Medical Committee in National Insurance in Petah Tikva

What is a Medical Committee in National Insurance?

A Medical Committee in National Insurance is the official body responsible for determining the degree of disability of a victim of a traffic accident or work injury, and accordingly — determining the disability percentages and the monetary compensation due to them from National Insurance. This is not a choice of the injured party, but a legal process dedicated to assessing the medical and functional impact of the injury on the person's daily life.

When you file a claim with National Insurance — whether for a traffic accident, work accident, or public injury — National Insurance does not simply accept your claim as is. It sends you for a medical examination before an expert medical committee, which will verify the causal connection between the accident and your damages and determine the disability percentages according to medical and legal criteria.

Why is this important? The disability percentages determined by the Medical Committee form the basis for calculating the monetary compensation you will receive. The higher the percentage, the greater the compensation. Therefore, understanding the process and your role during the medical examination is critical.

The Connection Between Medical Committee and Disability Percentages

Disability percentages are a numerical measure (0–100%) that indicates the extent of physical or mental injury caused to you as a result of the accident. The Medical Committee examines your medical documentation, conducts a direct clinical examination, and according to scientific and legal criteria — determines the final percentage.

Disability percentages are not arbitrary. They are based on official tables of the National Insurance, called the "Disability Percentages Table", which details for each type of injury (bone fracture, nerve damage, chronic pain, etc.) an expected range of percentages. The Medical Committee uses this table as a framework, but may vary according to the specific circumstances of your case.

The Medical Examination Process — Step by Step

When a claim is filed with National Insurance, the process begins with a medical examination. Here are the main steps:

1. Filing the Claim and Initial Medical Documentation

Following an accident, you must file a claim with National Insurance. In the claim form, you will describe the accident and the damages you sustained. At this time, it is important that you document all your medical treatment — examinations, diagnostic tests, treatments, medications, etc. Every medical document will become part of your National Insurance file.

2. Appointment for Medical Examination

National Insurance will summon you for a medical examination before a medical committee. The summons will include the date, time, and location of the examination. It is important to appear on time and bring with you all relevant medical documentation — examination reports, X-ray images, letters from physicians, etc.

3. Clinical Examination Before the Committee

The medical committee will examine you. The examination may include a physical examination (range of motion testing, muscle strength testing, pain assessment), questions about the accident and your injuries, and review of medical documentation. The committee may also order additional tests if necessary (imaging tests, nerve tests, etc.).

4. Determination of Disability Percentage

Following the examination, the medical committee will determine your disability percentage. This may be 0% (if the committee believes there is no causal connection between the accident and your injuries), or any percentage between 1% and 100%. The committee will send you a letter with its decision and an explanation of the reasoning.

5. Right of Appeal

If you disagree with the medical committee's decision, you have the right to appeal to a medical appeals committee. In your appeal, you can present additional medical evidence, dispute the findings of the initial committee, or request additional examinations.

Disability Percentages — How Do They Affect Compensation?

The disability percentages determined by the medical committee are the key to calculating the financial compensation you will receive from the National Insurance Institute. The basic formula is:

Compensation = Average Monthly Salary (or Income) × Disability Percentage × Coefficient from Official Table

For example: If you are an employee whose monthly salary is 8,000 NIS, and the committee determined that you suffer from 30% disability, your compensation will be calculated based on 30% of your salary, multiplied by a certain coefficient. This may be a one-time payment or monthly pension, depending on the level of disability.

Different disability percentage ranges also have different implications:

• 0–10%: Mild disability; generally no monthly pension, only a small one-time compensation (if any).
• 11–20%: Mild-to-moderate disability; moderate one-time compensation.
• 21–50%: Moderate disability; may include one-time compensation or partial monthly pension.
• 51–100%: Moderate-to-severe to severe disability; full or partial monthly pension for life, plus one-time compensation.

This is why determining the correct disability percentage is so important. If the committee sets a percentage that is too low, you may receive compensation that is far less than what you deserve.

Previous Disability Assessments and Additional Compensation

In some cases, if your disability deteriorates over time, or if your functioning improves or worsens, you can request an update to your disability assessment. This can lead to additional compensation or a change in your monthly pension.

Common Mistakes in the Medical Committee Process — And How to Avoid Them

1. Failure to Bring Complete Medical Documentation

A common mistake is appearing for a medical examination without bringing all relevant medical documentation with you. The committee needs to see all blood tests, imaging studies, physician letters, and treatments. If documentation is missing, the committee may be unable to fully assess your condition.

2. Presenting Inconsistent Claims

If in your first meeting with the physician you stated that you suffer from back pain, but in the medical committee examination you claimed you suffer from neck pain, the committee may question your claims. It is important that your claims remain consistent throughout the entire process.

3. Failure to Appear for Examination or Delay

If you fail to appear for the medical examination, or if you appear with significant delay, the committee may cancel the examination and even reject your claim. It is important to appear on time and be prepared.

4. Failure to Cooperate with the Committee

If the committee requests additional tests, or if it asks questions, it is important to cooperate and respond thoughtfully. Failure to cooperate may lead to the assumption that you are not serious about your claim.

5. Treating the Process as Unimportant

Some claimants think that the medical examination is merely a formality and do not acknowledge its importance. This is a mistake. The medical examination is the decision that will determine all of your compensation. It is important to prepare yourself, bring evidence, and be active in the process.

Right of Appeal — What to Do If You Disagree with the Decision

If the medical committee determined a disability percentage that you believe is too low, or if it rejected your claim entirely, you have the right to file an appeal. An appeal is a legal process in which an additional medical appeals committee will review the decision of the first committee.

What Can You Do in an Appeal?

In an appeal, you can present new medical evidence that was not available to the first committee — for example, a report from an additional specialist, a new medical examination, or testimonies from people who witnessed the accident or the impact of the injuries on you. You can also dispute the medical conclusions of the first committee, or argue that it failed to properly apply the disability percentage tables.

Importance of Legal Representation in an Appeal

An appeal is a more complex process than the initial examination. It is important to be represented by an experienced attorney specializing in national insurance claims. An attorney can help you gather strong medical evidence, present legal and medical arguments, and increase your chances of winning the appeal.

How Mandelbaum, Gor, and Witzman-Gor Can Help You in the Medical Committee Process

The law firm Mandelbaum, Gor, and Witzman-Gor, Attorneys at Law in Petah Tikva specializes in National Insurance and bodily injury claims. We represent claimants exclusively in the field of tort law, meaning we work only on behalf of injured parties and not for the National Insurance Institute or insurance companies.

Our services include:

• Preparation for the medical examination: We help you prepare for the medical examination, including gathering medical documentation, preparing a symptom list, and providing guidance on how to conduct yourself during the examination.
• Legal representation: We accompany you throughout the entire process, from the initial claim submission to the final decision of the medical committee.
• Review of the decision: Once the committee has determined your disability percentage, we review the decision and advise you whether it is worthwhile to appeal.
• Filing an appeal: If you decide to appeal, we represent you before the medical appeals committee, including preparing strong legal and medical arguments.
• General legal consultation: We provide advice on your rights, the compensation you are entitled to, and the best ways to increase your chances of receiving full compensation.

Our experience since 2008 in this field has given us a deep understanding of the nuances of the medical committee process, the difficulties faced by injured parties, and the best ways to protect your rights. We operate from two branches — Petah Tikva and Ramat Gan — and provide personalized and dedicated service to every client.