{"id":2976019,"date":"2024-04-25T16:19:03","date_gmt":"2024-04-25T16:19:03","guid":{"rendered":"https:\/\/easyjur.com\/blog\/?post_type=modelos-de-peticao&p=3650"},"modified":"2024-04-25T16:19:03","modified_gmt":"2024-04-25T16:19:03","slug":"parecer-medico-inss-modelo-completo","status":"publish","type":"modelos-de-peticao","link":"https:\/\/easyjur.com\/blog\/modelos-de-peticao\/parecer-medico-inss-modelo-completo\/","title":{"rendered":"[MODELO] PARECER M\u00c9DICO INSS – Modelo Completo"},"content":{"rendered":"

ANEXO V<\/strong><\/p>\n

INSTRU\u00c7\u00c3O NORMATIVA N\u00ba 77 \/PRES\/INSS, DE 21 DE JANEIRO DE 2015<\/strong><\/p>\n

PARECER M\u00c9DICO \/ MEDICAL REPORT<\/strong><\/p>\n

1. Dados relativos ao examinado \/ Information regarding the examined<\/strong><\/p>\n

\tSegurado \/ Insured dependente \/ dependent <\/strong><\/p>\n\n\n\n\n\n\n\n\n
\n

Nome e sobrenome \/ Name and Surname:<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Nome do pai \/ Father’s name:<\/strong><\/p>\n<\/td>\n

\n

Data \/ Date:<\/strong><\/p>\n<\/td>\n

\n

Sexo \/ Sex:<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Escolaridade \/ Education :<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

N\u00famero de inscri\u00e7\u00e3o no Brasil (NIT) \/ Registration number in Brazil (NIT):<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Endere\u00e7o na data da solicita\u00e7\u00e3o \/ Address on the date of the request:<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Documento de Identidade (tipo e n\u00famero) Brasil \/ Document of Identity (type and number):<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Ocupa\u00e7\u00e3o Laboral (descrever) \/ Labor Occupation (describe):<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n\n\n\n
\n

C\u00f3digo Internacional da Ocupa\u00e7\u00e3o Laboral \/ International Code of Labor Occupation:<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Data do \u00faltimo dia trabalhado (DUT) \/ Date of last day worked:<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

2. Antecedentes pessoais e familiares \/ Personal an family history<\/strong><\/p>\n\n\n\n\n\n\n\n\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n<\/table>\n

3. Antecedentes Laborais \/ Employment Background<\/strong><\/p>\n\n\n\n\n\n\n\n\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n<\/table>\n

4. Hist\u00f3rico da Doen\u00e7a Atual \/ Current Disease history<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
\n

Data do In\u00edcio da Doen\u00e7a (DID) (dd\/mm\/aaaa) \/ Date of Onset of Disease (mm\/dd\/yyyy):<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

5. Exame F\u00edsico Geral \/ General Physical Examination<\/strong><\/p>\n\n\n
\n

Observa\u00e7\u00f5es Objetivas \/ Objective Observations:<\/strong><\/p>\n

Estado Geral \/ General Condition:<\/strong><\/p>\n

Altura \/ Height: Peso \/ weight: <\/strong><\/p>\n

Press\u00e3o Arterial \/ Blood Pressure: Pulso \/ Pulse:<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n\n\n
\n

Aspecto geral \/ General Prospect:<\/strong><\/p>\n

Biotipo (brevilineo, normolineo, longelineo) \/ Body Type (slim, average, elongated):<\/strong><\/p>\n

Marcha \/ March: <\/strong><\/p>\n

Colora\u00e7\u00e3o da pele e das mucosas \/ Staining of the skin and mucous: <\/strong><\/p>\n

<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n\n\n
\n

Exame F\u00edsico \/ Physical Examination:<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

6. Exames Complementares Apresentados \/ <\/em>Complementary Tests Presented<\/strong><\/p>\n\n\n
<\/td>\n<\/tr>\n<\/table>\n

7. Exames Complementares Solicitados \/ <\/em>Complementary Tests Requested<\/strong><\/p>\n\n\n
<\/td>\n<\/tr>\n<\/table>\n

8. Diagn\u00f3stico(s) cl\u00ednico(s) fundamentado(s) \/ <\/em>Clinical Diagnosis Based<\/strong><\/p>\n\n\n
\n

Diagn\u00f3stico principal \/ Main Diagnosis: CID 10:<\/strong><\/p>\n

Diagn\u00f3stico(s) secund\u00e1rio(s) \/ Secondery Diagnosis: CID 10:<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

9. Considera\u00e7\u00f5es sobre a incapacidade para o trabalho \/ Considerations about incapacity for work<\/strong><\/p>\n\n\n\n
\n

H\u00e1 incapacidade para o trabalho: sim\/n\u00e3o \/ There is incapacity for work: yes\/no<\/strong><\/p>\n

Em caso afirmativo, qual a data do in\u00edcio da incapacidade (DII): dd\/mm\/aaaa<\/strong><\/p>\n

If so, what is the date of onset of disability: mm\/dd\/yyyy<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

H\u00e1 incapacidade tempor\u00e1ria: sim\/n\u00e3o \/ There is temporary disability: yes\/no<\/strong><\/p>\n

H\u00e1 incapacidade permanente para a ocupa\u00e7\u00e3o habitual: sim\/n\u00e3o<\/strong><\/p>\n

There is permanent disability for the usual occupation: yes\/no<\/strong><\/p>\n

Em caso afirmativo, h\u00e1 indica\u00e7\u00e3o de reabilita\u00e7\u00e3o profissional? sim\/n\u00e3o<\/strong><\/p>\n

If so, is there indication of professional rehabilitation?: yes\/no<\/strong><\/p>\n

H\u00e1 incapacidade permanente para todas as ocupa\u00e7\u00f5es: sim\/n\u00e3o<\/strong><\/p>\n

There is permanent disability for all occupations: yes\/no<\/strong><\/p>\n

H\u00e1 incapacidade permanente para todas as ocupa\u00e7\u00f5es com necessidade de ajuda de terceiros: sim\/n\u00e3o<\/strong><\/p>\n

There is permanent disability for all occupations and need help from others: yes\/no<\/strong><\/p>\n

Incapacidade decorrente de acidente do trabalho: sim\/n\u00e3o<\/strong><\/p>\n

Disability due to accident at work: yes\/no<\/strong><\/p>\n

Incapacidade decorrente de enfermidade\/doen\u00e7a ocupacional: sim\/n\u00e3o<\/strong><\/p>\n

Disability due to illness\/occupational disease: yes\/no<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

10.<\/strong><\/p>\n\n\n
\n

H\u00e1 necessidade de uma nova avalia\u00e7\u00e3o clinica? Em caso positivo, qual a data sugerida?<\/strong><\/p>\n

There is need for further clinical evaluation? If so, what is the suggested date?<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

11.<\/strong><\/p>\n\n\n\n\n\n\n
\n

Outras observa\u00e7\u00f5es \/ Other observations<\/strong><\/p>\n<\/td>\n<\/tr>\n

<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n
<\/td>\n<\/tr>\n<\/table>\n

12. M\u00c9DICO QUE EMITE O PARECER \/ PHYSICIAN THAT ISSUES THE REPORT<\/strong><\/p>\n\n\n\n\n\n\n\n\n
\n

Nome e sobrenome \/ Name and surname<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Endere\u00e7o \/ Address<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Realizado em \/ Accomplished in<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Data \/ Date<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Assinatura \/ Signature<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Endere\u00e7o eletr\u00f4nico \/ E-mail address<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Telefone \/ Phone Number<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n

Data \/ Date :<\/strong><\/p>\n

___________________________________________________<\/strong><\/p>\n

Assinatura do examinado<\/strong><\/p>\n

Signature of the examined<\/strong><\/p>\n","protected":false},"featured_media":0,"parent":0,"menu_order":0,"template":"","meta":{"content-type":""},"categoria-modelo":[154],"class_list":["post-2976019","modelos-de-peticao","type-modelos-de-peticao","status-publish","hentry","categoria-modelo-previdenciario"],"_links":{"self":[{"href":"https:\/\/easyjur.com\/blog\/wp-json\/wp\/v2\/modelos-de-peticao\/2976019","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/easyjur.com\/blog\/wp-json\/wp\/v2\/modelos-de-peticao"}],"about":[{"href":"https:\/\/easyjur.com\/blog\/wp-json\/wp\/v2\/types\/modelos-de-peticao"}],"wp:attachment":[{"href":"https:\/\/easyjur.com\/blog\/wp-json\/wp\/v2\/media?parent=2976019"}],"wp:term":[{"taxonomy":"categoria-modelo","embeddable":true,"href":"https:\/\/easyjur.com\/blog\/wp-json\/wp\/v2\/categoria-modelo?post=2976019"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}