The Senate approved this Wednesday (3) a provisional measure that opens the way for the exemption of medical expertise from the INSS (National Social Security Institute) for the granting of benefits for temporary incapacity, replacing the procedure with the presentation of medical reports or certificates.
On the other hand, the text also expands the list of “fine combs”, including accident assistance among the benefits that will undergo temporary reassessments to maintain the benefit. It also amends the legislation regarding the review of benefits to provide for the analysis of processes that show signs of irregularity.
The proposal was symbolically approved by the senators. As had already been processed by the Chamber of Deputies, it goes to the sanction of President Jair Bolsonaro (PL).
The text of the provisional measure states that the objectives of the changes are to reduce the INSS queue and rationalize the flow of administrative resources, giving more agility to the service of applicants and beneficiaries.
The MP provides that the Minister of Labor and Welfare will be able to publish an act to establish “the conditions for waiving the issuance of a conclusive opinion of federal medical expertise regarding work incapacity”. In this case, the granting of the benefit will be made through document analysis, certificates or medical reports. The analysis will be carried out by the INSS.
The measure aims to streamline processes to reduce the queue for expertise, which has become a major obstacle for workers seeking benefits.
Sick or injured workers who need to undergo INSS expertise to obtain the benefit may need to wait until 2023 to be assisted. This is the deadline that many policyholders find when making an appointment at Meu INSS or by calling 135.
Such as Sheet released, in May, the queue of medical expertise of the INSS exceeded more than 1 million appointments, according to information from the Ministry of Labor and Welfare. In all, 1,008,112 policyholders are waiting to be seen by a doctor.​
The text of the provisional measure also changes the current legislation referring to social security to add accident assistance to the list of INSS benefits that will be subject to periodic evaluations and revisions.
Accident assistance is intended for workers who suffer accidents and have permanent sequelae that affect their work capacity, which can also occur due to occupational diseases. The benefit works as a kind of indemnity, as it does not prevent the person from continuing to work.
The MP provides that insured persons who receive aid for temporary incapacity, accident aid or disability retirement and invalid pensioners, whose benefits were granted judicially or administratively, are subject to evaluation. If they miss these assessments, they may miss out on benefits.
Assessments may include medical examinations carried out by the INSS, a professional rehabilitation process prescribed and paid for by Social Security, and treatments offered free of charge, with the exception of surgeries and blood transfusions, which are optional.
The MP also applies to these cases the rules that exams can be done remotely or also by analysis of medical reports and certificates. An act by the Minister of Labor and Welfare will define the chances of replacing face-to-face expertise with remote exams, as well as the conditions and limitations for their performance.
The rapporteur of the proposal, Carlos Viana (PL-MG), defended the review of the expertise, arguing that cases of fraud can impact the INSS.
“If we are here facilitating access to resources, giving the INSS the condition to solve the problem without judicialization, if we are facilitating access to experts, why not ask for a review of all beneficiaries in certain periods, including accidents work?” he asked.
“It’s a matter of us increasing surveillance even more and naturally whoever is in full exercise, in the enjoyment of this benefit will be served quickly, will have their benefit maintained”, he added.
The government leader, Senator Carlos Portinho (PL-RJ), said that the review of benefits could lead to savings of R$ 4 billion per year.
The provisional measure also amends the benefits law to provide for the analysis of processes that show signs of irregularity or potential risk of undue expenditure in the granting, appeal or review of administered benefits.
The review program must contain the follow-up by an expert doctor of lawsuits for disability benefits and the on-site medical examination carried out in the Social Security service units whose maximum period for scheduling medical expertise is greater than 45 days.
The appeals of proceedings related to the financial compensation of the Social Security and the supervision and inspection of the own social security systems will be judged by the Social Security Appeals Council after the implementation of the units responsible for their judgment and after the definition, in the internal regulations of the Council, of the procedures to be observed in its process.
The MP also authorizes the INSS to enter into partnerships with other institutions to carry out social assessments for the granting of the BPC (Continued Provision Benefit). This benefit is granted to the elderly and people with disabilities are entitled to the benefit if the income per person in the family (per capita) is up to a quarter of the minimum wage.
The MP also adds provisions to the law dealing with the organization of Social Assistance with regard to inclusion assistance. It will not be possible to accumulate the benefit with the BPC.
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