If you are applying for Social Security Disability Insurance (SSDI) and have a grave medical condition, you may qualify for expedited processing through the Compassionate Allowances (CAL) program. This initiative aims to fast-track the approval process for individuals whose condition(s) meet(s) the Social Security Administration’s (SSA) definition of disability. We would like to share here with you a comprehensive guide to understanding Compassionate Allowances, determining who qualifies, and what to expect if your condition is on the list.
What Is a Compassionate Allowance?
A Compassionate Allowance is a special provision by the SSA designed to expedite the processing of disability claims for individuals with severe medical conditions. The program allows for a faster review and approval of claims when medical evidence unmistakably demonstrates that the individual meets the SSA’s criteria for disability. If your condition is included on the CAL list, you could receive a decision within weeks, significantly reducing the typical processing time.
The Compassionate Allowances list currently includes over 200 conditions, such as specific types of cancer, adult brain disorders, and rare genetic disorders in children. It’s important to note that this program does not affect the amount of benefits you receive; it only accelerates the decision-making process.
Who Qualifies for a Compassionate Allowance?
Individuals with conditions on the CAL list may qualify for this expedited review process. The SSA identifies these conditions based on their severity and the clarity of the medical evidence that demonstrates an inability to work.
Individuals with rapidly progressive or terminal medical conditions
The Compassionate Allowance program is designed for individuals facing medical conditions that are either rapidly progressive or terminal. These conditions are so advanced or severe that extensive additional evidence is not required to establish eligibility.
Individuals diagnosed with specific diseases
As discussed, the Social Security Administration maintains a list of conditions that qualify for Compassionate Allowances. This list encompasses various types of cancer, severe adult brain disorders, and several rare genetic disorders. Examples include:
- Cancer: Advanced stages of cancers such as breast, lung, and pancreatic cancer
- Neurological Disorders: Conditions such as early-onset Alzheimer’s disease and frontotemporal dementia
Late-stage cancer patients
Patients diagnosed with late-stage or aggressive cancers, particularly those that have metastasized or are in advanced stages, are likely to qualify for Compassionate Allowances due to the extremely poor prognosis associated with these conditions.
Adults with severe brain disorders
Adults suffering from severe brain disorders, such as early-onset Alzheimer’s disease or severe frontotemporal dementia, and Lewy body dementia, among others, may be eligible. These conditions typically cause significant cognitive decline and severely impact daily functioning.
Children with rare genetic disorders
Children diagnosed with certain rare genetic disorders, including Rett syndrome and Zellweger syndrome, are also eligible for Compassionate Allowances. These conditions often have profound effects on a child’s health and development.
For the full list of qualifying conditions, refer to the SSA’s Compassionate Allowance Conditions list.
Do You Need to Apply for a Compassionate Allowance Separately?
You do not need to apply separately for a Compassionate Allowance. The SSA uses advanced technology to review medical records or assess functional limitations in order to identify potential CAL candidates through the standard disability application process. If you apply for SSDI or Supplemental Security Income (SSI), the SSA will automatically determine if your condition qualifies under the Compassionate Allowance criteria.
Even though SSA will be able to identify potential eligibility under the compassionate allowance rules, it is a good idea to contact your local Social Security office after submitting your application to let the representative know you have applied for disability benefits under the CAL rules. Confirm that your application has been received and emphasize that your case should be prioritized due to the urgency of your condition.
You can find your local Social Security contact number by searching online for “Social Security + [your ZIP code]” or by entering your ZIP code on the SSA’s official website office locator page.
Additionally, consider including with your application any relevant photos or medical evidence that can help illustrate or support your condition. This supplementary information can be valuable in expediting your case.
If you have any doubts about your eligibility for benefits under the CAL rules or about your application in general, please do not hesitate to contact our offices for assistance.
What Happens After Compassionate Allowance Approval?
Upon approval of an SSDI Compassionate Allowance, the process moves forward with the following actions:
Immediate processing of application
Once your application is flagged for Compassionate Allowance, the SSA begins processing it immediately. The gravity of the condition means that there’s no need for additional medical documentation to establish eligibility. The streamlined process afforded by CAL approval ensures that your claim is handled as quickly as possible.
Fast tracking of disability benefits
Compassionate Allowance approval leads to fast-tracking of your disability benefits. Applicants typically receive a decision within weeks rather than the usual months or years. This rapid processing can provide you with much-needed financial support sooner.
Initiation of benefit payments
After approval, the SSA will initiate benefit payments usually within the first month. This ensures that you begin receiving financial assistance quickly, helping to alleviate some of the burdens associated with your condition.
Don’t let a complex and time-consuming process delay your access to SSDI benefits. If your condition qualifies for a Compassionate Allowance, we can help you expedite your claim. Contact LaPorte Law Firm today to learn more.
FAQs
The CAL program, administered by the SSA, prioritizes the processing of applications for individuals with severe conditions to expedite their access to disability benefits. This program identifies certain conditions that meet the SSA’s disability criteria and uses technology to expedite these claims. While the CAL does not alter how much an individual is eligible for, it helps them receive those benefits faster.
Eligibility for a Compassionate Allowance is determined based on a list of conditions that the SSA has identified as meeting its disability standards. This list is developed using input from the public, medical and scientific experts, and organizations such as the National Institutes of Health.
Conditions that may qualify for a Compassionate Allowance include:
- Certain cancers: Acute leukemia, esophageal cancer, gallbladder cancer, brain cancer, inflammatory breast cancer, liver cancer, pancreatic cancer, salivary and sinonasal cancers, and small cell cancer, as well as cancers that are inoperable, have recurred despite treatment, or have metastasized
- Rare disorders: Choroid plexus carcinoma (a rare, aggressive brain cancer) and FOXG1 syndrome (a neurological disorder usually diagnosed in infancy)
- Other conditions: Adult-onset Huntington disease, Alzheimer’s disease, Ewing’s sarcoma, and hypoplastic left heart syndrome
Even with a Compassionate Allowance, there is a mandatory five-month waiting period before benefits can commence, as required by federal law.
Compassionate Allowances are designed to provide financial assistance to those who are unable to work due to severe medical conditions. The benefits include financial relief to help cover medical care and treatments, expedite processing, and ensure that applications will be processed quickly during a challenging time. This provides candidates with peace of mind, knowing that they will receive financial assistance more quickly.
Once flagged for Compassionate Allowance, applications can be processed in as little as a week or take a few months.
The SSA’s Compassionate Allowances program provides expedited disability benefits for severe medical conditions. Some qualifying conditions include:
- Early-onset Alzheimer’s disease: Alzheimer’s disease is a degenerative, irreversible brain impairment that usually affects older people and causes dementia characterized by the gradual loss of cognitive abilities, such as memory, language, judgment, and the ability to function. However, a diagnosis of early-onset Alzheimer’s appears in individuals in their 30s, 40s, or 50s, and accounts for approximately 5–10 percent of people with Alzheimer’s.
- Amyotrophic lateral sclerosis (ALS): Also known as Lou Gehrig’s disease, ALS is fatal and a severely disabling condition.
- Brain tumors: Conditions such glioblastoma multiforme, which spread quickly and are often fatal, are on the list of qualifying conditions for CAL.
- Cholangiocarcinoma: This is a type of bile duct cancer occurring near the small intestine.
- Acute leukemia: Both acute leukemia and chronic myeloid leukemia qualify for Compassionate Allowance processing.
- Sarcomatoid mesothelioma: A form of mesothelioma is also considered under Compassionate Allowances. This is a rare, aggressive, and difficult-to-treat type of cancer that occurs in the lining of the lungs, stomach cavity, and other organs.
For the full Compassionate Allowances list please refer to this link.
