Anyone preparing for a medical board — at the National Insurance Institute (Bituach Leumi), before the Ministry of Defense, or within a civil damages claim after an accident — sooner or later encounters the term “expert medical opinion.” This page explains, from an ophthalmologist’s perspective, what such an opinion actually does, when it helps, and what separates a good opinion from one that adds nothing.
A useful starting point is the eye disability percentage calculator on this site: it gives a preliminary estimate based on the impairment schedules themselves and helps, even before any decision, to understand which range is relevant to your case.
When is an expert eye opinion needed?
In several typical situations, an opinion from a specialist ophthalmologist adds real value:
- Preparing for a medical board — when the file is complex: several impairments in parallel (for example reduced visual acuity alongside a constricted visual field or ocular surface disease), findings scattered across years, or a condition that has changed since the last tests.
- Appealing a low percentage — when the percentage determined does not reflect the documented findings. A well-founded appeal rests on a finding the first board did not see or did not take into account, and the opinion is the instrument that presents it in the language of the schedule.
- A gap between findings and decision — for example, corrected visual acuity that was measured and documented, yet the assessment does not match the table.
- Combined impairments — when several defects require weighting and correct application of the ceilings; this is where most errors occur.
- Damages claims after accidents — in civil claims following road accidents, work injuries and other injuries, the impairment schedule serves only as a guiding reference; medical disability in ophthalmology is determined on the basis of expert opinions, while functional disability is determined by the court.
What does a good eye opinion contain?
Here the difference between one opinion and another is large. A professional ophthalmic opinion rests on:
- Properly documented best corrected visual acuity — the single figure that decides in the table, so it must be measured with full optical correction and documented in a stable state, not on one good day.
- A reliable visual field test — Goldmann or computerized perimetry, with an assessment of the test’s reliability; an unreliable field is the most common weak point in eye files.
- Imaging where relevant — corneal topography, retinal or optic nerve OCT, ocular surface photography — according to the diagnosis, not as a precautionary checklist.
- Application of the correct schedule — the National Insurance impairment schedule and the Ministry of Defense regulations are not identical, and in ophthalmology the differences are substantial; an opinion quoting the wrong schedule weakens the file.
- Weighting and ceilings — correct calculation of combined defects, including the single-eye ceiling and its explicit exceptions.
- Causation where required — in damages claims and in tracks where the impairment must be attributed to an event, the opinion must address this directly and with appropriate caution.
The difference between National Insurance, the Ministry of Defense and damages claims
The three tracks use similar but distinct instruments:
- National Insurance (general disability and work injuries) — assessment under the impairment schedule, updated in ophthalmology in 1992 and 2012. The foundation is the visual acuity table, alongside separate clauses for the visual field, the eyelids and conjunctiva, and others.
- Ministry of Defense (IDF disabled veterans) — the 1969 regulations, a different schedule with different valuations: minimal findings there yield 1%, and clauses repealed under National Insurance remain alive and in force. The differences are set out in detail on the calculator page.
- Damages claims (road accidents, work injuries, injuries) — the National Insurance schedule serves only as a guiding reference; medical disability is determined on the basis of expert opinions, and functional disability by the court.
Appealing a medical board decision: deadlines and rules
The rules here are strict, and worth knowing in advance. (Data from the National Insurance Institute website, current as of July 2026.)
- General disability: an appeal to the appeals board is filed within 60 days of receiving the written notice, and only if less than 80% medical disability was determined.
- Work injuries: a reasoned appeal is filed in writing within 30 days of receiving the notice, on Form 247. If the appeal is filed on time without reasons, a further 30 days are given to submit them.
- Further appeal: a decision of the appeals board may be appealed to the regional labour court within 60 days — on questions of law only.
- Important to know: the appeals board is also entitled to lower the percentage determined, and it gives advance notice of this; in such a case, withdrawing the appeal can be considered. A sound appeal is therefore one built on a finding, not on dissatisfaction.
For a fuller sense of how this works in a real example, see the article on dry eye and disability percentages.
Prof. Michael Mimouni, Director of the Cornea Unit at Rambam Health Care Campus, prepares expert ophthalmic opinions for disability files and medical boards. To arrange an examination and assessment you can contact the clinic. Everything on this page is general information only: it is not legal advice and not a substitute for an examination or an individual opinion.
Frequently asked questions
Do I need a private expert opinion in order to go before a medical board?
No. The board examines the claimant itself and reviews the medical file; the right to be assessed is not conditional on an expert opinion. A structured opinion helps mainly in complex files: several impairments requiring weighting, findings scattered across years, or a gap between what is documented and what was determined. Its role is to focus the board on the relevant findings and clauses, not to replace the examination.
How is an expert opinion different from my ordinary medical records?
Clinic notes are written for treatment: complaint, finding, recommendation. An opinion prepared for disability purposes does something else — it maps the findings onto the clauses of the relevant impairment schedule, applies the weighting and ceiling rules, and explains why the medical picture matches a particular percentage. These are two different languages, and the board reads the language of the schedule.
When is a counter-opinion worth considering?
Above all when there is a gap between the documented findings and the decision: visual acuity or visual fields that were measured and recorded but not reflected in the assessment, impairments not considered under the appropriate clause, or weighting that did not account for every defect. Before an appeal it matters that the opinion rests on a documented finding the first board did not see or did not take into account — not on a feeling that the result was low, all the more so because the appeals board is also entitled to lower the percentage.
Which eye tests matter most before a medical board?
The foundation is best corrected visual acuity, ideally measured on more than one date so that a stable state is demonstrated. Where the impairment concerns the visual field — a reliable, current field test. Beyond that, targeted tests according to the diagnosis: corneal imaging and topography, retinal or optic nerve OCT, serial documentation of the ocular surface. The recurring principle: a finding documented over time persuades far more than any verbal description of symptoms.