Individual taxpayers are not entitled to receive accident assistance from the INSS
The 1st Panel of the Federal Regional Court of the 1st Region (TRF1) reformed the sentence that upheld the request to condemn the National Social Security Institute (INSS) to pay accident aid with retroactive effect from the date of administrative rejection.
In its appeal to the Court, the INSS claimed that the beneficiary is not entitled to accident benefit, as she is an insured member of the General Social Security Regime (RGPS) as an individual contributor, therefore, she is expressly excluded from the protective scope of the social security rule.
In his vote, the rapporteur of the case, federal judge Morais da Rocha, explained that the essential requirements for granting the accident benefit benefit are: quality of insured person; the insured has suffered an accident of any nature; partial and definitive reduction in capacity for usual work and causal link between the accident and the reduction in capacity. Furthermore, according to social security legislation, insured employees, independent workers and special insureds are eligible to receive the aid and individual and optional insured contributors are not eligible.
The judge also noted that in order to grant the accident benefit benefit, proof of reduced working capacity for the role performed at the time of the accident is necessary. In this matter, according to medical expertise, the author has sequelae of trauma to the cervical region and, therefore, is partially, multidisciplinary and permanently incapacitated for activities that require movement of the cervical spine since 2009, the date on which the accident occurred. However, from 2006 to 2019, the time of the accident, the plaintiff was an individual contributor, having received sickness benefit from 2009 to 2010 and in 2019.
In these terms, the judge found that the plaintiff is not entitled to the benefit, given the fact that she was an individual taxpayer during the period of the accident. Therefore, the rapporteur voted to deny the appeal, having been accompanied by the Board.
SOURCE: TRF-1st Region