One who has gone through the process of Submitting a Special Services Benefit (Attendance Allowance) Claim, appeared before the committee for Special Services, and is unsatisfied with the decision, may file for an appeal.
- The decision of the Appeals Committee may be appealed to the Regional Labor Court.
Appeals concerning the percentage of disability
- One whose claim for attendance allowance was rejected due to the percentage of disability set by the General Disability Medical Committee which did not entitle him/her to the benefit, may appeal to the medical board for general disability within 30 days.
Appealing to the Attendance Allowance Appeals Committee
Target Population and Preconditions
- One who appeals to a Medical Board Appeal Committee regarding Special Services Provision must meet one of the following conditions:
- The appeal may be filed with respect to the decisions made by the Medical Committee for Special Services on these matters:
- The established amount of the benefit
- Date in which the entitlement to the benefit commenced.
- Rejection of the benefit application.
Filing the Appeal through the Medical Committee Appeals for Special Services
- The appeal must be submitted within 60 days of receiving written notification regarding the decision of the Medical Committee for Special Services. However, the National Insurance Institute does not reject appeals filed within 90 days, but it is recommended to file the appeal, when possible, within the specified time according to the law.
- The appeal must be submitted in writing and contain details of the reasons why the decision of the medical committee should be changed.
- The appeal should be submitted to the closest National Insurance Institute branch to one's place of residence.
The decision process by the Medical Committee Appeals for Special Services
- The Medical Appeals Committee meets to discuss the appeal within 60 days from the date filed.
- The Committee is authorized to approve or change the score given in view of the dependence test following the filing of the appeal, and add or subtract from the score determined by the Medical Committee for Special Services.
- One may ask not appear before the committee during the hearing of the appeal, via a letter to the branch of the claimant, or by contacting the National Insurance Institute hotline, *6050.
- It is recommended to come to the committee with accompaniment. For more information see Accompaniment to a medical committee through the National Insurance Institute.
- Composition of the Medical Appeals Committee :
- a doctor - specialist.
- a nurse.
- psychologist specialist, a physical therapist, occupational therapist, or speech therapist.
- Upon entering the meeting, committee members will be introduced by the Secretary of the Commission by full name and title (in addition, the committee members will be wearing identification tags).
- Subsequently, the claimant will submit the appeal and detail the arguments on which the appeal is substantiated.
- In certain instances, a physical examination will be carried out in accordance with the decision of the doctor who sits on the committee. In the case that a physical examination was not done, the committee's decision will be based on medical documents in the file.
- In the case that the Appeals Commission is considering reducing the amount of points, one can cancel the appeal and keep the score as determined by the Commission for Special Services.
- A committee which considers reducing the score will stop the deliberation process and specify this within the Committee's minutes.
- If the claimant is not present during the hearing committee, he/she will receive a letter announcing the end of the deliberation process, the possibility of reducing the score, and the possibility to continue with the appeal.
- If the claimant wants to withdraw the appeal, he/she must send a letter to the Department of Committees and inform them of this decision.
- The committee's decision will be sent to the claimant one month after convening the committee.
Non-appearance before the Committee
- One who filed an appeal and was asked to appear before the committee, the committee is permitted to make a decision on the appeal in his absence and they can also fine him.
- For more information see: Failure to Appear before the National Insurance Institute's Appeals Committee and Medical Committee]
- The decision of the Appeals Committee can be appealed to the Regional Labor Court, within 60 days of receiving written notification about the decision, and may only address legal questions.
- One can appeal to the Labor Court to get free legal aid from the Justice Ministry's legal aid, regardless of economic ability or inability.
Additional Issues to Appeal
- There are cases where the appeal deals with issues such as the claimant's work periods, age, education, income, or if the claim was rejected due to laws or regulations, for example:
- One was hospitalized in an institution which provided medical, nursing care or rehabilitative services.
- One who resided abroad.
- Recipient of the Mobility Benefit.
- Recipient of a Special allowance under any other law.
- Receives retroactive payments over 6 months.
- In these types of cases, one can submit a request for a further hearing to a claims committee within 6 months of receiving the written decision from the National Insurance Institute]].
- Alternatively, or if the claims committee hearing did not help, one can file an appeal with the Regional Labor Court within 12 months from the date one received notice of the decision of the National Insurance Institute.
- In appeals to the Labor Court the applicant may receive free legal aid from the Justice Ministry's legal aid department, regardless of economic ability or inability.
- One can apply for reimbursement of expenses incurred due to appearance before the special services committee, (including transportation, lodging, finances and loss of working hours).
- Medical Board Appeals - services for the severely disabled National Insurance Institute's site.
- Original information in this article was written with the assistance of Department of Medical Committees of the National Insurance Institute.
- English translation and maintenance by The Shira Pransky Project.