Permanent Disability Guide After an Accident — Everything You Need to Know

What is Permanent Disability and Why It Changes Everything

Permanent disability is a medical condition determined to be permanent and irreversible, affecting your ability to work, function in daily life, and participate in activities that were natural to you before the accident. Unlike temporary disability, permanent disability remains with the injured party throughout their lifetime, which is why the Israeli legal system assigns significant financial weight to it when calculating compensation.

When you experience a motor vehicle accident, workplace accident, or any other accident causing bodily injury, the process of determining permanent disability begins with a comprehensive medical examination. The purpose of this examination is to assess your remaining capacity and measure the actual impact on your quality of life. This is not a simple process, and each case is unique.

On this page, we will review all important aspects of permanent disability following an accident: how permanent disability percentages are determined, how compensation is calculated, what your rights are in a claim with the National Insurance Institute or liability insurance, and how you can protect yourself to receive the full amount you are entitled to.

Permanent Disability Percentages — How They Are Determined

Determining permanent disability percentages is a medical-legal process based on several precise criteria. The National Insurance Institute, or in tort claims — the court, use defined tables and criteria to assess the degree of disability.

The main factors affecting the determination of permanent disability percentages:

• Type of Injury: Injury to limbs, spine, head, chest, abdomen, or senses (vision, hearing). Each type of injury has its own evaluation table.
• Degree of Amputation or Functional Disability: Whether the limb has full, partial, or no function. For example, amputation of a finger changes the disability percentage differently than amputation of an entire hand.
• Ability to Work: Whether the injured party can work in their previous occupation, in another occupation, or cannot work at all.
• Impact on Quality of Life: Assessment of the difficulty in performing daily activities, self-care, mobility, and recreational activities.
• Age of the Injured Party: Younger age means loss of income over a longer period, which may affect the calculation of total compensation.
• Pre-existing Medical Condition: Examination of whether there were prior health issues that may affect the disability assessment (the "eggshell plaintiff" principle).

The medical examination itself is conducted by a physician appointed by the authority or court, and in most cases includes physical examination, imaging tests (X-rays, MRI), functional tests, and an in-depth interview about the difficulties you are experiencing.

Permanent Disability Percentage Ranges — Typical Examples

While each case is unique, there are typical ranges of permanent disability percentages recognized in Israeli case law and national insurance tables. Here are some general examples:

• Limb Injury: Amputation of one finger — typically 5–10%; amputation of a hand — 20–40%; amputation of an entire arm — 40–60%; amputation of two limbs — up to 80–100%.
• Spinal Cord Injury: Spinal cord injury with partial paralysis — typically 30–70%; complete paralysis — 100%.
• Head Injury and Cognitive Impairment: Mild cognitive dysfunction — 10–20%; moderate impairment — 20–50%; severe impairment — 50–100%.
• Loss of Vision or Hearing: Loss of vision in one eye — typically 20–25%; loss of vision in both eyes — 100%; loss of hearing in one ear — 5–10%; loss of hearing in both ears — 30–50%.

It is important to emphasize: these are general ranges only. In practice, a detailed medical evaluation and additional factors such as age, profession, prior health condition, and inability to work can significantly affect the final percentage determined.

How Permanent Disability Compensation Is Calculated

The calculation of permanent disability compensation is an economic-legal process that considers two main components: future loss of income and loss of earning capacity.

Future Loss of Income: This is calculated based on your income before the accident, the assumption regarding the period during which you will not be able to work (or will work partially), and estimated retirement age. The formula is typically: monthly income × disability percentage × number of months/years until retirement. Additionally, an assessment of future medical expenses (treatments, medications, medical equipment) is calculated.

Loss of Earning Capacity (non-pecuniary damages): This refers to non-monetary damages — pain, suffering, fear, impact on family life, marital life, and ability to enjoy life. This calculation uses criteria such as the level of disability, the age of the injured party, and the extent of the impact on quality of life. Such amounts are typically determined by the court or the National Insurance Authority in accordance with existing case law.

In tort claims (i.e., against the party responsible for the accident or their insurance company), compensation may be higher than in a national insurance claim, since in tort claims you can claim for both pain and suffering and for full loss of income.

Difference Between National Insurance Claim and Tort Claim

It is important to understand the difference between the two methods of filing a claim, as each may be relevant depending on the circumstances of the accident:

National Insurance Claim

When you suffer a work accident or road accident (typically a traffic accident), you are entitled to file a claim with the National Insurance. This covers medical expenses, disability benefits (if permanent disability is determined), rehabilitation costs, and in some cases — a one-time compensation payment. National Insurance provides fixed amounts based on your disability percentage and your income before the accident (up to a maximum amount that is updated annually).

Tort Claim

This is a claim against the party responsible for the accident (another driver, employer, contractor, municipality, etc.) or their insurance company. In this claim, you can sue for all damages caused to you, including loss of income, medical expenses, pain and suffering, loss of earning capacity, and also anticipated future damages. Compensation amounts in tort claims are typically higher than those of national insurance.

In some cases, you can file both claims simultaneously — a national insurance claim and a tort claim. However, there are "double recovery" rules that you should be aware of: if you received compensation from national insurance, you generally cannot receive double compensation for the same injury in a tort claim, but you can claim the difference between the amount you received and the amount you are entitled to receive under tort law.

The Process of Appealing a Permanent Disability Determination

Sometimes, the initial assessment of your disability percentage does not reflect the full extent of the damage caused to you. In such cases, you have the right to appeal the decision. This appeals process is very important, because an increase of even a few percentage points in permanent disability can lead to a significant difference in the compensation you will receive.

Steps in the Appeals Process:

• First Stage — Request for Re-examination: You can submit a request to the National Insurance Institute (or to the court in a tort claim) for a re-examination by a physician, typically if your medical condition has deteriorated, or if there is new evidence indicating an error in the initial assessment.
• Second Stage — Filing an Appeal: If a re-examination did not change the ruling, or if you disagree with the result, you can submit a request to an appeals committee. In tort claims, this will be done through the court.
• Third Stage — Hearing Before the Appeals Committee: At the appeals committee, you can present additional evidence, medical testimony, new medical documentation, and also request an additional medical examination by a different physician.
• Fourth Stage — Appeal Decision: The appeals committee will decide whether to increase the disability percentage, decrease it, or leave it as is. This decision is usually final, but can be appealed by petition to the Supreme Court in exceptional cases.

The appeals process may last several months, and sometimes years, depending on the complexity of the case and the workload of the appeals committees. This is why it is very important to be represented by an experienced attorney who knows how to build a strong appeal case with appropriate medical evidence.

Additional Rights in a Permanent Disability Claim

Beyond compensation for the disability itself, you are entitled to claim for several additional damages resulting from the accident:

• Medical Expenses: All medical expenses incurred for treatment of the injury, including examinations, treatments, medications, medical equipment, physiotherapy, and any additional medical treatment required in the future.
• Rehabilitation and Retraining Expenses: If the disability prevents you from working in your previous occupation, you are entitled to compensation for retraining expenses to acquire a new profession.
• Home and Vehicle Modifications: If the disability requires adaptations to your home (ramps, adapted bathroom, elevator, etc.) or to your vehicle (wheelchair accessibility, hand controls, etc.), you are entitled to compensation for these costs.
• Assistance with Housework and Personal Care: If the disability prevents you from caring for yourself or performing housework, you are entitled to compensation for the cost of hiring a home care assistant.
• Medical Transportation: Compensation for transportation expenses to medical treatments, doctor visits, and hospital visits.
• Loss of Quality of Life: As mentioned, this relates to pain, suffering, fear, and impact on quality of life. This amount is usually determined by the court in accordance with case law.

How Mandelbaum, Gor, and Witzman-Gor Can Help You

When dealing with permanent disability following an accident, it is very important to be represented by an experienced attorney who understands the complexities of tort law, national insurance, and personal injury claims. Mandelbaum, Gor, and Witzman-Gor Ltd. specializes in representing accident victims since 2008, and we have extensive experience handling permanent disability claims.

Our services include:

• Preliminary claim assessment: We will review all details of the accident, medical injuries, and the impact on your ability to work, to assess the potential value of your claim.
• Guidance through the National Insurance process: We will help you file a claim with the National Insurance Institute, accompany you through the medical examination, and represent you in an appeal if necessary.
• Filing a tort claim: If the accident was caused by another party (another driver, employer, contractor, etc.), we will file a tort claim to obtain the full compensation you are entitled to.
• Collection of medical evidence: We will work with doctors and medical experts to obtain the best evidence supporting your claim.
• Appeals management: If the initial permanent disability assessment does not reflect the actual damage, we will help you file an appeal and build a strong case before the appeals committee.
• Negotiation with insurance companies: We will represent you in disputes and negotiations with insurance companies to obtain the highest possible compensation.

Our office is located in Ramat Gan and also in Petach Tikva, and we are available for an initial consultation meeting at no cost. In this meeting, we will hear your story, assess your claim, and clearly explain your options and next steps.