A experiência do periciado no Instituto Nacional do Seguro Social (INSS)
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Data
2016-06-24
Autores
Oliveira, Luciana Montes de [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução. O Instituto Nacional do Seguro Social (INSS) é a autarquia federal responsável pela arrecadação das contribuições devidas à Previdência Social e pelo pagamento de benefícios aos segurados. Entre os serviços e benefícios da Previdência Social, estão aqueles recebidos em consequência de incapacidade do segurado. A Perícia Médica é o corpo técnico responsável por avaliar e emitir parecer conclusivo quanto à capacidade do segurado para o recebimento ou não do auxílio por incapacidade. Objetivos. Compreender a experiência do usuário da perícia médica do Instituto Nacional do Seguro Social (INSS) e elaborar um modelo teórico representativo dessa experiência. Método. Pesquisa qualitativa conduzida em Agências da Previdência Social (APS) do interior paulista, Brasil. As entrevistas foram conduzidas e audiogravadas em locais que assegurassem o anonimato e o sigilo das informações dos atores. A saturação teórica se configurou mediante a análise da 17a entrevista, segundo os passos da Teoria Fundamentada nos Dados (TFD). Resultados. Da análise dos dados, compreendeu-se a experiência de usuários do INSS com o ato pericial médico, cujas categorias identificadas e relações teóricas estabelecidas possibilitaram o desenvolvimento de um processo analítico e explicativo das ações e das interações acerca do processo vivencial. Este se compõe de três subprocessos: acreditando na legitimidade de sua incapacidade; encontrando-se entre a frustração e a satisfação com o contexto pericial; refletindo sobre outros fatores intervenientes no ato pericial: Estado, perito e usuário. Do realinhamento dos componentes que formaram esses subprocessos, pode-se descobrir uma categoria designada central que os abarcam, constituindo então o processo da experiência, denominado: movendo-se entre a frustração e a satisfação com a perícia: Estado, perito e usuário como intervenientes na legitimidade do incapaz. Do modelo teórico emerso destacam-se três representações simbólicas relativas a frustração do usuário: perito como barreira para a legitimação do incapaz e do direito de acesso ao benefício do INSS; ato pericial subjetivo; postura fragilizada do Estado no apoio ao cidadão incapaz para o trabalho. Considerações Finais. Este estudo aponta às necessidades de se reavaliar a comunicação e, especificamente, o relacionamento médico perito – usuário durante o ato pericial, para minimizar a vulnerabilidade do perito à violência e do usuário a sofrimentos, assim como mostra-se essencial orientar esse usuário quanto aos direitos, deveres e procedimentos envolvidos no ato pericial, para obtenção do benefício do INSS. Essas intervenções poderiam melhorar a relação do usuário com o INSS e seus atores que lá atuam.
Introduction. The National Institute of Social Security (INSS) is the federal agency responsible for the collection of contributions payable to the Social Security and the payment of the benefits to policyholders. Among the services and Social Security benefits, are those received as a result of the insured's disability. The Medical Examiner is the technical body responsible for evaluating and issuing conclusive opinion on the insured's ability to receive or not the aid for disability. Goals. Understanding the user experience of the medical examiner from the National Institute of Social Security (INSS) and develop a theoretical model representing this experience. Method. Qualitative research conducted in Agencies of Social Security (APS) in the country town of São Paulo State, Brazil. The interviews were conducted and audio recorded in places that would ensure anonymity and the confidentiality of the information of the actors. Theoretical saturation was configured by analyzing the 17th interview, according to the steps of Grounded Theory. Results. Data analysis, understood the experience of the users in NISS with the medical expertise act whose categories identified and established theoretical relationships enabled the development of an analytical and explanatory process of actions and interactions about the experiential process. This is composed of three sub-processes: believing in the legitimacy of their disability; lying between frustration and satisfaction with the expert context; reflecting on other factors involved in the forensic act: State expert and user. The realignment of the components that formed these sub-processes, one can discover a core category assigned to the cover then constituting the process of the experience, called: moving between frustration and satisfaction with the expertise: State expert and user as intervening the legitimacy of the incapable. The aftermaths theoretical model highlights three symbolic representations of user frustration: expert as a barrier to the legitimacy of the incapable and the right of access to the benefit of the INSS; subjective expertise act; weakened State stance in supporting to the citizen unable to work. Final Considerations. This study points to the need to re-evaluate the communication and, specifically, the relation the expert doctor-user during the expert act to minimize the vulnerability of the expert to violence and the user suffering, as well as shown to be essential guide this user as the rights, duties and procedures involved in the expertise act to obtain the benefit of the INSS. These interventions could improve the relationship of users with the INSS and the actors who work there.
Introduction. The National Institute of Social Security (INSS) is the federal agency responsible for the collection of contributions payable to the Social Security and the payment of the benefits to policyholders. Among the services and Social Security benefits, are those received as a result of the insured's disability. The Medical Examiner is the technical body responsible for evaluating and issuing conclusive opinion on the insured's ability to receive or not the aid for disability. Goals. Understanding the user experience of the medical examiner from the National Institute of Social Security (INSS) and develop a theoretical model representing this experience. Method. Qualitative research conducted in Agencies of Social Security (APS) in the country town of São Paulo State, Brazil. The interviews were conducted and audio recorded in places that would ensure anonymity and the confidentiality of the information of the actors. Theoretical saturation was configured by analyzing the 17th interview, according to the steps of Grounded Theory. Results. Data analysis, understood the experience of the users in NISS with the medical expertise act whose categories identified and established theoretical relationships enabled the development of an analytical and explanatory process of actions and interactions about the experiential process. This is composed of three sub-processes: believing in the legitimacy of their disability; lying between frustration and satisfaction with the expert context; reflecting on other factors involved in the forensic act: State expert and user. The realignment of the components that formed these sub-processes, one can discover a core category assigned to the cover then constituting the process of the experience, called: moving between frustration and satisfaction with the expertise: State expert and user as intervening the legitimacy of the incapable. The aftermaths theoretical model highlights three symbolic representations of user frustration: expert as a barrier to the legitimacy of the incapable and the right of access to the benefit of the INSS; subjective expertise act; weakened State stance in supporting to the citizen unable to work. Final Considerations. This study points to the need to re-evaluate the communication and, specifically, the relation the expert doctor-user during the expert act to minimize the vulnerability of the expert to violence and the user suffering, as well as shown to be essential guide this user as the rights, duties and procedures involved in the expertise act to obtain the benefit of the INSS. These interventions could improve the relationship of users with the INSS and the actors who work there.
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Palavras-chave
Previdência Social, Médicos, Prova pericial, Relações médico-paciente, Seguro por invalidez, Social security, Physicians, Expert testimony, Physician-patient relations, Disability insurance