Question: From what stage is it advisable to apply for recognition by the National Insurance Institute? Is it done automatically?

Answer:
I will address this issue from both emotional and practical perspectives.

Emotional perspective:
Recognition of disability can have emotional implications. For some, such recognition serves as a constant reminder of living with a chronic illness, which might worsen their mental state. These individuals may prefer to continue functioning as normally as possible, maintaining full-time work and their previous routine, delaying recognition until more challenging times. Others, however, find institutional recognition important as it validates their functional decline and helps in obtaining acknowledgment and additional support from family, workplace, and friends. It can also assist in securing financial aid for necessary assistance.

Practical perspective:
Recognition of general disability by the National Insurance Institute is not automatic and is subject to specific criteria. If you meet the eligibility conditions, you can apply:

1. Age: Between 18 and retirement age.
2. Medical Disability: At least 60%, or at least 40% combined from several impairments.
3. Loss of Work Capacity: A partial or full loss of earning capacity, meaning you’ve lost at least 50% of your ability to earn a living or manage a household.
4. Income Threshold: Up to 7,522 NIS.

For the “Special Services” benefit, the degree of dependence on others for daily activities like bathing, dressing, eating, walking, controlling bodily functions, and housekeeping is evaluated. Eligibility involves a 3-month waiting period where functional decline, loss of work capacity, and income reduction are assessed.

Question: The disease affects my behavior. What should I do?

Answer:
Multiple sclerosis can cause functional decline and evoke various emotional responses in patients. It may lead to emotional tension, loss of self-confidence, and anxiety due to lack of control and uncertainty about the future. Some individuals struggle with living with a “big secret” and its impact on relationships with friends and at work. The disease can also affect the couple’s relationship and family dynamics, sometimes requiring shifts in responsibilities and external help.

You can seek psychosocial support starting with an assessment meeting with a social worker to evaluate your needs. Based on this evaluation, a treatment plan tailored to your personality and situation will be created. This can include individual, couple, or family therapy sessions, as well as practical support in exercising your rights if needed.

Question: What services does a social worker provide for multiple sclerosis patients?

Answer:
Since I don’t have specific details about your situation, I’ll respond generally.

1. Therapeutic Support:
   Social services offer counseling and psychosocial therapy from the moment of diagnosis and throughout all stages of the disease. Receiving a diagnosis can evoke feelings of helplessness and uncertainty, leading to emotional distress. Professional support can reduce this distress, help regain control, and facilitate a return to routine as much as possible. This is also relevant during relapses or worsening of the disease when adjusting to the new situation is necessary. The illness can impact family dynamics and roles, leading to friction. If independent coping is challenging, individual, couple, or family support is available both emotionally and practically.
2. Practical Support:
   For those who are fully independent, work full-time, and earn above the income threshold, financial assistance might not be available. However, for others experiencing significant changes in their situation, social services can provide guidance and assistance in realizing their rights. After evaluating the functional condition, support can include filing claims with authorities such as the National Insurance Institute, the Ministry of Health, private insurance companies, or the Tax Authority. Guidance may also cover vocational rehabilitation, accessibility equipment, or home modifications. For those who do not work, engaging in leisure activities that add meaning to life is encouraged.

Contacting social services is highly recommended. Their guidance can streamline and simplify processes, making them more efficient and successful.