Eye Injury at Work — From Recognition to a Disability Rating

An eye injury at work runs along two parallel tracks that are easily confused. One is medical — what was injured, what healed and what remains. The other is administrative — recognition of the injury, injury allowance, determination of a disability degree, and appeal. This page explains both, and the points at which they meet, from an ophthalmologist’s perspective.

For the broader explanation of how the National Insurance Institute rates eye impairment see Ophthalmic Expert Opinions for the National Insurance Institute, and for an initial numerical estimate, the eye disability calculator.

The first question is recognition, not percentages

In the work-injury track the first question is not how many percent, but whether the event is recognised as a work injury and whether the eye impairment arises from it. Only after recognition does the case reach rating.

Reporting is done on form BL/211 — claim for injury allowance and notice of a work injury, which serves both purposes in a single document: it reports the event and claims the allowance. It can be filed online.

What matters at this stage is not legal drafting but medical documentation. Two things prove decisive in hindsight: the record made in the emergency room or clinic on the day of the event, and in particular the description of the mechanism — a grinding fragment, a chemical splash, blunt impact, welding arc; and the visual acuity measured at that time, in both eyes. The difference between a strong file and a problematic one is usually settled in the line written on the evening of the injury, not two years later.

Injury allowance — up to 91 days

The injury allowance is paid for the period in which you did not actually work and required medical treatment, for a maximum of 13 weeks (91 days).

• The day of the injury itself is paid by the employer.
• If the absence is shorter than 12 days, the Institute pays from the third day after the injury.
• If it is longer than 12 days, payment begins from the day after the injury, and the Institute recovers the first 12 days from the employer.

In many eye injuries this period is far shorter: a superficial burn or a foreign body that was removed heals within days. That is precisely why it matters to understand that the injury allowance and the disability degree are two separate things — the end of the allowance is not the end of the case, and says nothing about what remains in the eye.

The injuries that actually recur

The same groups appear repeatedly in occupational eye cases, each with a different healing pattern:

• Corneal foreign body — a metal fragment from grinding, polishing or welding. In most cases removed and healed without residue. What matters is where the scar sits: a peripheral scar usually does not affect vision; one in the visual axis does.
• Chemical burn — a splash of an alkaline or acidic substance. Alkalis penetrate more deeply and are considerably more dangerous. Damage to the limbal stem cells is what determines the long-term prognosis, not the size of the area burned on day one.
• Welding arc — a UV burn of the corneal surface. Very painful, and usually resolves without residue within a day or two.
• Blunt trauma — a blow from a tool or a flying object. This is where the significant injuries concentrate: bleeding into the anterior chamber, angle damage, retinal injury, and in the longer term traumatic cataract or a rise in intraocular pressure appearing years after the event.
• Penetrating injury — the most severe event, and the one with the greatest functional consequences.

Two of these have a long tail: traumatic cataract and post-traumatic glaucoma may surface long after the file has closed. This is one of the practical reasons a committee sometimes sets a temporary rather than a permanent degree.

From a temporary degree to a permanent one

Once the condition stabilises, form BL/200 — claim for determination of a degree of work disability is submitted, and the case goes to a medical committee for work injuries.

The committee may set a temporary degree where the condition is not yet stable and is likely to change — for a period not exceeding one year, at the end of which the insured is called back. Once the condition stabilises, a permanent degree is set.

In ophthalmology this distinction matters more than in most fields, because the biological timetable does not align with the administrative one. A corneal scar clears over months; a traumatic cataract matures at its own pace; a visual field after retinal injury stabilises slowly. A permanent determination made too early fixes a partial picture in place.

How the eye injury itself is rated

Rating follows the same ophthalmic chapter that applies across National Insurance cases — there is no separate schedule for work accidents. The principal clauses:

• Clause 52 — visual acuity. The foundation. A two-dimensional table in which the acuity of both eyes meets, based on best corrected vision rather than vision without glasses. Where one eye is injured and the other is sound, the rating stops within a defined range: 6/60 — 20%, 3/60 — 25%, and 1/60 or absence of light perception — 30%. Loss of the eye itself adds 5% arithmetically.
• Clause 61 — corneal opacities. 5% or 10%, but only where there is no visual impairment that itself attracts a degree. The purpose is to prevent the same scar being counted twice.
• Clause 62 — the lens. This is where traumatic cataract falls, rated according to actual visual capacity. Note that pseudophakia — an eye with an implanted intraocular lens — is rated 0% under the text in force since 1 January 2012, and what is assessed is the vision achieved after surgery.
• Clause 55(d) — dry eye. Relevant after a chemical burn affecting the ocular surface: 0% for a mild condition controlled with drops, 10%–15% for a persistent condition with an objective finding.

And a rule that touches almost every file: where several separate impairments exist they are weighted from the remainder rather than added — 10% plus 10% is 19%, 20% plus 10% is 28%. Most of the calculation errors I see are made precisely here.

Regulation 15 — exists only in this track

Regulation 15 allows the committee to increase the permanent degree by up to half of the degree determined — 30% may rise to 45% — where the injured person cannot return to the work they did and their income has been permanently reduced by more than 20%.

In eye injuries it arises mainly in occupations where vision is the tool of the trade: work at height, operating machinery, professional driving, welding, and occupations requiring binocular vision or a full visual field. Loss of vision in one eye, for instance, impairs depth perception — a limitation barely visible in the percentage table but decisive in certain trades.

This is an occupational and economic question rather than a purely medical one, and the decision rests with the committee. A medical opinion does not determine it, but it can describe precisely what the visual limitation permits and what it does not. The explanation here is general and does not constitute legal advice.

Grant or pension — the threshold that decides everything

• Below 9% — no payment.
• 9% and above, under 20%, for permanent disability — a one-time grant equal to the monthly pension multiplied by 43.
• 20% and above — a monthly pension.

In eye cases this threshold is unusually tangible. A difference of a few percent around 20% is the difference between a single payment and a continuing pension, which is why most disputes concentrate in that range — and why precise medical documentation carries its greatest weight exactly there.

Appeal — 30 days, and with care

An appeal against the committee’s decision is filed within 30 days of receiving the notice, on form BL/247. The appeal is expected to include reasons; if filed on time without them, a 30-day extension is granted to complete them.

One point worth knowing in advance: the appeals committee may also reduce the degree, not only raise it. Where it is considering doing so, the injured person has the option of withdrawing the appeal and preserving the original rating. The practical conclusion is that an appeal is not an automatic step but a decision best taken on an assessment of what the file actually shows.

What an ophthalmic opinion adds in a work-accident file

The gap I see again and again is not between a strong file and a weak one, but between a file written in the language of treatment and one written in the language of the rating schedule. In the work-injury track there is a further question that does not arise in general disability: the link between the event and the impairment. An ophthalmic opinion for disability purposes:

• Separates what the injury caused from a pre-existing condition or an age-related change — the central question in this track.
• Maps the findings to the correct clause and explains why that one.
• Addresses the reliability of the tests, foremost the visual field — the most common weak point in eye files.
• Considers whether the condition has genuinely stabilised, or whether a temporary degree reflects it more faithfully.
• Applies the weighting rules and ceilings correctly, where most calculation errors accumulate.

And equally important is what an opinion does not do: it does not replace the committee’s examination, does not bind it and does not guarantee an outcome.

Where a civil proceeding runs alongside the National Insurance process over the same accident, the relevant aspects are explained on Ophthalmic Expert Opinions for Civil Damages Claims.

How to get in touch

Examinations and assessments take place in Haifa and Herzliya, by prior arrangement. There is no need to send a full medical file with the first enquiry — a brief description of the injury, the stage the process has reached and what has been determined so far is enough to establish whether the case is suited to an assessment within this field of expertise. Every enquiry is considered on its own merits, with no undertaking as to a conclusion or to the outcome of the proceedings.

Get in touch to check suitability for an assessment