Who is entitled to receive Sickness Benefit?

Learn who's eligible for sickness benefits, how long they last, a list of eligible illnesses, and much more. Read on!

What is Sick Pay?

Sickness Benefit (or Temporary Disability Benefit) is a social security benefit granted by Social Security and paid by the National Social Security Institute (INSS).

This is assistance aimed at Brazilian citizens who, due to illness or accident, are unable to perform their professional tasks and activities.

This amount, which serves as an alternative source of income for the worker, can be requested in cases where the worker needs to be unable to work for more than 15 days.

What differentiates Sick Pay from common certificates?

For employees with formal employment contracts, the first 15 days the employee is unable to work are paid by the employer. Social Security pays the benefit starting on the 16th day of absence.

Steps to obtain Sickness Benefit

To access the aid, the applicant must complete two essential steps. These two steps are:

Benefit request

The applicant accesses the My INSS. Next, log in to the platform and select "Schedule your Expertise." If this is your first appointment, simply click "Schedule New."

Then, just follow the progress of your application directly through Meu INSS, using the “Application Result/Disability Benefit” option.

Attend the examination

The second step is to attend the Medical Examination. At this stage, the applicant must go to the INSS unit for the examination.

Just like in the previous stage, after the examination is carried out, the worker will follow the request and the expert result directly through My INSS to see if the benefit has been approved.

Workers can also contact the INSS by calling 135, one of the INSS's customer service channels. The service is available Monday through Saturday, from 7 a.m. to 10 p.m.

List of illnesses that grant Sickness Benefit

There isn't a specific set of illnesses that entitle workers to claim benefits. Any illness that leaves a citizen unable to perform their activities entitles them to this benefit.

The list below includes illnesses that exempt citizens from the waiting period, as they are classified as serious illnesses. They are:

Active tuberculosis;
Hansen's disease;
Ankylosing spondyloarthrosis;
Mental alienation;
Malignant neoplasm;
Acquired Immune Deficiency Syndrome (AIDS);
Blindness;
Irreversible and disabling paralysis;
Severe heart disease;
Parkinson's disease;
Severe nephropathy;
Advanced stage of Paget's disease (osteitis deformans);
Radiation contamination based on the conclusion of specialized medicine;
Severe liver disease.

Although they stand out for being serious illnesses, applicants who have any of these illnesses must go through the same process when requesting the benefit.

How long does Sick Pay last?

In order to continue receiving this sickness benefit, the worker must prove that he or she is temporarily unable to carry out his or her activities.

This examination is carried out by Social Security's own medical experts.

The exam must be retaken periodically while the applicant is unable to work.

Payment of this benefit will cease from the moment the worker recovers 100% and is ready to return to work.

If the applicant does not recover, the benefit changes and becomes a disability pension.

How long can the applicant receive Sick Pay?

In fact, there is no maximum period in which the user can receive the benefit.

But if this disability continues for a long time, the condition can become a permanent disability, resulting in disability retirement.

However, in this case, it is necessary to receive a report from the responsible doctor for this change to take place.

Who is entitled to Sick Pay?

For a worker to be eligible, he or she must meet certain requirements: be insured, meet the minimum requirement of 12 months, and be unable to carry out his or her normal activities.

Below, we will explain a little more about each of these requirements:

Meet the minimum requirement of 12 months

This minimum requirement refers to the minimum period of contribution to the INSS. To request the bbenefit, the worker must have spent the 12-month period contributing correctly in order to be entitled to request the benefit.

Have a temporary disability

This is the most obvious requirement, right? To apply for this benefit, the worker must have some type of illness or have suffered an accident that prevents them from performing their normal activities for more than 15 days.

Insured status

Another very important – and indispensable – requirement to be able to apply for the benefit is that you are insured and are affiliated with the INSS.

Can people who receive Sick Pay work?

In theory, no. While the beneficiary is receiving the benefit, they cannot engage in paid work, under penalty of having the benefit terminated.

But there are some exceptions.

When a worker carries out more than one paid activity and is unable to carry out just one of them, he or she may continue to carry out that activity, but in this case, the sickness benefit installment will be proportional, given that the citizen has another source of income.