Sickness aid: how to ask for help online
Sickness aid is a Social Security benefit granted to insured persons who are incapacitated due to illness or accident.
Updated on November 17, 2022
Much has been said about sick pay in the media in recent days due to the latest measures adopted by the government, which aims to reduce the number of people who can receive this benefit.
It may seem simple, but care must be taken when seeking information on the subject due to the various changes that it may undergo whenever there is a change in legislation. The calculation of the benefit, for example, underwent a slight change due to the Social Security Reform.
What is sickness benefit? Sickness aid is a social security right that favors the citizen who is in a state of disability after the INSS insured person proves, in medical expertise, to be temporarily unable to work due to illness or accident.
To apply for sick pay, proof of incapacity is required by medical expertiseWhat is needed to receive sick pay? The worker must have made at least 12 contributions to the INSS to get the right. In this way, you now have the so-called “Insured Quality”, which consists of the period in which you are entitled to claim the benefit, which will be maintained as long as you contribute.
The Qualification of the Insured may be suspended if the contribution is interrupted.
To facilitate this process, you can use the Insured Quality Calculator, a software developed for legal calculations used by more than 2,000 pension offices, which allows you to know how long you have maintained your insured status in view of the number of your contributions.
If you lose the status of insured, you will have to fulfill half of the grace period (6 months) to be entitled to sickness aid again.
In some cases, there may be an exemption from the grace period. That is, if you have a specific disease or one developed in the workplace, or even suffered an accident in the environment, you can receive the benefit without having made contributions to the INSS. Are they:
Active tuberculosis Leprosy Mental alienation Multiple sclerosis Severe liver disease Malignant neoplasm Blindness Irreversible and disabling paralysis Severe heart disease Parkinson's disease Ankylosing spondyloarthritis Severe nephropathy Advanced state of Paget's disease (osteitis deformans) Acquired immune deficiency syndrome (AIDS) Radiation contamination In cases of accident of work, the law guarantees that the grace period is not required.
It is worth remembering that medical expertise will assess the case. You will not necessarily be entitled to sickness benefit if you have any of the conditions listed above. When in doubt, the ideal is to consult the INSS itself, by calling 135, or a professional who works with social security law.
How to apply for sickness benefit? The first step is to access and log in to the Meu INSS website and select the option “Schedule your Expertise” in the left side menu. Then, click on “Schedule New” – for the first order or “Schedule Extension” to extend the benefit.
An INSS unit will be selected for you where it will be done.
In the option “Application Result/Disability Benefit”, you will be able to follow the progress of your consultation appointment.
It can also be booked through the number 135 (free for landlines).
Citizens have the right to request the presence of a companion during the investigation, including a health professional who assisted them. For this purpose, it is necessary to fill out a companion request form, which must be taken on the day of the examination.
The request will be analyzed by the expert and with due justification it may be denied if the presence of a third party interferes with the expert act.
If it is not possible for the citizen to attend the medical examination on the scheduled date, he will be given the right to request a rescheduling only once, up to three days after the scheduled date.
If the subject is hospitalized or bedridden, the rescheduling period will be seven days or until the scheduled date. By law, it is also allowed to request that the hospital expertise be carried out at your home.
When to apply for assistance? Individual, optional contributor insured persons, independent workers and domestic servants, may request the benefit as soon as they are incapacitated.
Despite this, for insured employees, urban and rural, one must expect 15 days of leave due to the health condition in a period of 60 days.
The employee who has an accident in the work environment will resort to the Accident sickness benefit. It also follows the same 15-day rule within a 60-day window.
Remote service In the same tab of the website, the insured person can request a remote service. The procedure is the same for both those who will file the request and those who already had the expertise scheduled.
Necessary documents Official identification document with photo, which allows the recognition of the applicant. CPF number. Work card, contribution booklet and other documents that prove payment to the INSS. Medical documents resulting from your treatment, such as certificates, exams, reports, etc., to be analyzed on the day of the INSS medical examination (not mandatory). For the employee: declaration signed by the employer, informing the date of the last day worked (if necessary, print the application). Reporting of an accident at work (CAT), if applicable. For the special insured (rural worker, farmer, fisherman): documents that prove this situation, such as lease contracts. Read also: Childcare allowance: how to apply and what is the benefit amount
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