Special Services Benefits are paid to National Insurance Institute beneficiaries from age 18 years and 3 months old, who require significant assistance from another person in performing daily activities (such as dressing, eating, bathing, mobility in the home, and continence), or who need constant supervision to prevent them from posing a risk to their own lives or the lives of others.
Who is eligible?
- Those insured by the National Insurance Institute who meet all of the following conditions:
1. Help or Care - they require assistance of another person in daily activities (dressing, eating, bathing, mobility and control in discharge), or they need constant supervision to prevent a life-threat to themselves or others. Recently added, one can reapply for an evaluation of the need for help of another person in the household-related activities.
2. Age - Eligibility is from age 18.
- Those insured who reach retirement age can file the claim fund no later than 1/2 year after retirement age. They will be eligible for the benefit, if a National Insurance Institute doctor determines that they were eligible for the period prior to their arrival at that age.
- One whom is eligible for a pension when they reach retirement age will receive that pension after retirement age, as long as they continue to meet the eligibility criteria.
3. They are In the Country - those who submit the claim must be in the country, except in the following cases:
- Claimants who are abroad will receive the allowance for 3 months after their departure, on the condition that they received the allowance for at least two consecutive months before leaving the country.
- Claimants who have gone abroad for medical treatment or work (for themselves or for their spouses) on behalf of an Israeli employer, may be eligible for the allowance up to 24 months from leaving the country, at the discretion of the National Insurance Institute.
- Claimants who are abroad on behalf the State will be entitled to continue to receive the allowance indefinitely provided they continue to qualify for the conditions of eligibility.
4. Applicants must meet one of the following conditions:
- 1. The applicant receives a General Disability Pension and his/her disability has been established by the National Insurance Institute as at least 60% (relevant to special services).
- 2. If the applicant does not receive a General Disability Pension, but his/her disability has been established by the National Insurance Institute as at least 75% (relevant to special services), he/she must meet the following two conditions:
- He/she does not receive a Disability Pension and Disability Grant for Work Injury Victims from the National Insurance Institute and does not receive financial assistance for medical treatment or assistance at home under any other law.
- Their monthly work income is not more than 5 times the average wage 48,365 NIS, as of 2017.
5. The applicant is not receiving a Mobility Benefit, unless his/her mobility disability has been defined by a Ministry of Health medical committee as 100%, or he/she requires and uses a wheelchair, or is bedridden. An applicant who owns a car is only eligible to receive a Special Services Benefit if he/she has mobility disability established as at least 100%.
- In addition, the following situations entitle a person to claim the benefit:
- Those who receive dialysis at least twice a week.
- Those who underwent Organ Transplants (kidney, heart, pancreas, lung, liver) - entitlement is for six months from the date of the transplant.
- Those who underwent a bone marrow transplant from a donor are entitled to the benefit for six months after the transplant. Those who underwent a autologous bone marrow transplant are entitled for 3 months after the transplant.
- Cancer Patients who receive treatment from a list of treatments appear which appear in the National Insurance Institute's Circular []
- Individuals with disabilities who live in an institution that provides medical services, long-term care, or rehabilitative treatment are not eligible to receive a Special Services Benefit.
Immigrants with Severe Disabilities
- Immigrants with severe disabilities are entitled to a Special Services Benefit composed of two parts:
- Special Services for Immigrants: People with severe disabilities from age 18 to retirement age are entitled to a Special Services Benefit from the 91st day of their aliyah until the end of their first year after making aliyah. Eligibility for this benefit is determined by an examination of their dependence on others and not by any other medical test.
- General Disability for Immigrants: Those found to be entitled to the special services for immigrants benefit, are also entitled to a General Disability Pension from the 181st day of their aliyah until the end of their first year after making aliyah.
- After the first year of aliyah, their eligibility will be reviewed according to the regular rules for General Disability Pension and Special Services Benefit.
Benefit Rates as of 2018
- Those who require significant assistance performing most everyday activities, most hours of the day, or who need constant supervision, are entitled to receive a benefit which is 50% of the full disability pension - 1,405 NIS.
- Those who require significant assistance performing all everyday activities, most hours of the day, are entitled to benefit at the rate of 112% - 3,086 NIS. Beginning from March 2018 an additional 200 NIS are paid to those receiving a benefit of 112% (the benefit amount was essentially raised to 3,286 NIS).
- Those who are completely dependent on others for performing all activities, throughout all hours of the day, are entitled to 188% of the full disability pension - 5,061 NIS. Beginning from March 2018 an additional 200 NIS are paid to those receiving a benefit of 188% (the benefit amount was essentially raised to 5,261 NIS).
- One who receives a benefit at the rate of 188% and is in need of a respirator at all times is entitled to an additional allowance.
Benefit Rates for those who need Supervised Care
- In accordance with the National Insurance Institute Circular, as of 01.07.2015, the eligibility rate has been raised for those whom a doctor has determined require supervised care to prevent danger, requiring the presence of people in their daily care:
- One who requires supervision and is eligible for the benefit at a minimum rate (50%), will be eligible for payment provided at the intermediate level (112%).
- One who requires supervision, and according to tests of ADL and IADL he/she is entitled to a benefit at the intermediate level (112%), will be eligible for payment given at the high level (188%).
- For details on the benefit rates from previous years see the National Insurance Institute website.
How to claim it?
- In preparation for submitting a claim, the applicant should prepare medical documents which detail the ailments he/she suffer from, as well as the treatments and medications he/she has had.
- Yad Mechavenet Centers, working on behalf of the National Insurance Institute, provides free advice before submitting an application or before meetings before the National Insurance Medical Committee.
|What's now?||For additional information||Comments|
|Submit the benefit claim||Submitting a Special Services Benefit (Attendance Allowance) Claim||
|After submitting the claim the applicant will be invited to a medical committee||Special Services Medical Committee||
|Decision of the Medical Committee and Establishment of Eligibility by the Claims Officer||
||In specific cases, the applicant will also be checked at home by a professional to assess the extent of his/her dependence on others.|
|Receiving the Decision||After the all of the exams are completed, the decicion regarding the claim will be mailed to the applicant's house along with the the medical committee report.||There is a fast track for people with serious disabilities that allows the claim to be dealt with, within 30 days.|
|Payment of the Benefit||
||A National Insurance Institute doctor may establish entitlement to a retroactive benefit for a period of up to 6 months prior to the date the claim was submitted, as long as the applicant meets all relevant conditions of entitlement.|
|If one is not satisfied with the decision of the medical committee, they may, in certain circumstances, submit an appeal within 90 days.||Appealing a Special Services Benefit (Attendance Allowance) Decision|
|If one is not satisfied with the appeals committee decision, they may submit an appeal on legal questions only to the district labor court within 60 days.||Appealing the Decision of the National Insurance Institute's Medical Appeals Committee||Free legal aid may be requested from the Ministry of Justice's legal aid division.|
|If one wants to appeal the claims officer's decision on an issue that is not related to the medical committee (issues such as hospitalization, institutionalization, income amounts etc.):||
|If the severity of the medical situation increases, a new claim may be submitted after 6 months have passed.||Renewed request for the special services benefit||
Special Services Benefit and Long-Term Care Benefit
- Upon reaching retirement age, people with disabilities who receive a Special Services Benefit may convert the benefit's monetary value to personal care services as part of a Long-Term Care Benefit.
- It is not possible to receive both a Special Services Benefit and a Long-Term Care Benefit. Those entitled to both must choose between them.
- For most levels of entitlement, the monetary value of long-term care services may be significantly lower than the Special Services Benefit.
Receiving Benefits Abroad
- Recipients who are abroad will continue to receive the benefit for 6 additional months if they received the benefit for at least 2 consecutive months prior to their departure.
- For recipients who go abroad for medical treatment or for their own or their spouse’s work for an Israeli employer, the National Insurance Institute may, at its discretion, continue to pay the benefit for up to 24 months (from the month they went abroad).
- Special Services Benefit recipients are also eligible to employ a foreign nursing care worker.
- The National Insurance Institute sends a Certificate of Disability to anyone found to be eligible for a Special Services Benefit.
- The National Insurance Institute may review a recipient's medical condition and functioning at any time.
Laws & Regulations
- The National Insurance Law - section 206
- National Insurance Regulations (Disability Insurance) (Provision of Special Services)
- National Insurance Institute Circular no. 1951 - Addition of the IADL test as an additional eligibility test to determine eligibility for the Special Services Benefit.
- National Insurance Institute Circular no. 1972 from 05.08.2015 - Raising allowances for the special services and disabled child benefits, and addition of a new benefit for those ventilated with a tracheostomy, following the adjustment of the minimum wage.
- Original translation performed by The Shira Pransky Project as part of a grant from The Fellowship Fund.