Introduction:

Children with heart disease are eligible for a Disabled Child Benefit according to the conditions details below
For more information regarding benefit eligibility due to medical treatments see the National Insurance Institute website

Children who are Heart Patients may be included in those eligible for a disabled child benefit because they require special medical treatment.

  • The general process for receiving the benefit and the details of each step of the process are found in the charts 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?

  • A child from age 91 days (or from birth if he requires regular hospital treatment) through 18 years who has a heart disease or defect.
  • Eligibility may be determined by the need for supervision of the child, special medical treatments or for the constant presence of others, or because of dependence on others (the reason in each case will determine the amount of entitlement):
    • A child who needs partial supervision - in this case the pension is in the amount of 50% (before 22.10.2018 the condition for this amount was the need for constant supervision).
    • A child who needs special medical treatment-
      • Children who receive at least 3 of the treatments from the list of treatments that entitle one to a disabled child benefit receive a pension amount of 100%.
      • Children who are unable to attend their educational framework at least 3 days a week for at least 3 consecutive months because they require special medical treatment in the hospital, are entitled to a pension amount of 188% (this can be determined already from birth).
      • For more information see Disabled Child Benefit for Children Requiring Special Medical Treatment.
    • A child who needs constant presence of another person - in this case the pension amount is 100%.
    • A child above age 3 that is completely dependent on another person (according to the dependency test) - in this case the pension amount is 188%.
  • For more information on how eligibility is determined for children with heart disease in various situations, see National Insurance Institute circular from 17.08.2016.
  • 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.
  • In cases where a significant improvement in the child's condition is expected after he/she receives the medical treatment, a temporary entitlement to the benefit may be determined.

Necessary Preparations

Necessary medical tests

  • An up to date echocardiogram

Necessary Documentation

  • An up to date report from the child's pediatric cardiologist, including
    • The story/history of the disease
    • Physical examination findings
    • Findings from other tests especially regarding to heart and lung functioning
    • Details of Medication, catheterization and surgical treatments.
    • Details of previous hospitalizations.
    • Plan for future treatment.
    • Side effects and other complications.

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.


Benefit Amounts

  • 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 2,222 NIS, correct as of 2019.
  • 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%.
  • 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 1,264 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.

Disabled Child Benefit at a rate of 100%

  • 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.

Disabled Child Benefit at a rate of 188%

  • 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).

Supplement amount for children who are ventilated with a tracheostomy

Previous Rates


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.


Please Note


Aid Organizations

Government Agencies

Laws and Regulations

Credits

English translation and maintenance by The Shira Pransky Project.