Introduction:

After Submitting a General Disability Pension Claim, applicants are invited to appear before a medical committee to determine their medical disability
Applicants may appear before the committee accompanied by anyone of their choosing, an interpreter, or a lawyer, who will be permitted to represent them in front of the committee and speak on their behalf
Applicants may submit a request to receive a reimbursement for expenses related to appearing before the committee.
In cases of severe disability, medical disability may be determined without appearance before the committee.


National Insurance Institute instructional video

After Submitting a General Disability Pension Claim, applicants are invited to appear before a medical committee to determine their medical disability.

  • The process required for receiving the allowance is not simple, but not very complicated. See the following diagram and the details of the necessary steps which will be expected to take.
Tip
Before eligibility for the disability benefit is established and until it is received a person can check if he/she is eligible for income support
Warning
There are several ways to receive professional assistance during the process of making a disability 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.
  • The medical committee is composed of a doctor who specializes in a certain field of medicine or a number of doctors specializing in different fields, and a secretary whose job is to inform the applicant regarding his/her rights and to record the minutes of the hearing.
  • Applicants suffering from a variety of illnesses or medical disorders may be examined by a number of doctors at the same committee hearing and, if necessary, be invited to different medical committee hearings focusing on different illnesses and disabilities.
  • It is possible that applicants with a serious disability/illness will not be required to appear before the committee. For more information, see: Expedited Process ("Fast Track") for Submitting a General Disability Pension Claim.
  • Likewise, those who have undergone an eye examination test to determine eligibility for Certificate of Blindness/Visual Impairment through the Service for the Blind and have agreed that the information will be transferred to the National Insurance Institute, will not be required to undergo further examination of eligibility for disability.
  • If a high enough degree of medical disability has been established, a degree of incapacity will be established and eligibility for a General Disability Pension will be examined.

Target Audience and Prerequisites

Tip
The National Insurance Circular lists cases when it is recommended to determine disability based on the documents submitted and without summoning the applicant to the medical committee Intellectual Disabilities, Oncology Patients, the Blind, Severe Renal Failure, Organ Transplants recipients (kidney, heart, liver, lung ect), Advanced Cardiac Patients, Paralysis, degenerative illness in advanced stages (e.g Parkinson's, Multiple Sclerosis, ALS) Autism, Schizophrenia, extended hospitalization, requires a respirator.

Necessary Preparations

  • In preparation for submitting the claim, prepare the relevant exams and documents.
  • The documentation required for various disabilities can be found in this listing of entries.

Prior to the Committee Hearing

  • It is recommended that a list be prepared in advance with all disorders, disabilities, serious illnesses and functioning difficulties which the applicant wishes to present to the committee, in order to help make sure that none of these issues are forgotten during the proceedings (including those impairments forgotten at the time of Submitting a General Disability Pension Claim).
  • Preparation of medical documentation -
    • All of the relevant medical documentation which was not attached to the original claim should be neatly organized and photocopies of all of the documentation should be made so that they can be left with the committee if necessary.
    • Relevant documentation may include professional medical opinions, illness summaries, x-rays and analysis.
    • There is no need to bring documentation that was already attached to the claim and submitted.
  • It is necessary to arrive at the hearing with one's Teudat Zehut or other picture identification.
  • It is recommended for applicants to bring someone to accompany them to the hearing. For more information, see: Accompaniment in a National Insurance Institute Medical Committee Hearing.
  • If necessary, applicants may come to the committee hearing with an interpreter, or lawyer who will be permitted to represent them in front of the committee and speak on their behalf.
  • It is important to arrive on time, though delays are always possible and sometimes the committee sees applicants out of order.
  • Applicants who cannot appear at the appointed time must notify the National Insurance Institute in advance and in writing; those who fail to do so may be fined. For more information, see: Failure to Appear Before a National Insurance Institute Medical Committee.

During the Committee Hearing

  • At the beginning of the hearing, the committee members will be introduced according to name and title by the committee secretary (the committee members also wear name tags).
  • Description of Disorders, Illnesses, and Difficulties -
    • Applicants must briefly describe all of the ailments from which they suffer.
    • Applicants must provide details of any difficulties functioning at work or if someone else's assistance is required in performing daily activities (bathing, getting dressed, mobility in the home, eating, etc.).
    • There is no need to point out the pains that the applicant suffers (pain and suffering do not affect the disability percentage). However, if the pain has an effect on the applicants functioning, one should describe this effect.
    • Applicants may use the list of disorders/difficulties they prepared in advance.
    • The list can be submitted for the committee doctor to review and so it can be attached to the committee report.
  • All of the relevant medical documentation which was not attached to the original application should be submitted for the committee doctor to review and so it can be attached to the committee report.
  • After detailing all of the disorders and difficulties and submitting the medical documentation, the committee report must be approved and signed and consent to be examined by the doctor must also be signed.

Examination by the Committee Doctor

  • Depending on the type of illness or medical disorder, the doctor will decide whether a physical examination is necessary (sometimes a physical examination is not required and the doctor will base his/her decision on the submitted medical documentation). Applicants suffering from a number of issues may be examined by a number of different doctors at different times.
  • The examination will be performed with consideration given to the difficulties presented to the committee and the type of disorder(s) and illness(es).
Example
An applicant may be asked to demonstrate how s/he performs daily activities, such as:
  • Putting on a shirt or pants and taking them off;
  • Sitting in a chair and standing up after sitting in a chair;
  • Going from a reclining position to sitting up and vice versa;
  • Falling down and getting up following a fall in order to demonstrate the ability to do so on ones own.
  • It is permitted to request that someone else be present during the physical examination.
  • It is permitted to request that the physical examination be performed with only the doctor present and not in the presence of the committee secretary.
  • The physical examination is only intended to establish the degree of disability and the committee doctor does not have the authority to make any decisions related to treatment or to respond to requests related to medical care.
  • Completing the Committee Hearing and Establishing the Level of Disability

    • After the applicant leaves the hearing room, the doctor determines the percentage of medical disability according to the medical documentation in the file and the physical examination.
    • If the committee decides that further medical examinations/testing or more documentation is required before determining medical disability, a letter indicating this will be sent to the applicant.
      • If more documentation is required, the applicant will be responsible for providing it to the committee.
      • If further medical examinations/tests are required, the applicant must undergo them through his/her health plan.
      • Upon receiving the requested materials, the committee will determine medical disability without requiring the applicant to appear before the committee again.
    • For more information on determining the degree of disability


    Continuing the Process

    What Now? For Further Details Notes
    Medical Board's Decision
    • In the following circumstances, your case will be transferred to the claims official in order to determine the degree of disability:
      • If the medical committee established medical disability of at least 60%.
      • If the medical committee established medical disability of at least 40%, and one disability is at least 25%.
      • For a housewife - if the medical board determined medical disability of at least 50%
    There are rights given based on percentage of medical disability, independent of the determination of the degree of disability and eligibility for disability.
    The Decision of the Claims Official and Establishing the Degree of Incapacity
    • The claims official will recheck your income, with reference to the percentage of medical disability which has been established.
    • The official determines to what extent your medical disability affects your ability to work and to earn (for a housewife-on her ability to function within household responsibilities) based on recommendations by a doctor and the rehabilitation clerk.
    In cases in which a rehabilitation clerk recommendation is necessary, you will be invited to an interview.
    Receiving the Decision * Upon finishing all of the examinations, you will be sent in the mail notification of the decision on your claim with the attached report of the medical committee.
    • Important Reminder:
      • Your eligibility for the allowance is a result of the established percentage of medical disability determined by a medical committee as well as the level of incapacity to function established by a claims assessor.
      • Both of these decisions can be appealed as outlined below.
    Payment of the Allowance for those Eligible
    • For those who were determined eligible for the allowance, payment for the disability allowance will be 90 days from the date in which the degree of incapacity was determined.
    • The benefit is paid on the 28th of the month to the bank account of the disability benefit recipient or his/her legal guardian (if one has been appointed)
    • Whoever is eligible for Sick Pay, will begin to receive the allowance upon finishing the period in which he/she receives the sick pay.
    • Eligibility for retroactive payment of the allowance will be for a maximum of 12 months before submission of the claim.
    *Someone who has an establish disability of 100% for a period of at least 6 months is eligible to receive a disability payment from the 31st day from when the disability was established.
    • Payment for the 31st day and on is paid after the 91st day from when the disability was determined.
    • Those eligible for a dependents' supplement will only receive it from the 91st day (and not for days 31-90).
    • Those who are also eligible for a Special Services Benefit (Attendance Allowance) will receive the higher of the two benefits during this time period.
    If you are not satisfied with the decision of the medical committee, you can appeal the decision within 60 days. Appealing a General Disability Medical Committee Decision
    • According to the National Insurance Institute Law, in cases in which the medical committee determined disability of less than 80%, one may appeal the decision.
    • Despite this, the courts have ruled that one may appeal the medical committee's decision, even in cases in which a higher degree of disability was established.
    • It is best to submit an appeal within the amount of time prescribed in the law (60 days) but the National Insurance Institute will not reject appeals that are submitted within 90 days.
    If you are not satisfied with the decision of the appeals committee, you may submit an appeal (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
    • One can submit an appeal for two types of decisions regarding incapacity to function:
      1. the decision that you did not lose the ability to work, or work less than 50%.
      2. the decision that the inability to function is not more than 74%.
    • In a situation in which the committee is deciding to reduce the level of incapacity, one may cancel the appeal submission and retain the current level of incapacity determined by a claims assessor.
    If you are not satisfied with the decision of the appeals committee, you may submit an appeal (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.).
    • You can submit Request to the Claims Committee within 6 months from the day in which you received the rejection from the claims assessor.
    • Alternatively, if you are not satisfied with the decision of the appeals committee, you can submit an appeal to the regional labor courtss within 12 months from the day in which you received the decision from the claims officer regarding your allowance.
    One may submit another claim after 6 months have passed, or if the applicant's medical condition has worsened another claim may be submitted without a waiting period. Reexamination of Disability Pension Eligibility

    Reimbursement for Expenses

    Please Note

    • If the applicant is personally connected with one of the doctors on the committee, that doctor may not participate in the committee hearing. The committee secretary should be notified of this in order to schedule a hearing with a different committee.
    • Those who are interested may fill out a satisfaction survey after their committee hearing (surveys may be filled out anonymously).

    Aid organizations

    • For a comprehensive categorized listing of healthcare organizations offering assistance and support for people with disabilities, click here.

    Court Rulings

    Rules and Regulations

    Credits

    • Original information on this page was written with the help of the Medical Committee branch of the National Insurance Institute.
    • Original translation performed by The Shira Pransky Project as part of a grant from The Fellowship Fund.