Epilepsy and social security: General aspects of the insured claimants and medical decisions

Article type: Research Article

Authors: Ferreira, Lisiane Seguti^; | Palhares, Dario^; | Gava, Marília | Seguti and, Vladimir Ferreira^; | Marasciulo, Antônio Carlos Estima^{; ;}

Affiliations: University of Brasilia, Brasília, Brazil | Hospital de Base of Brasília, Brasília, Brazil | Labor Health Service of the Hospital of the Armed Forces of Brasília, Brasília, Brazil | INSS (Brazilian National Institute of Social Security), Brasília, Brazil | Orthopedics, Hospital of the Armed Forces of Brasília, Brasília, Brazil | Federal University of Santa Catarina, Florianópolis, Brazil | University of Itajai Valley, Itajai, Brazil

Note: [] Address for correspondence: Dario Palhares, SQS 408 bl C ap. 307, Asa Sul, Brasília 70257-030, DF, Brazil. Tel.: +55 61 32423638; E-mail: [email protected]

Abstract: BACKGROUND: Epilepsy affects adults at productive age and interferes with their ability to work. However, the granting of social security benefits to these patients has not received sufficient attention. This article aims to provide a profile of individuals with a previous diagnosis of epilepsy that file claims for social security benefits and a profile of the medical advisory decisions that support the concession of these benefits. PARTICIPANTS: A sample of thirty individuals with illness-related problems due to epilepsy was selected from the claimants that receive Social Security Incapacity/Sickness benefits. METHODS: An exploratory data analysis of the 188 Social Security medical files of the thirty claimants was performed using the clinical and epidemiological information and the medical advisory criteria. RESULTS: The mean age of the claimants was 39 years and most of them were males in jobs that do not require a lot of schooling. The first claim was filed within an average of four years of employment. On average, each worker files a claim every three months, which entitles him/her to receive incapacity/sickness benefits for seventeen months. The frequency of seizures and the medications used by the claimants were registered in 60% of the medical files. In addition, the description of the physical and neurological exam was incomplete in 50% of the files. Furthermore, 60% of the files did not include the argument or the clinical evidence that was used to justify the concession of a benefit. CONCLUSION: The medical advisory decisions on epileptic workers tend to be inconsistent, overly lenient and generally lacking in clinical evidence. The disparities among the granted benefits indicate the need for the National Social Security System to review and draft specific guidelines for epilepsy.

Keywords: Incapacity, sickness benefits, medical advisory

DOI: 10.3233/WOR-131620

Journal: Work, vol. 46, no. 1, pp. 99-105, 2013