What do you need to know before applying for Sickness Benefit?

Sickness benefit, also known as temporary disability benefit, is offered by the INSS. It is available to people who, for some reason, be it illness or a broken limb, for example, are unable to work for a period of time in recovery.

But after all, what do you need to know before applying for sickness benefit? This is not always an easy process and requires a series of data and information for the process to be completed. To understand, continue reading this article.

What is sick pay?

Sickness benefit is a benefit granted by the National Social Security Institute (INSS) to workers who are temporarily unable to carry out their work activities due to illness or accident.

To be entitled to the benefit, it is necessary to meet certain requirements, such as a minimum of 12 monthly contributions, except for exceptions for serious illnesses provided for by law.

In addition, the worker must undergo a medical evaluation carried out by an INSS expert, who will certify the temporary incapacity for work.

This benefit is essential to guarantee the worker's subsistence during the period in which he is unable to carry out his professional activity.

Who can access sickness benefit?

To have access to sickness benefit, you must be insured by the INSS and regularly contribute to Social Security.

In addition, it is necessary to meet the qualifying period requirement, which is normally 12 months of contributions. However, there are exceptions for serious illnesses, such as cancer and HIV, which waive the qualifying period.

Employed workers, individual contributors, special and optional insured persons may apply for the benefit. It is important to highlight that the incapacity to work must be proven by means of a medical examination carried out by the INSS.

Sickness benefit should not be confused with other benefits such as BPC/LOAS or disability retirementeach of which has specific criteria.

The worker must be aware of the requirements to avoid problems during the application, especially in cases of a fine-tooth comb at the INSS, which is a review of benefits to avoid fraud.

In more complex cases, it may be advisable to consult a social security lawyer to ensure that all rights are respected.

What do you need to know before applying for sickness benefit?

Before applying for sickness benefit, it is essential to understand all the necessary requirements to avoid having your application rejected.

The worker must be aware that the medical examination carried out by the INSS is a crucial step, as it is based on this assessment that the granting of the benefit will be determined.

Furthermore, it is important to be up to date with all contributions, as failure to meet the required period may result in the denial of aid.

Another relevant point is that sickness benefit is only granted when the incapacity is temporary, that is, when the insured person is expected to recover and return to work.

If the disability becomes permanent, it is possible to request the conversion of the benefit into a disability pension. During the process, the worker must pay attention to communications from the INSS and provide all requested documents.

The absence of any document may delay or even prevent the granting of the benefit.

In cases of doubt, seeking guidance from a social security lawyer can be a good measure to ensure that all rights are preserved and that the process is conducted appropriately.

What documents are required to apply for sickness benefit?

To apply for sickness benefit, the insured person must present a series of documents that prove both their insured status and their inability to work.

Basic documents include ID, CPF, proof of residence, work card and contribution books, if you are an individual or optional contributor.

In addition, it is essential to present medical certificates, reports, exams and prescriptions that prove the illness and the inability to work. These medical documents must be detailed and recent, as they will be evaluated by the INSS expert during the medical examination.

In the case of employed workers, the Work Accident Communication (CAT) form is also required if the incapacity is due to a work accident.

Another important document is the Last Day of Work Declaration (DUT), which must be issued by the employer.

The lack of any of these documents may compromise the granting of the benefit, so it is essential that the insured person organizes themselves before starting the process.

In more complex situations, where the documentation is extensive or there is some type of dispute by the INSS, it may be useful to have the support of a social security lawyer to ensure that all necessary documents are presented correctly.

Do I need a lawyer to apply for sickness benefit?

Although it is not mandatory, having a social security lawyer when applying for sickness benefit can be extremely advantageous.

The benefit application process can be complex, especially in cases where there is a dispute by the INSS or in situations involving a fine-tooth comb, where the INSS reviews the benefits granted to avoid fraud.

A social security lawyer can help gather the necessary documentation, advise on the best time to file the claim, and accompany the insured person during the medical examination.

In cases where the benefit is denied, the lawyer can file administrative appeals or, if necessary, legal action to guarantee the insured's rights.

Additionally, the lawyer can assist in the transition from sickness benefit to other benefits, such as disability retirement, if the disability becomes permanent.

Therefore, although it is not mandatory, the presence of a social security lawyer can provide greater security and peace of mind to the insured, ensuring that all their rights are fully respected and that the process is conducted correctly and efficiently.

Featured Photo: sickness benefit (reproduction/disclosure)