this is how they are assessed by the INSS

The processing of sick leave due to so-called “stubborn covid” There are more difficulties than managing sick leave due to other illnesses. The large number of symptoms and their diffuseness make their diagnosis difficult, and hence the work of the medical inspectors who follow this type of cases.

Certified by the Professional Association of Social Security Medical Assessors (Apromess). Medical writing that when issuing a patient assessment in this situation, They follow as a guide a document promoted by the Spanish Association of Occupational Medicine Specialists. This document analyzes the most common and significant symptoms in persistent covid and their functional assessment, which serves as a guide for physicians’ evaluation.


Limiting symptoms with occupational consequences

The paper highlights these symptom which are taken into account both because of their frequency and because of the “impact they can have on occupational health”. limitation and may affect work performance. At the physical level, fatigue, asthenia, dyspnea, aphonia, cough and arthralgia are emphasized. At the psychological level, anxiety, depression, insomnia and post-traumatic stress disorder stand out. Finally, in the neurological realm, they mention “mental fog,” headaches, and epileptic seizures. General malaise, muscle aches and loss of smell are also included.

Given the ambiguous nature of some of these symptoms, it begs the question whether a disease like persistent covid may end up prolonging some victims longer than necessary. “When comparing the actual and ‘optimal’ durations of sick leave due to various health problems, those based on objective signs or data deviate almost nothing from those theoretical durationswhile those due to problems based on the symptom or subjective reference deviate much more,” explains Apromess. So the general rule they follow is that sick leave should be extended or not, always appropriate “for the symptomatic intensity and the work performed’ by the affected person.

The association points out that although the criteria for evaluating acute covid have changed since the beginning of the pandemicdue to the different legal and health scenarios that existed at the time, in casualties due to persistent covid “the evaluation criteria are very similar, if not the same”.


Partial medical discharge

This way, medical inspectors can refer to the document when asking whether leave due to ongoing covid needs to end. The document itself admits it Assessing a person’s functional limitations and work ability in these cases is not easy and leaves a procedure when symptoms persist but the limitations they present are no longer incapacitating: “partial medical discharge.” “This is the best solution for the worker with persistent covid and the best way to provide health monitoring. Partial exemption should be facilitated for preventive and effective integration, temporary reduction of time requirements and physical and mental burden,” they assure . The ultimate goal of this protocol is to help and facilitate decision-making and is useful for both working doctors and primary care and medical inspections.

Finally, the recommendation is to establish a data collection methodology so that there are precedents and sufficient information to facilitate the work of assessors regarding future cancellations of these characteristics. It is required to indicate, in addition to personal and health data, “if an ability, adaptation or incapacity is recognized, as well as the development of the return to work at least in the next year”.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend that the reader consult a health professional for all health-related questions.

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