INSS investigations in Justice are paid again after release of R$ 312.7 million

Judicial expertise of actions involving the INSS (National Social Security Institute) in Justice were again paid by the federal government after the release of R$ 312.7 million allowed by the approval of law 14,331, of 2022.

The impasse in the payment of amounts started on September 23, the deadline for the government to bear the costs of expert examinations, according to law 13,876, of 2019.

Since then, doctors and social workers who work in disability benefit processes, such as sick pay, disability retirement and BPC (Continued Benefit Benefit), were not receiving.

According to the CJF (Council of Federal Justice), R$ 82 million has already been transferred to the TRFs (Federal Regional Courts) to pay off debts with 300,000 experts — 90% of them are doctors and the rest, social workers.

The total refers to what was not paid until June of this year. The BRL 312.7 million is the total budget needed to settle these debts throughout 2022. According to the CJF, from a budgetary point of view, the payment of expertise provided in Federal Court proceedings will occur on an ongoing basis, “on the dates of ordinary financial schedules”.

In practice, the Executive will pay for the necessary expertise and, at the end of the process, if the insured is defeated and if he is a beneficiary of free Justice, the payment is on behalf of the Executive. Otherwise, the citizen will have to bear the cost. However, for the amounts to be released, it is necessary to approve another project, which is already being processed in Congress, but which still has no rapporteur and no date for voting.

It is estimated that the country currently has more than 4,000 experts who work in the Federal Judiciary without being paid for their work. The category involves doctors and also social workers. On average, doctors do 10 to 20 forensics a day. The cost is R$ 200. Social workers, on the other hand, carry out an average of two forensic examinations per day, as these professionals often have to travel and the exams take longer.

How the INSS expertise in Justice works

Judicial expertise occurs when the citizen goes to court against the INSS for having the benefit denied or cut, or because he asks for a review of income.

They are made in cases of sickness aid, disability retirement and BPC (Continued Benefit Benefit), among other benefits. There are two types of examination: the medical examination, to define the disease, and the social expertise, which takes place in actions involving the granting or review of BPC.

In this case, it is necessary to assess the social condition of the insured, in addition to the general situation in the case of people with disabilities who go to court in search of the benefit.

Benefits in Justice

The insured can go to court in search of INSS benefits if they are administratively denied or the answer takes a long time to come out.

In the INSS, the insured does not ask for the specific disability benefit. He schedules an expertise. In court, however, he can make the direct request according to his case. If the incapacity is temporary, it is the sickness benefit that must be applied for. If it is permanent, the request is for disability retirement.

See three cases in which the insured can go to the Judiciary

1 – If the benefit is denied

• If the expert denies the benefit, the worker can go directly to the Judiciary, without filing an administrative appeal with the INSS.
• It is also possible to file a lawsuit in cases where the citizen believes he is permanently disabled, but the expert grants the sickness benefit.

2 – After 45 days without a response from the INSS

• The insured administratively has up to 45 days to receive a response from the INSS
• If the institute does not manifest itself within this period, it can go to the Judiciary
• The INSS agreement with the Federal Supreme Court (STF) extended the deadlines, but experts say that the law has force majeure than the agreement and, therefore, the questioning can be made from 45 days for any type of benefit

3 – When having the benefit cut in the fine-comb skill

• When summoned for INSS expertise, the citizen must schedule an exam within 30 days
• If it goes through the expertise and the income is cut, the insured can go to court
• If you have your benefit cut because you missed deadlines to schedule the exam, you can also go to the Judiciary

Necessary documents

• Reports and medical reports without erasures, with the doctor’s name and CRM and ICD (International Code of Diseases), in addition to the indication of the time that must remain away
• Drug prescriptions, if you have
• Other documents that can attest to the incapacity