Doctors warn that granting sickness benefit without expertise is “breaking” the INSS

The granting of sickness benefit without expertise to beneficiaries of the National Social Security Institute (INSS) may be deepening the hole in the accounts, according to the National Association of Federal Medical Experts (ANMP). The measure was taken through an ordinance from the Ministry of Social Security to reduce the queue that already has more than one million people waiting for assistance.

According to the ministry, authorization to grant sickness benefit can only be requested by sending documents from the insured person – such as a medical certificate – through Atestmed, a new INSS system that dispenses with the previously mandatory medical expertise. Analyzes that had already been scheduled were also dismissed.

This concession format was adopted during the Covid-19 pandemic, in 2020 and 2021, and in the last half of last year. And it was recently resumed by the INSS, in which the user “can make the request exclusively through document analysis” with no minimum waiting period for scheduling an examination, according to the president of the institute, Alessandro Stefanutto.

The measure, however, may have turned into an indiscriminate granting of benefits, according to Luiz Carlos Argolo, president of ANMP. For the entity, the government “is breaking Social Security in Brazil”.

“This same certificate can be presented countless times. In other words, everything they are doing is a complete facilitation to, as the president says, avoid the embarrassment of workers going to the medical examination”, said Argolo in an explanatory video published on a social network (see in full).

For the president of the entity, the government “generally authorized” the granting of benefits with a view to the 2024 municipal election, a “partisan, electoral thing”, in which the insured “must go there [no INSS] and insist that your benefit will be granted regardless of whether you have an expert or not.”

He highlights that the INSS can grant sickness benefit for up to 180 days, which can be extended upon presentation of any certificate from the beneficiary’s doctor – and that this directly affects the Social Security fund.

Argolo argues that the government made cooperation agreements with bodies that “have nothing to do” with the operation of the INSS, such as city halls, unions, rural entities, among others.

“If you intend to take time off from work, have a certificate in your hand from a doctor saying that you are suffering from an illness and that the period of leave is indefinite, you will immediately receive six months of INSS benefits without any questions”, highlighted Francisco Eduardo Alves, vice-president of the entity.

“They are taking medical expertise out of the picture to facilitate the concession, with a view to next year’s elections”, he added.

In the same video, Paulo Liporaci, the association’s lawyer, states that the government is granting the requests indiscriminately. “Obviously, when applications do not undergo an in-person assessment by medical experts, the entire system for assessing work incapacity is weakened,” he stated.

Carlos Lupi, Minister of Social Security, confirmed that the Atestmed platform eliminates the need to issue a conclusive medical expert opinion regarding work incapacity and simplifies the rules for granting benefits due to temporary incapacity, the former sickness benefit, through documentary analysis .

“Since July, we started a major mobilization to publicize Atestmed, which allows citizens, in a practical way, to forward the certificate for analysis. This eliminates the need for in-person expertise and ensures greater agility in completing the benefit granting process,” stated the minister.

The ministry did not comment on the ANMP video, but stated in news on the website that applications through Atestmed are analyzed within five days, and that if it is not possible to grant the benefit just through the documentary analysis sent, the user is forwarded to an appointment face-to-face expertise. The medical documentation, it says, must have been issued within 90 days of the request date.