INSS fine comb: aid can be cut from the 19th

On the eve of the deadline for scheduling the fine-tooth comb, the INSS (National Social Security Institute) is waiting for around 85 thousand policyholders to respond to the call. As of November 19, policyholders who have not scheduled the fine-tooth comb may have their sick pay suspended. The deadline would end on Thursday (11), but the INSS informed, on Wednesday (10), that it will be possible to schedule the expertise until November 19th. You can consult the list of policyholders who need to make an appointment here.

In August, the INSS began reviewing benefits for temporary incapacity maintained without expertise for a period exceeding six months and that do not have a stipulated termination date or indication of professional rehabilitation through the PRBI (Disability Benefit Review Program).

In July, around 173,000 beneficiaries were summoned by letters to the address shown in the insured’s registration. In September, the INSS summoned, through the Official Gazette of the Union, 95 thousand remaining policyholders who had not yet scheduled the expertise.

Those called must schedule a medical examination through the Meu INSS app or the gov.br/meuinss website until Friday of the next week, November 19th. It is also possible to call Central 135, which is open from Monday to Saturday, from 7:00 am to 10:00 pm.

On the date scheduled for the examination, personal documents must be presented, in addition to all medical documentation available to the insured, such as reports with ICD, certificates, prescriptions and recent exams.

who was summoned

The fine-tooth comb is intended exclusively for beneficiaries of the old sickness benefit, including accident workers, and only covers people who have not gone through a medical examination for more than six months and have no defined date for termination of the benefit.

It is worth noting that disability retirees and people who receive assistance support for the disabled do not undergo this review.

According to the INSS, this fine-tooth comb “is not only intended to terminate the benefit, but rather to observe the condition of each insured, providing technical and qualified referral: to establish a future termination date, for permanent monitoring, in accordance with the statement of the insured; transform it into disability retirement, when the total impossibility of recovery is verified; forward it to the professional rehabilitation process or even terminate the benefit in cases in which the full recovery of work capacity is verified”.

HOW TO RESPOND TO THE CALL

It is necessary to schedule a medical examination through one of the INSS service channels — My INSS (application or website gov.br/meuinss) or by calling 135.

Through My INSS, just follow the following step-by-step:

1. Log in to my INSS
2. Click “What do you need?”, type “Schedule Skills” and then “New Application”
3. Choose between “Initial Expertise”, if it is the first time, or “Extension Expertise”, if you are already on benefit.
4. Follow the directions that appear on the screen.
5. Enter the necessary data to complete your order

over the phone

• It is also possible to book by phone. 135, from second to Saturday, from 7am to 10pm
• When calling, the insured must note the date and time scheduled for the expertise

Main questions answered by the INSS

If the person has not received the letter, how can he know whether or not he has been summoned?

Information can be provided by calling 135, which is the INSS Call Center.

I’m not sure if my address/phone number is correct in the INSS register. How can I check and correct the address?

You can add or change the contact address and telephone number also via 135.

What should the person called for the review do?

She must schedule a medical examination for evaluation. Scheduling is done through Meu INSS (application or website gov.br/meuinss) or by phone 135. All instructions are sent in the letter of invitation.

What will the INSS check in this review?

It will be evaluated whether the beneficiary remains unable to work, through a new medical examination.

Will the summoned be able to choose where the medical expertise of the review will be carried out?

Policyholders may carry out their medical examination at any INSS unit, as the revision is not conditioned to the agency that maintains the payment of the benefit.

What happens if the called beneficiary does not schedule the medical examination on time?

If the insured does not schedule the inspection within the stipulated period, the benefit will be suspended and will only be reactivated after the appointment of the medical examination. If the citizen does not respond, the aid will be permanently terminated.

What must be presented on the forensic review day?

Official identification document with photo and updated medical documents must be presented, such as exams, reports and medical prescriptions, which demonstrate the permanence of the incapacity for work. The INSS emphasizes that there is no established period of days to characterize the validity of medical documents.

How does the person find out about the result of the review forensics?

The result will be available for consultation after 9 pm on the day of the investigation at Meu INSS (application or website gov.br/meuinss) and by calling 135.

The Insured carried out the forensic inspection, but the result is not available. What should he do?

If the result is not available after the deadline, there may be some pending benefit. The insured must contact the Service Center 135 and, in the event that the benefit is pending, must request, through the Center, the service “Post-expertise settlement”. This service is intended to make it possible to settle pending items by a civil servant at the institute, without the insured having to appear at the INSS agency, unless called later for possible proof.

If the benefit is cut and the person disagrees, what can they do?

If you disagree with the decision, the insured can file an appeal, within 30 days, from the knowledge of the result.

What happens if the person cannot attend the examination on the scheduled day, including for reasons of mobility difficulties?

The person called may reschedule the expertise only once, as long as the reason is justified. This must be done up to one day before the scheduled date, by using My INSS (application or website gov.br/meuinss) or by calling 135.

What happens if the person doesn’t reschedule and doesn’t show up on the forensic day?

The benefit may be suspended and later terminated.

What happens if the person shows up for the exam but the expert with whom they were scheduled has been absent or the agency is “out of system”?

If the expert assistance cannot be carried out, the agency itself will reschedule the appointment. The Insured may check the new date of the expertise through My INSS or Central 135, from 12:00 on the day following the day on which the fact became known. In cases where the INSS, for some reason, does not contact you, the insured must make an appointment. It is important to remember that the policyholder must keep their contact information up to date.

What if the insured person has the benefit ceased? There is a way to reactivate the benefit later of this?

After termination of the benefit, it will only be possible to file an appeal or apply for a new benefit, following the normal procedures of the INSS.

Did the insured have their benefit cut? what should he do?

It is important to clarify that it is up to the medical expert to assess whether the illness presented by the insured person incapacitates him for work. In other words, the maintenance of the benefit is linked to the incapacity for work and not the illness. The INSS states that in case of disagreement with the result of the expertise, the insured may file an appeal within 30 days from the knowledge of the result.

The INSS experts discharged me, but the company does not want to accept my return to work. What to do?

The insured person can appeal the decision to the Social Security Appeals Board or, after 30 days from the date of termination established by the expert, apply for a new benefit.

Can the person who had the incapacity benefit granted in court also be called for this review?

Yes. The fact that it was granted by the Justice does not prevent it from being administratively reviewed by the INSS. Any temporary incapacity benefit, even if it was granted through the courts, may have to go through review.

There is a waiting list for the completion of medical expertise. Won’t the review further increase this queue?

The average waiting time for expertise is 39 days, below the 45 days provided for the analysis of the aid, as agreed between the INSS and the Public Ministry. In any case, the review examinations will be carried out at extraordinary times – that is, without prejudice to other appointments already scheduled.

According to the INSS, the insured person who was selected for this review cannot claim any other benefit that requires medical expertise. What should the person who wants to claim disability pension or the 25% surcharge for the caregiver do in these cases?

The request for any other service is subject to prior scheduling by the PRBI (Disability Benefit Review Program).

What are the measures taken to ensure that expertise is carried out safely?

• Supply and installation of individual and collective protection equipment against the dissemination of Covid-19 for servers that work in the service of agencies;
• Controlled access to the interior of the branches, which will be restricted to servers and contractors, and users with prior appointments for face-to-face service;
• Adequacy of spaces, furniture and signage of the agencies, in order to allow adequate social distance and maximum limit of people in the same environment, according to their dimensions;
• Cleaning and disinfection, carried out periodically throughout the working hours, especially in environments of common use and in offices intended for expert medical evaluation.