What is a disability lawsuit?

What is a disability lawsuit?
Published on: 21 February 2023

A disability lawsuit involves filing a claim with the National Social Security Institute (INSS). The process begins when a permanent disability pension of any level is denied. In addition, disability lawsuits against the INSS must be brought before the Social Court. Most of the time, the result of this process is that the public bodies condemn the granting of incapacity to workers. An labour lawyer can help you to claim your disability.

Permanent disability claims are the means by which many people obtain their pensions. To file a claim against Social Security for disability, you must first go through both stages of the administrative process in the disability claim. If the claim is accepted, a disability trial hearing will be held.

When the claim is not accepted, the case is closed and the option remains to go to court to sue the INSS. The length of the trial can vary from case to case, but in general, the judgement usually takes two weeks to a month. If the judge is right, not only can disability benefits be collected, but also compensation for back payments that should have been received can be considered.

What to do in the event of a disability claim?

Applications for invalidity must be submitted through administrative channels and reviewed by the Medical Tribunal. The INSS will issue a decision on the file, but it may take up to 135 working days for the decision to be issued. The decisions may be to approve pensions, assign grades or deny rights that we have.

When this happens, the first complaint is not through the courts, but with the Social Security itself. What will be done is to file a claim in advance. You also disclose the reasons behind the complaint and state your real claims. The time limit for filing an advance claim is 30 working days from the issuance of the first adverse decision. Once the claim has been filed, the INSS has 45 working days to respond to the worker.

Essential elements of a disability claim

In a disability lawsuit, the essential element will be an up-to-date medical report that finally accounts for the sequelae and functional limitations. In many cases, it is very important to have a good expert report and approval at trial.

After analysing the after-effects of the disease, a medical expert will explain to the judge the medical reasons for the alleged disability. The lawyers will also tell the judge not only the patient's current condition but also whether the number of calculations on the statutory basis deteriorates over time. During the trial, lawyers for both sides will present their arguments and present evidence and arguments. The parties or the judges may take the initiative to invite court experts to testify at trial to clarify medical questions such as pathologies, sequelae, among others. Expert opinion can be a decisive factor in these proceedings.

The lawyer will also explain to the judge not only the patient's current condition but also whether it will worsen over time in order to calculate the number of regulatory bases. During the trial, the lawyers on both sides will present their arguments and present evidence and arguments. This is due to the fact that 55% of the supervision basis is charged for total invalidity and 100% for absolute invalidity.

What are the degrees of incapacity in the judgements?

La Seguridad Social tiene cuatro niveles de incapacidad permanente:

  • Partial incapacity: compensation for such disability is received in a lump sum equivalent to 24 monthly payments. The basis for supervision is that which would have been the basis for temporary incapacity if the claimant had been entitled to it. This compensation is subject to personal income tax (Impuesto sobre la Renta de las Personas Físicas - IINPF).
  • Total: Cash benefits for such disability are monthly and lifetime amounts. Claimants under the age of 60 can claim a lump sum calculated on a fixed basis. In this case, the taxable amount is 55% of the amount, which may be increased by up to 20%. The amount received may be higher if the permanent incapacity is due to an occupational disease or an accident at work. This amount may be increased by between 30% and 50%.
  • Absolute: The financial benefits for such disability are monthly and lifelong amounts. The benefits received for such disability are 100% of the supervision base and are exempt from personal income tax (IINPF). Permanent disability can be caused by occupational diseases, common diseases, occupational or non-occupational accidents. 14 monthly benefits and 2 special benefits in case of disability due to an accident at work or general illness. If it is related to an occupational disease or accident at work, it is paid in 12 monthly instalments and the additional costs are prorated.
  • Major disability: The amount corresponding to this disability will be the total permanent disability. A supplement for carers is added to this amount.

The higher the sign of disability, the higher the degree of disability. However, the amount is not always higher, as it depends on the specific regulatory basis.

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