A., a 49-year-old resident of Kfar Saba, who worked as a cashier at the Brinks company, was seriously injured in his back after jumping from a tall armored vehicle during his work.
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But despite being completely disabled from work, and despite the fact that the incident was recognized as a work accident, a medical committee at the National Insurance Institute (NII) determined that he had a disability of 0%, claiming that there was no connection between his medical condition and the accident he suffered.
This was appealed by Attorney Ido Penn, who was hired by A. - an appeal that was ultimately accepted and overturned the discriminatory decision of the medical committee at the National Defense University.
The incident occurred in the afternoon of August 2021, when A. arrived on Sokolov Street in Ramat Hasharon, as part of his job to transfer money to customers. Upon getting out of the high-rise vehicle, he landed incorrectly on the road, and immediately felt severe pain in his lower back and left leg.
Immediately after the incident, he was rushed for medical tests, which revealed that he suffered from significant nerve damage in his lumbar spine, which required him to undergo complex surgery to stabilize his spine.
At this stage, A. contacted Attorney Penn to ensure that his medical rights were exercised. Attorney Penn contacted the National Labor Relations Board with a request to recognize the incident as a work accident - and his request was granted.
Despite this recognition, a first-level medical committee convened and unexpectedly determined that A. does not suffer from any disability due to his work - disability level 0% - because there is no connection between the accident he reported and his medical condition.
Attorney Penn filed an appeal against this determination, which was heard before the Appeals Committee at the National Court of Justice.
In the appeal, Attorney Penn argued that the first-tier medical committee has no authority at all to cancel the recognition that has already been determined by the National Insurance claims officer, in accordance with existing law. In other words, the medical committee is not permitted to appeal the recognition of the event as a work accident, but only to discuss the level of disability from which the plaintiff suffers.
A. appeared before the Appeals Committee and described his daily suffering: "I cannot lift anything, have great difficulty standing or walking, and suffer from chronic pain in my back and left leg.".
His appearance and words clearly illustrated the severity of the health and functional impairments he suffered from as a result of the accident, and highlighted the sense of injustice from the determination of 0% disability by the medical committee at the National Defense Force.
After being impressed by A's performance, and convinced by Attorney Penn's legal reasoning, the Appeals Committee accepted the appeal in all its parts, and determined that A' had permanent medical disability at a rate of 28%.
But the committee was not satisfied with this, and decided to activate Regulation 15, which examines the effect of medical disability on the insured's functioning, and aims to increase the disability percentage, by up to 501%, in cases of serious impairment of earning capacity.
Due to the activation of Regulation 15, A's disability was increased to a rate of 42%. As a result, A's monthly pension increased significantly, and was set at 4,854 shekels per month, from the time the claim was filed and for the rest of his life, an amount whose total value is estimated at approximately two million shekels.
At the same time, the "Ayalon" insurance company, with which A. was insured under a personal accident policy, decided to compensate him with an additional lump sum of approximately 295,000 shekels.
According to attorney Ido Fenn, the case proves that even a determination by a medical committee at the National Health Insurance Fund is not the end of the story, and many times, when an appeal is filed, the results can be expressed in millions of shekels in favor of the insured.
Attorney Penn: "The final decision of the National Insurance Institute achieved justice for A. and may help him deal with the medical and financial consequences of the accident he suffered for many years to come.".
