Three hundred and twenty thousand waiting for the first visit with theinps and another 860 thousand more Asl, in the areas where there is no agreement with the social security institution. In all, well over a million people: these are figures that give an idea of how in the past year and a half thecivil disability has become an emergency. Because Covid and the limitations it has caused, but not only.
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INPS, which directly manages about a quarter of the medical procedures for this service, is taking action with an ambitious plan that aims to close the backlog within the year, through the creation of a centralized hub in Rome and the massive use of visits to the administration , or remotely based on the documentation sent by the citizen. But in perspective, the phenomenon is destined to grow further, as one of the many effects of the population’s aging process. To the point that Gabriella Di Michele, director-general of the institute, wonders how long the system will last: “It is a problem of structures, but also of financial sustainability of the system – argues Di Michele – and perhaps should we begin to wonder whether it is really the case to link benefits more to income, in order to be able to concentrate aid on those who need it most ».
THE STANDARD According to the regulations in force, the benefit for disabled citizens (287.09 euros for thirteen months with a reduction in working capacity from 74 to 99 percent) is paid with a personal income limit of 4,931.29 euros per year while the disability pension (it must be 100% are) has a threshold of €16,982.49 per year. Instead, the corresponding compensation (€522.10 for 12 months with 100 percent disability and inability to perform day-to-day activities) is recognized for everyone, regardless of income. Following a ruling by the Constitutional Court last year, disability pension holders aged 18 and older are entitled to an increase of up to €651 per month based on a different income limit. What happened to the pandemic? “Last year, after the suspension of visits that actually lasted until November, another 150 thousand files were collected for deletion, while for 2021 we estimate that there will be 650 thousand against the usual 510 thousand, because many who are now have renounced applying »explains Di Michele.
The INPS is facing this wave with 300 doctors on staff and about 1,400 working on a 25-hour weekly schedule. “We are now managing to employ 189, but they will not enter service until next year,” notes the general manager. It is a situation in which – it is argued on Via Ciro il Grande – there is only one way to react: by taking advantage of the possibility offered by a law of 2020 to be present or not, but only on the basis of documentation. Currently they are just under 25 percent of the total, now they should rise to 70-80 percent. At the same time, a specialized hub will be created in the INPS offices in Via Ballarin in Rome, which will centralize the applications and ultimately sort them through the various medical-legal centers. In this way, ongoing visits that have accumulated above normal levels should be settled by the end of the year. And we will return to the average time of 120 days to define a health practice. “The one before Covid, which we certainly cannot define as optimal, however,” explains Di Michele. But to lower it, new resources are needed, starting with doctors.
THE PROCEDURES It should be recalled that the social security institution administers invalidity medical procedures in Lazio, Calabria, Basilicata, Campania (excluding Naples) and in other provinces of Friuli, Veneto and Sicily. The problems of deprivation are concentrated in urban centers, with a particular critique of Rome. Since 2010, INPS has been responsible for the payment of benefits, which is normally within 25 days of the doctors giving the last green light. A good result compared to the previous period in which this task was entrusted to the prefectures. In the recent annual report, Tridico’s chairman asked for a review of a regulation that is still fragmented today: “It would be good to centralize the disease assessment process in INPS, avoid the local health authority, simplify the committees, uniformity of judgment and certain times short in decisions “Of course the control measure remains against those who may not be entitled to benefits. Audit visits are made by law every three years. In perspective – but a legislative intervention would be necessary – the practice of asking repeated questions for the same pathology can be counteracted, a cunning that was mainly used in the past.