As a general rule, it is not required to invite children to a medical committee hearing in order to determine their eligibility for a Disabled Child Benefit
In a case that the claim seems like it may be rejected, the child is invited to a medical committee hearing
If eligibility is determined based on documents alone, it is possible to request that the request be checked by a committee with the child present, within 45 days

The Disability Circular (Children with Disabilities) 1916 establishes that as a general rule, the child does not need to be present at the medical committee hearing in order to determine his/her eligibility for a disabled child benefit and this can be done on the basis of documents alone.

  • The general process to receive a disabled child benefit is outlined in the chart below. More details for the steps that occur after the medical committee hearing can be found below
Receiving notification about the decision of the committee
If the answer is positive, see, Benefit Rates
In any case, you may

Target Audience and Prerequisites

Stages of the Process

  • Parents who would like the medical committee hearing to take place in the absence of their child must sign on the "permission for a doctor to determine eligibility without the child" on the claim form.
  • In signing that section the parents agree that:
    • A decision will be made regarding their child without his/her presence.
    • They know that despite their request the committee may still require the child to be checked by a doctor.
    • If their request is accepted, a Disabled Child Benefit Dependency Test can not be performed. This test is given to children above age 3 if they have the maximum eligibility level - 188% (There are certain exceptional cases in which dependency points can be determined without requiring the presence of the child at the medical committee hearing).
  • It is very important that the documents attached to the claim form be from a doctor authorized to treat the child (not only the family physician) and that they be detailed, specific and up-to-date.
  • In cases where it is possible to determine eligibility (partial or maximum) based on documents only, a decision will be made without the presence of the child even if the parent did not sign the consent form as specified in the preceding sections. In such cases, the family will be sent a letter explaining that the decision was made without presence of the child and that they can request a hearing in the presence of the child in order to examine the child's level of dependency on others.
  • In any event, a claim without an examination in the presence of the child, or on the basis of documents alone, will not be rejected. If a claim is likely to be rejected, the child will be summoned to the medical committee.
  • In the following cases eligibility will be determined based on documents alone, without the presence of the child:

Continuing the Process

What Now? For More Information Notes
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. In certain situations, temporary eligibility may be established (relevant cases are detailed in the Specific Information for Eligible Populations section.
  • In cases where temporary disability is established, towards the end of the established period of disability, the National Insurance Institute will request updated medical information and the person will be invited to appear before an additional medical committee.
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. See Disabled Child Benefit#Benefit Rate.
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 (if eligibility was rejected or only partially/temporarily established), 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.
If you wish to appeal a decision of the claims officer that is not related to the decision of the medical committee
  • The Claims committee is only authorized to recommend that the claims officer reconsider his decision (in cases where it deems fit).
  • In an appeal to the Regional Labor court, free legal aid may be requested from the Justice Ministry's legal aid branch.
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.

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