PTSD is assessed under Section 34(ב). It is not alone there — the section brings together a long list of conditions, and all of them are measured on the same scale:

Section 34(ב) — what it covers Phobic anxiety disorders; other anxiety disorders; obsessive-compulsive disorder; reaction to severe stress; post-traumatic stress disorder (PTSD); adjustment disorders of all kinds; dissociative (conversion) disorders; somatoform disorders; eating disorders: anorexia nervosa, bulimia nervosa and unclassified eating disorders.

What this means: the diagnosis does not set the percentage. A person with PTSD and a person with an adjustment disorder are measured on exactly the same ruler. What distinguishes them is not the name of the condition but how much it limits them.

The scale — and what is missing from it

0% 10% 20% 30% ↛ no 40% 50% ↛ no 60% 70% 100%

Note the holes. The scale jumps from 30% to 50%, and from 50% to 70%. There is no way to receive 40% or 60% under this section — which means every move between rungs is a significant jump, not a fine adjustment.

Section 34(ב) — full quotation of the seven rungs.
The conditionPercentage
(1) Full remission, with no disturbance of functioning and no limitation of the capacity to work0%
(2) Full remission or residual clinical signs, mild disturbance of mental or social functioning, mild to moderate limitation of the capacity to work10%
(3) Remission, mild clinical signs, a need for drug treatment exists, moderate disturbance of mental or social functioning exists as well as moderate limitation of the capacity to work20%
(4) Partial remission, with clinical signs of moderate severity, a need for regular drug treatment exists, marked disturbance of mental and social functioning exists, marked limitation of the capacity to work exists30%
(5) Partial remission with clear clinical signs, a need for regular drug treatment exists, severe disturbance of mental and social functioning exists, there is severe limitation of the capacity to work50%
(6) Active illness with very severe disturbance of mental and social functioning, there is very severe limitation of the capacity to work, or there is a need for prolonged psychiatric day hospitalisation70%
(7) Active illness, a need for constant supervision or full psychiatric hospitalisation exists100%

The three components that recur at every rung

Read the table across rather than down, and you see that every row is built from the same three components:

  1. The clinical signs and the degree of remission — full, partial, or active illness
  2. The disturbance of mental and social functioning — mild, moderate, marked, severe, very severe
  3. The limitation of the capacity to work — on the same scale

And hovering between them is a fourth component: the need for treatment. The 10% rung does not mention drug treatment at all; from 20% “a need for drug treatment” appears; and from 30% upwards — “regular drug treatment”. Continuity of treatment is itself a distinguishing sign.

The seven criteria — the committee’s checklist

At the end of the section there is a note setting out exactly what is examined. It is probably the single most useful paragraph in the whole section:

Note to Section 34(ב) For the purpose of determining the disability percentage under this item, the criteria set out below shall also be examined, in whole or in part, as the case may be: the intensity, frequency and duration of the disturbance; the number of episodes in the last two years; the number of hospitalisations, their length and their cause in the last two years; the length of the period of remission; compliance with and response to drug or other treatment; mental and social functioning; capacity to work.

Note that two of them are limited to the last two years — the number of episodes and the number of hospitalisations. A severe event five years ago does not count there. What decides is the current picture.

Source: Section 34 of 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.

What your file should contain

  • A detailed psychiatrist’s letter — not just a diagnosis, but a description of mental, social and occupational functioning in terms of what can no longer be done
  • Psychological treatment summaries, including frequency and continuity
  • Prescriptions over time — they are what proves “regular drug treatment”, a term that appears in the Regulations from 30% upwards
  • Documentation of hospitalisations — including length and cause. The criterion refers to the last two years
  • Employment records: breaks in work, sick days, changes in working hours, employer letters
  • A family member’s account of functioning at home
  • If the injury arose from a war event or a hostile action — documentation of the event itself and of your proximity to it

In the psychological field, a document that says “suffers from PTSD” is worth less than a document that says what the person stopped doing because of it.

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.

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The Yad Otefet team

Specialists in realising the rights of hostile-action casualties, with extensive experience in post-trauma claims and in dealing with the National Insurance Institute.

Not sure which rung your file sits on?

We will go through the documentation against the three components the Regulations require — with no obligation

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