Deterioration in your condition —
when you can ask for a re-examination

Your disability percentage was set a year ago, and since then things have got worse. The pain increased, a medication stopped working, or a new diagnosis was added. The percentage on your letter reflects who you were then — not who you are today. The law lets you ask for a re-examination, but there is a threshold condition, there is one document without which your file will not even be opened, and there are a few things worth knowing before you file.

What “deterioration” actually means

It is a request to Bituach Leumi (the National Insurance Institute) to look again at your disability percentage, on the grounds that your medical condition has worsened since the last determination. It is worth separating it from an appeal:

• An appeal says: “the committee misjudged my condition at the time.” It has a short deadline.
• A deterioration claim says: “the committee was right then, but my condition has changed since.”

If more than six months have passed and your condition has genuinely worsened, this is the relevant route. (On the difference in full: appealing a Bituach Leumi decision.)

Three routes, three forms

The rules differ according to the type of disability for which the percentage was set:

The threshold: six months

All three routes require six months from the last determination. There are two exceptions worth knowing:

• Work injury: in exceptional cases the Institute’s doctor may approve a re-hearing before the six months are up.
• General disability: if the claim was rejected for a non-medical reason — income that was too high, for example — you may file again with no waiting period at all.

The document without which the file will not be opened

This is what stops most claims. Feeling that things have got worse is not enough, and nor is a pile of medical records — a dedicated deterioration certificate is required:

• Work injury: a deterioration certificate from a doctor authorised for this in your health fund, or alternatively a hospital discharge letter for a hospitalisation caused by the accident — provided no more than 90 days have passed since discharge. The form states explicitly that without it your claim cannot be handled. It is also worth attaching the tests and opinions the doctor relied on, and obtaining a copy of the last committee’s protocol before you go to the health fund.
• Hostile-action casualties: a certificate from a specialist doctor in your health fund confirming a deterioration arising from the injury — the causal link is part of the requirement, not a technicality.
• General disability: you must describe the change in your medical and employment situation since the previous examination, and attach medical documents supporting it.

How to file

The form and documents can be scanned and sent through the “document submission” service on the National Insurance Institute website, or delivered by post, by fax, or to the service box at the branch for your place of residence. The fax numbers for the disability, hostile-action and work-injury departments appear on our page for each branch — Bituach Leumi branches. For enquiries: *6050.

Four questions before you file

1. Have six months passed since the last determination?
2. Do you have a deterioration certificate from an authorised doctor — not just a sense that things are worse?
3. Does the documentation describe your condition today, or is it two years old?
4. On the general disability route — have you taken into account that the committee may also reduce the percentage?

How we help

We go through the previous committee’s protocol, check whether the documentation genuinely supports a deterioration, help gather what is needed, and prepare you for the committee — what it examines and how to describe your condition accurately. We do not appear before committees in your place; we prepare you for them. (how to prepare for a medical committee.)