Pregnancy maintenance benefit claim – when? whom? and how?
In a country like ours, and especially with the National Insurance Institute, knowledge is power, and in our case, quite a bit of money as well.
In this article we will understand when and especially how it is possible to receive substantial sums of money from the National Insurance Institute for a medical condition during pregnancy.
We set off…
Sometimes pregnant women are at medical risk to themselves or the fetus and a doctor determines that they should stay at home due to their type of work, place of work or other reasons.
Sometimes the nature of her work prevents her from working as usual, for example: X-ray technician, horse trainer, etc.
It should be emphasized that in addition to the nature of her work, the employer must confirm that he is unable to place her in a more suitable position, such as secretary, etc.
In such cases, the employer does not pay her for the days of absence, but the National Insurance Institute, when this benefit is called a claim for pregnancy preservation.
Who is entitled to pregnancy protection?
Resident of Israel.
An employed or self-employed person who has paid or had social security contributions paid for her for at least 6 months out of 14 before the doctor’s examination that determined the need for her absence.
The pregnancy maintenance period will not be less than 30 days and if it is necessary to extend it, each extension will not be less than 14 days.
Stay in Israel – if the pregnant woman decided to go abroad during the period of maintaining the pregnancy, her right to claim will be denied.
$ important highlights $
If the employee decided to receive payment from the employer at the expense of her sick days, she will not be entitled to payment from National Insurance for these days.
This is the place to point out that in the past the women who were on maternity leave were required to use up all their sick days and only then claim the maternity allowance.
A doctor on behalf of the National Insurance may request additional documents, which justify the granting of the medical certificate, and may also not approve the claim if in his opinion the type and/or place of work are not the causes of the medical risk.
The claim can be submitted up to 12 months from the date of the beginning of the pregnancy maintenance.
A controlling owner of a limited liability company will be required to prove an employer-employee relationship by presenting payslips, bank statements showing the execution of salary transfers, etc.
If the insured has more than one job, benefits can be claimed based on both salaries.
Similar to all claims against social security, if the claim is rejected, you can file a claim called “Request for Justice”, which is used as a request “before the line of justice”
How do you submit a claim?
1. Form 330 must be filled out – claim for payment of benefits for maintaining a pregnancy.
2. Form 331 must be filled out – medical certificate regarding benefits for maintaining a pregnancy.
It is important to note that the National Insurance requires document 331 to be signed by a specialist gynecologist and not a family doctor.
3. A confirmation from the employer must be attached that the nature of the insured’s work does not allow her to continue working during the pregnancy period and that no alternative work has been found for the employee.
4. Medical documents that support the request, such as: the results of the tests on which the claim for pregnancy maintenance benefits is based, summaries of visits to the emergency room if there were any, and relevant family history.
5. The forms can be submitted 30 days after the start of pregnancy monitoring.
6. About two weeks after filing the claim, you should contact the National Insurance Representative Center and check the status of the claim, whether documents need to be completed and respond accordingly.
What is the amount of the benefit you receive?
The benefit amount will be the lower of the two options:
1. The base amount for calculating allowances, which currently stands at NIS 8,760 divided by 30
NIS 292 per day of pregnancy protection.
2. The average salary in the three months preceding the pregnancy is divided by 90, relevant when the insured’s salary is higher than NIS 8,760 per month.
When, similar to other salary-replacement pensions received from the National Insurance, this pension also deducts social security contributions, health insurance contributions and income tax.
Successfully!