DA EFETIVIDADE DOS BENEFÍCIOS POR INCAPACIDADE ANTE A POSSIBILIDADE DE MEDIAÇÃO ON LINE NO ÂMBITO ADMINISTRATIVO PELO INSTITUTO NACIONAL DO SEGURO SOCIAL

Disability benefits have undergone modifications in light of the Social Security Reform -Constitutional Amendment No. 103/2019: what was called sickness benefit and disability retirement, is now a temporary and permanent disability benefit, in addition to the criteria for calculating income initial monthly. All this modification resulted in its concession in a period of global social instability. This is because, months after the aforementioned constitutional amendment, the whole world is suffering the effects of the COVID-19 pandemic, with changes in all sectors of society. It is worth mentioning that it was no different in relation to the National Institute of Social Security, in view of the granting of disability benefits, having the need to implement its entire digital system, with the creation of a field for the insertion of documents and carrying out indirect expertise, via online. In this scenario, mediation is of crucial importance as a way of solving many cases to be resolved at the administrative level, meeting the movement for legalization, and it may well have its applicability within the scope of cases brought to the National Institute of Social Security and, if implemented, generate effectiveness in the analysis of these benefits in favor of the insured party. This article aims to demonstrate the effectiveness of the use of online mediation, if inserted in relation to disability benefits, in an administrative scope, from a historical-bibliographic research, aiming at the concretization and realization of better quality in the provision of State service, in relation to all the insured affected by some temporary or permanent disability.

Disparities in Health Care and Medical Evaluations by Gender: A Review of Evidence and Mechanisms

Male and female patients often receive different medical evaluations and treatment even when they have the same symptoms, and relative to men, women are less likely to receive benefits within social insurance programs that rely on medical evaluations. This article reviews evidence from prior research that documents the existence of these gender gaps in health care and disability benefit receipt. The article then describes potential mechanisms underlying these gender gaps. The article concludes by discussing new work on the role of health-care providers in contributing to gender gaps.

Disability and Distress: The Effect of Disability Programs on Financial Outcomes

What is the relationship between disability programs and financial distress? We provide the first evidence on this relationship using several markers of financial distress: bankruptcy, foreclosure, eviction, and home sale. Rates of these adverse financial events peak around the time of disability application. Using variation induced by an age-based eligibility rule, we find that disability allowance reduces the likelihood of bankruptcy by 20 percent, foreclosure by 33 percent, and home sale by 15 percent. We present evidence that these changes reflect true reductions in financial distress. Considering these extreme events increases the optimal disability benefit amount and suggests a shorter optimal waiting time between application and benefit receipt. (JEL G51, H55, J14)

Inability to Work Fulltime, Prevalence and Associated Factors Among Applicants for Work Disability Benefit

Purpose Inability to work fulltime is an important outcome in the assessment of workers applying for a disability benefit. However, limited knowledge is available about the prevalence and degree of the inability to work fulltime, the associations between disease-related and socio-demographic factors with inability to work fulltime and whether the prevalence and the associations differ across disease groups. Methods Anonymized register data on assessments of workers with residual work capacity (n = 30,177, age 48.8 ± 11.0, 53.9% female) applying for a work disability benefit in 2016 were used. Inability to work fulltime was defined as being able to work less than 8 h per day. Results The prevalence of inability to work fulltime was 39.4%, of these 62.5% could work up to 4 h per day. Higher age (OR 1.01, 95% CI 1.01–1.01), female gender (OR 1.45, 95% CI 1.37–1.52), higher education (OR 1.44, 95% CI 1.33–1.55) and multimorbidity (OR 1.06, 95% CI 1.01–1.11) showed higher odds for inability to work fulltime. Highest odds for inability to work fulltime were found for diseases of the blood, neoplasms and diseases of the respiratory system. Within specific disease groups, different associations were identified between disease-related and socio-demographic factors. Conclusion The prevalence and degree of inability to work fulltime in work disability benefit assessments is high. Specific chronic diseases are found to have higher odds for inability to work fulltime, and associated factors differ per disease group.

Impact of COVID-19 Pandemic on Patients with Immune Thrombocytopaenia

Background and Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the lives of patients with immune thrombocytopaenia (ITP) treated at our hospital. Materials and Methods: The study was conducted in the Community of Madrid, which has the highest number of COVID-19 cases in Spain. We included 143 adult patients with ITP (130 with chronic ITP, 8 with persistent ITP, and 5 with newly diagnosed ITP). We conducted a telephone survey to collect the data and created a registry. Materials and Methods: Overall, 24 patients presented symptoms suggestive of COVID-19, which was confirmed by RT-PCR in 8 cases. The cumulative incidence of confirmed SARS-CoV-2 infection was higher in the patients with ITP than in the Madrid population. There were no differences in the disease incidence or clinical course of infection in the patients treated with immunosuppressants. Almost all of the patients reported adherence to the prescribed treatment, although 49.2% of the hospital visits were either cancelled or postponed, 17.2% because of the patients’ fear of coming to the centre. Nearly half of the cohort was considered vulnerable, and 17% had been granted a dependency or disability benefit. Conclusions: COVID-19 had a major impact on the psychosocial, occupational, and quality of care of patients with ITP.

Evidence, objectivity and welfare reform: a qualitative study of disability benefit assessments

Background: Anti-welfare narratives depict welfare systems as overly-permissive, open to fraud, and fundamentally unfair. Countering these supposed ills have been political appeals to evidence and reforms made to disability benefit assessments under the banner of objectivity. But objectivity is a complex construct, which entails philosophical and political choices that tend to oppress, exclude and symbolically disqualify alternative perspectives.Aims and objectives: To examine reforms made to UK disability benefits assessments in the name of objectivity.Methods: Thematic analysis of 50 in-depth qualitative interviews with UK disability benefit claimants.Findings: Reforms made in pursuit of procedural objectivity reproduce existing social order, meaning claimants without personal, social and economic resources are less likely to succeed. Data reveal an increasingly detached and impersonal assessment process, set against a broader welfare landscape in which advocacy and support have been retrenched. In this context, attaining a valid and reliable assessment was, for many, contingent upon personal, social and economic resources.Discussion and conclusions: Political appeals to evidence helped establish an impetus and a legitimising logic for welfare reform. Procedural objectivity offers superficially plausible, but ultimately specious, remedies to longstanding anti-welfare tropes. Despite connotations of methodological neutrality, procedural objectivity is not a politically neutral epistemological standpoint. To know disability in a genuinely valid and reliable way, knowledge-making practices must respect dignity and proactively counter exclusory social order. These latter principles promise outcomes that are more trustworthy by virtue of their being more just.<br />Key messages<br /><ul><li>Appeals to evidence are central to anti-welfare politics</li><br /><li>Procedural objectivity has informed reforms to disability benefit assessments</li><br /><li>Despite connotations of methodological neutrality, procedural objectivity is not a politically neutral epistemological standpoint</li><br /><li>Reforms to disability benefits reproduce existing social order and act as a lever for inequality</li></ul>

Health Service Use of Australian Unemployment and Disability Benefit Recipients: A National, Cross-Sectional Study.

Background: Healthcare is funded and delivered separately from social care programs such as unemployment and disability insurance. Greater understanding of the health service use (HSU) of social assistance benefit recipients would support more effective design and delivery of health and social care. This study aimed to characterise the HSU of disability and unemployment benefit recipients relative to people earning wages, and to identify personal, household and health-related factors associated with HSU in disability benefit recipients.Methods: A cross-sectional national survey of 9,520 working age Australian adults in three groups: (1) 638 receiving the disability support pension (DSP); (2) 442 receiving unemployment benefits; and (3) 8440 earning wages. Outcomes included count and frequency of health professional consultations, hospital attendance and admission in the past 12 months, as well as medication and supplement use in the past 2 weeks. Analyses compared DSP and unemployment benefit recipients to wage earners using age and sex adjusted risk ratios and incident rate ratios. Negative binomial regression models were constructed to examine factors associated with hospitalisation and general practitioner services in DSP recipients. Results: DSP recipients were significantly more likely than wage earners to have consulted 15 of 22 types of health professionals, had 2.5 times greater risk and 3.8 times higher rate of hospital admission, and 3.4 times greater risk of prescription medication use. Unemployment benefit recipients were significantly more likely than wage earners to have consulted 5 of 22 types of health professionals, had 1.5 times greater risk of hospital admission and 1.2 times greater risk of prescription medication use. Younger age, hypertension, more co-morbid conditions and poorer self-assessed health were associated with higher rate of hospital admission among DSP recipients. Conclusions: People receiving unemployment and disability insurance benefits use significantly more health services than wage earners. A range of personal and clinical characteristics are associated with greater HSU among disability benefit recipients. Greater coordination between health and social care systems may improve health, reduce HSU and improve work ability in unemployed and working age people.