INSS: aid without expertise advances and teleexpertise comes out in 2024 – 02/16/2024 – Market

Four out of ten requests for sickness benefit from the INSS (National Social Security Institute) made through Atestmed — a system for including medical certificates via the internet — are granted without the need for an in-person medical examination.

Of the total of 1.386 million temporary disability benefits requested remotely via the Meu INSS app or website in 2023, 627.6 thousand were granted, which represents 45%.

The others followed two paths: scheduling the in-person examination or forwarding to a system called post-inspection, where it is analyzed whether the citizen requesting the benefit is, in fact, INSS insured. The latter represents 25% of orders.

In the opinion of the institute’s president, Alessandro Stefanutto, Atestmed has proven to be effective, which means that the organization will move forward in implementing teleexpertise this year.

A pilot project is underway this month. Consolidated results should be released in March.

“I can tell you, first hand, that the results are encouraging. We didn’t have any technical problems,” he told Sheet.

Remote sick pay was implemented temporarily in March 2020, when INSS agencies were closed due to the coronavirus pandemic. In 2022, a law approved during Jair Bolsonaro’s government brought back aid without expertise.

In 2023, the measure was improved with the implementation of Atestmed. According to Stefanutto, who joined Social Security 24 years ago and was the agency’s attorney, the possibility of releasing sick pay over the internet emerged in 2012, when he won a lawsuit authorizing the measure.

At the time, it didn’t work. “It was a disaster because there wasn’t the technology that we have today,” she says. In July 2023, when he assumed the presidency of the institute, the former prosecutor requested the improvement of the tool for receiving certificates via the internet and started using Atestemed.

The latest data shows that the average waiting time for aid to be granted online was 26 days in December, and the savings with the measure, implemented in the second half of 2023, reached almost R$1 million;

In January this year, the average time for granting social security benefits in general was 46 days, above the 45 days provided for by law.

Now, the institute is using artificial intelligence and data analysis to prevent fraud, which is why some medical experts were against the implementation of Atestmed. According to Stefanutto, the 1.3 million requests for assistance created a database of more than 1 million medical certificates in the Social Security system.

With this, it is possible to cross-reference information about doctors, such as which hospital they work in and whether the registration number with the medical council actually belongs to that professional.

The implementation of teleexpertise also encounters resistance from experts, who claim that there is a federal council opinion against the measure.

Stefanutto, however, says that there is nothing that justifies forcing an insured person to walk kilometers to have an in-person examination when it is possible to carry out online consultations. “No Brazilian needs to travel, take a disabled person, a sick person 150 kilometers, 200 kilometers, to carry out an examination.”

What is Atestmed?

It is the INSS system in which the insured person who needs sickness benefit, today called temporary incapacity benefit, sends a medical certificate to obtain the benefit. Demand fulfillment is done entirely online, via the Meu INSS app or website

How to get sick pay remotely?

• Access the My INSS app or website
• You must have a password for the Gov.br Portal; Enter your CPF and then your password
• Click on “Request disability benefit”
• Expertise appointments will appear on the next page, but to make the request, you must click on “New request”
• Go to “Disability Benefit (Sickness Benefit)” and then to “Aware”
• Read the information on the screen and click “Next”
• On the next page, enter personal data, such as CPF, telephone number, address and email
• Choose “Yes” to track the case number via the app, email or Telephone Center 135
• Indicate whether you are self-employed or employed by a private company (in this case, you must inform the date of the last day of work and the company’s CNPJ)
• Below, click on the plus sign and include your documents, such as the certificate and medical reports, in addition to personal documents
• After each addition, click “Attach”, then “Next”
• Then, indicate the zip code of your residence so that you can choose the nearest INSS agency to which you will be linked.
• Check the information, click on “I declare that I have read and agree with the information above” and click “Next” again

What should the certificate be like to get sick pay online?

The medical or dental certificate must be on paper without erasures, and contain the following information:

• Full name
• Issuance date (which cannot be equal to or greater than 90 days from the date of entry of the application
• Full diagnosis or ICD code (International Classification of Diseases)
• Signature of the professional, which can be electronic and must comply with current regulations
• Identification of the doctor, with name and registration with the class council (Regional Council of Medicine or Regional Council of Dentistry), with the Ministry of Health (Ministry of Health Registry), or stamp
• Start date of rest or withdrawal from usual activities
• Time required for recovery, preferably in days (this date can be an estimate)

What is teleexpertise?

It is the medical expertise system through online consultation, using a cell phone or computer. The INSS doctor goes to the Social Security agency where he works, and treats the insured person anywhere in the country, without the need for the sick person to go to that agency.