Introduction:

The article specifies how and in what cases a Disabled Child Benefit may be filed.
Disabled Child Benefit recipients who are completely dependent on the assistance of others and who do not receive a benefit supplement, may request to have their level of dependenceexamined
A new service from the National Insurance Institute, allows filing of the claim by phone at *3928

This page is dedicated to the process of filing a claim for a Disabled Child Benefit.

  • The process for receiving the benefit is described in the following flowchart, and further on in this article.
Receiving notification about the decision of the committee
If the answer is positive, see, Benefit Rates
In any case, you may
reapply

Target Audience and Prerequisites

A disabled child benefit claim can be submitted in the following cases:

  • Children between the ages of 91 days and 3 years who cannot perform most motor skills of the head, limbs and torso that others their age are capable of performing.
  • Children between 3 and 18 years and 3 months old who require much more assistance performing daily activities than others their age (i.e. dressing, eating, bathing, moving about the house, and control of bodily functions).
  • Children between the ages of 91 days and 18 years and 3 months who require the constant presence of another during all hours of the day, due to an inability to discern elements of danger to themselves or to others or those who have medical condition that need immediate treatment of others (children who have a moderate, severe or difficult intellectual disability, severe behavioral issues, severe illness or a severe disability).
  • Children between the ages of 91 days and 3 years who require partial supervision of another person in order to prevent situations of danger to the child or others to a degree which significantly exceeds that of other children of the same age because of a disability or a chronic illness (such as [[Disabled Child Benefit for Children with Life Threatening Food Allergies|life threatening allergies or Duchenne in its early stages), a behavioral issue (such as severe ADHD or a mild intellectual disability).
  • Children with a special impairment:
  • Children requiring assistance communicating due to a complete lack of verbal communication (from age 3 until age 18 and 3 months)
  • Children requiring special medical treatment (from age 91 days to 18 years and 3 months)
    • Children from birth age, who receive regular treatments in the hospital are, in certain situations, entitled to a benefit at the rate of 188%.
  • Children ages 3 and up, who are totally dependent on others, who require help at all times performing all daily activities (such as dressing, eating, bathing, personal hygiene and mobility in the home) are eligible for a benefit at the rate of 188%.

Additional Conditions of Eligibility

  • Populations of children that meet the specified criteria must, in addition, meet the following conditions:
    • The child's parent must be insured and an Israeli resident (or someone who was insured and passed away as an Israeli citizen).
    • A child who made aliyah without parents may be eligible if he/she made aliyah with a legal guardian that is one of the following family members: brother/sister, grandparent, aunt/uncle.
    • The child is in Israel. Eligibility will be allowed under certain conditions for a child out of the country.
    • The child does not live in an institution or dormitory that provides therapy services, nursing care or rehabilitation, except in the following cases which may be filed for a child who is in an institution.
      • The parents cover the cost of keeping the child in an institution.
      • The family has another child receiving the disabled child benefit.
      • The child will be released from the institution and confirmation of the release date, and programs that integrate the child into the community.
    • Children who receive regular medical treatment in the hospital may be eligible for the benefit in certain circumstances.
    • A child who is entitled to a benefit and is hospitalized, will continue to receive the benefit for one year from the date of admission. At the end of this year, their eligibility will be reviewed, depending on the reasons for hospitalization:
    • A child is not living with a foster family. Since December 2016, a foster child on a respirator is eligible for an additional allowance for a disabled child on a respirator and Disabled Child Benefit and Related Benefits.
    • The child does not receive a mobility allowance, except in cases specified below.

Entitlement for Child Mobility Benefit and a Disabled Child Benefit

  • A child will be eligible for both a Mobility Benefit and a Disabled Child Benefit simultaneously in any of the following cases:
    • Children for whom limited mobility of at least 80% has been established by the medical committee.
    • The medical committee determined that the child requires a wheelchair and he/she uses one.
    • The medical committee determined that due to lower body impairment the child cannot walk on their own and because of their disability they are unable to use a wheelchair.
    • Two or more siblings are eligible for Disabled Child Benefit, or one child is eligible for disabled child benefit and one child is eligible for child mobility benefit.
  • Children for whom limited mobility of under 80% has been established, must choose between the Mobility Benefit and the Disabled Child Benefit.
  • One cannot switch from a Mobility Benefit to a disabled child benefit, if the family car was purchased through a loan and the loan has not been repaid.
  • In order to verify that receiving mobility benefits will not impact Disabled Child Benefit eligibility, it is important to contact the Disabled Child Department at your local National Insurance Institute branch.


Necessary Preparations

Tip
There are several ways to receive free, professional assistance during the disability claim process.

Submitting a Claim

  • A Disabled Child Benefit claim must be submitted by a parent with whom the child resides.
  • For a child not living with his/her parents, the child's legal guardian or the person with whom the child actually resides may submit the claim.
  • A Disabled Child Benefit Claim Form should be filled out.
  • The following documents must be attached to the form:
    • Medical documentation and illness summaries including the date the illness, disability, etc. began and the treatments that have been provided. The form includes details regarding the required documentation for every case.
    • Proof of education from the pre-school or school that the child learns in (see the appendix to the claim form.
    • For children younger than 3 who are not in an educational framework and who receive developmental therapy, documentation regarding the types of therapies from the head of the facility where they are provided must be given.
  • Parents who would like the claim decision to be made solely on the provided documentation without requiring the child to appear before a medical committee must sign a form indicating their consent ("הסכמה לקביעת רופא ללא נוכחות"). Nonetheless, in rare cases only, the National Insurance Institute may still decide that it is necessary for the child to appear before a medical committee. for additional information
  • Claims may be submitted in the closest National Insurance Institute branch to the applicant's place of residence. Click here to locate the closest branch.
  • Claims may also be submitted by mail, fax, or in a branch's service box.
  • When submitting a claim, the child's parent, guardian, or custodian must present personal identification.
  • Claims can also be filed online via Disabled Child Benefit Claim Form.
Tip
A new service provided by the National Insurance Institute allows claims to be made on the phone at *3928.


Retroactive Claim in the Case of the Death of the Child

  • In the case of the death of the child, one can file a claim retroactively and enclose the detailed medical documentation, including hospitalization summaries from last year, to allow as much as possible to determine eligibility based on the documents.

Continuing the Process

What Now? For More Information Notes
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.
  • 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. See Disabled Child Benefit#Benefit Rate.
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.
If you wish to appeal a decision of the claims officer that is not related to the decision of the medical committee
  • The Claims committee is only authorized to recommend that the claims officer reconsider his decision (in cases where it deems fit).
  • In an appeal to the Regional Labor court, free legal aid may be requested from the Justice Ministry's legal aid branch.
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.


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