The degree of incapacity, according to its amount, is what provides eligibility for the General Disability Pension.
- The level is determined according to the conditions used in order to determine the level of medical disability by the medical committee.
- The process of receiving disability allowance is not simple, but it is not overly complicated. For clarification, see the diagram below and the steps needed to be followed to receive the allowance.
Fast Track for Special Circumstances
and receiving a response in the mail
appeal the decision regarding incapacity to function
resubmit a claim
The National Insurance Institute runs Yad Mechuvenet that provides free guidance and assistance for those who are preparing to appear in front of the medical committee.For more information on other ways to receive assistance see Free Aid for Filing Disability Claims with the National Insurance Institute.
- Before submitting a claim, all relevant documentation should be prepared.
- Those suffering from multiple ailments and disabilities are advised to prepare relevant documentation and tests for each of the disabilities in order to increase the percentage of disability that will be established by the claim.
- Required documents for specific illnesses can be found here.
- If a person submits the application for a specific disease, such as heart disease, it is recommended to examine thoroughly whether he/she is suffering from another illness /disability that will give him/her additional medical disability percentages.
- In the above example, let's say that in addition to heart disease, the person also suffers from diabetes and subsequently submitted to the committee the documents required regarding the diabetes.
- Suppose the Medical Board determines :
- 40% disability with respect to the heart disease
- 20% disability with respect to the diabetes
- According to these figures, a weighted medical disability of 52% will be determined.
- For an explanation of the calculation method and additional information, see weighted medical disability as determined by the National Insurance Institute for multiple diseases
Target Audience and Prerequisites
- Establishment of the level of disability is done for people whom medical disability has been established by a medical committee according to the following levels:
- Medical disability of at least 40% with at least one impairment at a level of at least 25% disability.
- Medical disability of at least 60% if no one impairment is at a level of at least 25% disability.
- Medical disability of at least 50% for a homemaker.
Stages of the Process
- After a General Disability Medical Committee has established medical disability, a National Insurance Institute claims assessor will decide if the applicant is to be considered disabled, and will determine the degree of earning incapacity after consulting with a specially certified physician and a National Insurance Institute rehabilitation assessor.
- The degree of earning incapacity is determined according to the impact the medical impairment has with regard to the applicant's capacity to work and earn a living, to return to work and/or to work in a different profession or learn a new vocation (as suitable according to the condition).
- The degree of incapacity to function in the home is determined according to the impact the medical impairment has with regard to the applicant's capacity to function in the home (see details below).
- The possible degrees of incapacity are 60%, 65%, 74% and 100%.
- Those with incapacity of 75% or higher are entitled to receive 100% of the General Disability Pension.
- Those with incapacity of between 60% and 74% are entitled to receive a partial disability benefit. For example, if incapacity of 60% was established for someone, he would receive 60% of a full pension.
- Those with loss of capacity below 50% are not entitled to a disability pension.
- The National Insurance Institute's decision regarding level of incapacity and eligibility for a General Disability Pension is sent to the applicant's home.
- As long as an applicant's medical condition or functioning capacity is unstable, the National Insurance Institute has the right to establish incapacity for a limited period of time up to two years. At the end of the defined period of time, the degree of incapacity will be reviewed.
Examining the Functioning Capacity of a Homemaker
- The degree of incapacity to function in the home is determined according to the impact the medical impairment has with regard to a homemaker's capacity to function in a regular home.
- Examination Location:
- Capacity to function in the home is assessed in one of the assessment centers which are located at Beit Levinstein, and at Tel Hashomer.
- However, according to a directive of the National Insurance Institute, in the following circumstances the medical examination and establishment of the degree of incapacity to function in the home will be performed at the National Insurance Institute branch, instead of the the function assessment centers:
- In a case when the institute doctor believes that the claimant does not have a disability that will entitle her to a pension (meaning, at least 50%).
- In a case when the institute doctor believes that the claimant complete loss of capacity to function in the home.
- Examination Process in a Function Assessment Center:
- The assessment is inter-disciplinary and is performed by a physician, a social worker, and an occupational therapist.
- The physician assesses functioning capacity according to medical findings, the social worker considers medical information along with personal and family background, and the occupational therapist performs an assessment of functioning in a kitchen which is specially built for this purpose.
- According to the applicant's limitations, she may be asked to perform basic housekeeping functions (such as cooking, cleaning, and straightening up), in accordance with that which the occupational therapist deems necessary.
Establishing a Temporary Degree of Incapacity
- As long as the beneficiary's medical condition or functioning is not stable, or the vocational rehabilitation has not been completed, the claims assessor may establish the degree of incapacity for a limited period of time up to two years.
- At the end of the determined period, the degree of incapacity will be re-examined according to the beneficiary's condition.
Appealing the Established Degree of Incapacity
- Those whom it was determined that no capacity to earn a living or function in the house was lost; or those whom it was determined that less than 50% capacity was lost; or those whom less than 74% incapacity was established, are permitted to appeal to the appeals committee.
- For more details, see Appealing a Decision Regarding Incapacity
Appealing Another Claims Assessor Decision
- A claims assessor decision which is unrelated to the degree of incapacity (such as a decision relating to the period the applicant worked, applicant age, education, or income) may be appealed before a regional labor court.
- The appeal must be submitted to the court within 12 months of receiving the claims assessor decision. For more information, see: Appealing a National Insurance Institute Decision.
- Free Legal Aid from the Ministry of Justice's Legal Aid Division is also available and is not dependent on meeting any type of economic criteria.
Continuing the Process
|What Now?||For More Information||Notes|
|Receiving the Decision||
|Payment of the Allowance for those Eligible||
||*Someone that has an established disability of 100% for a period of at least 6 months is eligible to be a disability allowance from the 31st day from when disability was established.
|If you are not satisfied with the decision of the medical committee, you can appeal the decision within 60 days.||Appealing a medical decision regarding general disability||
|If you are not satisfied with the decision of the appeals committee, you may appeal the decision in the regional labor courts (for legal questions only) within 60 days.||One may request free legal assistance from the Justice Department's branch for free legal assistance.|
|If you are not satisfied with the level of incapacity determined, in certain cases you can appeal the decision of the claims assessor within 90 days.||Appealing the decision determining incapacity to function||
|If you are not satisfied with the decision of the appeals committee, you may submit an appeal to the regional labor courtss (for legal questions only) within 60 days.||One may request free legal assistance from the Justice Department's branch for free legal assistance.|
|If you would like to appeal the decision of the claims assessor, independent of the level of incapacity determined, for matters such as periods of employment, your age, your level of education, income, etc.).||
|One may submit another claim after 6 months, with no waiting period, as long as there has not been a worsening of the medical condition.||Reexamination of Disability Pension Eligibility|
Laws and regulations
- The National Insurance Law
- Disability Circular #1928 - Performing a medical examination for a homemaker and establishing the degree of incapacity to function in the home in the branch
- The National Insurance Institute's Research and Planning Administration: Functional assessment survey for homemakers with disabilities
- Original translation performed by The Shira Pransky Project as part of a grant from The Fellowship Fund.