Severely Disabled, but Ineligible for Mobility Benefits

Outdated criteria force hundreds of Israelis to pay for an adapted car out of pocket, while others get state financing.

David Sousi, 51, was diagnosed with cancer nine years ago. The Health Ministry and the National Insurance Institute recognized him as 100 percent disabled, and the former even financed a motorized wheelchair for him. But unlike other people with similar disabilities, the Tel Aviv resident isn’t entitled to a car adapted to his needs. His wife ferries him to his hospital appointments and his dialysis treatments in a specially adapted car for which he paid thousands of shekels out of his own pocket.

This is just one example of the bizarre system that determines which people are entitled to have the state finance a car adapted to their needs and which aren’t. Some people with mobility problems get the money; others with problems no less and sometime even more severe, are turned down. Why? Because they don’t fit the rigid criteria drafted in the 1970s that have never been updated.

For many people with disabilities, this is a serious problem. Sousi’s wife, Giselle, for instance, related that a few months ago. “We got a driver’s license from the ministry that restricted us and required us to install an accessory for the disabled in our car. We didn’t have a choice: We paid several thousand shekels out of pocket and installed it.”

In the mid-1970s, the health and finance ministries signed an agreement that was meant to provide funding for people with mobility limitations. The NII adopted the current criteria in 1977, and since then, they haven’t been updated.

The criteria relate both to the level of disability and the reason for it – paralysis, amputation, birth defects, etc. These two factors determine what sort of vehicle the applicant needs, what the state will pay toward its purchase and what monthly allowance he will receive.

Generally, the state shares up to 80 percent of the cost of buying the vehicle and adapting it to the disabled person’s needs. To receive state assistance, at least 40 percent disability is required, and the greater the percentage of disability, the greater the assistance. It also pays a monthly mobility allowance of anywhere from a few hundred shekels to NIS 7,500 to cover the costs of maintaining and insuring the vehicle.

Currently, some 35,000 Israelis receive mobility allowances, of whom only about 6,000 are able to work and earn a living. People can obtain the allowance even if they don’t drive themselves, especially in the case of children, since the relative or caregiver who drives them may need a specially adapted car to do so. But the allowance is paid only until the recipient reaches retirement age.

According to figures provided by the Health Ministry, district committees meet almost every day and discuss an average of 15 cases a day. According to these figures, some 11,000 people apply to these committees every year. Some get what they request, others are rejected or receive a percentage that does not satisfy them, and so some 2,000 people submit appeals every year to a special committee.

Chronic diseases excluded

At first glance, the list of conditions that confer eligibility seems to be expansive. But these conditions are very narrowly defined, so many people with mobility limitations are left out. For instance, paralysis of the lower limbs entitles someone to a mobility allowance only if at least two out of three specific muscles are paralyzed.

Moreover, the list excludes many chronic diseases, such as cancer, that can cause severe and permanent mobility problems as a side effect.

“We know of applications from disabled people whose disability doesn’t appear in the [criteria], so even though there’s no doubt about their disability, they aren’t entitled to the benefits,” said Moshe Ofek, CEO of TMN, a company that customizes cars for the disabled.

The company’s marketing director, Vered Margalit, is a lawyer who has represented people with disabilities in the past. “I deal on a daily basis with people with disabilities who come to us with severe mobility limitations but aren’t entitled to a mobility allowance because their disability comes from another source and not from their lower limbs,” she said. “It could be as a result of cancer, or a pulmonary disorder that leaves the person tied to an oxygen tank and unable to move. But even in cases of leg injuries, why are blocked veins not included while blocked arteries are, if both cause the same disability? Why is paralysis defined only as two muscles in the thigh, and not elsewhere? The Health Ministry recognizes their disabilities and finances motorized wheelchairs for them at a cost of tens of thousands of shekels, but beyond that, there’s no way to get them out of the house and move them around.”

Someone who is turned down for a mobility allowance can appeal the decision to a special committee, then to the courts. But Margalit said that both the committee and the courts adhere closely to the NII criteria . “They want to narrow the opening, and this creates distinctions that are very artificial,” she said.

The Health Ministry and the NII both acknowledged the problem, but the ministry said it is bound by the NII’s criteria.

The Health Ministry responded that “the regulations need to be upgraded by a public committee headed by the NII.”

The NII said it realizes that the criteria need to be updated, “and we are currently moving forward with setting up a committee that will deal with this issue.”

Tess Scheflan