According to the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report statistics, one in four U.S. individuals has a disability that significantly limits their main living activities. Thankfully, Social Security offers disability benefits to people who cannot work due to a disability, despite the number increasing every year. Because the process can be drawn out and challenging, the compassionate allowance program exists to help people with serious medical disabilities.
The Social Security Administration (SSA) runs a program called Compassionate Allowances (CAL) that speeds up the disability claims procedure for people with serious medical conditions. There are five things you need to know about compassionate allowances.
Compassionate allowances quickly identify diseases and conditions that meet disability benefit standards. Conditions include certain cancers, adult brain disorders, and rare disorders in children. The CAL initiative reduces waiting times for individuals with severe disabilities. The program identifies claims meeting the SSA’s statutory standard for disability. The SSA uses the same rules to evaluate CAL conditions for both the SSDI and Supplemental Security Income (SSI) programs.
What Conditions Qualify for Compassionate Allowances?
There are over 200 conditions on a list of disabilities that are eligible for compassionate allowances on the Social Security Administration’s list.
Amyotrophic lateral sclerosis (ALS), adult non-Hodgkin lymphoma, Joubert syndrome, and various types of cancer, such as pancreatic or esophageal cancer, are some of the most prevalent illnesses that qualify for a compassionate allowance, indicating the precise set of requirements for how severe or progressive the condition must be. Breast cancer, for instance, can be eligible for a compassionate allowance if it has spread to other parts of the body or is in stage IV.
To find out what records and medical documentation are required in your application for SSDI benefits, visit the SSA’s Blue Book listing. The full list of ailments eligible for compassionate allowances is available on the SSA website. If your ailment is not listed and you believe it should be because it is so serious, you can also submit a condition on the SSA website.
Below, we will explore the five things you need to know about compassionate allowances in detail.
1. Quick Approval
Applying for Social Security disability payments is typically a lengthy process.
A Social Security representative must carefully analyze all required paperwork, including the application itself and the numerous medical records and testimony offered, to assess a person’s eligibility. It can potentially result in a 6–12-month delay in the decision-making process.
For individuals with really severe disabilities, compassionate allowances expedite this process. Compassionate allowances are frequently available to people with serious genetic abnormalities and terminal malignancies, allowing families to receive benefits while the remainder of their application is being processed.
Sometimes, applications for disability are rejected months after receiving compassionate allowance benefits because the clearance process is quick. The family in these situations is exempt from having to pay back the money they have already received.
2. Payments Aren’t Instant
Unfortunately, benefits cannot be immediately given under the Compassionate Allowances Program. Even with the accelerated process, the timing of the provided medical records, the volume of other applications, and further mandatory examinations might occasionally cause the decision to be delayed.
Most applicants, however, only have to wait a short while for their payments to begin; they typically start receiving Compassionate Allowance benefits between a few weeks and two months after the application is accepted.
3. No Extra Work Required on the Application
Even with substantial documentation of the applicant’s life, health, and work history, the Social Security disability application can be challenging enough as it is. Fortunately, requesting a compassionate allowance does not involve any more effort.
When examining a claim, a Social Security representative looks at the applicant’s disability before consulting the list of compassionate allowances. The applicant will start receiving funds right away if the documentation indicates that they have a qualifying medical condition.
4. Potential Eligibility for Retroactive Payments
When determining a person’s eligibility for benefits, Social Security also considers how long the applicant has had a disability before submitting their application. Applicants are eligible for retroactive pay for the months between the beginning of their disability and the time their application was approved, after deducting the 5-month waiting period.
Social Security will give you enough money to cover your disability, even if the application process takes longer than expected.
5. When is Medicare Awarded?
While compassionate allowances offer early access to monthly financial benefits, no accelerated Medicare application process exists. Compassionate Allowance beneficiaries normally receive Medicare 24 months after the date on which their impairment first manifested, just like other disability applicants do.
Applicants must look into other insurance plans if their monthly benefits are insufficient to cover ongoing medical and financial needs.
What Conditions Automatically Qualify for Disability Benefits?
The SSA understands the importance of making decisions about and disbursing benefits to Social Security disability applicants with cancer and other serious medical conditions as soon as possible.
The SSA has listed over 200 ailments on its Compassionate Allowance list that, in most cases, immediately entitle a person to disability benefits. The SSA processes applications more quickly when there is evidence of these conditions.
The following conditions may be on the Compassionate Allowance List:
- Certain inoperable or metastasized cancers
- Atresia
- Creutzfeldt-jakon Disease
- Acute Leukemia
- Alstrom Syndrome
- Malignant Melanoma
- Joubert Syndrome
- Early-onset Alzheimer’s Disease
- Child Neuroblastoma
- Heart Transplant Waitlist
- Lewy Body Dementia
- Non-Hodgkin Lymphoma
- Ohtahara Syndrome
- Zellweger Syndrome
- Progressive Bulbar Palsy
- Wolman Disease
The CAL includes a variety of disabilities, many of which have a major impact on a person’s capacity to work or quality of life. The list also includes several terminal or inoperable conditions.
The list of eligible compassionate allowance criteria is updated regularly by the SSA.
Conclusion
The SSA’s Compassionate Allowances program streamlines the disability claims process for people with serious medical problems, such as terminal cancers. This program allows those who qualify to get benefits quickly while their applications are being reviewed. Qualifying conditions include severe genetic abnormalities and terminal illnesses.
Retroactive payments are possible, as is Medicare, after a 24-month waiting period. Determining eligibility and completing the application process successfully might be easier with the help of an SSA advocate, or if you fear your application might be denied, consider working with a highly experienced SSDI attorney.
