Patients with cancer: how to obtain an online oncology certificate

In Italy three and a half million people live with a cancer diagnosis and about a third continue to carry out their profession. For everyone, and in particular for sick and working family members, it is essential to be able to quickly access the concessions provided by law: legal and economic benefits and job protection pass through the recognition of disability, the bureaucratic process of which is not very simple. But the correct and rapid assessment of disability and handicap simplifies the life of patients and caregivers, already severely distorted by the tumor and by therapies. Precisely for this reason, INPS and Agenas, together with the Federation of Cancer Voluntary Associations (Favo), have launched a project that wants to develop an operating protocol that is the same for all of Italy establishing uniform procedures for issuing the Introductory telematic oncology certificateand that it is issued directly and immediately by the person making the diagnosis.

What is the Introductory Telematic Oncology Certificate?

the necessary prerequisite to start the INPS telematic procedure for the recognition of invalidity and disability and serves to provide the INPS medical-legal Commission with all the clinical, diagnostic and therapeutic information useful for a correct assessment of the state of disability connected and consequent to the pathology oncology and related therapies explains the lawyer Elisabetta Iannelligeneral secretary of the Favo.

When should it be done and why?

Following the oncological diagnosis, the sick person can start the procedure for the recognition by INPS of the invalidity and handicap which are the necessary prerequisites to be able to take advantage of the economic benefits and legal protections, even at work (permits and leave paid), per se for the family caregiver who accompanies him during the oncological path for visits, diagnostic tests and anticancer therapies clarifies Iannelli.

Who releases it?

The certificate filled in and sent to INPS by the certifying doctor who can be the specialist (oncologist or surgeon, or other specialist) or the family doctor. Once the INPS has received the request to ascertain the invalidity and disability electronically, it calls the interested party to visit, but it is also possible that the assessment of the more or less serious condition of disability takes place simply on the basis of the health documentation sent, the so-called assessment “on record” introduced during the pandemic emergency in 2020 as a method of simplifying the assessment without a direct visit in the presence of the patient, the INPS director general replies, Gabriella Di Michele.

What is the correct procedure to follow?

The procedure is divided into two interconnected phases – he clarifies Raffaele Migliorini, director of the Inps Medical Forensic Coordination -: the certifying physician accredited by the INPS (general practitioner or specialist doctor) fills out the introductory and important oncological certificate online on the INPS website that signals that it is a neoplastic disease (Law no. . 80 of 2006) to activate the preferential lane which ensures the call to visit and the response of the commission within 15 days. The procedure issues a receipt with an identification code that the doctor gives to the person concerned together with a copy of the digital medical certificate. The patient, personally or through an authorized intermediary (patronages), within 90 days of sending the oncological certificate, must fill in and electronically send the administrative application linked to the introductory certificate to INPS.

What are the current problems and what are the proposed solutions?

Unfortunately, it happens that the introductory specialist certificate is not filled in correctly or that relevant evaluation elements are omitted for the purpose of a correct assessment of the oncological disability – concludes Iannelli -. It is therefore necessary that the certifying doctors are adequately trained in the use of this certificate and that ad hoc agreements are activated with scientific research institutes and hospitals to make it possible to issue the certificate directly in the treatment centers of cancer patients.

The positive experience in some Regions

The model of agreement with the treatment centers has been tested in recent years in some hospitals in Lazio, Puglia, Piedmont and Emilia Romagna. The pilot experiences leave no doubt about the advantages: reduction of the time elapsed between diagnosis and submission of the application, from an average of 121 days to 67; 100% of patients evaluated within 15 days; sharp decline in review practices. We will continue to work jointly with the INPS and together with the Regions for the definition of a national protocol – concludes the director general of Agenas, Domenico Mantoan -. We know that in this way we can greatly improve three crucial aspects: first, reducing the latency time between diagnosis and assessment in patients with serious illnesses and sometimes with a short life expectancy; second, to immediately obtain comprehensive and appropriate clinical information for the assessment of commissions remotely and at no cost to the patient; third, limit reviews and litigation.