INSS aid will undergo new inspections and Brazilians are in despair; understand!

INSS intensifies inspection of medical certificates: learn about the new rules and the impacts on Brazilians!

In recent days, shocking news has shaken the lives of many Brazilians who depend on sickness benefits from the National Social Security Institute (INSS).

A new inspection measure, based on artificial intelligence (AI), promises to change the rules for granting this benefit, with the main objective of combating fraud in medical certificates.

This change brings to light a series of concerns and uncertainties for citizens who need sickness benefit to survive, especially in times of economic instability.

Artificial intelligence at INSS: how the new measures will affect the granting of sickness benefit in Brazil. (Credit: @jeanedeoliveirafotografia / pronatec.pro.br).

The AI ​​revolution in INSS inspection

The highlight of this change is the introduction of an artificial intelligence system, developed by Dataprev, responsible for analyzing medical certificates sent by policyholders through the Atestmed platform. This technology promises to carry out a thorough analysis, checking details such as the doctor’s name, signature and registration with the Regional Council of Medicine (CRM).

Furthermore, the AI ​​will check the file’s origin address, in order to ensure that the documents comply with the standards established by the INSS. Last year, there were more than 1.6 million complaints registered through the Atestmed platform. However, surprisingly, around 46% of them were refused due to irregularities in the certificates.

The consequences of fraud

It is important to note that forgery or the use of false medical certificates can have serious legal repercussions. Those caught in this situation can face penalties ranging from significant fines to five years in prison. Furthermore, sick pay beneficiaries who are discovered purchasing fraudulent certificates may be dismissed for just cause and will still have to reimburse the amounts received.

New rules for medical certificates

With the changes implemented, medical certificates must only be sent by health professionals duly registered with the Regional Council of Medicine (CRM) and must be in perfect condition, without erasures and completely legible.

Furthermore, these documents must specify the period of leave necessary for the patient’s recovery and establish the diagnosis only when expressly authorized by the patient.

Furthermore, another important point is the identification of the doctor, which must occur through a signature and stamp or registration number in the CRM. For certificates sent through the Atestmed platform, it is essential that they are accompanied by the corresponding International Classification of Diseases (ICD) number.

After all, who is entitled to INSS sickness benefit?

To clarify, it is important to remember that insured persons who are proven to be completely incapable of working, resulting in absence from work activities, are entitled to sickness benefit. In this context, it is essential to understand that the disability must be exclusively total.

There are some illnesses that do not require compliance with the waiting period, making the insured person immediately eligible for the benefit. Namely, these diseases include:

Active tuberculosis; Leprosy; Mental alienation; Cancer; Blindness or monocular vision; Irreversible and disabling paralysis; Severe heart disease; Parkinson’s disease; Ankylosing spondyloarthrosis; Severe nephropathy; Advanced stage of Paget’s disease (osteitis deformans); Acquired immunodeficiency syndrome (AIDS); eRadiation contamination, based on the conclusion of specialized medicine, as well as severe liver disease.

In summary, the new INSS inspection measures aim to guarantee the integrity of the system and the correct granting of sickness benefit, while at the same time protecting the rights of beneficiaries.

This change brings challenges and uncertainties, but also promises greater transparency and fairness in the benefit granting process. We will closely monitor how these changes will affect the lives of Brazilians and any adaptations that will be necessary.

Post a Comment

Previous Post Next Post