Permanent Disability Claim in National Insurance in Ramat Gan

What is Permanent Disability in National Insurance?

Permanent disability in national insurance is a condition in which a person suffers permanent physical injury caused as a result of a work accident, traffic accident, or an occupational disease, which significantly affects his or her ability to earn income and function in daily life. When the National Insurance recognizes permanent disability, the injured party is entitled to receive a monthly pension as well as a one-time lump sum compensation, according to the percentage of disability determined.

The definition of "permanent disability" is not subject to arbitrary discretion. The National Insurance relies on standard medical tables, in-depth medical examinations, and determinations by expert medical committees. However, the process of obtaining recognition of permanent disability and claiming full compensation is complex, requires strong medical evidence, and often requires—professional legal representation.

Who is Entitled to Claim Permanent Disability in National Insurance?

Not every accident victim is entitled to recognition of permanent disability. The requirements are stringent:

• Source of disability: The injury must be caused as a result of a recognized work accident, a traffic accident under certain conditions, or an occupational disease.
• Permanence and continuity: The disability must be permanent or have a high likelihood of being permanent, not temporary or reversible.
• Degree of disability: Generally, an disability percentage of at least 20% is required (under certain circumstances, a lower percentage may apply) in order for permanent disability to be recognized.
• Impact on work capacity: The disability must significantly affect the injured party's ability to earn income and function.

If you meet these conditions, you have a legal right to file a claim; however, obtaining recognition requires comprehensive medical documentation, convincing evidence, and often — opposition to the positions taken by the National Insurance.

Process for Filing a Permanent Disability Claim with National Insurance

The process of filing a claim with the National Insurance includes several critical stages:

1. Filing an Initial Application: The injured party submits an application to the National Insurance, accompanied by initial medical documentation, physician reports, test results, and any relevant evidence.
2. Medical Examination by National Insurance: The National Insurance arranges an independent medical examination, in which a specialist physician from the National Insurance examines the injured party and assesses the degree of disability.
3. Receipt of Initial Decision: The National Insurance issues a decision regarding recognition of permanent disability or rejection of the application. In some cases, the National Insurance recognizes only partial disability, at a lower level than expected.
4. Filing an Appeal or Objection: If the initial decision is unsatisfactory, the injured party may file an appeal before a National Insurance appeals committee, or file a lawsuit in court.
5. Negotiation and Settlement: In some cases, filing an appeal or submitting a legal claim leads to an agreement between the injured party and the National Insurance, which limits litigation costs.

Each stage requires careful preparation, strong medical evidence, and a deep understanding of the injured party's rights. Attorneys specializing in this field can have a significant impact on the outcome of the claim.

Types of Compensation in a Permanent Disability Claim

When the National Insurance recognizes permanent disability, the injured party is entitled to receive several types of compensation:

• Monthly Allowance: A fixed monthly payment for the entire period of disability (or until a certain age, depending on the legal conditions). The allowance is calculated based on the income the injured party was expected to earn, and according to the percentage of disability determined.
• One-time Compensation: A substantial lump-sum payment, calculated based on bodily injury, loss of earning capacity, and other losses. This amount can be very substantial, especially in cases of high disability.
• Medical Treatment Payments: The National Insurance may cover part of the medical treatment costs required as a result of the disability, such as physiotherapy, psychological treatment, medications, or installation of medical devices.
• Compensation for Pain and Suffering: In legal proceedings (not in direct National Insurance proceedings), the injured party may be entitled to additional compensation for pain and suffering, loss of quality of life, and impact on family and social relationships.

The total compensation amount depends on many factors: the percentage of disability, the age of the injured party, the income they had before the accident, the length of the expected disability period, and the type of bodily injury. In some cases, the amounts can be particularly high.

Differences Between National Insurance and Private Insurance

It is important to distinguish between a National Insurance claim and a private insurance claim (property insurance, third-party liability insurance, etc.). In a National Insurance claim, the injured party sues the National Insurance itself, which is a state institution. In a private insurance claim, the injured party sues a private insurance company or the party responsible for the accident (such as a driver who caused the accident).

In some cases, the injured party may be entitled to file claims through both channels simultaneously: a National Insurance claim for permanent disability and monthly allowance, as well as a civil claim for additional damages (pain and suffering, loss of enjoyment, additional medical expenses) against the responsible party or their insurance company. However, there are "double compensation" rules that can limit the total compensation to prevent unjust enrichment of the injured party.

Risks and Barriers in Claims

A permanent disability claim is not straightforward. The National Insurance is considered a cautious and critical body, and rejection of requests is not uncommon. Among the common barriers:

• Denial of Permanent Disability Recognition: The National Insurance may argue that the disability is not permanent, or that the percentage of disability is lower than required.
• Assessment of disability percentage as too low: The National Insurance assesses a lower disability percentage than expected, resulting in significantly lower compensation.
• Lack of medical documentation: If the medical records are incomplete, or if there are insufficient examinations, the National Insurance may reject the request.
• Discrepancy between claims and medical examination: If the injured party claims severe disability, but a medical examination shows more moderate findings, the National Insurance may rely on the examination.
• Causation issues: If it is difficult to prove that the disability was caused as a result of the specific accident (and not from another cause), the National Insurance may reject the request.

Beyond these barriers, the process can be prolonged and exhausting, requiring constant follow-up, additional evidence, and may require undergoing repeat medical examinations. Avoiding these barriers requires expert legal representation from the outset.

Why Choose Mandelboim, Gor, and Witzman-Gor Attorneys for a Permanent Disability Claim?

The law office of Mandelboim, Gor, Witzman-Gor & Co., Attorneys at Law, has been representing plaintiffs in tort law since 2008. Our extensive experience in National Insurance claims, traffic accidents, and work-related injuries provides us with a deep understanding of the rights of injured parties and the complex procedures they must navigate.

Representation of Plaintiffs Only: We represent only plaintiffs and injured parties, not insurance companies or employers. This means you have complete trust in us, with no conflicts of interest. Our goal is simple: to obtain the full compensation you deserve.

In-Depth Legal Experience: More than 18 years of experience representing clients in tort claims, including dozens of bodily injury cases, permanent disability claims, and National Insurance matters, equip us with the tools to handle complex proceedings and legal obstacles.

Personal and Dedicated Approach: Every claim is unique, and every injured party deserves personal attention. We accompany you at every step, explaining the process in clear language, and ensuring you understand your rights.

First Consultation at No Cost: We offer a free initial consultation to meet you, understand your situation, and evaluate the chances and available options for you.

Location in Ramat Gan: Our office is located in Ramat Gan, at Donosh 1, to serve residents of Ramat Gan, Ramla, Givatayim, Petach Tikva, and the entire central region. You can easily visit us or arrange a phone or video meeting.

Comparison Table: Typical Scenarios in Permanent Disability Claims

Below is a table presenting typical scenarios in permanent disability claims, demonstrating the differences between various cases:

Important Note: The table above presents typical scenarios only. Each case is unique, and disability percentages and compensation amounts may vary depending on specific circumstances, the age of the injured party, prior income, and medical examination results. Mandelblit, Gur, and Witzman-Gur attorneys will thoroughly review your case and help assess your prospects accurately.