Disability percentages —
how are they set and what affects them?

When it comes to medical rights with the National Insurance Institute, there is one number that decides almost everything: the disability percentage. It determines whether you receive an allowance, how much it will be, what benefits and discounts you will get — and even whether the door opens to an income tax exemption. And yet most people do not really understand how that number is arrived at, what affects it, and why two people with exactly the same illness may receive completely different percentages.

In this article we explain in plain language how the disability percentage system works in Israel — from the Schedule of Impairments to the weighted calculation — so that you know what to expect and how to prepare properly.

What is a “disability percentage”, exactly?

A disability percentage is a numerical expression of a person’s medical or functional impairment. The more severe the impairment and the greater its effect on functioning, the higher the percentage. The percentage is set by a medical committee of the relevant body — the National Insurance Institute, the Ministry of Defence, the Tax Authority and others — on the basis of an examination, medical records and an official schedule of impairments.

An important point right at the start: there is no “single disability percentage” across all the systems. The same person may receive one percentage from the National Insurance Institute, a different one for income tax exemption purposes, and a third from the Ministry of Defence — because each body applies its own criteria and examines the situation for a different purpose.

It is also worth understanding: a disability percentage stays with a person for years, sometimes for life. It affects not only the monthly allowance but a long list of rights and benefits — which makes it well worth investing in understanding how it is set and preparing properly for that determination.

The Schedule of Impairments — the basis of every determination

At the heart of the disability percentage system stands an official document called the “Schedule of Impairments” (also known as the Disability Tests). It sets out hundreds of medical conditions, and alongside each one the range of percentages that can be determined for it.

Every impairment — an orthopaedic problem, heart disease, a psychological impairment, a neurological injury — has its own “section” in the schedule, with percentages graded by the severity of the condition. The doctor on the committee chooses the appropriate section and the degree of severity, and that is how the percentage is set.

What this means: the percentage is not the doctor’s “invention” but is derived from a defined table. But there is considerable discretion in choosing the section and setting the degree of severity — which is why how the condition is presented and how it is documented directly affect the final outcome.

The weighted calculation — why 30% plus 20% does not equal 50%

This is one of the most important and least understood points in the system. Where a person has several different impairments, their disability percentages are not simply added together. Instead a “weighted calculation” is carried out:

• First the highest percentage is taken in full.
• Every further percentage is calculated on the “remainder” that is left — not on the full 100%.

An illustration: a person with an impairment of 30% and a further impairment of 20%. The calculation is not 50%, but: the first 30%, and then 20% of the remaining 70% (that is, 14%). The final weighted total: 44%.

The practical meaning: the more impairments accumulate, the less each further percentage is “worth” in the overall calculation. Precisely for that reason it is so important to identify and present every impairment in full — because an impairment that was never presented simply does not enter the calculation.

Understanding the weighted calculation also matters so as not to be disappointed for nothing: people sometimes expect that “the sum of all the illnesses” will produce a very high percentage, and are surprised to find the result lower than expected. That is not a sign that the committee got it wrong — it is simply how the system is built. That said, if you are convinced that a particular impairment was not properly considered or was left out entirely, that is certainly grounds for a review and an appeal.

Medical disability against degree of incapacity — two separate stages

In a general disability claim to the National Insurance Institute, the medical disability percentage is only half the story. The process involves two separate stages:

• Determining the medical disability percentage — by the medical committee, under the Schedule of Impairments.
• Determining the degree of incapacity for work — how far the impairment prevents the person from working and earning a living.

A person can receive a given medical disability percentage but a higher or lower degree of incapacity, depending on the actual effect on their ability to work. Generally, a minimum threshold of medical disability is required to reach the incapacity stage at all. The level of the general disability allowance ultimately derives from the degree of incapacity, and not only from the medical percentage.

It is worth noting: in work-injury disability and for hostile-action casualties the mechanism is slightly different — there the medical disability percentage is the main determinant of the level of the benefit.

How many disability percentage points do you need for an allowance?

This is one of the most common questions — and the answer depends on the type of claim:

• In work-injury disability: a disability percentage of 20% or more generally entitles you to a fixed monthly allowance. A percentage between 9% and 19% usually entitles you to a one-off grant, and below that there is no entitlement to payment.
• In general disability: a minimum threshold of medical disability is required to reach the stage of determining the degree of incapacity, and only then is entitlement to an allowance assessed — deriving from the degree of incapacity rather than from the medical percentage alone.

The exact figures and thresholds are updated from time to time, so it is important to check your specific entitlement with the relevant body or with professional support — sometimes a small difference in percentage points decides whether you receive a monthly allowance or only a one-off grant.

Disability percentages for psychological conditions

Psychological conditions — depression, anxiety, PTSD — are fully recognised within the disability percentage system, exactly like a physical injury. Here too there is a dedicated section in the Schedule of Impairments, with percentages graded by the severity of the disorder and its effect on functioning.

Because a psychological injury is not “visible” in the way a physical one is, medical documentation is especially critical to setting the percentage: psychiatric assessments, treatment summaries, continuity of treatment and a detailed description of the impairment to daily, social and occupational functioning. The fuller and more continuous the documentation, the greater the chance of a determination that reflects the true situation.

Common percentages — a few illustrations

It is important to remember that every case is assessed on its merits, but to give a general sense, here are a few areas and their emphases (the ranges vary by severity and by the precise section):

• Orthopaedic impairments (back, knees, shoulders) — the percentage is usually set by the degree of restriction of movement and functioning.
• Heart disease — by the functional class and the effect on the ability to exert oneself.
• Psychological disorders — by the severity of the disorder and its effect on social and occupational functioning.
• Chronic internal illnesses (diabetes and its complications, lung disease) — by the grade, the control achieved and the accompanying complications.

These are illustrations only — the precise percentage always depends on the specific section in the schedule and on the severity of the condition as it is documented and presented to the committee. It is worth remembering that even among people with exactly the same diagnosis, the percentage may vary considerably according to the severity of the symptoms, the extent of the effect on functioning and the quality of the medical documentation attached.

Temporary disability against permanent disability

Not every disability percentage is set for good. The committee can determine one of two things:

• Temporary disability — for a defined period, at the end of which a reassessment is carried out.
• Permanent disability — where the condition is stable and not expected to change.

Where disability is temporary it is important to keep track of the date of the reassessment and to prepare for it properly — the situation may change for better or worse, and preparation affects the outcome.

Can disability percentages be increased later on?

Yes. The percentage set is not necessarily final for life. If your medical condition has worsened since the determination, you can file a request for a “deterioration review” — an application for a reassessment intended to update the disability percentage upwards in line with the new situation.

A deterioration review is especially relevant for progressive illnesses or for psychological conditions that have worsened over time. It is important to submit the request with up-to-date medical documentation evidencing the deterioration. An updated disability percentage can significantly increase the allowance and the accompanying benefits — so do not give it up where the condition genuinely has worsened.

What affects the percentage you receive?

Contrary to what many people think, the percentage is not set only by “how ill you are”. Among the main factors affecting the outcome:

• The quality of the medical documentation — complete, up-to-date and detailed records
• Presenting the functional impact — not just the diagnosis, but how it damages daily life
• Choosing the right section in the Schedule of Impairments
• Proper, organised preparation for the medical committee
• Fully identifying every impairment — and not only the main one

Two people with exactly the same medical condition may receive completely different percentages — sometimes purely because of how it was presented and how well they prepared for the committee.

Common mistakes that can lower the percentage

Alongside the factors that improve the chance of a fair percentage, there are common mistakes that leave people with a lower percentage than they deserve:

• Arriving at the committee without orderly, up-to-date medical documentation
• “Playing down” the condition out of pride or embarrassment — saying “I manage” when in fact there is a real difficulty
• Not mentioning secondary impairments, which also enter the weighted calculation
• A general rather than detailed description of the effect on daily functioning
• Giving up after a first determination, without exercising the right of appeal

Proper preparation for the committee — knowing what to present, which documents to bring and how to describe the situation accurately and credibly — can be the difference between a low percentage and one that reflects the true position.

Received a lower percentage than expected?

If you were given a lower percentage than you had estimated, that is not the end of the road. Every medical committee determination carries a right of appeal, which must be filed within a defined period. The appeal is heard by a more senior committee, and in many cases the outcome can be improved with proper preparation, further medical documentation and supporting opinions.

The disability percentage is not just a number — it determines the level of the allowance, the benefits and your quality of life. It is worth understanding it thoroughly and preparing for it properly.

In summary

Disability percentages are at the heart of every process of realising rights with the National Insurance Institute. Understanding how they are set — the Schedule of Impairments, the weighted calculation, and the distinction between medical disability and the degree of incapacity — gives you a real advantage: knowing what to expect, how to present your situation to best effect, and when it is worth appealing.

The central conclusion is simple: the percentage is not set only by the severity of the medical condition, but also by how it is presented, the quality of the documentation and the degree of preparation for the committee. Those are precisely the things within your control — and where you can make the difference. Knowledge is the first step to realising the rights that are yours, so if you are facing a medical committee, it is worth preparing for it seriously and with the right support.