Acquiring rights and securing compensations from Bituach Leumi (National Insurance Institute)

Knowledge of a human body as well as medical procedures and terms

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A social welfare lawyer is not a doctor, however he/she has a deep knowledge of a human body, understands medical terms and knows functions of body parts. A lawyer who represents interests of sick or injured people is able to read and understand medical documentation, as well as diagnoses. This has a decisive importance for him/her to be able to represent you in case of filing a lawsuit against The National Insurance Institute (Bituach Leumi).

 

The criteria used for determining a degree of a disability are complicated and sometimes have subcategories. If your social welfare lawyer understands your medical case clearly, it will help him/her to represent your interests better and receive a higher percentage of disability. Eventually, this will result in a direct proportion of the amount of money that you will receive from The National Insurance Institute (Bituach Leumi).

 

Experience

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Your social welfare lawyer will tell you during your first consultation how to develop a strategy and  help you with filling out documents. Moreover, with the lawyer you will have an assistance at each stage of your lawsuit and he/she will tell you how to claim for medical aid for a desired result. 

 

Your social welfare lawyer will provide you not only with a legal but also a moral support. An experienced lawyer perfectly understands what you feel when you take a decision to start a lawsuit or before going in front of a medical committee. Good lawyers understand that you are worried, confused and maybe even a bit tired this. He/she knows how to secure some rest for you, insure economical stability and a monthly allowance.

 

What issues does The National Insurance Institute (Bituach Leumi) deal with?

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Industrial injury

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When an employee is physically or morally injured as a result of an accident at work, he/she is eligible for both an injury allowance from the Institute and for a loss of income compensation (it is called an injury allowance – dmei pkhia). In order to receive your compensation for an accident or an injury at work, you need to prove that the accident took place at work and physical or moral damage was caused as a result of the accident. 

 

One should fight for each percentage of a disability admitted as a coefficient of a disability has a decisive importance when calculating a compensation amount. Also, a method of payment will be chosen for receiving the compensation (a one-time payment or a monthly allowance).

 

Occupational disease or a microtrauma

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Occupational disease or a microtrauma is irreversible physical damage caused as a result of a change in body part or organ functioning as well as long-term effects of trauma or influence of bad working conditions. These conditions eventually jeopardize an employee’s health and quality of life. This kind of damage usually appears after several years of work in a certain area and can be a result of a specific nature of work or repetitive actions.

 

What is the difference between an occupational disease and an industrial injury?

 

An industrial accident at work it is a sudden, one-time event that happened to an employee in the course of fulfilling his/her work or as a result of fulfilled work including a travel to or from work. An occupational disease gradually develops in the body of an employee as a result of working conditions.

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Employees who received an industrial injury are eligible for a loss of income compensation (an injury allowance - dmei pkhia) from The National Insurance Institute (Bituach Leumi) for the time of employee’s absence at work and medical expenses. 

In case the amount of a disability received, as a result of an industrial injury, exceeds 20%, employees are eligible for a disability pension. If a percentage of disability received as a result of an industrial injury is from 9% to 19%, an employee is be eligible for a one-time compensation. 

 

Vocational rehabilitation

 

Bituach Leumi helps people who were injured to get integrated back into work. 

 

Vocational rehabilitation includes: occupational assessment, academic or occupational studies, how to finance study aids and support during ongoing studies as well as help with job placement.

 

A person, who has an industrial injury and the board of The National Insurance Institute (Bituach Leumi) acknowledged his/her disability as permanent and that the percentage of this disability is not less than 10%, is eligible for vocational rehabilitation. This person should also meet the following criteria:

• due to dysfunction caused as a result of disability this person is not able to resume his/her work or cannot do any other jobs in his/her field which match his/her qualifications, skills and work experience;

• this person needs vocational training to help him/her to get integrated into work environment;

• vocational rehabilitation will help this person to get integrated into work in order to receive means of subsistence in a free labour market.

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General Disability (nekhut klalit)

 

You may be entitled for a vocational rehabilitation under general disability law of you are a citizen of Israel and you are 18 years old or above but have not reached the retirement age, who suffers from physical, mental or psychiatric disorder as a result of a disease, an accident or a birth defect. 

 

You must prove that your general disability makes up 60% or 40% (if a disability of one of body organs is 25%) and that as consequently you have at least 50% of disability.

 

If a plaintiff meets all the above-mentioned criteria, he/she will be paid a monthly allowance in accordance with the percentage of his disability determined by the board of The National Insurance Institute (Bituach Leumi).

 

A person whose percentage of disability does not meet the criteria according to the findings of the medical board of the Institute will not be able to claim for any allowances or payments.

 

Not everyone knows, however, that The National Insurance Institute (Bituach Leumi) starts with  checking your income from work. It will begin to consider your claim only if you do not work at all and your income is less than 60% of an average salary which is 6,313 shekels as of 01.01.2020.

 

If your income exceeds the determined level of income, your claim will be rejected. In other words, if your income from work is 6,500 shekels, you can not be eligible for social welfare even if your percentage of disability is 100%.

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Appeal against medical board’s decision

 

A decision of the medical board on the percentage of disability can be appealed to the Appeal Committee. Such committee consists of two or three doctors and they can change any decision taken by the medical board: increase or even decrease the percentage of disability. 

 

The decision of the Appeal Committee can be appealed in court only on the ground of legal rationale. The court tries only legal issues. A judge cannot interfere with medical decisions on the percentage of disability. 

 

For instance, one can take a case to court if:

• the committee did not state their decision in the appropriate form;

• ignored medical documentation which have a decisive importance for determining the percentage of disability;

• the committee did not consider an application for disability in the appropriate order;

• did not take into account all submitted findings etc.

 

It is crucial to remember that the terms for appeal or taking your case to court are limited, thus you should consult with your social welfare lawyer (bituach leumi) before submitting such kind of documents.

 

An increase in percentage of disability due to the deterioration of health (achmarat matsav)

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Six months after the percentage of disability is determined (bituach leumi), there is a possibility to apply for a new hearing on the grounds of the deterioration of health.

 

In such a case, it is essential to ask your social welfare lawyer (bituach leumi) for advice and evaluate all risks and perspectives of the case. For example, a medical board can conclude that a patient’s health is improving and has not worsened at all. Under such circumstances the existing level of disability will be decreased.

 

Our office specializes in all kinds of applications for social benefits and support to bituach leumi.

 

Within the framework of legal field we practice tort law and represent the victims who

• suffered an industrial accident;

• suffered a road accident;

• are victims of war and terrorist attacks;

• suffered accidents in public places;

• have been in a private accident;

• are victims of occupational (industrial) diseases.

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We deal with the following cases:

• a loss of working capacity;

• claims against bituch leumi;

• claims against insurance companies;

• we represent victims of medical malpractice;

• we represent disabled people whose claim for a long-term nursing care insurance benefits have been rejected (bituach siudi);

• any other kinds of victims.

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Since our office specializes in civil offense cases, we cooperate with world-reknown medical experts who can consult you or give you medical findings which will increase your chances to win the case or secure better results.