O Auxílio-Doença é um benefício previdenciário pago pelo INSS às pessoas que ficarem incapacitadas para o trabalho por mais de quinze dias seguidos e que cumprirem 3 requisitos: (i) incapacidade para trabalho ou atividade habitual; (ii) cumprir carência; (iii) ter a qualidade de segurado.
Os requisitos devem estar presentes no momento do fato gerador do benefício, ou seja, na data de início da incapacidade, e o valor do benefício depende das contribuições realizadas pelo segurado durante sua vida laboral.
A incapacidade laboral existente antes da filiação ao Regime Geral de Previdência Social impede a concessão dos benefícios de auxílio-doença e aposentadoria por invalidez.
Assim, o segurado que se filia à Previdência Social já com doença incapacitante não possui direito aos dois benefícios.
Esta determinação está prevista na Lei nº 8213/91, artigo 59: “não será devido o auxílio-doença ao segurado que se filiar ao Regime Geral de Previdência Social já portador da doença ou da lesão invocada como causa para o benefício, exceto quando a incapacidade sobrevier por motivo de progressão ou agravamento da doença ou da lesão”. Esta vedação legislativa, como pode ser observado, não se aplica aos casos de agravamento – ou progressão – da doença
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