The National Insurance Institute is at your side during your life, from birth to advanced age, granting you a variety of social rights adapted to changing life situations. Further information...
The National Insurance Institute is responsible for the social security of Israeli residents. Its primary mission is to ensure means of subsistence for those unable to earn their living. Further information...
The National Insurance Institute collects insurance contributions from all residents according to their social background and status, and pays benefits to those entitled. Hence, the income of economically established groups is transferred to weak and vulnerable groups and, thereby, the National Insurance Institute contributes to a more equitable distribution of national income and the reduction of dimensions of poverty. Further information...
Further information...
The form is intended for insured over 18 years old who, due to a physical, intellectual or mental impairment, have lost his or her earning capacity, or whose earning capacity dropped to 50% and above.
Tutorial video on how to fill out the claim form (in Hebrew)
Please note,
By clicking on the fill-in button below, you will be able to complete the claim for and send it online with additional documents.
The form is for completing details about the income of disability pension recipients.
Designed exclusively to those who were asked to complete this form, due to a decision by the National Insurance Institute to appoint them as benefit recipient on behalf of someone else.
This form is proof of your existence for consulates or those authorized to know according to the laws of the state.
The form is designed for work and non-work income statement by the disabled and the spouse.
The form is sent to the insured in case of missing information regarding the income of the disabled or the spouse.