General Disability and Disability Resulting from an Accident Handicap
These are two different categories and both are covered according to the National Insurance (Bituach Leumi) regulations.
A person’s handicap renders him/her eligible for one-time compensation and/or monthly payments, as well as other benefits such as home care, etc.
The principle difference between them is not in the result of the accident, for in any case, the accident victim is suffering, handicapped and in need of and eligible for monetary compensation for his/her injury. The difference is that general disability is a handicap and/or illness caused by any number of reasons, while occupational disability is a handicap caused directly or at least related, in one way or another, to the person’s work.
A work accident victim can also file a claim for disability compensation, according to the “General Handicap” law. However, according to the law, the claimant cannot receive a double stipend. Therefore, it is advisable to carefully consider the best way to proceed when an insured party, who was hurt on the job, has to file a claim for disability compensation.
Who is eligible for Disability Compensation?
A disabled person who is an Israeli resident, over 18 years of age but who has not yet reached retirement age who, as a result of physical, mental or psychological handicap resulting from disease or birth defect, cannot earn a living and does not have any income, the value of which is 25% of the average income, or whose ability to earn a living was reduced by 50% or more; a disabled homemaker whose ability to do housework was reduced by 50% or more.
Eligibility to receive Disability will be determined based on 2 different tracks: the first track – recognizing a health based handicap of at least 60%, or at a rate of at least 40% if one of the disabilities is at the rate of 25% and with regard to the homemaker, a medical report will have to be submitted, which classifies the disability at 50% or more. The second track is a diagnosis of at least 50% disability.
Medical Committee
After filing the claim, the insured party will be called before a Medical Committee (Va`ada Refu`it) whose purpose is to determine the degree of health disability of the claimant, according to the list of medical criteria listed in the National Insurance Regulations for diagnosing the degree of handicap. For this reason, the Committee relies on the medical documents and clinical examination reports of the work accident victim and also, when called for, on external medical advisors. In such circumstances, it is extremely important that the insured present medical reports before the Committee. Upon the decision of the Medical Committee, the insured can appeal to an Appellate Medical Committee that can second the decision, change, or amend it. The decision of the Appellate Medical Committee is final and can only be appealed to the Labor Court (Bet Hadin La`avoda). The Court does not serve as a medical committee and is not authorized to deliberate on medical issues. Therefore, the wording of the appeal is of utmost importance and can influence the judgment on the claim.
Disability Committee
Upon granting medical disability, the injured party will be examined to determine the degree of the inability to earn a living or function. The claims clerk will determine the degree of disability after consulting a qualified medical doctor, as well as the rehabilitation clerk.
The injured party can then appeal the decision of the claims clerk to an Appellate Committee. The decision of the Appellate Committee is final and can then only be appealed to the Regional Labor Court.
