In emergency departments, clinics and offices, doctors are always faced with patients who want a certificate not to show up for work, even without any illness. In these cases, many invent symptoms.
The doctors’ experience guarantees them experience to identify when a person is lying about their health condition. There are those who refuse to give a certificate, but they can also resort to a specific ICD-10 code (International Classification of Diseases) that tends to cause a big problem for the patient.
If the doctor writes “Z76.5” in the reason for the leave, he will be claiming the following reason: person pretending to be sick (conscious simulation).
An unsuspecting patient may not see a problem with this, but when presenting the document to the company, it is common for the HR department and occupational medicine to check the illness that removed that employee.
Once CID Z76.5 has been verified, the company may choose to dismiss the employee for just cause. There are recent judgments of the Labor Court that maintained the employer’s reason in this type of decision.
In 2020, the 4th Panel of the Regional Labor Court of the 6th Region, in Pernambuco, upheld a lower court judgment in the case of a woman who had been dismissed for just cause after presenting a medical certificate with CID Z76.5.
The doctor who signed the document himself testified in the process. He said that, before that occasion, the woman had attended the UPA Nova Descoberta on 56 occasions, “mostly simulating illnesses”.
The judges, therefore, maintained the employer’s thesis, that the woman had committed an act of impropriety, provided for in art. 482, paragraph A, of the CLT.
But why, then, do all physicians who suspect a patient not put ICD Z76.5 on the certificate? Because they can be punished if this is done without the patient’s authorization.
The TST (Superior Labor Court) has already overturned the clause of a collective agreement that required medical certificates to have a CID for them to be considered valid by companies.
The bottom line is that patients have a right to privacy. If the physician inserts the ICD without the patient’s agreement, he may face disciplinary proceedings at the Regional Council of Medicine.
“The patient has the right to privacy, and it is up to him exclusively to authorize, on the certificate sheet itself, the inclusion of the International Classification of Diseases (ICD). In this case, the doctor must accept the request and record it in the medical record”, guides the CRM-ES (Regional Council of Medicine of Espírito Santo) on its website.
Still according to the TST, “secrecy in the doctor-patient relationship is an inalienable right of the patient, and it is up to the doctor to protect and guard it”.
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