Introduction:

Children between 91 days and 18 years old and 3 months, receiving medical treatment as detailed below are entitled to a Disabled Child Benefit of 100%
Children from birth, who require ongoing medical care in a hospital may be eligible for a benefit at the rate of 188%.

According to the first addition to the National Insurance Regulations (Disabled Child) children age 91 days until 18 years and 3 months, who receive medical treatment as explained below, are eligible for a disabled child benefit at the rate of 100%.

receive medical care provided by a hospital may also be eligible for a child benefit; if the child cannot attend their educational or therapeutic framework at least 3 days a week for 3 consecutive months.

  • The process to receive the benefit is shown in the following diagram Details on each stage may be found below:
Receiving notification about the decision of the committee
If the answer is positive, see, Benefit Rates
In any case, you may
reapply

Who is Eligible?

Children between 91 days and 18 years old and 3 months (or from birth in the case of regular treatment as noted) who fulfill one of the following criteria:

Factors of Eligibility Conditions of Eligibility Additional Information
Parents involved in child's treatment A child who from birth requires regular medical care from a hospital according to their Physician's recommendation, is unable to attend preschool or school at least 3 day a week for 3 consecutive months and the parent or person who receives the benefit on behalf of the child, is present and takes part in treatment. Eligibility is for a benefit at a rate of 188%
Blood transfusions A child who requires a transfusion of one of the following at least once per month: blood, blood products, blood substitutes, antibiotics and other infusions as part of extended treatment.
Dialysis A child who, from birth receives regular dialysis treatment. Disabled Child Benefit for Children on Dialysis Treatment
Bladder catheterization A child requiring regular bladder catheterization (at least twice a day) .
Organ Transplant Children, from birth, receiving regular daily immunosuppressive treatment following an organ transplant or bone marrow transplant - for up to 3 years from the date of transplant and during the time when the child suffers from a severe and regular secondary disease caused as a result of the treatment. Disabled Child Benefit for a Child who Underwent an Organ or Bone Marrow Transplant
Cancer Children, from birth, requiring infusion of cytotoxic drugs at least once a month or receiving radiation treatment before or after surgical resection of a malignant tumor - for the duration of the treatment period, and half a year afterwards, as well as during the time when the child suffers from a severe and regular secondary disease caused as a result of the treatment. Disabled Child Benefit for Children with Cancer
Gastrointestinal Problems *Children who, due to a severe physical impairment, require intravenous feeding (eligibility from birth) or feeding via a nasogastric feeding tube, or for whom feeding lasts at least one hour.
  • Children who, due to severe physical impairment, have a gastrostomy, colostomy, cystostomy, jejunostomy or ureterostomy for at least a year.
Eligibility is for a benefit at a rate of 188%
Pathological Bone Fractures or Severe Chronic Bone Infections Children requiring treatment and supervision due to pathological bone fractures or severe chronic bone infections, for which physical therapy or other rehabilitative therapy may not be performed.
Eating Disorders Children who have uncontrollable urges to eat, and who are constantly and compulsively looking for food, without regard for the food's quality, as the result of a proven chromosomal abnormality (i.e. ­­­­­Prader–Willi syndrome). Disabled Child Benefit for Children with Eating Disorders
Frequent Blood Tests
  • Children who require, according to a doctor's order, regular blood tests (at least twice per day)
  • Children who require , according to a doctor's order, regular blood tests that cannot be performed at home, at least once a week for at least six months.
Disabled Child Benefit for Children with Diabetes
Breathing Difficulties Children receiving oxygen therapy most of the day, or who have a tracheotomy. Benefit Supplement for Child on a Respirator
Rare Diseases (Orphan Illnesses) Children who require special treatment due to a rare and severe illness or syndrome (one case in 100,000) which creates an extremely heavy burden on their family. Disabled Child Benefit for Children with Rare Diseases or Disorders
Severe Motor Problems
  • Children requiring the permanent use of an assistance device due to the lack of functioning in two limbs or the absence of two limbs, or who, due to dysfunction in two limbs, have significant difficulties performing actions such as standing, walking, grasping objects, and eating as compared to others of the same age group.
  • This is generally relevant for children with cerebral palsy (CP).
Disabled Child Benefit for Children with Cerebral Palsy (CP)
Need for several regular treatments Children requiring at least 3 of the following 7 treatments due to one illness, or at least 4 of the 7 treatments due to two illnesses, on a regular basis for at least six months:
  1. Treatment with inhalers or aspirators at least twice a day.
  2. Daily treatment with antibiotics/cardiac pressors/diuretics/anti-seizure medications/immunosuppressants/blood pressure stabilizers.
  3. Daily physical therapy due to a physical impairment, as prescribed by a doctor.
  4. Follow-up in a specialty clinic (a sub-specialty relevant to the child's chronic illness) at least once during the 6 month period.
  5. Hospitalization due to a physical or mental impairment (including day-treatment but excluding emergency room treatment) for at least 30 days during the 6 month period that preceded submission of the claim or hospitalization for 45 days in a year.
  6. Changing of bandages and topical treatment at least twice a day or use of a pressure suit if the affected area is at least one fifth of the body's surface area.
  7. Children requiring partial supervision who require the presence of someone else, to a degree which significantly exceeds that of other children of the same age, in order to prevent dangerous situations from arising (for example children with epilepsy or children with life threatening food allergies.

More Information About Specific Illnesses

Benefit Rates

  • The Disabled Child Benefit at the rate of 100% is 2,600 NIS (this amount includes the supplement amount of 378 NIS), correct as of 2019.
  • The Disabled Child Benefit at the rate of 188% is 4,757 NIS (this amount includes the supplement amount of 580 NIS), correct as of 2019. (The supplement was raised retroactively from January 2018).



Necessary Preparations

  • In preparation for submitting the claim, prepare the relevant exams and documents.
  • Before submitting the claim or appearing before the medical committee, free guidance is available at "Guiding Hand" centers, provided by the National Insurance Institute.

Required Documents

  • Up to date medical documentation regarding the child's medical state and functioning, including medical history, the type of treatment required, and its frequency.
  • Report on outpatient monitoring at specialist clinics and specification of continuing treatment plan.
  • For a child on a ventilator - a diagnosis from the treating physician that includes the ventilator indications, specifying the type of machine and the start date of the intervention.

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. 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.
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.
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.



Families with two or more disabled children

  • 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.


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