THE ESSENTIALS
Before you start
- Article 30 does not describe an automatic cut for every missed appointment.
- Lack of justification and a link to incapacity or worsening matter.
- Clinical disagreement has specific routes and should be documented.
The rule requires more than recording an absence
Article 30(1) of Portugal's Law 98/2009 requires the injured worker to undergo treatment and follow the designated doctor's clinical and surgical prescriptions necessary for recovery and restoration of working capacity, without prejudice to requesting a court expert examination.
Paragraph 2 allows compensation to be reduced or excluded under the general rules where incapacity or worsening damage results from unjustified refusal or failure to follow those prescriptions. Reading missed appointment in a message therefore does not automatically establish total loss of compensation. The justification and causal link to the specified consequences require assessment.
The Act identifies a refusal that is justified
Paragraph 3 always treats refusal of surgery as justified where the procedure's nature or the injured person's condition puts their life at risk. This must not be confused with general permission to disregard any clinical instruction.
Tiago asks the professionals to explain the procedure, risk and difficulty he reported. Fear, inability to attend and risk to life are not interchangeable descriptions. This guide neither classifies anyone's clinical situation nor replaces the medical explanation needed.
Disagreeing with the doctor differs from abandoning the process
Article 33 recognises the right to disagree with decisions of the treating doctor. Article 34 provides a dispute-resolution route, beginning with the possibility of a doctors' conference and then distinguishing hospitalised and non-hospitalised cases. This should not be decided through social-media comments.
As an organisational method, Tiago records the instruction, specific difficulty, when he reported it and the reply received. He asks about the appropriate route for the disagreement and keeps communications. A clear chronology helps separate a communication failure from a clinical issue needing assessment.
Ask about the decision and its grounds
If notified of a reduction or exclusion, identify the affected benefit, the conduct relied upon, the justification considered and the link alleged with incapacity or worsening. Request the decision's grounds and guidance on the appropriate challenge route. Do not assume submitting a complaint automatically suspends every effect or deadline.
To organise an insurance question about an existing accident, use RMACHADO's policy and claims support. Share clinical documents only through the designated private process. Clara leaves four practical points; she does not recommend changing treatment, decide compensation or replace clinical or legal support.
KEEP THESE QUESTIONS
Your checklist for the next conversation
- Report the difficulty through the treatment channel and retain the reply.
- Request clinical clarification and identify the instruction in question.
- Use the appropriate documented route for clinical disagreements.
- Check the affected benefit and grounds of any decision received.
FROM THE ARTICLE TO YOUR SITUATION
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Content updated on .
Consultation dates are stated in individual references when available.
Numerical examples are fictional and explain concepts. Editorial interpretations are identified in the text.
Information from RMACHADO GROUP. This is not an insurance offer or individual advice. Covers, acceptance, exclusions, sums insured and costs depend on the policy. The intermediary does not underwrite the risks.