Introduction:
As part of the General Disability Pension claim process, the applicant's level of medical disability is determined by a General Disability Medical Committee
This page includes details on how disability is calculated as well as links to specific information relevant to specific diseases
For more information see the National Insurance Institute website
As part of the General Disability Pension claim process, the applicant's level of medical disability is determined.
- This page details how medical disability is calculated.
- This page also provides links to specific information about different types of disabilities and illnesses the applicant may have (including what sections of the regulations are relevant and what documents should be prepared before appearing before the General Disability Medical Committee.
- There are various benefits given to people with medical disability that are not contingent on eligibility for the disability pension or level of incapacity.
- The diagram below shows the different stages of the disability benefit claim process. Detailed steps are provided in the chart below.
Submitting a General Disability Pension Claim through the Regular Track
or
Fast Track for Special Circumstances
or
Fast Track for Special Circumstances
Establishing the Degree of Incapacity
and receiving a response in the mail
and receiving a response in the mail
If the response is positive, see: Pension Rates
If you are not satisfied with your response, you can appeal the medical decision
or
appeal the decision regarding incapacity to function
or
appeal the decision regarding incapacity to function
In any case, one can
resubmit a claim
resubmit a claim
Before eligibility for the disability benefit is established and until it is received a person can check if he/she is eligible for income support
There are several ways to receive professional assistance during the process of making a disability claim.
The National Insurance Institute runs Yad Mechuvenet that provides free guidance and assistance for those who are preparing to appear in front of the medical committee.
For more information on other ways to receive assistance see Free Aid for Filing Disability Claims with the National Insurance Institute.Target Audience and Prerequisites
- Insured Israeli residents from age 18 through retirement age that submit a general disability pension claim.
A person who wants to have (general) medical disability determined by the National Insurance Institute that is not through a general disability claim can submit a request to the Tax Authority to be evaluated by a Income Tax Exemption Medical Committee.
For example, a man who suffers from an illness that caused disability after he reached retirement age and therefore he can't submit a disability pension claim because of his age but he is interested in receiving benefits given to those with medical disability (that are not contingent on receiving a disability pension).
Necessary Preparations
- Those suffering from multiple ailments and disabilities are advised to prepare relevant documentation and tests for each of the disabilities in order to increase the percentage of disability that will be established by the claim.
- The National Insurance institute calculator gives you the option to receive a detailed list of the medical documents you should include in you claim based on your medical diagnosis.
- Likewise, required documents for specific illnesses can be found on their specific pages.
- If a person submits the application for heart disease, it is recommended to examine thoroughly whether he/she is suffering from another illness /disability that will give him/her additional medical disability percentages.
- In the above example, let's say that in addition to heart disease, the person also suffers from diabetes and subsequently submitted to the committee the documents required regarding the diabetes.
- Assume the the medical committee determines :
- 40% disability with respect to the heart disease
- 20% disability with respect to the diabetes
- According to these figures, a weighted medical disability of 52% will be determined.
- For an explanation of the calculation method and additional information, see weighted medical disability as determined by the National Insurance Institute for multiple diseases
Establishing degree of disability
- After the discussion in the General Disability Medical Committee is over, the committee's doctor established the degree of disability based on the regulation additions ("Medical Tests Guide").
- The doctor also determines the start date of the medical disability and whether is is temporary or permanent.
- If temporary disability is established: Towards the end of the prescribed period, the National Insurance Institute will contact the policyholders to request submission of updated medical information and to invite them to appear before an additional medical committee hearing.
- When a person suffers from multiple diseases and disabilities that each have their own established degree of disability, medical disability is calculated based on their weighted calculation.
- If the weighted number is not a whole number it is rounded up to the next whole number (for example 89.1% is considered 90%).
The National Insurance Circular lists cases when it is recommended to determine disability based on the documents submitted and without summoning the applicant to the medical committee Intellectual Disabilities, Oncology Patients, the Blind, Severe Renal Failure, Organ Transplants recipients (kidney, heart, liver, lung ect), Advanced Cardiac Patients, Paralysis, degenerative illness in advanced stages (e.g Parkinson's, Multiple Sclerosis, ALS) Autism, Schizophrenia, extended hospitalization, requires a respirator.
Disabilities that are not taken into account in determining eligibility
- There are certain medical conditions that cause medical disability but have been determined not to impact a person's ability to work and earn money and therefore are not taken into account when determining the degree of general disability.
- These conditions are detailed in the addendum to the National Health Insurance Regulations (Disability Insurance) (Establishing Degree of Medical Disability, Appointment of Appeals Committees, and other directives)
- According to section 17(b) of the National Health Insurance Regulations (establishing disability for work accident victims), removal of the spleen gives a person a medical disability of 10%.
- Section 17(b) is part of the list of conditions that don't count toward disability.
- Therefore the medical disability of 10% established after the spleen removal is not taken into account when calculating the degree of general disability.
Information on Specific Types of Disabilities
- Determining Disability after a Stroke
- Determining Disability for People with Kidney Disease
- Determining Disability for Heart Patients
- Determining Disability for People with Diabetes
- Determining Disability for Cancer Patients
- Determing Disability for People with Fibromyalgia
- Determining Disability for Parkinson's Disease Patients
- Determining Disability for People with Lung Disease
- Determining Disability for People with Rheumatic Diseases
- Determining Disability for People Coping with Mental Health Issues
- General Disability Pension for those affected by Sexual Assault
- Determining Disability for People with Urological Problems
- Determining Disability for People with Orthopedic Issues
- Determining Disability for People with Gynecological and Urogynecological Problems
- Determining Disability for People with Gastric Problems
- Determining Disability for People with Gender Dysphoria
- Determining Disability for People with Endocrine Disorders
- Determining Disability for People with ADD/ADHD
- Determining Disability for People with Blocked Arteries
- Determining Disability for People with Visual Impairment and Eye Disease
- Determining Disability for People with Ear, Nose and Throat Diseases
- Determining Disability for People with Blood Disorders
- Determining Disability for People with Venous Disease
- Determining Disability for People with Liver Disease
- Determining Disability for People with Skin and Allergy Diseases
- General Disability Pension for People Suffering from Corona Complications
Continuing the Process
What Now? | For Further Details | Notes |
---|---|---|
Medical Board's Decision |
|
There are rights given based on percentage of medical disability, independent of the determination of the degree of disability and eligibility for disability. |
The Decision of the Claims Official and Establishing the Degree of Incapacity |
|
In cases in which a rehabilitation clerk recommendation is necessary, you will be invited to an interview. |
Receiving the Decision | * Upon finishing all of the examinations, you will be sent in the mail notification of the decision on your claim with the attached report of the medical committee.
|
|
Payment of the Allowance for those Eligible |
|
*Someone who has an establish disability of 100% for a period of at least 6 months is eligible to receive a disability payment from the 31st day from when the disability was established.
|
If you are not satisfied with the decision of the medical committee, you can appeal the decision within 60 days. | Appealing a General Disability Medical Committee Decision |
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If you are not satisfied with the decision of the appeals committee, you may submit an appeal (for legal questions only) within 60 days. | One may request free legal assistance from the Justice Department's branch for free legal assistance. | |
If you are not satisfied with the level of incapacity determined, in certain cases you can appeal the decision of the claims assessor within 90 days. | Appealing the decision determining incapacity to function |
|
If you are not satisfied with the decision of the appeals committee, you may submit an appeal (for legal questions only) within 60 days. | One may request free legal assistance from the Justice Department's branch for free legal assistance. | |
If you would like to appeal the decision of the claims assessor, independent of the level of incapacity determined, for matters such as periods of employment, your age, your level of education, income, etc.). |
|
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One may submit another claim after 6 months have passed, or if the applicant's medical condition has worsened another claim may be submitted without a waiting period. | Reexamination of Disability Pension Eligibility |
Government Agencies
Laws and Regulations
- The National Insurance Law
- The National Insurance Regulations (establishing disability level for work accident victims) 1956
- National Health Insurance Regulations (Disability Insurance) (Establishing Degree of Medical Disability, Appointment of Appeals Committees, and other directives) 1984
- General Director's Circular from 27.06.2016 - Diagnosis and evaluation of dependence based on documents and without summoning the applicant to a medical committee for general disability, special services and a handicapped child.
Credits
- Original translation performed by The Shira Pransky Project as part of a grant from The Fellowship Fund.