Introduction:

A Special Services Benefit (Attendance Allowance) (Sharam) is paid to adults who require significant assistance from another person in order to accomplish day to day tasks and tasks to maintain the household
Determining eligibility is contingent upon the disability rates determined by the General Disability Medical Committee
In order to ease the process for people with severe disabilities, they are entitled to a Fast Track claim process
The National Insurance Institute now provides a new service enabling people to submit claims through the call center *3928

This page outlines the process of submitting a claim to receive a Special Services Benefit.

Tip
There are several ways to receive free professional help with the process of submitting disability claims

Target Audience and Prerequisites

  • 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:

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 [[1]]
  • 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

  • New Immigrants (Olim) with severe disabilities are entitled to a Special Services Benefit composed of two parts:
    1. 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.
    2. 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.


Stages of the process

Fast Track for People with Severe Disabilities

Information for Cancer Patients

Medical Form

Exemption from Undergoing a Medical Examination

  • A decision regarding eligibility for the benefit may be determined based on the submitted medical documentation, without requiring the applicant to undergo a medical examination.
  • In order to be granted exemption from undergoing a medical examination, a written consent form must be submitted with the claim wherein the applicant agrees to accept the decision made by the National Insurance Institute doctor based solely on the medical documentation.
  • Even with submission of the consent form, in some cases, the National Insurance Institute will still deem it necessary to require the applicant to undergo a medical examination.
  • Those suffering from severe side effects from chemotherapy are entitled to have their eligibility determined based only on their medical documents. For more information see Establishing eligibility for the Special Services Benefit for Cancer Patients without appearance before a medical committee.

Information for the Blind and Visually Impaired

  • According to the National Insurance Institute's Circular there is no longer a need to undergo an eye examination through the National Insurance Institute and through the Service for the Blind, rather, one of the following tests will suffice:
  • Anyone who first contacts the National Insurance Institute will be reviewed by the Institution; if it will be determined that there is a 90% or higher vision defect, the examination can be subsequently passed over to the Service for the Blind.
  • Within the appeal for review through the Service for the Blind, the opinion of the doctor can be transferred to the Social Security Institute. The doctor will submit his opinion on the degree of incapacity to function (general disability). The National Insurance Institute will make a decision regarding how to proceed, without the need for an additional summons of the claimant.
  • To allow the transfer of medical information between the agencies, the patient has to sign that he agrees to such transference of information.

Appeal

Reconsideration of a Claim

  • An applicant whose claim was rejected or accepted for only a partial benefit entitlement, may request a reconsideration of the claim if the applicant’s condition has declined.
  • Additionally, due to changes in the assessment of entitlement to the allowance, and the addition of the IADL test, which evaluates dependency in household-related activities, eligibility can be re-evaluated.
  • For more information see Filing a Special Service Pension Reconsideration

Please note

  • The National Insurance Institute may review an applicant’s medical condition and functioning at any time.

Government agencies

Laws & Regulations

Credits