INSS rehabilitation has been disrupted and generates loss to the worker, says survey

Unpublished research published this Wednesday (2) points out that changes to the INSS from 2018 onwards led to a loss of protection for Brazilians who seek to return to the job market after illness, injury or accident.

The study “Recent transformations in the INSS Professional Rehabilitation Program”, published in the scientific journal “Trabalho, Educação & Saúde”, analyzed the technical manuals of procedures of the Professional Rehabilitation Program of the agency, published in 2011, 2016 and 2018.

The authors show that the program, aimed at the professional reinsertion of workers who receive benefits such as sick pay, underwent a process of disruption from 2018 onwards and started to take into account only the physical health of the insured, leaving aside aspects such as social and economic integration.

The research was conducted by INSS analyst and master in sociology Kelen Clemente Silva and by Fernando Kulaitis, professor of sociology at UEL (Universidade Estadual de Londrina).

The main change, according to the authors, took place in 2018, from the concentration of the power of patient assessment and decision in the hands of medical experts, determined by the body that year.

Previously, decisions such as the insured’s aptitude to participate in the program or which new jobs he could perform were made jointly, with the presence of the worker, the doctor and a reference professional, such as a psychologist, physical therapist, social worker or psychiatrist. Social, economic and cultural criteria were weighed, in addition to their potential and aptitudes, according to the study.

“This was the biggest problem that we found: decisions are now concentrated on the medical expert, deconfiguring all protection for the worker’s health. The insured person is left unprotected because he no longer has an assessment of education, profile, where he lives, his family issue. . The expert assesses only the physical restriction”, says Silva. “The other issues that interfere with returning to work are not considered.”

In the long term, the researcher assesses that the change results in difficulties for the worker to re-enter the labor market, making him subject to more precarious jobs and more susceptible to depending on social assistance again.

Adriane Bramante, from the IBPD (Brazilian Institute of Social Security Law), says that sickness benefit is today the most judicialized INSS benefit, for reasons that include the quality of expertise, lack of information on the usual activity of workers and outdated medical exams. .

“The INSS rehabilitation process has always been very precarious and brings little effective result to those who undergo it. I understand that this disruption since 2018 has contributed to aggravating this service available to workers. I do not believe it is the only cause, but it may have contributed to the worsening”, says Bramante.

Social security lawyer Wagner Souza, from Ieprev (Institute of Social Security Studies), assesses that the problems of the relocation program predate the 2018 changes, but were intensified by the pandemic and temporary suspension of face-to-face activities of the body.

“Before the changes, the program already had many execution flaws and it was common for the INSS not to implement it effectively, even in the face of workers who could no longer perform the function they used to. of the company itself, although it is an obligation of the INSS.”

The lawyer points out the undue cut of benefits of insured persons who are not ready to return to work as the main cause of actions against the body, often recognized in the courts. He agrees that the limitation of analysis by physical health contributes to the scenario. “In fact, it focuses a lot on the medical aspects, so we defend a multidimensional evaluation, which evaluates the real chances of that worker reentering the market, considering factors such as the stigma of certain diseases in small towns, advanced age and low qualification, factors that can be impediments to getting another vacancy.”

For Luiz Carlos Argolo, president of ANMP (National Association of Expert Doctors), changes in the job market and the development of an informal market with professionals with low education have resulted in greater difficulty in developing professional replacement programs for the INSS. “Such factors have implied the loss of social protection”, says Argolo.

The doctor also defends that assessments such as the recognition of incapacity for work are a prerogative of the category, according to the legislation.