Exercising Medical Rights / General Disability / Disability From Work - Social Insurance

The reasons a claim is rejected may vary due to complicated procedures, regulations, and a lack of familiarity with the law. The complex regulations and working procedures in the National Insurance Institute may be devastating and cause a claim to fail even before it is examined on its merits.

Obtaining benefits from National Insurance requires careful and professional preparation – knowing what medical documents to bring and what and how to say at each medical board.

Mistakes during the preparation work, in the filing of the claim, and finally in the appearances and examinations at the medical committees (which last several minutes each) may lead to the rejection of the claim and damage in future claims.

Close supervision by a lawyer specializing in social security claims greatly increases the chance of receiving an allowance. Contacting a lawyer even before referring to the National Insurance will ensure that the lawyer will accompany the stage of collecting the documents and the medical tests. This step is crucial, and the lawyer’s extensive experience in the field of national insurance will help focus on the relevant medical impairment clauses to achieve the best results in the claim.

It is essential to know that only a lawyer is allowed to represent a claimant in the medical committee since this is a quasi-judicial procedure in which things are decided in the case of the claimant. The presence of a lawyer specializing in the field will ensure that the procedure will be conducted legally and the plaintiff’s rights will be fully protected.

From our experience, when claims are filed through a lawyer and receive full support from the beginning to the end, the claimant’s rights are preserved, and the claims are treated fairly. Unfortunately, there are justified and well-founded claims that, without appropriate support, are rejected due to a lack of familiarity with the procedure or focusing on irrelevant issues, leading to a wrong result that could have been avoided if the claimant had received the appropriate legal support.

Many times plaintiffs turn to a lawyer after receiving a rejection letter from the National Insurance Institute. It is important to know that the situation is not lost!

Rejection of a claim is not the end of the story! For the most part, it is possible to submit a reasoned and detailed appeal and appear before an appeal committee consisting of senior and experienced doctors who will examine the decision of the first-level medical committee and decide whether it is justified or wrong. Sometimes it is even possible to apply to the labor court in a lawsuit so that it will examine legal questions or errors that may arise during the administration of the suit.

The time window for submitting an appeal to the court is limited in time and the possibility of receiving an appeal after the end of the time limit very low! It is advisable to contact a lawyer immediately upon receiving the rejection letter to have time to collect documents and new medical tests and file an appeal which may overturn the previous decision and win the claimant the pension he needs.

In the National Insurance Institute, there are different classifications for different claims. General disability claims submitted for the first time receive a certain treatment. In contrast, claims submitted for the second time or committees held at the end of entitlement to temporary disability are classified differently. A repeated claim submitted after a postponement will receive a classification of “worsening condition,” and to receive an allowance, the claimant will have to prove that his condition has worsened since the previous examination – to change the earlier decision of his case.

Because of this, it is better to contact a lawyer before the initial referral to the National Insurance Institute to manage the claim professionally from the first moment and not lower the chances of the claim by past failures.

Filing a claim to the National Insurance Institute does not cost money. Filing a claim through a lawyer usually involves case opening fees which are only “seriousness fees” and are very low compared to the benefit obtained from being accompanied by a lawyer who specializes in the field of National Insurance, who advises and attends all the way.