Citizens who are away from work due to their inability to perform their duties and return to work may apply for sick pay. But when the insured person has the benefit request denied by the INSS, he has the right to contest this decision through an administrative appeal.
And during the period when you do not receive the benefit and at the same time are unable to return to work to earn your salary, there are some actions that can be taken in this situation.
What this article covers:
What is the INSS aid resource?
The appeal for assistance at the INSS is a service in which a person can disagree with the administrative decision of the same when their request for benefit is denied. Therefore, the request for an appeal must be made within 30 days after becoming aware of the result of the investigation. This request can be made by calling 135 or through the website or application Meu INSS.
The new analysis of the request will be carried out by other employees of the institute who are responsible for the judgments, at the Board of Appeals, which is the first instance of the Social Security Board of Appeals. And it will not always be carried out in the state in which the application was made.
Who is on the appeal should go back to work?
If the benefit was denied by the INSS, the insured must return to work immediately. Therefore, the employer cannot fire the worker while he is enjoying the social security benefit. However, if you do not report to the company communicating the Social Security decision, that is, that your benefit has been denied, even if you are not in a position to assume your duties, you may be dismissed for just cause for being absent for more than 30 days under allegation of job abandonment.
For this reason, it is necessary to make the appeal request to the INSS?? However, there is no consensus on what the company should do during the period in which the employee is appealing the INSS decision. Since the company has already fulfilled its obligation to pay for the first 15 days of leave, while the rest should be the responsibility of the Social Security.
In this case, it is possible to reach an agreement with the company to maintain the worker’s leave while seeking sickness benefit, having his salary paid by the company during the process of applying to the INSS. That is, the employee can file a lawsuit against his employer so that the courts will force the company to make the payment during the time they are resolving their situation with the INSS.
How long does it take to get a response from the INSS appeal?
The Social Security Appeals Council currently has 85 days to adjudicate and return the case to the INSS. The term was shorter, but the agency increased the number due to the high volume of resources. But when this deadline is not met, the insured person has the right to file a complaint on the INSS Ombudsman website or by calling 135.
The insured may also appeal in court if the wait for the response to the appeal exceeds the legal deadline through the writ of mandamus. Which is an action where he asks the judge to make the INSS judge the administrative appeal within 10 days, since there is an illegality in not meeting the deadline.
It is essential throughout this process to have the help of a professional to defend your rights.