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STJ Decision Guarantees That Those Who Suffered Accidents Since 2015 Receive Accident Assistance Right After Sick Pay, With Overdue Payments That Can Exceed R$ 100 Thousand.
Few workers know in detail about the accident assistance, a benefit paid by INSS to insured individuals who, after suffering an accident of any nature — whether at work, in traffic, or even at home — are left with permanent sequelae that reduce their work capacity. Unlike sick pay, which is temporary and covers the period of leave, accident assistance is compensatory and can be paid until the insured’s retirement.
The list of those who can apply includes:
- Employees with signed contracts, urban and rural;
- Self-employed workers;
- Domestic workers, for accidents occurring from 01/06/2015;
- Special insured individuals, such as family farmers and artisanal fishermen.
The amount corresponds to 50% of the insured’s benefit salary and is cumulative with work remuneration. This means that the worker can continue to perform their duties — even with limitations — and receive the assistance as compensation.
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The STJ Decision That Changed Everything
In 2021, in the judgment of Theme 862, the Superior Court of Justice (STJ) established an understanding that changed the lives of thousands of Brazilians.
The Court decided that accident assistance should be paid from the day following the end of sick pay, and not from the date the worker filed the administrative request.
This definition may seem technical, but it has a huge impact. Previously, many insured individuals only received the benefit from the moment they made the request at the INSS, which could take months or even years. Now, the rule ensures that the payment is retroactive, covering the entire period since the end of sick pay.
Moreover, the decision applies to accidents occurring from 2015, including domestic employees who now have expanded coverage under Complementary Law 150/2015.
How Much the Worker Can Receive in Back Payments
In practice, this change can generate a significant amount for those who suffered accidents and took time to formalize the request. The back payments — retroactive amounts that the INSS must pay — can easily exceed R$ 100 thousand in some cases, especially for those who went years without claiming the benefit.
Example:
- A worker who received R$ 2,000 in benefit salary would be entitled to R$ 1,000 per month in accident assistance.
- If they went four years without receiving (48 months), the total owed would be R$ 48,000, not counting monetary correction and interest.
- In longer cases, exceeding R$ 100 thousand is not uncommon, as indicated by recent decisions from the Federal Court.
The Impact for Those Who Suffered Accidents Since 2015
The 2015 timeframe is important because it was when domestic employees and special insured individuals gained consolidated rights to the benefit in cases of accidents. This greatly expanded the reach of accident assistance.
Thus, any insured individual who suffered an accident from 2015 onward, has been away with sick pay, and has permanent sequelae may be entitled to retroactive benefits.
This applies, for example, to:
- Construction workers who suffered injuries from falls;
- Urban transport drivers or truck drivers involved in traffic accidents;
- Domestic employees with sequelae from home or commuting accidents;
- Family farmers with limitations after accidents with tools or machinery.
Documents Required to Apply for Accident Assistance
To apply for the benefit with the INSS, it is essential to present documentation proving the history of the accident and the sequelae:
- Work Accident Communication (CAT), if it is a work-related accident;
- Medical reports indicating the permanent sequelae;
- History of absences and proof of receiving sick pay;
- Personal documents and work card.
In many cases, when there is a denial from the INSS, the worker can appeal to the Justice system, where decisions have followed the consolidated understanding of the STJ.
Examples of Favorable Judicial Decisions
The STJ has already consolidated its understanding, but regional courts have also confirmed the application of the thesis:
- In Rio Grande do Sul, TRF-4 ordered retroactive accident assistance payments to a rural worker who was left with sequelae after a chainsaw accident.
- In São Paulo, recent decisions guaranteed amounts exceeding R$ 90 thousand in back payments to insured individuals who went years without receiving the benefit correctly.
These examples show how the decision has an immediate practical effect on the lives of those who rely on Social Security.
What to Do Not to Lose the Right
The deadline to request the benefit is up to five years after the cessation of sick pay. If the worker takes longer, they risk losing part of the retroactive amounts, as only the last five years will be paid.
Therefore, experts recommend:
- Seek legal advice immediately after the end of sick pay;
- Keep all medical documents;
- Submit the administrative request to the INSS as soon as possible;
- In case of denial, appeal judicially, where the chance of victory is high.
Accident Assistance and Retirement: Benefits Can Be Cumulative
Another little-known point is that accident assistance can be combined with future retirement. This means that the insured continues to receive the benefit until retirement is granted, increasing their income.
Moreover, those still working can receive the assistance without losing their salary. It is, therefore, a benefit that guarantees financial compensation while the worker remains active.
The STJ’s decision represents a turning point in recognizing the rights of workers who suffered accidents. By determining that the benefit should be paid from the end of sick pay, the Court ensured not only justice but also financial security for thousands of families.
Workers who suffered accidents from 2015 onwards and have not yet received accident assistance should seek immediate advice. The amount can be surprising: payments exceeding R$ 100 thousand have already been confirmed by the Justice system.
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