this is how they are evaluated from the INSS

The processing of sick leave due to the so-called ‘persistent covid’ It has more difficulties than the management of sick leave due to other illnesses. The large number of symptoms, and how diffuse they can be, make their diagnosis difficult and, consequently, the work of the medical inspectors, in charge of monitoring this type of case.

From the Professional Association of Medical Assessors of Social Security (Apromess) they assure Medical Writing that, when issuing an assessment of patients in this situation, They follow as a guide a document promoted by the Spanish Association of Specialists in Occupational Medicine. This document analyzes the most prevalent and significant symptoms in persistent covid and their functional assessment, which serves as a guide for evaluating doctors.

Limiting symptoms with occupational repercussions

The document highlights those symptom which, both because of their frequency and “the impact they can have on occupational health” are considered limiting and may have an impact on job performance. On the physical plane, fatigue, asthenia, dyspnea, aphonia, cough and arthralgia are highlighted. On the psychological level, anxiety, depression, insomnia and post-traumatic stress disorder stand out. Finally, in the neurological sphere they mention “mental fog”, headaches and epileptic seizures. General malaise, muscle aches and loss of smell are also covered.

Given the ambiguous nature of some of these symptoms, the question arises as to whether a disease such as persistent covid can end up prolonging some casualties longer than necessary. “When comparing the actual and the ‘optimal’ duration of sick leave due to different health problems, those based on objective signs or data do not deviate almost anything from those theoretical durationswhile those due to problems based on the symptom or the subjective reference deviate much more”, they explain from Apromess. Thus, the general rule that they follow is that the sick leave must be extended, or not, always appropriate “to the symptomatic intensity and the work carried out” by the affected person.

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

Partial medical discharge

In this way, the medical inspectors can turn to the document when they question whether a leave due to persistent covid should come to an end. The document itself acknowledges that Assessing the functional limitations and work aptitude of a person in these cases is not easy and leaves a procedure when the symptoms persist, but the limitations they present are no longer incapacitating: the “partial medical discharge from work”. “It is the best decision for the worker with persistent covid, and the best way to ensure health surveillance. Partial discharge must be facilitated for preventive and effective integration, temporarily reducing the demands on time and physical and mental load” , they assure. The ultimate goal of this protocol is to help and facilitate decision making and it is useful both for work doctors and for Primary Care and medical inspections.

Finally, the recommendation is to establish a data collection methodology in order to have precedents and sufficient information to facilitate the work of the evaluators regarding future cancellations of these characteristics. It is requested to indicate, beyond personal and health data “if aptitude, adaptation or inaptitude was recognized, as well as evolution in the return to work at least during the following 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 the reader that any questions related to health be consulted with a health professional.

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