National Insurance The National Insurance law determines two disability degrees: 1. Medical disability percentage is: an objective assessment in percentage (determined by an authorized doctor) of how much did a person lose of his normal health due to the defect-disturbance in his physical, mental or emotional health. 2. General Disability degree - receiving a monthly pension from the National Insurance. Only an insured to whom 25% Medical disability was determined is entitled to a monthly disability pension. Such an insured is entitled to a monthly pension if the physical, mental or emotional defects have affected his ability to work and gain, or have affected his ability to return, in full or part time, to the work he had been engaged in before he became disabled, or have affected his ability to engage in any other work or obtain a new occupation.
Who may apply? Diabetics, 18 years plus three months old, may file a claim to be recognized as disable by the National Insurance, if they suffer from a medical problem resulting from Diabetes. A medical certification should be enclosed to the claim, describing the diabetic medical situation and the medical problems that stem from Diabetes such as: the inability to work an entire day, fatigue, decline in sight and other complications. The National Insurance committee relying on the medical statement of opinion determines the medical inability percentages. This committee assesses the decline in function and determines its rate in percentages. A diabetic treated by Insulin and whose diabetes is reasonably balanced is entitled to a 20% medical disability. If the diabetic has an additional medical problem or complications because of the diabetes, additional medical disability percentages will be granted according to regulations.
When are you entitled to a pension? When the National Insurance committee recognized no less than 40% medical disability and due to the existing disability there is an employment problem. Determining the disability percentages, no matter how high they are, does not suffice in order to receive a pension, unless the work ability and earning capacity of the diabetic have been harmed. If a monthly pension has been determined, then once in a period (of 6 months or a year) a reassessment is made regarding the insured ability to return to part or full time work, and the monthly pension is determined accordingly.
Families of Diabetic children Families who can prove that as a result of their dealing with the Diabetes of their son/daughter their income has been harmed; or that one of the family members had to cut down or stop his work and dedicate more time to the child due to visits to clinics and hospitalizations etc. which are often needed, such families may apply to the Disability Claim Department in the National Insurance office in their region, regarding assistance to their family according to the National Insurance regulations.
When are you entitled to Occupation rehabilitation? If the committee certified at least 20% disability, the diabetic is entitled to occupational rehabilitation (with no linkage to receiving a pension). The rehabilitation is granted if the diabetics lacks an occupation or if their health condition does not allow them to work in their profession and they need a professional training to enable them to return to their previous work or any other suitable work. The National Insurance provides: • A psycho-technical test in order to diagnose the diabetic abilities and recommend a suitable professional training. • Partial or full financing of the professional training by the National Insurance. • Professional training in various fields, i.e.: Computerized graphics, bookkeeping, computerized sketching, word processing, entrepreneurship etc. By means of the professional rehabilitation the National Insurance intends to bring the diabetic to a working ability that will enable him to earn his living and integrate in society.
Driving License The diabetic may issue a driving license for the following vehicles: • Private • Truck (up to 3 ton) • Motorcycle up to 500 cubic cent. In principle, each citizen applying for a driving license has to present a physical checkup form + an eye examination. It is recommended that the medical checkup will be filled by the family doctor who knows the person and his medical history. In case of Diabetes, it is recommended that the doctor treating the diabetes will directly fill the form created for this purpose by the Medical Institute of Road Safety. When the driving candidate reports to the Licensing Department with the form, the clerk hands the documents to an authorized doctor. The doctor decides if there is need for an examination in the institute or it is possible to accept the certification relying on the attached medical documents. Filling the form correctly and in detail will shorten the way to the commencement of the driving license procedure. The answer of the Road Safety Medical Institute is received two to three months after the medical certifications had been presented to the institute.
The criteria of the Medical Institute for recommending to issue a driving license to a diabetic vary according to: • The kind of the requested license. • The kind of Diabetes and the kind of treatment (kinds 1-2) • The patient cooperation extent regarding the treatment and the doctor’s instructions. • The patient’s occupation (the kind of work he operates).
The Diabetic driver The diabetic driver must carry in the car food or beverage with direct sugar, for immediate treatment of hypoglycemia. It is specifically indicated in the driving license: “Must carry with him sugar products while driving”. Not following this requirement causes fines during police inspections. In principle: 1. A diabetic, who is treated with Insulin and is balanced and has no frequent hypoglycemia attacks, whose sight is sufficiently sharp, and with no complications, may receive a driving license for a private car or a two-wheel with the limitation of: (a) carrying sugar products, (b) performing a follow-up examination. 2. The Ministry of Health does not allow a diabetic, dependant on Insulin, to drive the following vehicles: A heavy profession vehicle (crane, lever, tow-track, track over 3 tons), a public vehicle and an ambulance. It is important to state that these are general procedures. In individual cases there is room for the discretion of the qualified doctor of the Road Safety Medical Institute. 3. Serious hypoglycemia events ((fainting, unconsciousness) or unawareness to “hypo”, if they occurred in the last year, will cause refusal to grant a driving license and/or refusal to renew the license that year.
Military Service According to law, a diabetic treated by Insulin is exempt from enlisting to regular service. The diabetic may volunteer to military service at any convenient date, until the age of 25. If he enlists a year or more after the age of 18, the duration of service will be reduced relatively to the age of enlisting. A diabetic, whose Diabetes was discovered during his military service, may go on serving voluntarily in the army.
The procedure of volunteering to military service • Upon receiving the first mobilization order it is recommended to undergo all the procedures and tests required from every citizen. It is most important to perform the Psycho-technical and personal test as best possible. These tests determine the personal and diabetic profile in the army: physical health, skills, intelligence, mental health, leadership abilities etc. • In the second mobilization order there is a meeting with the medical committee. The diabetic should bring to this meeting a doctor’s certificate regarding his being diabetic and the treatment he receives. Following this meeting he will receive an exemption from military service. • 3-4 months before the date he wishes to enlist, he must fill out a volunteering contract in the recruiting office. After a while, he will be invited to a meeting with the volunteer-classification committee. It is recommended to bring to this meeting letters of recommendation relating to the quality of handling the Diabetes balance, school achievements, sport activities, activities in fields relevant to the army (i.e.: Electronics, photography, computers), the personal and the social role. • As of the moment he is recruited to the army the diabetic has equal rights and duties like any other recruited soldier. A diabetic treated by diet and/or pills will be enlisted in the recruiting framework as • a regular soldier with. A medical rating of 64 (See the article on the new regulations). • In principle, the association encourages volunteering to military service in IDF, in the framework of encouraging and supporting the diabetic to function, as much as possible, as the non-diabetic.
National Service Through the non profit “Shlomit Society”
“Shlomit Society” was established in 1994. Its main objective is to provide equal opportunity to boys and girls who do not serve in the army for religious and other reasons by volunteering for National Service contributing to society and thus to enjoy the same rights given to those who completed their military service. Many young people who were prevented from enlisting to the IDF, for medical reasons, have turned to the society since it started operating. This rejection by the IDF causes them problems and disrupts their plans for many years. The applicants desire to volunteer for National Service and contribute of their ability to society. The service of these young people will enable them, upon its completion, to enter the community and labor life as citizens with equal rights similar to the ones given to young people serving in the army.
Assurance of Rights The law and State authorities recognize the National Service, performed through “Shlomit society”. Those who have completed their Service are granted the same full rights like soldiers who have completed their military service.
Boys The existing Law grants boys and girls the same rights The National Service Scope of Activity Education – kindergarten, schools, day-care centers for children suffering of CP or mental retardation, neighborhood clubs, day centers etc. Welfare – Day centers for the elderly, assistance to pupils who have learning difficulties, treating anomalous children and adults, boarding schools for children under distress, clubs for young girls under distress, battered-women shelter, etc. Absorption – working with immigrants in the community. Health – Magen David Adom, hospitals and various community medical frameworks. Shlomit Society Tel: 03-5237571, Dizengoff 130, Tel-Aviv 64397.
Studies and professional training Diabetic have usually no problem to be accepted to post-high school and academic studies. Sometimes, in subjects requiring extended physical effort (Sport and Physiotherapy), problems might arise in the first application, however, by presenting a certification and a recommendation of the Diabetes’ doctor the matter is settled. If it does not settle – you should appeal and turn to the Society. Sometimes diabetic have problems in being accepted to certain technical schools or to certain sport teams. These problems usually resolve by presenting the appropriate certification given by the doctor treating the Diabetes.
Work Candidacy for work Government, public and private institutes do not have a unified policy regarding the acceptance of diabetics to work, (especially those treated by Insulin). The decision whether to accept a diabetic to work is “open” to personal and professional opinions of the family doctor, the occupation doctor, the human-resource managers in government/public institutes or private enterprises. The doctors treating Diabetes also have some disagreements as to the spectrum of professions, works and working conditions suitable for diabetics. Their disagreements mainly regard working in heights and operating heavy and complex machinery etc.
Some factors affecting the decision of accepting or not accepting a diabetic to work. Having out-of-date information, or lack of information regarding Diabetes and the diabetic as a worker. The employer fears that “Hypo” events will cause more accidents or physical damage to the diabetic himself or his colleagues, the employer fears that the diabetic will be more absent, and that he, the employer, will have to pay a higher premium for compensation or insurance for the diabetic employee. • The employer’s experience or the human resource manager’s experience with a problematic diabetic or a personal experience with a diabetic who has problems with balancing the Diabetes may affect the decision of accepting a diabetic to work. • It is important how a diabetic presents himself. If he emphasizes his special working needs in stead of stressing his personal and professional abilities and his ability to work under regular working conditions his prospects for being accepted to work decline. • Sometimes it is difficult to determine if refusing to accept him result from his being diabetic. • In some working places, the regular tests and follow-up test the diabetic has to undergo are calculated as vacation days rather than sick leave, and/or is some cases there is an attempt to limit his pension terms in advance. • If you come across such problems and/or similar ones, apply to the Society for assistance.
Sick Funds (Kupot Holim) We applied to the Sick Funds for information regarding the diabetic rights. “Kupat Holim Clalit”: No information was available. The fund management reported that the fund is negotiating regarding various medicines and therefore there is no clear answer to our question.
“Kupat Holim Leumit”: The fund participates in financing the existing medicines on the Fund Medicine Basket. The fund does not perform periodic laboratory tests including eyeground tests, kidney functioning, dental tests and foot examination. The Fund assists in purchasing Glucometer in a reduced price as well as assists in purchasing accompanying equipment, and supplies syringes and needles. The National Sick Fund does not certify foot supports and does not participate in buying suitable shoes. The National Sick Fund has a Foot clinic for diabetics located in the central clinic in Tel-Aviv. The fund participates in nursing care when necessary.
“Kupat Holim Maccabi” (Maccabi Sick Fund): The Maccabi Sick Fund reported that the diabetic have no special rights. All the medicines the diabetic needs are provided through the medicine basket. The medicines that are not included are provided through Maccabi Fund.
“Kupat Holim Me’uhedet” The following medicines are provided: APOPHAGE, DIABINESE, GLIBBTIC, GLUBEN’ GLUCAGON, GLUCMIN, GLUCOPHAGE RETARD, GLUCORITE ORSINON, PRANDASE, as well as all forms of Insulin. The patients are examines by all the medical disciplines if referred to by their family doctor or the Diabetes doctor. Currently, there is no central directing for performing the follow-up tests detailed in this section. The Fund participates, by law, in 90% of the cost of sugar sticks for testing, syringes and needles (meaning, 10% self-participation of the insured). The Fund participates in the cost of foot supporters, at a rate of 50% of their cost (up to twice a year), for those who are insured by a supplementary insurance. Specialists operate foot clinics. Nursing care is provided by law. It was also reported that the Fund is considering the opening of organized clinics to coordinate the treatment of the diabetic.