ASPECTS OF THE EXPERT ANALYSIS IN SICKLE CELL DISEASE
submitted June 7th accepted July 27th 2019
Fernanda Lima Kroger (1)
Lysla Cardoso Sudário (2)
Olivia Franco dos Santos (3)
Ianka Cristina Ernesto (4)
Marina Schuffner Silva (4)
Natália Cristina Sales de Paula (5)
Daniela de Oliveira Werneck Rodrigues (6)
Raquel Barbosa Cintra (7)
(1) Médica especialista em Medicina Legal e Perícias Médicas pela Faculdade de Medicina da Universidade de São Paulo.
(2) Médica, residente em Clínica Médica no Hospital e Maternidade Therezinha de Jesus.
(3) Acadêmica de medicina da Universidade Federal de Juiz de Fora – UFJF e bolsista de Iniciação Científica da Fundação Hemominas.
(4) Acadêmica de medicina da Universidade Presidente Antônio Carlos – UNIPAC e bolsista de Iniciação Científica da Fundação Hemominas.
(5) Assistente social da Fundação Hemominas.
(6) Médica doutora em Saúde Brasileira hematologista da Fundação Hemominas.
(7) Médica mestre em Bioética, professora colaboradora da Faculdade de
Medicina da Universidade de São Paulo e Mogi das Cruzes.
Sickle cell disease (SCD) is an autosomal recessive monogenic hereditary pathology with high prevalence in Brazil, inserted in the International Classification of Diseases (CID 10) 10th edition, Chapter III: Diseases of blood and hematopoietic organs group D57. According to the Ministry of Health there are 25 to 30 thousand cases of SCD, with an incidence of 3,500 cases/year. Most patients with SCD have developed acute episodes that can lead to prolonged hospitalizations, periods of disability and severe complications that result in permanent work absence and disability retirement. The objective of this research was to verify the number of retirements by CID 10: D57 and the study of technical elements that may assist the expert in the preparation of the social security medical report for granting sickness benefit and disability retirement in SCD. A bibliographic survey was performed in the scientific databases, a search of quantitative data available in the yearbooks of the Ministry of Social Security and a methodological documentary analysis proposed by Bardin. From January to June 2019, according to data from the National Institute of Social Security, total disability pensions amounted to 168,749, of which 2.96% were granted with CID 10 D57. Considering the high prevalence of SCD, which makes it a public health problem, the social security aspect is a matter of extreme interest. Clinical history, expert examination, supported by reports from the attending physician, are the basis for the conclusion of the expertise regarding labor limitation, as the diagnosis of SCD alone does not imply disability.
Key words: Sickle Cell Disease, Absenteeism, Medical Leave, Expert Report, Forensic Medicine