Contradiciting expert opinions judging unemployment insurance elegibility at administrative and judical levels

Abstract

Numerous controversies arise when the conclusion about the possibility of an employee returning to work differs between the occupational physician and the social security medical expert at the administrative level. In such cases, the employee resorts to the courts to try to solve the problem. Thus, this study was conducted in the form of a retrospective analysis of 25 legal investigations inspection filed against the National Social Security Institute (INSS) regarding refusals of applications for benefits at the administrative level, aiming to verify the conclusion of the legal medical expert. The expert evaluations were concluded in April 2010 in Santa Isabel Forum - São Paulo. The age of the claimants varied between 31 and 65 years with a male predominance. The claimants requested retirement due to disability, sickness or social benefit. Twenty authors had received some type of benefit previously. The judicial expert report concluded that 4 claimants were unable to work at any job; 16 had partial disability and 4 were considered capable of any work activity.