Introduction:
Children with Diabetes are eligible for a disabled child benefit in accordance with the conditions of eligibility detailed below
For more information see the National Insurance Institute website
Children who have Diabetes are eligible for a disabled child benefit because they require special medical treatment.
- The National Insurance Institute circular from 02.07.2015 details how eligibility is determined for children with diabetes, the benefit amount and that eligibility can be determined by medical documentation alone.
- The National Insurance Institute circular from 01.05.2016 refers to determining eligibility for children with diabetes as those who require blood tests twice a day.
- The general process for receiving the benefit and the details of each step of the process are found in the charts below.
Medical committee
for a child up to the age of 3
or
for a child above age 3
In some cases a
Disabled Child Benefit Committee Hearing in the Absence of the Child may be possible
for a child up to the age of 3
or
for a child above age 3
In some cases a
Disabled Child Benefit Committee Hearing in the Absence of the Child may be possible
Receiving notification about the decision of the committee
If the answer is positive, see, Benefit Rates
If you are not satisfied with the answer you may appeal the a decision of the medical committee
as well as
appeal the a decision of the appeals committee
In any case, you may
reapply
reapply
Who is Eligible?
- Children with diabetes that are eligible for a disabled child benefit are divided into 2 categories:
- Age 0-6: At this age, any child that has diabetes is entitled to a disabled child benefit of 100% because of their frequent medical events that require immediate adult attention.
- Age 6-18: According to the National Insurance Institute circular from 01.05.2015, children with diabetes in this age group are eligible for a disabled child benefit of 50%, without testing their metabolic balance.
- Please note: A larger benefit amount may be given according to the child's situation and the decision made by the doctor in the medical or appeals committee.
An 8 year old diabetic child has emotional difficulties and because of his situation and inability to understand dangerous situations he requires regular supervision from an adult. He therefore may be eligible for a benefit of 100%.
- Additionally the child has to meet the general disabled child benefit conditions. (See the additional conditions of eligibility section on the disabled child benefit page.
Necessary Preparations
- Before Submitting a Disabled Child Benefit Claim you should prepare all relevant tests and documentation.
- Before submitting a claim or appearing in front of a medical committee you can get free guidance at the Yad Mechavenet centers that are run on behalf of the National Insurance Institute.
Necessary Medical Documentation
- If the child was hospitalized because of his/her diabetes then the hospital discharge letter with a summary of the hospitalization should be provided.
- If the child was diagnosed in an endocrinology clinic (not in the hospital) - the medical documentation and diagnosis from the clinic should be provided.
How to Claim It?
- The general process of how to claim the benefit is found in the chart below.
- In accordance with circular no. 1982 eligibility should be determined for diabetic children without requiring the children or parents to appear before a medical committee.
- Those diagnosed before age 6 will initially receive a benefit amount of 100% and then will receive 50% from age 6 through age 18 and 3 months.
- Around age of 6, a letter will be sent to the family updating them of the reduction of the eligibility rate, based on the first decision. In the event that the family requests it, the case will be opened for re-examination.
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. | Disabled Child Benefit Committee Hearing in the Absence 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.
|
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.
|
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:
|
*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.
|
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. |
Benefit Amounts
- The Disabled Child Benefit at the rate of 50% is 1,264 NIS, correct as of 2019. The amount includes a supplement of 153 NIS (the supplement is paid retroactively from January 2018).
- A child who has 3 conditions that entitle him to a pension of 50% is entitled to a pension of 100% (2,600 NIS as of 2019). For more information see the National Insurance Institute website.
- 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.
Please Note
- A calculator on the National Insurance Institute website can be used to check eligibility to receive two benefits simultaneously.
- A child up to age 3 who is eligible for a Disabled Child Benefit may be admitted to a Rehabilitative Daycare Centers.
- According to the law, it is illegal to seize a Disabled Child Benefit. If there is a hold on a bank account, you must contact the executing offices and obtain confirmation of specific removal of the hold for Disabled Child Benefit funds and then submit it to the appropriate parties (bank, etc.).
- The National Insurance Institute sends a Certificate of Disability to anyone eligible for a Disabled Child Benefit.
Government Agencies
Laws and Regulations
- National Insurance Law
- National Insurance Regulations (Children with Disabilities, 2010
- National Insurance Regulations (Disabled Child)
- National Insurance Regulations (Disabled Child) (Amendment), 2016
- National Insurance Regulations (Disability Insurance) (Appeals Committee for Special Services and Disabled Children)
- National Insurance Institute circular no. 2028 from 02.07.2015 - The method of determining eligibility for children with diabetes, the rate of entitlement and determining entitlement based on documents.
- National Insurance Institute circular no. 1982 from 01.05.2016 - The method of determining eligibility for children with diabetes who require blood tests twice a day, the rate of eligibility and determination of eligibility based on documents alone.
Credits
English translation and maintenance by The Shira Pransky Project.