Disease allowance: everything you need to know

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Disease allowance: everything you need to know

Table of Contents

Sickness allowance is a right that the insured person has to receive from Social Security due to incapacity for work due to illness or accident proven by medical expertise. If proven and the insured is unable to perform his work activities, he must request this assistance, due to illness or accident.

For you to understand everything about sickness aid, you will see:

  • Main causes of sickness aid;
  • The types of sickness aid;
  • The benefit value;
  • How to calculate the benefit;
  • Deadline for receiving the benefit.

My Disease Aid was rejected!

The main causes of rejection of sickness benefits are the lack of quality of the insured, the lack of fulfillment of the need and the absence of incapacitating illness for work.

Other causes: The insured because he is unable to carry out his activities because a certain disease already existed when the worker started to contribute to Social Security in the function he is working on. Understand:

Law 8,213 / 91

“Single paragraph. Sickness allowance will not be due to the insured person who joins the General Social Security System who already has the disease or injury invoked as a cause for the benefit, […]”

If you applied for the benefit and did not get sickness benefits, check if this was the reason. If this is not the case, understand if the EHIC was wrong, seek a lawyer to request the benefit in court.

Do you know why the admission exam is so important? Click here!

What are the types of Disease Aid?

There are two types of sickness benefits: Social Security and Accident. Understand:

Disease aid Social Security (or common) is when the reason for the leave is not related to the job itself, it is not related to the function performed by the worker.

  • It is granted to all workers, including domestic and self-employed
  • Does not provide for job stability
  • The company is not obliged to deposit FGTS during the receipt of the benefit

Disease aid Accident it occurs when the social security insured person suffers an accident as a result of work, that is, it is related to the daily life and the functions of the worker. This aid, as an indemnity, can be combined with other benefits paid by Social Security, except for retirement.

According to the EHIC, the benefit is paid as a form of compensation due to the accident and, therefore, does not prevent citizens from continuing to work.

  • Employees linked to a company
  • Provides stability of 12 months after returning to work
  • The company is obliged to deposit FGTS during the receipt of the benefit

I got the benefit, how much will I receive?

The sickness benefit amount corresponds to 91% of the monthly income of the benefit salary. In other words, the amount will depend on your contributions made in previous years and the ceiling value of retirement, which is also the ceiling value of sickness benefit.

If you are registered as a self-employed person, the amount corresponds exactly to what was contributed by him. If you have contributed 2 minimum wages, your sick pay will be 2 minimum wages.

Understand how the benefit is calculated:

You can do this calculation in two different ways:

  1. The insured person’s 80% largest contributions since July 1994 are calculated (beginning of the Real Plan) and this value must be multiplied by 0.91. That is, the sickness benefit will be 91% of the benefit salary.
  2. Sum of the last 12 contributions divided by 12. This amount will also be multiplied by 0.91

The EHIC does both accounts and grants the lowest value as a benefit.

Attention, if you are a special insured (rural worker, fisherman, farmer), the sickness benefit will have the value of a minimum wage.

How do I get sick aid?

The steps to apply for this benefit must be done carefully and carefully so that the beneficiary is able to get sickness aid as quickly as possible. Below a step by step so you can check in without having any major worries and headaches. Look:

Look for a service station of the EHIC (National Institute of Social Security) closest to your home. You can get in touch by phone free of charge at number 135 and check which agency is closest to your home. Another possibility is that you can contact us, also free of charge through the website (www.previdencia.gov.br).

Once you have obtained this information, go to the agency or post and make a formal request for sickness aid.

When applying for insurance, you must present to the attendant the documents that declare the illness that the company where you work has issued, with a stamp and signature. That specific statement that you were dismissed as an employee because of illness and mentions the last day of work.

At that time, you must present the medical certificate issued by the company to the attendant. It must contain the following information:

  1. The reason for the removal
  2. What the doctor prescribed as treatment
  3. The period that was suggested by the doctor to leave work.
  4. In addition, you must present an identification document that has your photo, your Work Card and your CPF.

Once these procedures are done, you must wait, as the EHIC will inform you, probably by phone, when your medical expertise will occur. With these steps in mind, you will apply for sickness assistance assertively and appropriately as soon as possible.

Did I enter Illness Aid, when do I start receiving it?

During the first 15 days of leave, the company is paid the full salary. The benefit then begins to count from the 16th day of leave. In some cases, the withdrawal starts to count from the report of the beginning of the disability. And if the employee is away from work for more than 30 days, the benefit begins with the date on which the administrative request was filed with the EHIC.

The sickness benefit is one of the most important benefits of Social Security, as it aims to protect you worker in relation to one of the most sensitive needs of human beings: incapacity for work. An issue that can potentially affect all dependents of the insured and the future life of the insured. Precisely for this reason, it is essential to understand the benefit and its procedure, thus avoiding unwanted surprises when there is a need to make your postulation.

It is always best to seek specialized guidance before applying for Social Security benefits, thereby avoiding avoidable difficulties during the process. If you have any doubts, look for more information on the www.previdencia.gov.br

Intelligently manage your company’s benefits and absence control with HR Consultant UK, Contact us for more information!


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