[Supervised by Certified Social Insurance Labor Consultant Corporation] Complete Guide to Disability Pension Application: Explanation of Required Documents and Common Pitfalls

When illness or an accident suddenly results in a disability, it goes without saying that it can significantly impact one's health and daily life. More critically, it can lead to economic problems due to the difficulty in working. Disability pensions are an essential system that supports the economic issues arising from disabilities.

This article provides a detailed explanation of the basic information and methods for receiving disability pensions.

*Formally, the process of applying for a disability pension is called a "claim," but for clarity, this article uses the term "application."

This article is supervised by Advance, a social insurance labor consultant corporation in Fukuoka Prefecture, providing you with more specialized knowledge.

Reference: Fukuoka Disability Pension Lab | Advance Social Insurance Labor Consultant Corporation

1. What is a Disability Pension?

A disability pension is a financial benefit provided as part of Japan's public pension system to individuals who require support in daily life or find it difficult to work due to a disability caused by illness or injury.

This system aims to alleviate the economic burden on those who find it difficult to work due to a disability and support the lives of people with disabilities.

There are two types of disability pensions: the Basic Disability Pension and the Employees' Disability Pension.

The Basic Disability Pension is for those who were enrolled in the National Pension at the time of their first medical examination, mainly targeting self-employed individuals, full-time homemakers, and those with congenital disabilities who became disabled before age 20. On the other hand, the Employees' Disability Pension is for those who were enrolled in Employees' Pension Insurance at the time of their first medical examination, such as company employees.

The Basic Disability Pension has only two levels, 1 and 2, for more severe disabilities, while the Employees' Disability Pension has four levels: 1, 2, 3, and a Disability Allowance for less severe disabilities. This increases the likelihood of receiving a disability pension depending on the disability state.

Additionally, those who qualify for levels 1 or 2 of the Employees' Disability Pension automatically qualify for levels 1 or 2 of the Basic Disability Pension as well, resulting in a higher payout compared to the Basic Disability Pension alone.

There are several requirements to receive a disability pension, which we will review in the next section.

2. Three Requirements to Receive a Disability Pension

2-1. Initial Consultation Date Requirement

The initial consultation date is the date when you first visited a hospital for the illness or injury that caused the disability. The type of pension you can receive depends on the pension system you were enrolled in on this date.

Additionally, the disability pension is generally assessed 1 year and 6 months after the initial consultation date, known as the "disability certification date," to determine if the condition meets the "National Pension and Employees' Pension Insurance Disability Certification Criteria."

This period is required to confirm that the illness or injury is not temporary, and the 1 year and 6 months period is set for an objective and fair assessment.

The initial consultation date is crucial for a disability pension application, and accurate proof is necessary.

Reference: Disability Basic Pension Eligibility, Application Timing, and Pension Amount | Japan Pension Service

2-2. Insurance Premium Payment Requirement

The insurance premium payment requirement stipulates that you must have paid pension insurance premiums for a certain period before the initial consultation date for the illness or injury causing the disability.

For example, as of the day before the initial consultation date, premiums must have been paid for at least two-thirds of the insured period up to the second month before the month containing the initial consultation date. However, if you were unable to pay due to unemployment or studies, exemption or deferment applications are accepted.

Even if you do not meet the above condition, if there are no unpaid premiums for the year before the initial consultation date, a special provision allows for eligibility.

Reference: Disability Basic Pension Eligibility, Application Timing, and Pension Amount | Japan Pension Service

2-3. Disability Certification Criteria Requirement

The disability certification criteria requirement is the standard used to determine whether you can receive a disability pension based on the degree and type of disability.

To ensure a fair assessment of the disability condition, the Japan Pension Service has established the "National Pension and Employees' Pension Insurance Disability Certification Criteria," which is used to determine eligibility and the disability grade.

Below, we explain the disability certification criteria requirements and examples for each grade in an easy-to-understand manner.

• Grade 1: Disability requiring constant care in daily life
  Example: Able to barely manage personal needs but unable to engage in other activities, such as being confined to a bedroom at home or being hospitalized with limited activity around the bed
  
• Grade 2: Disability significantly hindering daily life
  Example: Not necessarily needing help from others, but daily life is extremely difficult, and earning income through work is impossible. For instance, able to perform very mild activities at home (like making light meals or washing underwear) but unable to do more, with activities mostly confined to the home
  
• Grade 3 (Employees' Disability Pension only): Disability significantly restricting work
  Example: Work is significantly restricted, or significant accommodations are needed to work. For example, employment under a disability quota where work is difficult without considerable accommodations

The conditions covered by the disability pension are broad, including not only physical disabilities but also mental disorders, cancer, diabetes, and other internal disorders.

For detailed information on the conditions covered by the disability pension, refer to the "National Pension and Employees' Pension Insurance Disability Certification Criteria" by the Japan Pension Service.

Reference: National Pension and Employees' Pension Insurance Disability Certification Criteria | Japan Pension Service

3. Disability Pension Application Process

3-1. Determine the Initial Consultation Date

The initial consultation date for a disability pension is not the date you were diagnosed with a condition, but the date you first received medical treatment from a doctor (or dentist) for the illness or injury causing the disability.

For example, the following summarizes the condition names and circumstances for reference.

You can apply for a disability pension 1 year and 6 months after the initial consultation date (or after the day before your 20th birthday if the initial consultation date was before age 20). However, if you do not remember the initial consultation date or cannot obtain documents or materials to prove it, your application may be denied.

The initial consultation date is a crucial part of the disability pension application, so if you cannot obtain the necessary documents yourself, consulting a social insurance labor consultant for assistance is one option.

Reference: Fukuoka Disability Pension Lab | Advance Social Insurance Labor Consultant Corporation

3-2. Check if You Meet the Insurance Premium Payment Requirement

Once you have determined the initial consultation date, the next step is to check if you meet the insurance premium payment requirement. You can check this at your local municipal National Pension Division or nearby pension office.

When checking, you will need your Basic Pension Number, so make sure to confirm the number on your Basic Pension Number Notification or Pension Handbook.

If you do not know your Basic Pension Number, visit the office or pension office directly for consultation (they cannot provide this information over the phone or email due to privacy concerns).

To receive a disability pension, you must meet certain conditions, such as having paid premiums for at least two-thirds of the insured period up to the second month before the month containing the initial consultation date, or having no unpaid premiums in the year before the initial consultation date.
*For detailed conditions, see "2-2. Insurance Premium Payment Requirement."

Once you confirm that you meet the insurance premium payment requirement, obtain the necessary documents for the application.

3-3. Obtain Documents to Prove the Initial Consultation Date

To prove the initial consultation date, you need a "Certificate of Consultation Status" prepared by the doctor at the initial medical institution. The Certificate of Consultation Status is usually not available at the medical institution, so first obtain it from your local office, pension office, or the Japan Pension Service website and request it from the doctor.

In some cases, the Certificate of Consultation Status may not be required, such as:

• When applying for intellectual disability and the initial consultation date is the "date of birth"
• When the initial medical institution and the institution preparing the medical certificate are the same (however, if there was a department transfer within the same institution, the initial department must provide the Certificate of Consultation Status)

Note that medical records are kept for 5 years from the last consultation date, so it may be difficult to obtain the Certificate of Consultation Status if the initial consultation records have been discarded. In such cases, prepare a "Statement of Inability to Attach the Certificate of Consultation Status" and request the second or subsequent medical institution to include details from the time of the first consultation to complete the Certificate of Consultation Status.

Proving the initial consultation date can be challenging, and some may give up on the application. If you find it difficult, consulting a social insurance labor consultant is one option.

3-4. Have a Doctor Prepare a Medical Certificate

Next, have a doctor prepare a medical certificate. There are eight types of medical certificates for disability pensions, and the format varies depending on the condition.