General Disability Claim in National Insurance in Ramat Gan

What is General Disability in National Insurance?

General disability in national insurance is a condition in which a person suffers from bodily injury or deterioration in health as a result of a work accident, traffic accident or occupational disease, which impairs their ability to earn a living through work. National insurance recognizes this disability and grants the injured party the right to file a claim for monetary compensation and additional benefits.

Unlike partial disability, general disability affects the injured party's overall work capacity—that is, their ability to work in any type of employment, not just in their former profession. A claim for general disability typically opens after the injured party has undergone a medical examination by a national insurance medical examiner, or after a claim has been filed and a request for examination has been submitted.

The claim includes several components: a one-time compensation payment for the disability, a monthly pension (under certain conditions), coverage of medical and rehabilitation expenses, and additional rights such as a pension for family members upon death. Each of these components requires deep legal understanding and the ability to assert your rights within the national insurance system.

Why is it important to have legal representation in such a claim?

Many accident or occupational disease victims are not fully aware of the compensation amount they are entitled to receive. The national insurance system often operates with broad discretion, and the initial assessment of disability percentages may be lower than the actual situation warrants. An experienced attorney can challenge the assessment, present strong medical evidence, and request a re-examination or an appeal before the national insurance appeals committee.

Furthermore, the claim involves complex calculations of future benefits, loss of earning capacity, and the impact on future earning capacity. Errors in these calculations could cost you tens of thousands of shekels. The Mendelboim, Gor, Witzman-Gor & Co. law office represents claimants exclusively in personal injury and national insurance claims, with over 18 years of experience in this field.

Stages of a General Disability Claim in National Insurance

The process of filing a claim for general disability in national insurance is complex and requires knowledge of national insurance procedures, accuracy in document submission, and presentation of strong medical evidence. Below are the main stages:

Stage 1: Filing the Claim with National Insurance

The claim is typically filed with the National Insurance branch where you are registered. You must submit an official claim form, accompanied by supporting documents: an employer's certificate regarding the accident or illness, medical reports, photographs of the injury (if available), and any other relevant documents. At this stage, it is important to be precise and thorough — any missing or incorrect information may delay the processing of your claim.

Stage 2: Medical Examination by National Insurance

After filing the claim, National Insurance will summon you for a medical examination conducted by their appointed physician. This examination is very important — the doctor will perform a physical examination, review previous medical reports, and issue an initial disability percentage. It is essential to prepare for this examination: bring all your medical reports, describe your pain and difficulties in detail, and do not misrepresent or conceal any medical evidence. An attorney can advise you on how to prepare for the examination and may even accompany you through the process.

Stage 3: Receiving the Initial Decision

Following the medical examination, National Insurance will issue an initial decision regarding the acceptance of the claim and the disability percentage. This decision is not final — if you disagree with it, you have the right to appeal before a National Insurance appeals committee within 30 days of receiving the decision.

Stage 4: Filing an Appeal (if necessary)

If the disability percentage awarded to you is lower than expected, or if new or stronger medical evidence is available, you may file an appeal. In the appeal, you must present strong legal arguments, additional medical evidence (reports from private physicians, additional tests), and sometimes even commission an independent third-party medical examination. The appeals committee will reconsider the claim and issue a final decision.

Stage 5: Receiving Compensation

After your claim is approved, National Insurance will transfer the lump-sum compensation to you, begin paying the monthly allowance (if awarded), and cover approved medical and rehabilitation expenses. National Insurance typically pays the compensation within weeks of claim approval, though each case is different.

How Long Does a General Disability Claim Take?

The duration of a general disability claim varies depending on the complexity of the case, the amount of medical evidence, and the responsiveness of the National Insurance Institute. Typically, from filing the claim to receiving an initial decision takes 2–4 months. If an appeal is filed, the process can extend an additional 3–6 months.

During this period, we handle all the technical matters so that you can focus on your recovery. We send reminders to the National Insurance Institute, track the status of your claim, and keep you informed of all progress.

Disability Percentages and Compensation Amounts

The disability percentage assigned to you determines the lump-sum compensation and monthly allowance (if assigned). The disability percentage is determined by the National Insurance Institute's examining physician, in accordance with medical principles and the National Insurance disability tables. These tables determine the disability percentage based on the type of injury, the location of the disability in the body, and its impact on earning capacity.

The lump-sum compensation amount is calculated according to a formula set by the National Insurance Institute, based on your average salary in the period before the accident or illness. If the disability percentage is 50% or higher, you are also entitled to a monthly allowance, which will remain in effect until death or until the disability changes. Additionally, the National Insurance will cover medical expenses, medications, medical equipment, and return-to-work assistance (if feasible).

These amounts change annually according to cost of living adjustments and National Insurance decisions. We keep our clients informed of any changes in laws or National Insurance decisions that could affect their claim.

Differences Between General Disability and Partial Disability

It is important to understand the difference between general disability and partial disability, as it directly affects the amount of compensation you receive. General disability is when the injured party cannot work in any type of work, or when the disability significantly affects their ability to earn income. Partial disability is when the injured party can still work in a certain type of work, but not in their former profession or in work requiring the same physical effort as before.

For example: If you are a construction worker injured in a work accident and cannot work in construction anymore, but can work in an office or desk job, this may be considered partial disability (if there is another type of work available for you). If you cannot work at all due to the disability, it is general disability.

The National Insurance Institute examines your "earning capacity" — meaning your ability to earn income from any type of work. If the disability significantly affects this ability, the National Insurance Institute may recognize it as general disability and award higher compensation. An experienced attorney can point to evidence demonstrating that the disability is general, not partial.