for a sick insured person, but only managed to get care for February 2023.
In another case, after waiting six months for the expertise, when trying to reschedule, there is a vacancy only for March 2023.
Experts say they meet deadlines
The vice-president of the ANMP (National Association of Expert Doctors), Francisco Eduardo Cardoso Alves, says that the expert examination deadlines have been met in most parts of the country. He points out, however, that there are places where delays may occur.
“In some very punctual places, this phenomenon of expertise damming may be happening. This is not the reality of expertise and we are working to reduce the liability of expertise in Brazilian territory. For the most part, the queue is shorter than 45 days”, it says.
Agreement in the Supreme Court is not valid in the event of a strike, says PGR
The agreement reached between the INSS and the STF determines a period of up to 45 days for the insured to provide assistance in cases of requests for disability benefits, which includes medical expertise for the release of sick pay, accident aid and disability retirement. The rule, however, is not valid when there are strikes, informs the PGR (Attorney General’s Office).
“The agreement provides for the suspension of deadlines in the event of force majeure or unforeseeable circumstances, such as a strike. In this sense, it is noteworthy that, on January 31, 2022, the first stoppage of federal medical experts took place, lasting for two days. “, says note.
For lawyer Roberto de Carvalho Santos, president of Ieprev (Brazilian Institute of Social Security Law), there is a breach of legal rules, as the law also provides for a period of 45 days for insured persons to be covered by the INSS.
He believes that the agreement between the institute and the Supreme Court has not been successful due to the lack of provision for punishment. “The big problem with the agreement is that no penalty was established. So, it ends up not being effective”, he says.
The PGR says that the Executive Committee monitoring the agreement monitors the average time of the expert’s queue and expects the gradual reduction of the stock of exams dammed after the end of the strike.
According to the lawyer, policyholders harmed by the delay can file a writ of mandamus in the Federal Court asking the INSS to carry out the medical examination and, if it is proven that there was an excessive delay in the service, they can file a lawsuit for moral damages later. “The delay can worsen the disease and even lead to death,” he says.
See the deadlines valid until June 2023
| order type | legal term | Term that came into effect on Jun.21 |
|---|---|---|
| Assistance benefit for people with disabilities | 45 days | 90 days |
| Elderly care benefit | 45 days | 90 days |
| Pensions (less for disability) | 45 days | 90 days |
| By disability retirement | 45 days | 45 days |
| Maternity pay | 45 days | 30 days |
| pension for death | 45 days | 60 days |
| Reclusion allowance | 45 days | 60 days |
| Benefit for common illness and for work accident or illness (temporary assistance for incapacity) | 45 days | 45 days |
| accident assistance | 45 days | 60 days |
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