DIVERGENT DECISIONS REACHED BY SOCIAL SECURITY MEDICAL EVALUATORS AND OCUPATIONAL EXPERT PHYSICIANS
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.
EXPERTISE CRITERIA FOR THE BENEFIT OF CONTINUED PROVISION OF THE ORGANIC LAW OF SOCIAL ASSISTANCE (LOAS)
Through a review of existing literature, the authors propose standard criteria to be followed by medical and social experts upon evaluation of disability claims, under the context of social benefits covered by the Organic Law of Social Assistance (LOAS).
ICD ON MEDICAL REPORTS AND ITS IMPORTANCE IN MEDICAL EVALUATIONS BY THE NATIONAL INSTITUTE OF SOCIAL SECURITY
The author presents original data gathered from medical evaluation reports registered at the Unified System of Benefit Information (SUIBE) in Recife, Brazil, between 2011 and 2015. The most common ICD codes and groups are identified, along with their frequency, and the importance of using standardized codes in medical evaluation by Social Security experts is reinforced.