Beyond Disability Metrics: Israeli October 7 Survivors Advocate for a Healing-Centric Rehabilitation System

Survivors, mental health experts, and political representatives warned at a Tel Aviv conference on Sunday that Israel’s system for victims of hostile acts remains fixated on verifying disability extent rather than supporting life reconstruction.

The conference was organized by 121 Engine for Social Change through two partnerships it leads: Or BaOfek (“Light on the Horizon”), which advocates for victims of hostile acts, and Tikva LaNefesh (“Hope for the Soul”), which focuses on mental-health and resilience policy.

The conference took place at Riverside in Tel Aviv, and was sponsored pro bono by Rafi Pomrock, the CEO of the Dynamo Group and a member of 121’s public council. It was hosted by journalist Rina Matzliach.

Founded in 2017, 121 describes itself as a nonpartisan social-policy organization that works with civil-society groups and professionals to advance legislation and government policy.

Or BaOfek was established following October 7 to press for changes to a system of recognition and rehabilitation that the organization argues was not built to handle tens of thousands of physical and psychological injuries.

Employment and Financial Stability Eroding for Terror Victims

During the conference, 121 shared preliminary results from a survey of 145 hostile act victims, revealing that merely 27% resumed their pre-injury employment levels, 35% remained unemployed, and 34% returned to work in a reduced capacity.

Approximately 61.8% of respondents reported worsened financial circumstances despite receiving allowances and compensation, with 35.2% indicating that a first-degree relative had to cut back on work hours due to the victim’s condition.

About two-thirds stated they lacked continuous and consistent state guidance, and rated the assistance received for navigating their rights at an average of 2.5 out of 5.

Collectively, these findings highlight how injury repercussions extend beyond state-recognized individuals, impacting family employment and finances while imposing added strain on caregiving relatives.

Roni Katz, mother of Arad Katz who survived the Supernova music festival massacre, shared in a conference video that she ceased employment to provide round-the-clock care for her son.

“My son Arad came back from Nova in a severe psychological state, and I’ve been providing constant care ever since,” she stated. “I lost my income, yet the state offered no financial aid, guidance, or treatments to assist my coping.”

Nova survivor Ron Segev explained that he previously worked 12-hour days as a salesman but now struggles to function as he did prior to October 7. He noted his current recognition as temporarily disabled through 2026, with a permanent disability assessment anticipated only in 2027.

“Rather than a system fixated on disability percentages, I require a personalized rehabilitation plan that identifies what I need to regain functionality and reclaim my life,” he emphasized.

Recognition Marks Just the Initial Step

Recognition as a victim of hostile acts and disability rating determination constitute distinct phases within the process.

Individuals pursuing recognition file a claim with the National Insurance Institute (NII), which forwards it to the Defense Ministry’s certifying authority. This body assesses whether the incident qualifies as a hostile act under legal definitions and decides on victim recognition.

Once recognized, individuals seeking disability compensation must submit a separate claim and appear before a medical committee, which evaluates whether the recognized injury resulted in temporary or permanent disability and assigns a corresponding percentage. The committee’s assessment is limited to injuries directly linked to the hostile act for which recognition was granted.

A disability rating below 10% does not qualify the victim for disability compensation. Ratings falling between 10% and 19% typically result in a one-time grant, whereas ratings of 20% or higher entitle the recipient to monthly disability payments.

Recognition can fund medical treatment related to the recognized injury even without a 20% disability rating, but numerous broader rehabilitation services, treatment options, and family benefits remain contingent upon surpassing higher thresholds.

The “One Soul” reform, for instance, applies exclusively to victims receiving monthly compensation with a disability rating of at least 20% for post-traumatic stress disorder, another mental injury, or a head injury.

Given the unprecedented influx of individuals into the system over the past three years, this distinction holds significant importance.

According to NII data featured in a recent Knesset Research and Information Center report, roughly 82,000 civilians received recognition as victims of hostile acts between 2023 and 2025, excluding fatalities.

By April 2026, approximately 38,000 had submitted applications for disability determination. Of these, around 88% were assessed as having a mental disability, approximately 6% with a physical disability, and another 6% presenting combined physical and psychological injuries. Among those diagnosed with psychological disabilities, the largest cohort received ratings ranging from 20% to 34%.

Religious Zionist Party MK Michal Woldiger remarked on Sunday that the committees responsible for determining these ratings have themselves evolved into impediments to recovery.

“The vast majority of medical committees today operate with an anti-rehabilitative focus,” she stated. “They concentrate on quantifying the degree of injury rather than exploring what the individual requires to regain functionality.”

Woldiger suggested that while abolishing the committees may not be necessary, their objectives and methodologies ought to be reformed to bolster individualized rehabilitation efforts.

Parallel criticisms surfaced during a June 9 convening of the Knesset Labor and Welfare Committee concerning medical committees for disabled IDF veterans and victims of hostile acts. One participant recounted an instance where a psychiatrist reduced her disability rating by 20 percentage points after inquiring whether she had commenced studying—an illustration of the apprehension that signs of recovery might be misconstrued as evidence that support is no longer warranted.

Trauma That Defies Conventional Definitions

Yashar Party candidate Inbar Yehezkeli Blilious contended that the legal criteria themselves necessitate reevaluation as the character of terrorist exposure undergoes transformation.

“Terrorism has evolved, and the law must adapt accordingly,” she asserted.

Individuals may endure profound psychological harm despite not being physically present at an attack site, she explained, including through real-time observation of events via smartphones or video footage. Where substantial harm can be substantiated, the state ought to contemplate expanding recognition criteria to encompass such cases, she emphasized.

Yehezkeli Blilious additionally advocated for earlier intervention through health funds and for extending support to siblings and other family members impacted by a survivor’s condition.

She also observed that some victims may resume employment while continuing to necessitate long-term support, meaning that employment alone should not serve as proof of completed rehabilitation.

Prof. Mooli Lahad, founder and president of the Community Stress Prevention Center, cautioned against interpreting every prolonged war response as PTSD. Certain individuals manifest alternative forms of unresolved distress, including what he termed “ambiguous loss,” demanding an expanded therapeutic lexicon and approach.

Individual treatment remains vital, Lahad noted, but cannot achieve full efficacy when an individual returns to a family, workplace, or community devoid of adequate support mechanisms.

“Authentic healing unfolds within an ecology of healing,” he declared.

Following years of persistent conflict and repeated recovery attempts, people are likewise encountering what he described as “healing fatigue.” Fortifying communities would enable them to furnish a protective framework for individuals and families, he explained.

“The more we nurture community healing, the more effectively they will envelop the individuals themselves,” Lahad added, underscoring that resilience should be perceived as a muscle requiring perpetual strengthening.

The strain on these communities is already evident throughout the public mental-health infrastructure.

A State Comptroller’s survey conducted in April 2024 revealed that 35% of adults experienced moderate or severe post-traumatic stress symptoms, 32% reported depressive symptoms, and 21% indicated anxiety.

Among respondents who indicated that they or someone close to them had been present at the October 7 events, 54% reported moderate or severe post-traumatic stress symptoms.

In the initial six months following the attack, health funds and resilience centers administered psychotherapy to roughly 58,000 adults and children. By the spring of 2024, the average interval between care request and treatment initiation—including diagnostic procedures—amounted to approximately six-and-a-half months.

The State Comptroller cautioned that delayed treatment risks entrenching symptoms and precipitating long-term detriment to victims’ employment, familial dynamics, and social functionality.

The local welfare framework anticipated to contribute to the communal response is likewise encountering difficulties. A June State Comptroller’s Report determined that merely 18% of the supplementary municipal social-work positions allocated in reaction to the war were occupied in 2023, escalating to 32% in 2024 before declining to 28% in 2025.

In a nonrepresentative survey conducted for the report, 54% of municipal social workers confessed to experiencing high or very high burnout since the war’s outset. The primary challenges they cited were excessive workload, chronic staffing deficiencies, and an escalating caseload volume.

Together Party representative Liran Avisar Ben Horin urged a transition from reactive crisis intervention only after escalation to proactive identification of individuals in distress.

Just as workplaces mandate the appointment of officials tasked with preventing sexual harassment, they should consider designating a mental-health officer capable of detecting distress signals and facilitating employee access to treatment, she proposed.

The conference’s proposals varied, but they shared a central premise: Israel cannot approach psychological rehabilitation as a temporary emergency initiative or reduce recovery to the percentage inscribed beside an individual’s name.

“The war forged a new reality that the State of Israel has yet to sufficiently address,” stated Liat Eilam, executive director of 121.

Israel must reconfigure the rehabilitation process around an individual’s return to functionality, broaden support to encompass families bearing caregiving burdens, and establish a national mental-health and resilience framework grounded in local communities, she affirmed.

“These represent two national imperatives that must occupy the foremost positions on the agenda of the subsequent government and Knesset.”

Source link