Back pain and disability percentages –
what the committee actually decides on

One of the questions we hear most often sounds roughly like this: “My MRI shows a disc herniation, so why did I get such a low percentage?”

The answer lies in a single section of the Regulations, and it surprises many people: the medical committee almost never sets the percentage from the imaging. It sets it from the range of motion measured in the room, from the neurological findings, and from ankylosis. You can arrive with an impressive imaging finding and leave with a low percentage — and the reverse is also true.

This page reproduces the full official table of Section 37, alongside what we actually see happening at committees.

Section 37 — the section that decides

Disability percentages for the spine are set under Section 37 of the Schedule of Impairments. Here is the section in full, in its own words:

Source: The Schedule of Impairments, in the Appendix to the National Insurance Regulations (Determination of Degree of Disability for Work Injuries), 5716–1956, as it appears in the National Insurance Institute’s Disability Tests book. The full Disability Tests book (Hebrew). The quotations are reproduced for information only. The actual determination is made by the medical committee alone, and the Regulations are updated from time to time. The Regulations are enacted in Hebrew and the Hebrew text is the only binding version; the English here is our working translation, and section numbers and percentages are given exactly as they appear in the original.

Three readings that explain almost every disappointment

1. The imaging does not decide — functioning does

Note the wording of 37(10): a healed disc herniation gives 0%. And where disturbances do exist, the Regulations set no percentage of their own but refer back to restriction of movement or to the neurological findings.

The practical meaning: a disc herniation is an explanation for a finding, not an impairment rated in its own right. Anyone arriving at the committee with a bulging disc but a range of motion measured as normal and no neurological finding will meet a gap between what they feel and what is recorded.

2. The upper back is rated unusually low

Compare the three regions of the spine for restriction of movement:

• Cervical — 37(5): 10% / 20% / 30%
• Lumbar — 37(7): 10% / 20% / 30%
• Dorsal — 37(6): 0% for mild restriction, and only 10% for moderate or severe

The mid-to-upper back is simply rated differently in the Regulations. This is not a mistake by the committee — that is what it says.

3. Ankylosis and restriction of movement are two different worlds

Ankylosis opens in Sections 37(1)–37(4) with a range of 10%–100%, whereas restriction of movement stops at 30%. The distinction between “favourable” and “unfavourable” is defined in the Regulations themselves: an angle exceeding 30° from the vertical is considered unfavourable, and in the lumbar spine an “unfavourable position” means a marked or gross change in posture.

What the committee checks in the room

The examination is short, and most of what is decided in it rests on three things:

• Range-of-motion measurement — flexion, extension, lateral bending and rotation. This is the central measure in almost every sub-section.
• Neurological findings — reflexes, sensation, gross strength, and signs such as straight leg raise.
• Consistency between the complaint and the documents — whether the medical documentation over time supports the picture described in the room.

What your file should contain before the committee

• Visit summaries from your treating physician over time — continuity matters more than any single document
• The full imaging report (CT / MRI), not just the closing line
• Referrals and orthopaedic or neurological follow-up
• Documentation of treatments: physiotherapy, injections, surgery
• Prescriptions for pain medication — they evidence intensity and continuity
• A precise description of the limitation at work and at home, in terms of activities

The recurring mistake: arriving at the committee with the imaging alone. The imaging explains why it hurts — it does not set the percentage.

How we help

At Yad Otefet we help you get ready for the committee: working out which sections are relevant to your condition as it is documented today, finding the gap between the symptoms and what the file actually says, and helping you prepare the documents. We do not appear before committees in your place and we do not give medical or legal advice — the determination is the committee’s alone.