A 54-year-old Barcelona resident suffering from advanced prostate cancer that has spread to his bones, lungs, and soft tissues has been denied permanent disability benefits and ordered to return to work by the Catalan government’s medical evaluation body. The decision came despite reports from his specialist oncologists stating his condition and the side effects of his treatment render him unable to perform any job.
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The ordeal for Pepe Espino began in 2020 with a sharp pain in his back. A subsequent MRI scan delivered a devastating diagnosis: stage IV prostate cancer, already metastasized throughout his body. At the time, he was 48 years old. For the next two and a half years, Mr. Espino continued to work as a sales director for a major sports brand, a high-stress role involving team management and frequent travel. However, the progression of his illness and the severe side effects of his palliative hormonal treatment eventually made his job untenable.
After two and a half years on medical leave, he was summoned on November 28 for an evaluation by the Institut Català d’Avaluacions Mèdiques (ICAM), the entity responsible for assessing work disabilities in Catalonia. He attended the appointment feeling confident, armed with medical reports from his oncology team at the prestigious Hospital Clínic de Barcelona.
One report from his oncologist explicitly detailed his condition and stated that the symptoms of his ongoing palliative treatment “prevent him from carrying out any work activity.” The treatment involves a chemical castration injection every six months to keep his testosterone at zero, leading to bone decalcification, joint stiffness in his hands and feet—including a case of ‘trigger finger’ requiring injections—constant fatigue, acute pain, and cognitive effects. “My memory is getting worse and worse,” Mr. Espino told La Vanguardia.
The Tribunal’s Verdict
Despite the evidence, the ICAM tribunal ruled against him. Consequently, the national National Social Security Institute (INSS) formally denied his application for a permanent disability pension. The official reason cited was that he did not present “serious anatomical or functional reductions, susceptible to objective determination and foreseeably definitive, that diminish or nullify his work capacity.”
Mr. Espino recounted that during the 20-minute interview, the ICAM doctors acknowledged that his tumor markers had reduced, a sign his body was responding to the palliative medication. While he confirmed this was true, he stressed that the treatment is ongoing and not curative. “I wish it were so,” he said, explaining that his oncologist has told him the cancer cells will eventually learn to bypass the medication. “It’s not a situation where the pathology has been overcome.”
“It seems that the reports from the medical team that treats me are worthless paper. I am outraged.”
He lamented that a brief interview seemed to carry more weight than five years of continuous treatment and expert medical opinion from a leading public hospital. “It seems that the reports from the medical team that treats me are worthless paper. I am outraged,” he said.
A Long Road Ahead
Mr. Espino has filed an appeal, a process his lawyer, Jaume Cortés of Col·lectiu Ronda, described as a mere “administrative formality.” Cortés anticipates the appeal will be rejected, forcing them to file a lawsuit against the INSS. “We will have to wait about two years for a trial date, which he has a high probability of winning,” the lawyer explained.
In the interim, Mr. Espino is in a precarious position. Officially, he should have returned to his job, but his employer has allowed him to take pending vacation days. Mr. Cortés fears the inevitable: “He will have to return to a job he cannot do, so the company will likely dismiss him, leaving him at 54, sick, without employment, and unable to work.”
Cortés called the case “flagrant” and questioned the ICAM’s process, where a general practitioner’s opinion can override that of a specialist oncologist in minutes. He also made a serious allegation regarding the institute’s incentives.
“The Social Security has a contract with the Generalitat de Catalunya for the provision of this service in which the denial of sick leave and disability is rewarded,” Cortés claimed. “That is, the ICAM doctors have a bonus in their salary for these denials.”
By making his case public, Mr. Espino hopes not only to resolve his own situation but also to spur systemic change within the ICAM. “This nonsense must be put to an end,” he concluded.
