INSS Sick Pay without expertise comes to an end; understand

The granting of sick pay from the INSS without the need to carry out an in-person medical examination will end this Friday (31), the last day of validity of the rule created by law 14.131/2021, the same one that also increased the margin of the payroll loan for retirees and pensioners.

Recreated in March of this year, the granting of the benefit based on the analysis of a medical report sent over the internet is part of the package of emergency measures adopted in early 2020 by the federal government due to the Covid-19 pandemic.

This time, however, the INSS stated that it does not have information about a possible re-launch of the program in 2022. The agency only guaranteed that it will keep until next Friday the releases, based on the analysis of the copy of the medical documentation sent by the insured.

This does not mean that claims submitted by policyholders within the deadline will be analyzed remotely, without face-to-face examination, according to Adriane Bramante, president of the IBDP (Brazilian Institute of Social Security Law).

“Those who are already incapable of work can apply until the 31st, sending a copy of the medical report, but if the expert responsible for the process assesses that attendance is necessary, the insured will have to take the physical examination”, he says.

Bramante assesses that the remote analysis can still be recreated due to the possibility of high in Covid-19 cases with the arrival of the omicron variant of the coronavirus in the country. For her, the government should make the program permanent, reserving the candidate’s physical examination for the benefit for necessary cases.

“The forensic examination for a medical document should not end at all. If the person has a medical report that he has broken his leg, there is no reason to go to the specialist to show the broken leg”, he says.

For social security lawyer Rômulo Saraiva, the INSS also loses out with the end of the distance service, as the shortage of medical experts could spend more resources and lead to delays in care.

“The INSS has already been computerizing its remote assistance, which would reduce the queues at the agencies. If the doctor felt the need to provide personal assistance, he could call the insured”, says Saraiva.

Policyholders must be prepared for examination at the clinic

Insured persons eligible for sick pay, officially called temporary disability benefit, must be prepared to personally deliver the medical documentation to a Social Security unit, even if the document has already been sent over the internet.

The medical report is the essential document for the assessment of disability. The report must be legible, have the ICD (International Statistical Classification of Diseases) number, doctor’s stamp, date and description of the disease and symptoms that result in incapacity for work.

The doctor can also inform the estimated time for the worker’s recovery, although the period of leave is at the discretion of the Social Security expert.

Requests filed until next Friday may eventually facilitate the approval of the benefit based only on the evaluation of the medical documentation.

The summoning of an insured for an in-person examination, to the detriment of the concession based on the objective criteria answered by the medical report delivered until December 31 of this year, can make the legal discussion easier, compared to the requests made from the next year, according to Saraiva.

Cristiane Gercina collaborated