Occupational Disease Claim in National Insurance in Ramat Gan

What is an Occupational Disease?

An occupational disease is a disease or injury at work caused by exposure to occupational hazards, such as toxic substances, noise, pollution, or harsh working conditions. Unlike a workplace accident, an occupational disease develops gradually over time, not as a result of a single isolated event. Common occupational diseases include asbestosis, silicosis, occupational dermatitis, and back and limb problems resulting from repetitive work.

In Israel, occupational diseases are recognized under the National Insurance Law, and entitled employees can file a claim with the National Insurance Institution by establishing the connection between the disease and their work. Recognition of a disease as an occupational disease opens the door to financial compensation, medical rehabilitation and additional support.

Who is Entitled to an Occupational Disease Claim?

Not every illness contracted by an employee is entitled to recognition as an occupational disease. For a claim to be accepted, three main requirements must be met:

• Proof of Disease: The employee must prove through medical examinations and medical documentation that they suffer from the relevant disease. This requires a detailed medical report from a specialist physician.
• Causal Connection: It must be proven that the disease was caused as a direct result of workplace exposure. This means that the employee was exposed to a specific occupational hazard and that exposure led to the development of the disease.
• Employment in Relevant Work: It must be proven that the employee worked in an occupation where they were exposed to the risk leading to the disease. This includes proof of the duration of employment, working conditions, and their nature.

Process for Filing an Occupational Disease Claim

The process of filing a claim with the National Insurance Institution for an occupational disease is complex and requires careful preparation. Here are the main steps:

1. Gather Medical Documentation: Obtain a detailed medical report from a specialist physician in the field of your disease. The report should contain a complete description of the disease, the date of diagnosis, and a description of the connection between the disease and your work.
2. Collect Work Documentation: Gather documents proving your employment in relevant work, such as employment contracts, pay slips, witness statements, and any other documents proving your working conditions.
3. Submit Your Application to the National Insurance Institution: Submit a formal application to the National Insurance Institution with all relevant documents. This application should include a detailed description of the disease, the connection to your work, and the evidence supporting your claim.
4. Medical Examination: The National Insurance Institution may order an additional medical examination by its own physician to verify the disease and its connection to your work.
5. Receipt of Decision: After reviewing all evidence, the National Insurance Institution will issue a decision regarding acceptance or rejection of your claim.
6. Appeal if Rejected: If the claim is rejected, you have the option to file an appeal to an Appeals Committee. At this stage, an experienced attorney can assist you in substantiating your decision and presenting additional evidence.

Types of Occupational Diseases Recognized in National Insurance

The National Insurance Institute in Israel recognizes certain categories of occupational diseases. Each category includes specific diseases related to certain types of work. Recognition of a disease as an occupational disease depends on meeting certain conditions, including duration of exposure, intensity of exposure, and medical documentation to establish a clear causal connection.

Diseases related to exposure to chemical substances, such as asbestosis and silicosis, require proof of prolonged exposure to the hazardous material. Diseases related to repetitive movements, such as carpal tunnel syndrome and tennis elbow, require proof of work involving repetitive movement patterns. Diseases related to noise, such as occupational hearing loss, require proof of exposure to high noise levels.

Challenges in Filing a Claim

Filing an occupational disease claim involves navigating several significant challenges. The National Insurance Institute typically requires strong and clear evidence of the connection between the disease and the work. In some cases, it is difficult to prove this connection because certain diseases can be caused by other factors unrelated to work.

Additionally, employers may dispute working conditions or the extent of exposure to occupational hazards. Testimony from other employees, occupational health and safety experts, or medical experts may be necessary to support the claim. Medical documentation must be accurate and detailed, and often requires multiple medical opinions.

Each occupational disease case is unique and requires thorough examination of the circumstances, working conditions, and medical evidence. Often, the likelihood of success in a claim depends on strong and clear evidence and a persuasive presentation of the connection between the disease and the work.

Benefits of Legal Representation

Hiring an experienced attorney in occupational disease claims can significantly increase the likelihood of success in your claim. An experienced attorney can help prepare medical documentation, gather supporting evidence, and present the claim before the National Insurance Institute. An attorney can also represent you in hearings before the appeals committee in case of initial rejection.

Our firm, Mandelbaum, Gur, Witzman-Gur & Co., has 18 years of experience representing claimants in the fields of tort law and national insurance. We understand the nuances of occupational disease claims and know how to build a strong case for you. Each case is handled with personal attention and dedication, and the first legal consultation is provided at no cost.

Compensation Amounts in Occupational Disease Claims

The compensation amount in an occupational disease claim depends on multiple factors, such as the degree of disability caused, loss of earning capacity, the worker's age, and the stability of income prior to the injury. Generally, National Insurance pays compensation in the form of a monthly allowance (maintenance benefits), a one-time disability payment, and coverage of medical expenses and treatments.

Compensation is calculated based on the percentage of disability determined by a medical committee. The higher the disability percentage, the higher the compensation. Additionally, if the disease resulted in significant loss of earning capacity, the worker may be entitled to an additional monthly allowance. Each case is evaluated individually according to its specific circumstances.

It is important to note that National Insurance pays compensation according to formulas defined by law, and the amount does not change as a result of negotiation. However, in some cases, it may be possible to obtain additional compensation from the employer or another insurance company, depending on the employment conditions and associated insurance coverage.

Procedure Timeline and Expected Duration

The process of filing an occupational disease claim with National Insurance can take several months. Generally, an initial medical examination is conducted within 2-4 weeks from the submission of the request. Following the medical examination, National Insurance reviews all evidence and issues a decision, typically within 1-2 additional months.

If the claim is rejected, there is a right to appeal to an appeals committee. The appeals process can take up to a year or more, depending on the complexity of the case and the number of hearings required. During this entire process, it is important to maintain contact with National Insurance and continue submitting additional documents if required.