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

Forms

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.
Preparation for Submitting the Claim
Submitting a Disabled Child Benefit Claim
Medical committee
for a child up to the age of 3
or
for a child above age 3
In some cases a
committee meeting without the presence 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

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.
Example
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%.

Necessary Preparations

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. 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.


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%. 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


Government Agencies

Laws and Regulations

Credits

English translation and maintenance by The Shira Pransky Project.