Work Disability Guide — Disability Percentages and Claims

What is Work Disability? Definition and Fundamental Rights

Work disability is defined as physical or mental injury caused as a direct result of a work accident or occupational disease, resulting in a reduction in the injured party's work capacity. In Israel, the National Insurance Institution recognizes work disability as significant damage entitled to substantial monetary compensation, in accordance with the determined disability percentage and pre-accident income level.

When an employee is injured in a work accident and remains with permanent disability, they are entitled to receive compensation from the National Insurance Institution and, in many cases, from the employer's supplemental insurance or from a civil claim against the party responsible for the accident. The process of proving disability and determining its percentage is complex and requires a deep understanding of legal and medical procedures.

Our firm, Mandelbom, Gor, Weitzman-Gor and Partners, with over 18 years of experience representing injured parties exclusively in tort and insurance matters, helps injured parties navigate the claims process and achieve the full compensation to which they are entitled.

Work Disability Percentages — How Are They Determined?

The disability percentage is determined by a medical committee of the National Insurance Institution, composed of specialist physicians. The committee examines the condition of the injured party, the impact of the injury on their ability to work and perform daily activities, and the documented medical findings. The disability percentage typically ranges from 1% to 100%, with 100% indicating total disability.

The determination of the disability percentage is based on several factors: the type of injury (physical or mental), the extent of the impact on work capacity, the age of the injured party at the time of the accident, their profession before the accident, and their ability to adapt to an alternative profession. Each case is examined separately, and sometimes litigation is required to achieve a fair determination.

It is important to note that the disability percentage is not necessarily permanent. In some cases, a request can be filed to change the disability percentage if the injured party's condition has changed substantially — either for improvement or deterioration.

• Disability up to 20%: Considered mild disability; compensation involves a one-time payment and minimal monthly allowance.
• Disability 21–49%: Moderate disability; compensation increases substantially, and the monthly allowance increases accordingly.
• Disability 50–74%: Severe disability; the injured party is entitled to a substantial monthly allowance and a high one-time payment.
• Disability 75% and above: Very severe disability; compensation is the highest, and additional rights exist such as assistance with foreign aid or transportation discounts.

Work Disability Claim — Process Steps

A work disability claim is a complex process involving several stages: filing notice of the accident with the National Insurance Institution, medical examinations, appearance before a medical committee, and likely — negotiation or litigation to reach agreement on the disability percentage and compensation amount.

In the first stage, an employee injured in a work accident must notify the National Insurance Institution as soon as possible. This notification is a necessary condition for receiving an allowance and one-time payment. Thereafter, the National Insurance Institution summons the injured party for various medical examinations, in which specialist physicians in the field of injury participate.

After completion of the examinations, the injured party is summoned to appear before a medical committee of the National Insurance Institution. At this appearance, the injured party may be represented by an attorney, their own specialist physician, or both. The committee hears the arguments of the injured party and the National Insurance Institution, and examines all medical findings. Subsequently, the committee issues a decision regarding the disability percentage.

If the injured party disagrees with the medical committee's decision, they have the right to appeal to an appeals committee. This appeal is an important legal stage, in which new evidence, additional medical reports, or legal arguments challenging the original decision can be presented.

Assessment of Compensation Amount

The compensation amount in a work disability claim consists of several components: a monthly allowance to be paid for years or until the end of the injured party's life (depending on age and disability percentage), a one-time amount determined by law, and an allowance for family members (if the injured party has a family). Additionally, in a civil claim against the party responsible for the accident, the injured party can claim compensation for pain and suffering, loss of future earning capacity, and medical expenses.

Calculation of compensation is based on the injured party's pre-accident income, disability percentage, age, and life expectancy. All of these affect the level of the monthly allowance. Our firm is expert in precise calculation of compensation and negotiation with the National Insurance Institution and insurance companies to achieve the maximum amount for the injured party.

Scenario Comparison — Compensation Calculation Examples

To illustrate the impact of disability percentage on compensation amount, below is a table presenting various scenarios (the data is for illustration only and each case is reviewed individually):

Important Note: The data in the table are general estimates only and based on standard assumptions. Each case is reviewed separately, and the actual compensation amount depends on the injured party's income prior to the accident, age, medical condition, and family status. Additionally, these amounts may vary in accordance with updated laws and decisions of medical committees.

Additional Rights of Work-Related Disability Victims

Beyond the monthly allowance and lump sum, a victim with a disability of 75% or higher is entitled to significant additional rights:

• Foreign Care Assistance: The National Insurance may pay for foreign care assistance (caregiver, cleaner, or home helper) if the injured party requires it.
• Transportation Discounts: The injured party is entitled to substantial discounts on public transportation cards and fuel (if applicable).
• Rehabilitation and Vocational Training: The National Insurance may fund courses or training programs enabling the injured party to adapt to a new profession.
• Medical Rehabilitation: Medical treatments, physiotherapy, and psychological treatments required as a result of the accident.
• Family Allowance: If the injured party passes away as a result of the disability, family members are entitled to a monthly allowance.

Our firm assists injured parties in identifying all their rights and obtaining full compensation from the National Insurance and insurance companies.

Civil Lawsuit Against the Responsible Party — An Additional Layer of Protection

In addition to a National Insurance claim, a victim of a work accident can file a civil lawsuit against the employer, contractor, equipment manufacturer, or any other party whose duty was to prevent the accident. This lawsuit is typically for damages not covered by National Insurance, such as additional suffering, loss of future earning capacity, private medical expenses, or loss of income.

A civil lawsuit requires proof of negligence by the defendant — that is, evidence that the defendant failed to exercise the required care and acted in a manner that caused the accident. In such lawsuits, the victim can obtain substantial amounts, which are lower than those paid by National Insurance but complement the overall compensation.

Our firm specializes in filing civil lawsuits in work accidents. We examine all aspects of the accident, we gather medical and technical evidence, and we influence negotiations with the defendant's insurance or file a lawsuit in court if necessary.

Occupational Diseases — Disabilities Developing Slowly

Not all work-related disabilities result from a sudden accident. Occupational diseases such as spinal problems (due to working in a bent position), hearing damage (due to noise), or tendonitis (due to repetitive work) are also work-related disabilities covered by National Insurance. Claims for occupational diseases require strong medical evidence that the disease was caused as a direct result of working conditions.

This evidence includes a detailed medical report, documented history of the accident or exposure, and evidence that the disease does not exist in the general population at the same rate. Our firm helps victims obtain strong medical reports and file a strong claim with National Insurance.

Appealing a Medical Committee Decision — How to Achieve a Fair Decision

If a medical committee has determined a disability percentage that you believe is too low, or if it has rejected your claim entirely, you have the right to appeal. This appeal is an important legal process that allows you to present new evidence and legal arguments that challenge the original decision.

To file a successful appeal, you must present new evidence that was not presented to the original committee, or argue that the committee erred in its evaluation of the existing evidence. New evidence may include an updated medical report, witness testimony, or legal analysis of the original committee's findings.

Our firm successfully influences many appeals. We engage specialist physicians who write strong reports that challenge the findings of the original committee, and we influence persuasive legal arguments before the appeals committee.