About the document
- Who files:
- Person insured with INSS (segurado) or their representative
- Where to submit:
- INSS agency or Meu INSS
- Authority:
- Brazilian National Social Security Institute (INSS)
- Country:
- Brazil
- Category:
- Social security and pensions (INSS)
- How to fill:
- Cards with hints → original form → PDF
- Price:
- form free · chat R$25 per document
- Last updated:
What this document is
The Requerimento de Benefício por Incapacidade is the INSS form an insured person (segurado) uses to apply for an incapacity benefit. The editable PDF is published under “Formulários” on the INSS website.
One page: insured person, address, sex and marital status, other activity covered by social security, representative, the employer section (“Atestado de afastamento do trabalho”) and a table of children for salário-família.
Who files it and where
- the person insured with INSS or their representative — an attorney (procurador) or a guardian (curador);
- the form is filed at an INSS agency or attached to a request in Meu INSS — check the channel for your case on the INSS website or by calling 135;
- for employees, the “Atestado de afastamento do trabalho” section is completed and signed by the employer (as the form’s instructions say);
- the form does not state deadlines or the medical examination procedure — check them with INSS.
What the form asks
- full name, date of birth, nationality, sex;
- “Doc. Inscrição”: the number and series of your work booklet (CTPS) or, if you have none, your NIT/PIS/PASEP;
- address: street, number, complement, neighbourhood, city, state, CEP;
- marital status and whether you have another activity covered by social security;
- name and address of the procurador or curador, if any;
- names and dates of birth of children for salário-família;
- the insured person’s handwritten signature.
What to bring
- identity document (RG, CIN, CRNM or passport) and CPF;
- medical documents about the illness or injury;
- power of attorney or guardianship order if a representative files;
- children’s birth certificates for salário-família;
- confirm the exact list with INSS.
How to fill it in with FoxDocs
- Answer the chat: personal details, address, marital status, representative, children.
- Check the cards: dates print as DD/MM/YYYY, nationality in Portuguese.
- Download the PDF, give it to your employer for the Atestado section, sign it and file it with INSS.
Source
Official INSS form: gov.br/inss — Requerimento de Benefício por Incapacidade. Checked 2026-10-27. This is not legal advice.