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DIVERGENT DECISIONS REACHED BY SOCIAL SECURITY MEDICAL EVALUATORS AND OCUPATIONAL EXPERT PHYSICIANS

How to cite: Tiossi CLD. Divergências Entre a Decisão Pericial do Instituto Nacional de Seguridade Social (Inss) e o Perito Médico Judicial. Persp Med Legal Perícia Med. 2017; 2(1).

https://dx.doi.org/10.47005/020103
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The author declare that there is no conflict of interest.

DIVERGÊNCIAS ENTRE A DECISÃO PERICIAL DO INSTITUTO NACIONAL DE SEGURIDADE SOCIAL (INSS) E O PERITO MÉDICO JUDICIAL

 

 

Camila Lucia Dedivitis Tiossi (1)

Lattes: http://lattes.cnpq.br/2007223389542788

(1) Hospital Darcy Vargas, São Paulo-SP. (Autor Principal)

E-mail: camilatiossi@uol.com.br

 

ABSTRACT

Controversies are generated when the Social Security medical examiner and an occupational physician reach divergent conclusions regarding the ability of a worker to return to his duties, often causing serious damage to the worker. In such cases the employee seeks the judiciary to resolve the dispute involving medical issues and labor and social security laws. We performed a retrospective analysis of 25 judicial evaluations in suits against the National Social Security Institute (INSS ) held in April 2010 in Santa Isabel Forum – São Paulo. The age ranged from 31 to 65 years (mean 48.6 years) with male predominance ( 14M : 11F ) . The insured required disability retirement (15 cases) , followed by medical leave (8 cases) and social benefit (2 cases) . Twenty individuals received some kind of social benefit previously. The most common occupation among these individuals was maid/cleaner (7 cases). The main disease group was found to correlate with osteoarticular diseases (20 cases), followed by cardiovascular (4 cases). The judicial expert report concluded that only 4 of these individuals were found to be unfit for any work . Sixteen found themselves able to work with restrictions -four fit for any activity. When we analyze ability to perform the main occupational activity, we found that most insured are unfit (72%). This fact creates a lot of conflict to workers leading to actions with the Judiciary system.

Keywords: medical expert evaluation, social security, disability claims, judicial system.

Bibliographical references

  1. Soares SCA, Soares IM. Limbo trabalhista-previdenciário: médico do trabalho e médico do INSS- reflexões médicas, éticas e jurídicas acerca dos aspectos polêmicos. Jus Naveganti. 2014; Maio.
  2. ABESO – Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. Diretrizes brasileiras de obesidade. Brasília: ABESO; 2010.
  3. Macedo FCC. Perícia Médica / INSS / Judicial / Benefício por Incapacidade / Auxílio Doença / Aposentadoria por Invalidez. São Paulo: 2013.
  4. Manual de Perícia Médica da Previdência Social. Versão 2. Brasília: Previdência Social, 2014.
  5. Portaria Conjunta INSS/PGF número 4 de 10 de setembro de 2014. Diário Oficial da União. 2014, 11 de setembro.
  6. Brasil – Tribunal de Justiça do Distrito Federal. Agravo de instrumento – Processo número: 20090020051282AGI a 2ª Turma Cível. Brasília: 2011.

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