Navigating Fibromyalgia Rights and Recognition at the National Insurance Institute
Adv. Ilanit Gadker Aharoni discusses the challenges fibromyalgia patients face in Israel when seeking recognition and disability benefits from the National Insurance Institute.
For many years, fibromyalgia patients struggled with a disease that no one could see. The pain, extreme fatigue, and brain fog were entirely real, yet outwardly they appeared completely healthy—and the system refused to recognize them. Many were forced to reduce their working hours or leave their jobs entirely, plunging into financial distress and repeatedly rejected by the National Insurance Institute (Bituach Leumi). At this exact point, exhausted from dealing with a disease that both medicine and the establishment struggled to see, they turned to Adv. Ilanit Gadker Aharoni, owner and founder of the Gadker Aharoni law firm, which represents patients facing the National Insurance Institute.
"Over the past few years, I have accompanied dozens of fibromyalgia cases," she says. "I especially remember a 45-year-old teacher, a mother of three, who was forced to gradually reduce her position until she had to leave her beloved job. She came to me after two years of coping with relentless pain, extreme fatigue, and brain fog that made it hard for her to even prepare lesson plans—something she had done easily for twenty years."
The Daily Reality of Living with Fibromyalgia
"Another case etched in my memory," Adv. Gadker Aharoni continues, "is that of a young 32-year-old high-tech engineer. Despite excelling at her work, she found herself increasingly struggling to concentrate in front of the computer due to headaches and muscle pain. Her bosses didn't understand—she looked completely healthy. But anyone who lives with fibromyalgia knows this is precisely the problem—this disease is invisible to the eye, but the pain and difficulties it brings are very real."
These stories are not exceptional. In Israel, as in the rest of the world, about 2-4 percent of the population copes with fibromyalgia, with about 90% of them being women. Figures point to over 200,000 Israelis living with the disease, most of them aged 20-50, at the peak of their working and active years.
"I have seen countless cases of people forced to stop working because of the disease, yet receiving no support or recognition of their rights," says Adv. Gadker Aharoni. "Many of them deteriorated into a difficult financial situation, forced to cope alone with the high costs of treatments and medications. They repeatedly encountered reactions of dismissal and skepticism, even from medical professionals. This dual struggle—both against the disease and the lack of recognition—was especially exhausting."
The Turning Point in Institutional Recognition
Before 2022, the system simply did not recognize fibromyalgia as a standalone diagnosis for determining disability. Anyone seeking recognition was forced to "dissect" the disease into parts and latch onto clauses intended for isolated symptoms—pain here, sleep disorder there—instead of pointing to the complete illness. The result was that the full picture of suffering remained outside the form, and no single clause managed to capture the true severity of the condition.
The change that arrived in March 2022 brought with it an organized system for assessing the severity of the disease. "This is a dramatic change," Adv. Gadker Aharoni emphasizes. "Today, the medical committees of the National Insurance Institute assess the situation according to clear criteria, which allows for a fairer evaluation of patients' conditions."
The new criteria allow for setting various disability degrees, ranging from 10% in cases of mild functional impairment, up to 40% when there is severe impairment requiring ongoing medical treatment. "But it is important to understand," Adv. Gadker Aharoni adds, "that in many cases there are also accompanying symptoms such as depression, digestive system issues, or sleep disorders, which can lead to higher disability percentages."
Managing the Process Before the National Insurance Institute
How is the procedure handled at the National Insurance Institute regarding those suffering from fibromyalgia?
Adv. Gadker Aharoni: "It is important to know that beyond the disability allowance itself, there are additional rights worth knowing. For example, those determined to have 20% permanent medical disability are entitled to vocational rehabilitation and study assistance. I have seen many cases where vocational rehabilitation was a turning point. It is an opportunity to professionalize in a new field that better suits the limitations of the disease."
According to Adv. Gadker Aharoni, the path to successfully coping with fibromyalgia is a combination of appropriate medical treatment, social support, and maximizing rights guaranteed by law. "At the end of the day," Adv. Gadker Aharoni concludes, "the goal is not just to receive recognition, but to rebuild a full and satisfying life, despite the challenges the disease presents."
What do you recommend for someone who needs to claim rights from the National Insurance Institute?
Adv. Gadker Aharoni recommends several steps: "First, it is important to document everything. I ask my clients to keep a journal documenting symptoms, the impact on daily functioning, and the treatments they receive. Second, it is important to gather all medical documentation—not just from the treating physician, but also from all specialists who treated accompanying conditions. And third, it is important to understand that the medical committee is effectively a medico-legal proceeding, and to prepare accordingly."
