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Compassionate Allowances: quick SSDI processing for the most severely disabled

The Social Security Administration was regularly criticized starting in the 1980s for its slow processing of applications for Social Security Disability Insurance or SSDI, the federal disability insurance program. Horror stories circulated in the media of terribly ill or severely injured workers who languished while their SSDI applications took months and years to process, sometimes dying before having been found rightfully eligible for financial benefits.

Fast tracking SSDI applications for the very ill

One of the agency's successful responses to this systemic problem was its Compassionate Allowances program, started in 2008. The program, also called CAL for short, fast tracks the SSDI application process when claimants have extremely serious medical conditions that are so obviously disabling that the claims require little proof or processing.

SSA disability definition

Once work history requirements are met, a person is eligible for SSDI if he or she meets SSA's definition of disability, meaning that he or she has a severe medical impairment or combination of impairments expected to last at least one year or cause death that keeps the individual from returning to previous work or doing different work.

Slow processing

It is not unusual for an SSDI application to take a long time for processing if the necessary medical evidence is not available, the seriousness of the medical condition is unclear or the application becomes caught in bureaucracy. A denied application has three levels of review within the agency and may thereafter be appealed to the federal court system. It is not unusual for the initial denial to be incorrect and for the claimant to be found disabled and eligible at one of the review levels. However, each level of review can add months to the waiting period.

CAL processing

When an applicant has a CAL condition, those months of waiting can be reduced to a couple of weeks or so. The agency will flag the claim as CAL for fast processing. Once the objective medical evidence of the CAL condition is in the file, the claim will be approved if other eligibility requirements are met.

Public outreach

The initial 2008 list of CAL impairments included 50 conditions. The SSA has been serious about continually working to expand the list, holding public hearings and working with health agencies, advocates and medical experts to identify the worst medical conditions. Many diseases on the list are overwhelmingly disabling, sometimes incurable or fatal.

CAL conditions

In January 2014, the agency announced it had added 25 more diseases to the list, bringing it to a total of 225. Among the more common classes of impairments on the CAL list are severe:

  • Autoimune diseases like Multicentric Castleman Disease and more
  • Mental illnesses, dementias, neurological disorders, and brain diseases and injuries like Creutzfeldt-Jakob disease, early-onset Alzheimer's disease, Stiff Person Syndrome, ALS, Perry syndrome, Progressive Bulbar Palsy and more
  • Cancers like esophageal, gallbladder, liver, pancreatic, bone, thyroid, Inflammatory Breast Cancer and more
  • Rare diseases and syndromes like Huntington disease, Aplastic Anemia, I Cell Disease, Pearson Syndrome and more
  • Heart diseases and defects like Endomyocardial Fibrosis and more
  • Lung diseases like Obliterative Bronchiolitis and more

An experienced SSDI lawyer can help a lot

Anyone whose medical condition prevents him or her from working should investigate SSDI eligibility, whether the disease or injury is likely to be on the CAL list or not. A knowledgeable disability attorney can assist with the initial application or at any level of appeal. Skilled legal counsel will know how to develop the medical record on a claimant's behalf.

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