Disabled Child Benefit (Right)

Hebrew source: גמלת ילד נכה
From All Rights (Kol-Zchut) (www.kolzchut.org.il)

Introduction:

A Disabled Child Benefit is paid in accordance with the child's disability and dependence on others. A child with more than one disability may only receive the benefit for one disability, whichever has a higher entitlement
The total amount of the benefit (at the rate of 100%) is 2,569 NIS correct as of 2018. This includes the supplement of 373 NIS.
The benefit at the rate of 50% is 1,098 NIS (correct as of 2018)
Children over age 3 who are completely dependent on others in performing daily activities and children from birth age who receive Regular Treatment at a hospital are entitled to a benefit rate of 188% of the amount (including the additional 373 NIS) which is 4,501 NIS, correct as of 2018.

A Disabled Child Benefit is paid by the National Insurance Institute for children between 90 days and 18 years and 3 months old, depending on the various disabilities and the degree of dependence on others.

  • Children with hearing impairments, and children with Down Syndrome are entitled to receive the benefit from birth.
  • The process to receive the benefit is shown in the following diagram and details of each stage of the process are found below;
הגשת תביעה לגמלת ילד נכה
ועדה רפואית

לילד עד גיל 3
או
לילד מעל גיל 3

במקרים מסויימים ייתכן
דיון בוועדה ללא נוכחות הילד
קבלת הודעה על החלטת הוועדה
אם התשובה חיובית, ראו שיעורי הגמלה
אם אינכם מרוצים מהתשובה תוכלו
לערער על החלטת הוועדה הרפואית
וכן
לערער על החלטתה של ועדת העררים
בכל מקרה ניתן
להגיש תביעה חוזרת


Who is eligible?

  • Children between the ages of 90 days and 3 years who cannot perform most motor skills of the head, limbs and torso that others their age are capable of performing.
  • Children between 3 and 18 years and 3 months old who require much more assistance performing daily activities than others their age (i.e. dressing, eating, bathing, moving about the house, and control of bodily functions).
  • Children between the ages of 90 days and 18 years and 3 months who require the constant presence of another and cannot be left alone without supervision even for very short periods of time, due to an inability to discern elements of danger to themselves or to others (i.e. those with moderate intellectual disability, severe illness or a severe mental disorder).
  • Children between the ages of 90 days and 3 years who require constant supervision, cannot be left alone without supervision even for very short periods of time, and who require the presence of another person nearby in order to prevent situations of danger to the child or others to a degree which significantly exceeds that of other children of the same age (i.e. a child whom has severe ADHD or a child whom a diagnosis committee has determined to have mild intellectual disability, and for whom the Ministry of Education has established a special educational framework).
  • Children with a special impairment:
    • Hearing Impaired (from birth until age 18 and 3 months)
    • Reduced vision (from 90 days until age 18 and 3 months)
    • [[he:גמלת ילד נכה לילדים עם לקות נפשית|Psychosis or a disorder on the autism spectrum and any other similar psychiatric disorders (from age 90 days to 18 years 3 months)
    • Downs Syndrome (from birth until age 18 and 3 months)
  • Children requiring assistance communicating due to a complete lack of verbal communication (from age 3 until age 18 and 3 months)
  • Children requiring special medical treatment (from age 90 days to 18 years and 3 months)
    • Children from birth age, who receive regular treatments in the hospital are, in certain situations, entitled to a benefit at the rate of 188%.
  • Children ages 3 and up, who are totally dependent on others, who require help at all times performing all daily activities (such as dressing, eating, bathing, personal hygiene and mobility in the home) are eligible for a benefit at the rate of 188%.

Additional Conditions of Eligibility

  • Populations of children that meet the specified criteria must, in addition, meet the following conditions:
    • The child's parent must be insured and an Israeli resident.
    • The child is in Israel. Eligibility will be allowed under certain conditions for a child out of the country.
    • The child does not live in an institution or dormitory that provides therapy services, nursing care or rehabilitation, except in the following cases which may be filed for a child who is in an institution.
      • The parents cover the cost of keeping the child in an institution.
      • The family has another child receiving the disabled child benefit.
      • The child will be released from the institution and confirmation of the release date, and programs that integrate the child into the community
    • A child who is entitled to a benefit and is hospitalized, will continue to receive the benefit for one year from the date of admission. At the end of this year, their eligibility will be reviewed, depending on the reasons for hospitalization:
      • If hospitalization is for the purpose of healing or rehabilitation, payment of the pension will continue beyond the year.
      • Hospitalization that is not for the purpose of healing or rehabilitation is defined as being in an institution and therefore payment of the pension is terminated.
    • A child is not living with a foster family. Since December 2016, a foster child on a respirator is eligible for an additional allowance for a disabled child on a respirator and Disabled Child Benefit and Related Benefits.
    • The child does not receive a mobility allowance, except in cases specified below.

Entitlement for Child Mobility Benefit and a Disabled Child Benefit

  • A child will be eligible for both a Mobility Benefit and a Disabled Child Benefit simultaneously in any of the following cases:
    • Children for whom limited mobility of at least 80% has been established by the medical committee.
    • The medical committee determined that the child requires a wheelchair and he/she uses one.
    • The medical committee determined that due to lower body impairment the child cannot walk on their own and because of their disability they are unable to use a wheelchair.
    • Two or more siblings are eligible for Disabled Child Benefit, or one child is eligible for disabled child benefit and one child is eligible for child mobility benefit.
  • Children for whom limited mobility of under 80% has been established, must choose between the Mobility Benefit and the Disabled Child Benefit.
  • One cannot switch from a Mobility Benefit to a disabled child benefit, if the family car was purchased through a loan and the loan has not been repaid.
  • In order to verify that receiving mobility benefits will not impact Disabled Child Benefit eligibility, it is important to contact the Disabled Child Department at your local National Insurance Institute branch.


Necessary Preparations

Warning
There are many ones that one can receive free professional assistance during the process of submitting disability claims.

Before submitting the claim or as appearance before the medical committee approaches, free guidance is provided by the National Insurance Institute at "Guiding Hand" centers.

For information on additional options for assistance, see Free Assistance with Submitting Disability Claims to the National Insurance Institute.

How to claim it?

What Now? For Further Details Notes
Submit a claim Submitting a Disabled Child Benefit Claim It is important to remember to send all required documents
After filing the claim, it will be decided if a decision on the amount of disability can be made without the presence of the child. Medical Committee Hearing Without the Presence of the Child. If the committee decides on eligibility based on documentation only, you can request that the child be checked by the committee within 45 days.
If it is decided after filing the claim that there is a need to check the child then an invitation to a medical committee hearing will be sent according to the age of the child. *Medical Committee for a Disabled Child up to Age 3 *It is important to arrive at the prescribed time, or to report the inability to attend in advance.
  • If the child does not need assistance in performing daily activities, you can request that these activities are not checked during the committee's examination.
The committee's decision Within 45 days of receiving the claim with all relevant documents, you will be sent the decision, together with the minutes of the medical committee meeting.
If eligibility is granted, the benefit will be paid from the month in which the claim was submitted The benefit will be transferred to the eligible recipient's bank account on the 28th of each month.
Retroactive Payment Retroactive payment for up to a year before the claim was submitted may granted if the conditions for eligibility existed before submission. The time is determined based on the earlier of these two dates:
  • The date in which the symptoms connected to the child's disability were first recorded in the child's medical records.
  • The date in which that child's disability began to cause a significant and heavy treatment load (according to a pediatrician who works on behalf of the National Insurance Institute).
*A child receiving the benefit because of a developmental delay (until age 3) may receive a retroactive benefit for up to half a year before the claim was filed.
  • A retroactive benefit is not automatic and should be requested along with the main claim submission.
If you are not satisfied with the decision, you can appeal within 90 days from the day it was received. Appealing the Decision of the Medical Committee for a Disabled Child
If you are not satisfied with the decision of the Appeals Committee, you can appeal within 60 days to the Regional Labor Court. Appealing the Decision of the Medical Appeals Committee of the National Insurance Institute You may requestfree legal assistance from the legal assistance division of the Ministry of Justice.
A repeat claim may be filed after 6 months, or if there has been a deterioration in health status - with no waiting period. Submitting a Disabled Child Benefit Repeat Claim
If your child (above age 3) is totally dependent on the assistance of others for daily activities (in a way that is significantly more than his/her peers) and the child receives a disabled child benefit without relating to this dependence, a dependence evaluation can be requested. Dependence Evaluation for a Disabled Child Benefit Recipient A request for a dependence evaluation can be submitted from age 2 years and 10 months.


Special Processes

Children on the Autistic Spectrum

  • A benefit claim for a child on the autistic spectrum can be submitted with a request for Recognition by the Office for the Care of the Autistic and P.D.D. Population.
  • After turning to the Ministry of Social Affairs in order to receive benefits, a claim for a disabled child benefit from the National Insurance Institute may be submitted there.
  • Social workers/supervisors from the Welfare Ministry will transfer the claim, together with medical material that they have, to the National Insurance Institute.

Information for the Blind and Visually Impaired

  • According to the National Insurance Institute's Circular as of 02.16.2015, there is no longer a need to undergo an eye examination through the National Insurance Institute and through the Service for the Blind, rather, one of the following tests will suffice:
  • Anyone who first contacts the National Insurance Institute will be reviewed by the Institution; if it will be determined that there is a 90% or higher vision defect, the examination can be subsequently passed over to the Service for the Blind.
  • Within the appeal for review through the Service for the Blind, the opinion of the doctor can be transferred to the Social Security Institute. The doctor will submit his opinion on the degree of incapacity to function (general disability). The National Insurance Institute will make a decision regarding how to proceed, without the need for an additional summons of the claimant.
  • To allow the transfer of medical information between the agencies, the patient has to sign that he agrees to such transference of information.


Benefit Rates

  • The rates of the disabled child benefit are determined based on on the percentage of the full benefit amount of a single person which is 2,196 NIS, correct as of 2018.
  • Benefit rates (50%, 100%, or 188%) are determined, in part, according to the child's level of functioning, the degree of dependence on the help of others, and medical treatment that the child requires.
  • Children above age 3 who are completely dependent on others and children (according to specific conditions) from birth who receive regular treatment in the hospital, are entitled to a benefit at the rate of 188%.
  • Disabled Child Benefit recipients at the rate of 100% or 188% receive an additional 17% supplement of 373 NIS correct as of 2018.
  • A child with more than one disability is entitled to receive one benefit - that which entitles him/her to a higher entitlement.

Disabled Child Benefit at a rate of 50%

  • The Disabled Child Benefit at the rate of 50% is 1,098 NIS, correct as of 2018.

Disabled Child Benefit at a rate of 100%

  • The Disabled Child Benefit at the rate of 100% is 2,569 NIS (this amount includes the supplement amount of 373 NIS), correct as of 2018.

Disabled Child Benefit at a rate of 188%

  • The Disabled Child Benefit at the rate of 188% is 4,501 NIS (this amount includes the supplement amount of 373 NIS), correct as of 2018.

Supplement amount for children who are ventilated with a tracheostomy

Previous Rates

Families with more than one child with disabilities

  • Families with two or more children entitled to the disabled child benefit are entitled to an increased benefit amount for each of the children.
  • The addition for each child is an additional 50% of entitled amount established for the child.
Example
A family in which one child is entitled to a benefit of 100% and the brother is entitled to a benefit of 50%:
  • The child that is entitled to a benefit of 100% will receive an increased benefit of 150%.
  • The child that is entitled to a benefit of 50% will receive an increased rate of 75%.
  • Families with two children with disabilities who only receive a Disabled Child Benefit for one of them are entitled to an increased benefit amount if the child for which they are not receiving the benefit is not eligible for it due to one of the following reasons:
    • S/he lives in an institution or other facility outside the home.
    • S/he is over the age of 18 and received a Disabled Child Benefit before reaching the age of 18.
  • Families where two children are eligible for a Disabled Child Benefit or where one child is eligible for a Disabled Child Benefit and the second is eligible for a Mobility Benefit may be entitled to both a Disabled Child Benefit and a Mobility Benefit for each of the children in accordance with each benefit's conditions of eligibility.

Please note

Court Rulings

Aid organizations

  • For a comprehensive categorized listing of healthcare organizations offering assistance and support to people with disabilities, click here.
  • For a list of organizations that assist with matters relating to the National Insurance Institute click here

Government agencies

Laws & Regulations

  • NII Circular No. 1972 as of 05/08/2015 Raising allowances for special services and disabled children, and the new supplement for those requiring respirators, following the adjustment of the minimum wage.

Credits