How does EHIC leave work?

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How does INSS leave work?

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Surely you’ve heard about the EHIC leave, but do you know how it works? The EHIC (National Institute of Social Security) is almost always associated with retirement, but it guarantees other benefits to workers.

Accidents, disability and illness are some of the reasons that lead a professional to leave the EHIC, when the absence period exceeds 15 days.

Thereafter the EHIC assumes the payment of salary and deposits in the professional’s FGTS account. It is important to note that this is an employee’s right under the labor law.

To better understand the withdrawal by the EHIC, in this article we will talk:

  • What is the EHIC ?;
  • How does the EHIC leave?
  • When is it possible to request the EHIC leave ?;
  • Who is entitled to claim the EHIC benefit ?;
  • How does expertise work?
  • Can the employee be dismissed on leave by the EHIC ?;
  • Do I lose my vacation if I am removed by the EHIC ?;
  • COVID, how was the removal by the EHIC in this case ?;

Find out all about the following topic. Good reading!

What is the EHIC?

THE EHIC or Instituto Nacional do Seguro Social is a public agency whose responsibility is to pay social security benefits such as retirement, sickness benefit, disability retirement and others.

It was created in 1990 from a merger between the National Institute of Social Security (INPS) and the Financial Administration of Social Security and Social Assistance (IAPAS). This body is linked to the Ministry of Economy.

How does the EHIC leave?

The withdrawal by the EHIC occurs mainly when a worker has a disease or has suffered a accident, at work or out of it. During the period of absence, the worker has his rights preserved under the labor law.

Even away, in the first 15 days of absence, the company continues to pay its salary. After this period, the employee on leave from the EHIC receives full salary from the public agency. This right is provided for in the Article 59 of Law 8,213 / 91.

Art. 59. The sickness benefit will be due to the insured person who, having fulfilled, when applicable, the grace period required in this Law, is incapacitated for his work or for his usual activity for more than 15 (fifteen) days consecutive. (See Provisional Measure No. 664, of 2014).

In addition, Law No. 8,213 / 91 says that the withdrawal by the EHIC counts as length of service, provided that the employee makes at least one contribution to the EHIC after the end of receiving the benefit.

In order to get the leave by the EHIC, the employee needs to schedule an investigation, where the case will be evaluated by the Institute’s own doctors. We’ll talk about it next.

When is it possible to request removal from the EHIC?

It is important that both the company and the employee have knowledge about when it is possible to request the removal by the EHIC. Check the reasons that lead the worker to ask for leave from work.

Serious illness or injury

When the professional is unable to perform his / her function for 15 days or more, due to an injury or illness, acquired at work or not, he / she is entitled to the benefit of the sickness allowance from the EHIC.

We already talked about sickness aid in another blog article, check it out clicking here.

For example: A professional has broken his arm and is unable to perform his activity. So, in the first 15 days, the company will pay its wages and after that, it will need to undergo an expert examination so that, from the 16th day of leave, the EHIC will pay this payment.

Invalidity

When the person is no longer able to exercise his function, having lost a member, for example, he may retire due to disability. Employees who resort to this leave through the EHIC will need to undergo medical expertise every two years.

Who is entitled to claim the EHIC benefit?

There are some requirements considered basic and necessary for those who need to apply for the EHIC leave benefit.

Contribution

The worker acquires the right to the benefit through the EHIC as long as he has contributed at least 12 months with the EHIC. However, the EHIC may, in specific cases of accidents or even illnesses, release payment even if the employee has not reached that time.

Insured

Every professional who joins the EHIC, that is, who contributes regularly, has the right to have recourse to the EHIC benefit. Who is in the CLT regime receives from the company in the first 15 days of leave and after that period the responsibility is the EHIC.

How does expertise work?

I decided to leave by EHIC, will I receive the money next? It is not quite like that. Before the EHIC will pay the salary of those who are away from work, they will assess the situation.

The worker will first need to undergo an expert examination with the organ’s doctor, who must give the endorsement for the leave, whether due to the accident or illness, proving that there are reasons for the release of the benefit.

The EHIC has up to 45 days to analyze the process and to conclude the granting of the benefit.

Entering a request with the EHIC, then, does not mean that you will automatically be approved to receive the benefit, since the agency may deny this right, according to the expert’s assessment.

In cases of negative results, the worker has the right to appeal and ask for a new expertise.

How do I know the result of the EHIC expert report?

The result of the examination usually leaves on the same day, until 9:00 pm. The worker can consult the approval of the benefit through the website, having in hand: CPF, full name, date of birth and the application number.

It is also possible to consult the result of the EHIC medical examination by telephone at 135.

How to schedule the expertise?

The referral to the expert examination can be done by the company, although it is not their obligation, or scheduled by the professional himself. Scheduling can be done via the internet, through the website My EHIC, or at 135.

When being scheduled, the employee must appear at the place and time previously passed on by the agency for consultation with the doctor. In this consultation, the applicant needs to explain the reason why he is requesting the benefit.

It is essential that on the day of the examination the worker is provided with exams, prescriptions, reports and other documents that prove the reason and the need for removal.

Recalling that the worker will only receive payments after the appraisal of the expert, and the deadlines begin to count from the moment you enter the order. In addition, it is possible, if the approval period takes a while, that the professional receives the retroactive value.

Can the employee be dismissed on leave by the EHIC?

Is dismissal fair in the event of leave by the EHIC? The CLT does not foresee any impediments to unfair dismissal in this period. However, it is common for justice to define that this practice is not legal, and there may be a gain of cause on the part of the worker.

Therefore, the ideal is that any dismissal in a period of withdrawal from the EHIC should be considered by the company and that this type of decision occurs only on the return of the professional to work.

Do I lose my vacation if I am removed by the EHIC?

Another common question is whether the leave by the EHIC interrupts the deadlines for counting holidays. In this case, it depends on whether the employee is in the concessive or acquisitive vacation period. This means that the months worked are taken into account.

If he worked 12 months he is within the concessional period, acquiring the right to vacation. As with the EHIC leave, the employment contract is suspended, if it occurs during the concessional period, he does not lose this right.

However, if this leave occurs during the acquisition period, and if he leaves the office for more than 6 months, he loses the right to vacation, as provided for in article 133 of the CLT.

Art. 133 – An employee who, during the acquisition period:

[…]

IV – has received from Social Security benefits for work accidents or sickness benefits for more than 6 (six) months, although discontinued.

Therefore, the withdrawal by the EHIC interrupts the deadlines for vacation counting, if the employee is still in the acquisition period.

Covid, how did the EHIC leave in that case?

Data from the Social Security and Labor Secretariat of the Ministry of Economy revealed that more than 40 thousand workers applied for sickness assistance in 2021, due to the absence from work due to COVID-19 complications.

2021 was an atypical year and many people needed to be removed from their duties because they contracted COVID-19. The big question is that the isolation for those who contract the disease is at least 15 days, but who assumes the worker’s salary during this period?

After the end of the public calamity decree, companies now need to pay for 15 days of leave and after that period, if the worker still needs to stay away, he will need to resort to the EHIC.

Remembering that it will be necessary to prove via exams or report that the removal is really necessary. We are considering, in this case, people who work in the formal regime, that is, in the CLT regime.

Leave by EHIC, pay attention to details

The withdrawal by the EHIC, as we saw throughout this content, is full of details in the sense of obligations of the company and the employee. This is because there are different ways to request the benefit.

Not to mention, that everything depends on the result of the medical expertise EHIC for the benefit to be released. That is, the worker needs to prove, via a report and exams, before the EHIC doctor, that his removal is really legal under the labor law.

In addition to all these details, in 2021, with the emergence of the coronavirus, new measures needed to be taken, since this disease requires social withdrawal for at least 15 days.

Thus, new questions arose about the rights of the employee and the company, which we have been answering throughout this article.

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