Attendance Allowance (Special Services): Eligibility for Help with Daily Activities and Supervision

What is the Attendance Allowance?

The Attendance Allowance is paid to a person with a disability who needs substantial help from another person with daily activities, or constant supervision to prevent danger to the person or to others. The assessment focuses on how much help is actually required, not solely on the name of the diagnosis.

The functional assessment includes activities of daily living (ADLs) and, where appropriate, instrumental activities of daily living (IADLs), such as preparing food, managing medication, shopping, and running errands. IADL components supplement the assessment but do not replace the track's basic eligibility requirements.

Key threshold requirements

• Age and residency: an Israeli resident from age 18 until retirement age. A first claim may be filed up to six months after retirement age. A person who is found eligible upon reaching retirement age continues receiving the allowance for as long as the requirements remain satisfied.
• Medical threshold: a person receiving the General Disability Pension needs 60% weighted medical disability, or 40% when one impairment is rated at 25% or more. A person who does not receive the General Disability Pension needs 75% weighted medical disability.
• Employment income: gross monthly income may not exceed five times the average wage. As of January 1, 2026, the limit is NIS 68,845 per month.
• Institutional residence and duplicate payments: a person residing in an institution that provides medical, nursing, or rehabilitation services, or receiving another payment under law for personal care or help at home, is not eligible. During a general hospitalization, a recipient continues receiving the allowance for the first 90 days.
• Combination with Mobility Benefits: Attendance Allowance and Mobility Benefits may both be received when the Attendance Allowance level is 112% or higher, when 100% limited mobility has been determined, or when a medical committee has found that a wheelchair is needed and used.

What exactly does the dependency assessment examine?

The National Insurance Institute assesses the help required with dressing, eating, bathing, mobility inside the home, and personal hygiene, as well as the need for supervision to prevent danger. It also assesses the need for help with preparing food, operating appliances, maintaining the home, taking medication, shopping, and handling financial and administrative matters.

Points are awarded only for limitations caused by the medical condition. Lifestyle habits or the division of household responsibilities do not, by themselves, generate points. The percentages 50%, 112%, 188%, and 235% are names of benefit levels, not medical disability percentages.

• 20 to 43 points qualify for the 50% benefit level.
• 44 to 58 points, or a need for supervision, qualify for the 112% benefit level.
• 59 to 67 points, or 24 to 47 points together with a need for supervision, qualify for the 188% benefit level.
• 68 points or more, or 48 points or more together with a need for supervision, qualify for the 235% benefit level.

Allowance amounts in 2026

The monthly amounts published by the National Insurance Institute effective January 1, 2026, are NIS 1,943 at the 50% level, NIS 4,501 at the 112% level, NIS 7,181 at the 188% level, and NIS 9,126 at the 235% level.

A recipient who has a child under age three may receive an additional NIS 1,215 for each child, for up to two children. Special supplements also exist for a person found to need two caregivers and for a person continuously dependent on a ventilator, but each supplement has separate requirements that must be checked for the individual case.

How should dependence be described accurately?

It is important to describe what the person can do independently, how the activity is performed, how long it takes, whether an assistive device is required, and exactly what the helper does. Difficulty, pain, or slowness does not always amount to a need for help. Conversely, performing an activity unsafely or inconsistently may be material.

A claim based on supervision should explain the risk, how often it arises, prior incidents, and how another person's presence prevents it. A general statement such as "needs supervision" without examples and documentation may not be enough.

Eligibility start date and appeal

In appropriate cases, the National Insurance Institute may assess retroactive eligibility for up to six months before the claim was filed, if all requirements were also met during that period.

A denial or the assigned benefit level may be appealed to the Attendance Allowance Appeals Committee within 90 days. When the dispute concerns medical disability percentages that do not meet the threshold, the review route and deadline may differ, so the decision letter itself should be read carefully.

How the process works

1. 01

   Document functioning in each activity and the assistance provided throughout a typical day.

2. 02

   File the claim with current medical and functional records and information about income and other benefits.

3. 03

   The National Insurance Institute assesses the medical threshold and the remaining eligibility requirements.

4. 04

   A dependency assessment or other examination is conducted according to the circumstances, and additional documents may be requested.

5. 05

   The benefit level is determined and a written decision is sent to the insured person.

Documents you may need

• Current medical summaries describing diagnoses, course, treatment, and limitations.
• Occupational therapy, physical therapy, nursing, mental-health, or rehabilitation records, according to the functional difficulty described in the claim.
• A medication list, assistive-device information, and documentation of incidents requiring supervision.
• A detailed functional description of a typical day and the help provided with each activity.

Common mistakes to avoid

• Focusing on diagnoses and disability percentages without explaining practical dependence.
• Describing ability only on a good day, or instead describing an exceptional episode that does not reflect most days.
• Failing to disclose a parallel benefit, institutional residence, or Mobility Benefit that may affect the track.
• Using general terms without examples, frequency, and documentation.