INSS has more than 1 million insured in the medical expert queue

The medical examination line at the INSS (National Social Security Institute) has exceeded more than 1 million appointments, according to information from the Ministry of Labor and Social Security. In all, 1,008,112 policyholders are waiting to be seen by a doctor.

The number of skills includes all types of benefits that require expert evaluation to be granted. The list includes accident assistance, temporary disability assistance – formerly sickness benefit –, and permanent disability retirement – ​​formerly disability retirement –, paid to those who have some incapacity for work.

There are also other benefits, such as BPC (Continued Benefit), retirement for people with disabilities and special retirement, among others, that require the analysis of a doctor.

A few weeks ago, the number of citizens waiting for assistance was around 780 thousand, but with the beginning of the experts’ strike, which on Friday (29) reached 31 days, the situation worsened. Data from the ANMP (National Association of Expert Doctors) show that there have been at least 320,000 rescheduling of forensic examinations since the start of the strike.

The wait to get care is also long and is about 60 days, according to government information sent to the National Congress in the edition of provisional measure 1,113, which tries to implement remote medical expertise in some benefits, with the sending of a certificate via the internet. , as occurred in the Covid-19 pandemic.

Francisco Eduardo Cardoso Alves, vice president of the ANMP, says that the category has complied with the decision of the STJ (Superior Court of Justice) and maintains 70% of medical experts in attendance at the agencies, while 30% are stopped. Today, the Federal Medical Expertise has about 3,400 professionals, but with absences, approximately 3,200 are active.

“The experts feel indignant with the way the government has been treating the category. We have more than 320,000 investigations rescheduled in the period and, so far, they have not moved to negotiate”, he says.

Among the demands of doctors are salary replacement of 19.9% ​​—the government offers a 5% readjustment to all servers—, better working conditions, with all professionals attending face-to-face and with none of them “out of the care agenda” and public tender for regions of the country where more professionals are needed.

INSS queue reflects strike, dammed demand and lack of servers

The more than 1 million insured in the INSS queue for medical expertise reflects a set of factors, according to experts. Among them are the experts’ strike, the pandemic, which increased the number of disabled citizens seeking benefits in a period when branches were closed, and the lack of servers.

“Actually, it’s this set of things. We had the pandemic period, which prevented the expertise. Then, we had the return of calls, but some agencies remained closed for a long time, the lack of servers and the strikes”, he says. Adriane Bramante, president of the IBDP (Brazilian Institute of Social Security Law.

Roberto de Carvalho Santos, president of Ieprev (Institute of Social Security Studies), says that the lack of servers affects much more than strikes — administrative employees are also stopped. “What we see is the lack of competition to have more servers. No matter how much you invest in artificial intelligence, it doesn’t solve it. It needs human action in the matter of Social Security, of trained servers”, he says.

Santos and Adriane point out that the pandemic has increased the number of sick insured persons, which also makes the demand for disability benefits, which require medical expertise to be released, increase.

Insured who are not attended to in the expertise must document their presence

The insured who has a scheduled expertise cannot fail to compare with the Social Security agency on the day and at the scheduled time. If you can’t get care because of the strike, you have to prove, in some way, that you were there.

The ideal is to ask an INSS employee for a document recording the date and time he/she was at the INSS post, with the signature and stamp of the agency. If this is not possible, experts advise you to take a photo, which contains the date and time, and talk to people who were also there, who can serve as a witness, if necessary.

According to Rômulo Saraiva, a lawyer specializing in Social Security and a columnist for Sheetit is necessary to have documents that prove the trip to the agency to guarantee the payment of arrears from the date of entry of the application.

“Insureds can lose arrears. It is not uncommon in this type of stoppage for the administrative decision to justify that the benefit is denied because [o segurado] did not attend the expert examination, even though he was on strike. The person can lose all or part of the arrears,” he says.

Check out the main guidelines:

1. Go to the branch, as not all servers will join and there are chances of service, even with a longer delay than usual
2. If the branch is closed, photograph the information that will likely be on the door as proof that you attended
3. If there are servers, but they deny service, request a certificate of attendance and the rescheduling of the procedure
4. Call 135 to get a redial request protocol number

Government that deploys remote expertise and experts disagree

The federal government has been trying, since the beginning of the pandemic, to permanently implement distance medical expertise, with analysis of the certificate sent by Meu INSS. For some specialists, telemedicine is here to stay, as Adriane Bramente points out.

However, experts believe that this type of concession is more prone to fraud, because there is no way to make an exact analysis of the insured’s disability as is the case with a face-to-face exam. “It is not possible to carry out this analysis remotely. During the six months in which the INSS was closed, it was necessary, so as not to cause greater irreparable damage”, says Francisco Cardoso Alves, from the ANMP.

For him, telemedicine can be used in other situations, not for granting disability benefits. “In a normal doctor-patient relationship there is a will on both sides, you can count on the patient for a result. In the expertise, the citizen is interested in the benefit and the expert is there to assess whether he is entitled.”