Below is important information on the issue of Parkinson's patients dealing with the National Insurance, by Engineer Danny Marco, member of the association.

This article deals with three topics:

1. General Disability Allowance and Special Services (Sharam)
2. Exemption from income tax
3. Dealing with the National Insurance and insurance companies.

This article summarizes years of in-depth study by the author of the article, and is based on the text of the law and the accumulated experience of the author of the article and other members.
For your attention: keep up to date on the National Insurance website (click here) regarding the current percentages and numbers.

introduction

The purpose of the article is to explain how one should act to receive a disability allowance and special services. The knowledge on which my articles are based I have accumulated from studying the material and the law, from collecting stories from other members, and from a successful experience in obtaining the rights without a lawyer.
What is important is common sense, order, and above all: a little luck.

Thanks to my friends in the association, who told me their story and expanded my knowledge.

Note: It should be remembered that the doctors and the officials in the National Insurance are doing their job. Their job is to verify the correctness of our illness, otherwise they would accept the findings of our doctors as the Sinaitic Torah.
And we, our job is to get what we deserve, and sometimes disagreements arise. Remember that you can deal with them in a civil way and with respect.

What is insurance?

Insurance is the purchase of an annuity, or a sum of money, or a service that is provided only under the circumstances detailed in the policy terms.
If the incident did not happen as specified in the policy conditions - you will not receive anything.
That is why it is important that every document is aimed at the terms of the policy.

Each medical document in the file will mention how the event for which the policy exists (National Insurance Law) was caused.

General disability - National Insurance

The insurance case:

1. Degree of incapacity to get drunk at a rate of 75% (60% partial) - our deficiencies cause incapacity.
2. Medical disability in percentages 60% (50% partial).
3. The higher numbers get a full allowance (the lower numbers get a partial allowance).

Disability insurance - private

The insurance case:

Total or partial loss of working capacity in the insured's profession

including a poor external impression and stigma.

Sharm Insurance - National Insurance

until retirement age

The insurance case:

A patient who needs a lot of help with most daily activities and most hours of the day is entitled to 50% of the full allowance

A patient who needs a lot of help in all daily activities most hours of the day is entitled to 100% of the full allowance

A patient who is completely dependent on another person for all daily activities at all hours of the day is entitled to 150% of the full allowance

Activities of daily living: dressing, eating, bathing, mobility at home and control of secretions. or needs constant supervision.

Klalit's long-term care insurance is perfect at Dekla Co

The insurance case:

Similar to a nurse at home or in a hospital.

If unable to perform 3 or 4 daily activities as defined in the policy and according to the age on the day of joining the long-term care insurance.

This is several thousand shekels per month for 3 years.

In Maccabi for 5 years.

Why claim nursing care at home and not in a hospital?

Because there is a better chance of seeing the money.

Insurance according to the Nursing Law after retirement age - National Insurance

Similar to a perfect nursing home in terms of the insurance case, but you actually get weekly hours of help.

It is necessary to demonstrate to a specialist nurse how we are unable to perform the actions detailed in the claim forms of the National Insurance.

What is the order of treatment (see advanced content)

1. The disease appears
2. Tests and getting a diagnosis (when necessary, get a professional opinion from a specialist doctor)
3. Studying the law and the terms of the policy, as well as consulting with the members of the association
4. Understanding the method of calculating the percentage of disability
5. Filing the claim
6. medical committee
7. Receiving a social security decision
8. consent or appeal
9. Acceptance of appeal

When is a professional opinion from a specialist doctor required?

If the attending physician refuses to write the necessary document referring to the detailed conditions of the law and/or the policy. That is, if despite your condition, the doctor refuses to explicitly write what is needed, then there is no choice and you have to pay for a professional opinion (between NIS 5,000-1,500).

For example, if despite the documents you have, the doctor is not ready to write when the disease began.

For clarification:

What will happen in this case will be as follows: the doctor of the committee will determine himself, and not always correctly. Therefore, in this case, a professional opinion of a Parkinson's specialist is preferable.

First first, and last last, before filing the claim:

Take the information booklets from the National Insurance and read them until you understand.

Consult association members.

Use the "Exercise of Rights" forum on the association's website. The association's legal advisor and other lawyers will be happy to answer targeted questions

At each visit to the neurologist and the general practitioner, any limitation was reported, and a written summary of the visit was also requested.

Get the diagnosis in writing and anything else relevant, in detail and with a date.

It is a good idea to submit the forms for the claim for general disability with a claim to the Prime Minister (or at least have them ready, in case they are needed).

Who is entitled to a disability benefit:

Resident of Israel from the age of 18 until retirement

Those who have a physical, mental or mental impairment due to illness, accident or birth

Those who do not have the ability to earn and do not earn an amount equal to 25% of the average salary (NIS 1,884 as of April 2007)

Or - those whose ability to actually get drunk due to the impairment has decreased by 50% or more.

To receive a full allowance:

He was approved for 60% medical disability or 40%, if one of the disabilities is over 25%.

He was approved for a degree of incapacity of at least 50% (those who have been approved for 75% incapacity will not pay insurance premiums while he is entitled to an allowance)

Please note: those who work part-time, then their income ceiling also includes taxable benefits, such as owning a car.

Disability - receiving a disability allowance while working. It is possible to work, earn and receive a disability allowance, if in the opinion of the National Insurance, due to your medical condition, you cannot earn more than you actually earn, and if your monthly income from work (gross) is one of the following 3 options:

1. Your monthly income from work (gross) is up to 25% of the average salary.
2. Your monthly income from work has been reduced, and is half or less of the income from work you had before the degree of disability was determined. In these cases the entitlement is usually for a partial pension. How do you determine if your income from work has been reduced by at least half? The determination is made by comparing your monthly income from work (gross) after determining the degree of disability, to the income before determining the degree of disability (income also includes one-time payments such as clothing, recovery, etc. in a monthly calculation). The income before the determination of the degree of disability is calculated as follows: if you were a salaried employee - according to the average of your income in 6 months out of the 18 months preceding the determination of the degree of disability (taking into account the 6 months in which the income is the highest). If you were self-employed - according to your income in one of the 3 years preceding the year in which the degree of disability was determined (taking into account the year in which the income is the highest).
3. For those who did not work before determining the degree of disability or whose income from work (as an employee or self-employed) was low - the income from work allowed to you is determined according to your level of education and it is:

For an academic or someone with equivalent education - up to 55% of the average salary in the economy (average salary: 7,663 NIS as of 01.01.2008.

For high school graduates or those with equivalent education - up to 45% of the average salary in the economy (average salary: 7,663 NIS as of 01.01.2008.

For those with a lower education than these, including no education - up to 37.5% of the average salary in the economy (average salary: 7,663 NIS as of 01.01.2008

For the calculation according to education of 45% or 55% of the average salary, you must produce certificates of the education

The manner of filing the claim

1. At the National Insurance branch nearest to your place of residence, ask for forms to claim disability benefits and SRAM
2. Medical documents, work and salary certificates or any other income must be attached to the claim form
3. A self-employed worker will also submit certificates for the reduction of his income

Beginning of entitlement to an allowance

Entitlement to an allowance begins 90 days from the date of loss of capacity, but no earlier than 15 months from the date of filing the claim for disability.

When filling out the forms:

1. It is necessary to explain to the doctors what the law says, and explain what the purpose of their opinion is.
2. In a conversation with an occupational doctor, for example, it is necessary to explain how the impairment affects the ability to work.
3. It must be emphasized to the neurologist that his opinion must take into account the fact that Parkinson's is bilateral, and that it must be stated what its level of severity is and from what date.
4. It should be emphasized to the internist how the deficiencies interfere with daily activities.
5. You should prepare a draft of the appropriate letter, and ask the doctor if he likes it.
6. And most importantly: write a reminder letter to the medical committee, as will be detailed later.

Sharm pension levels

1. Needs a lot of help doing most of the day-to-day activities most of the time 50%
2. Needs a lot of help doing all day to day activities most hours of the day 100%
3. Completely dependent on another person for doing all day-to-day activities at all hours of the day - 150%
4. Full allowance for rank % 100=1763+502 (as of July 2005, must be updated)
5. Daily activities: dressing, eating, bathing, mobility at home, controlling secretions, or who need constant supervision to prevent life-threatening situations.

The reminder letter to the committee

Preferably it should be printed on a page of a different color! The letter will include:

1. identifying data
2. Description of the effort you made to continue working
3. Seniority in the disease, including documentation and documents
4. problems, and how they interfere with work, including a doctor's certificate and appendix number (incapacity)
5. Daily functioning problems as a result of a medical problem, including a doctor's certificate and an appendix number (for the need of the Chief Minister)
6. Medical problems in addition to Parkinson's disease, including the date of their appearance, accompanied by medical certificates.

See detailed examples below.

The medical committee

Prepare the document file in 4 copies:

1. One to send to the committee through the reception desk of the National Insurance branch. Make sure you get an "received" stamp on your copy.
2. Keep 2 more copies with you, in case their copy did not arrive in the file.
3. A fourth copy will remain with you anyway.
4. When the committee begins, you will immediately ask that they refer to the reminder letter, since your memory is not the same as yesterday and you don't want to forget points.
5. Do not sign the minutes of the committee, until the clerk specifically notes that you wish to be treated as written in the reminder letter.
6. Join the committee with your partner and don't be ashamed to accept his help. If you are asked if you can wash your face (a misleading question) answer the truth - yes, you can wash your face, but you cannot reach different parts with your hand to wipe them (in case this is the truth of course). Make sure it registers.
7. If the secretary recorded only part of your answer - state this to him.

In the medical committee - how to answer frustrating questions

We do not plan the questions that are addressed to us, but we can plan our answers so that the truth will come out.

Examples:

"Can you walk in your house?"

The truth must be told, reflecting the Parkinson's disease and the difficulty. For example, "I don't have a particular problem in open places, but in crowded places such as the bathroom, I feel like my feet stick to the floor."

"How do you claim that you are not mobile in your house?"

You can answer: "Because in crowded places I get stuck."

This is an answer that corresponds to the condition of many Parkinson's patients.

(For example, I wrote in the reminder letter that I get stuck in tight spots.)
It is advisable to mention additional facts that are suitable for many Parkinson's patients, such as "Getting out of the state of sticking to the floor takes a lot of effort and time for me."

I would like to offer a "dictionary" that explains to the best of my understanding the things that are said during a medical committee:

Take out an ID card = the doctor checks how long it takes the patient to perform the operation

Take off your shirt so I can check you = already at this point, the doctor is checking your ability to do this

Get on the examination bed = here, too, the doctor tests your physical ability to get on the bed

can you wash your face = You are independent in washing

Does it hurt here? = The doctor checks the truth of your words

Are there other things that bother/disrupt? = Remember: everything you didn't write down wasn't written down. Therefore, say the entire list that you attached to the reminder letter.

Please sign = remember: sign only after you make sure that the reminder letter will be part of the statement.

The method of calculating the medical disability percentages

Let's say you got 40% for the right side + 30% for the left side + 10% for the orthopedic section.

The calculation will be like this:

Subtract the disability percentage greater than 100%

That is: 60% = 40%-100%

The second largest disability percentage is multiplied by the remaining 18% = 30X60

58% = 40+18% disability percentage from the first two large sections

42% = 100-58% in reduction from one hundred percent, this is what remains

4.2% = 42%X10 the balance is multiplied by the third largest deficiency percentage

62.6% = 4.2%+58 percentage of disability from the three deficiencies.

Now suppose you got 50% for the right side + 40% for the left side + 10% for the orthopedic section.

The calculation will be like this:

50% = 100-50% remaining after subtracting the first defect in size.

20% = 50X40 the rest is multiplied by the second largest eclipse.

70% = 50%+20% sum of the first two defects.

30% = 100-70% the balance from one hundred percent.

3% = 30X10 times the percentage of the third largest defect.

73% = 50+20+3 Finally, adding the three deficiencies in the weighted form.

At what % of medical disability should you request an exemption from income tax?

with a disability percentage of 73% in the National Insurance.

The calculation of the income tax is carried out, according to the Arbel High Court, by a normal addition of the two sides of Parkinson's disability:

90% = 50+40%

10% = 100-90%

1% = 10%X10

91% = 90%+1%

And here you can get an exemption from income tax.

Social Security Mobility Benefit

The insurance case:
You have not reached retirement age + a medical committee has determined a percentage of mobility disability due to defects in his legs, according to section A.7 - as of 12.7.07/XNUMX/XNUMX
The benefit rate and the other options, such as the owner of a vehicle who drives, who does not drive and another drives it, etc.

The amount of allowances

Full disability allowance does not include supplements
For a disabled person with 75% incapacity, the group is NIS 1,937 as of January 2007.
These disabled people with a medical disability of at least 50 percent have an addition of NIS 208-308 in direct proportion to the medical disability.

Between 60-74% are entitled to a partial pension. (The date of submission must be updated - the data is, as mentioned, correct for 2007).
A man who has dependents is entitled to an increase for 2 dependents, at a rate of 40% per dependent, in addition to receiving other pensions for old age pension.

Recipients of a general disability allowance and recipients of an income guarantee allowance will receive the general disability allowance or the income guarantee allowance until retirement age. From the age of retirement they will start receiving an old age pension only.

Those who received a general disability pension close to the time they became eligible for an old age pension, their old age pension will not be reduced by the rate of the last monthly disability pension paid to them, and it will be updated at the rates and times when the general disability pension is updated.

Notes regarding ways of exercising rights through legal litigation

The cost of a lawyer's treatment varies: from just opening a case, to full treatment until the verdict. The cost can be significant in the round and it is appropriate to find out all its details in advance.

The cost of membership to exercise medical rights does not include representation in the discussions, and it should be ascertained in advance - because the coffee is also important to you.

Methods of contacting an attorney

1. You handle the case and he advises you on an hourly basis.
2. The lawyer handles the case on a percentage basis.

Remember: there is always the possibility that you are handling the case alone!

Successfully!!

Click here for an example of a reminder letter to the medical board...