SSA Expands List of Compassionate Allowances for Disability Benefits

The Social Security Administration (SSA) recognizes its obligation to get Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits to applicants with serious medical conditions as quickly as possible. The Compassionate Allowances List (CAL) is one means by which SSA adjudicators identify medical conditions that quickly qualify for a disability determination under the Listing of Impairments. An applicant need only prove such conditions with minimal objective medical information.

In July, SSA Commissioner Michael J. Astrue announced that 12 new conditions have been recognized, extending the Compassionate Allowances list to 100 diseases and medical conditions. The additions were made based on input in seven public hearings focusing on topics such as dementia, heart disease, traumatic brain injury (TBI) and autoimmune diseases.

The 12 new Compassionate Allowances are a variety of specific cardiovascular conditions, not surprising in light of the fact that heart disease is the leading cause of death in the U.S.:

  • Aortic Atresia
  • Eisenmenger Syndrome
  • Endomyocardial Fibrosis
  • Heart Transplant Graft Failure
  • Heart Transplant Wait List, 1A/1B
  • Hypoplastic Left Heart Syndrome
  • Left Ventricular Assist Device (LVAD) Recipient
  • Mitral Valve Atresia
  • Primary Cardiac Amyloidosis
  • Pulmonary Atresia
  • Single Ventricle
  • Tricuspid Atresia

Other conditions on the list include thyroid cancer, pancreatic cancer, acute leukemia, breast cancer, Creutzfeldt-Jakob disease and early-onset Alzheimer's disease. While many CAL cases involve terminal conditions, some non-terminal conditions also qualify, such as a person with a spinal injury who may still live a long life. Compassionate Allowances allow Social Security to provide rapid assistance to the most obviously disabled individuals in a time of likely distress and economic hardship.

Expedited Processing for CAL Cases

Like other processes such as Terminal Illness (TERI) claims and Quick Disability Determinations (QDD), the SSA provides expedited processing for CAL cases. The CAL process is triggered when a claimant alleges that he or she has a disease or other medical condition that is on the CAL list. Based on that information, the disability determination process must be initiated by SSA staff within one day.

Even though a verifiable CAL condition is subject to expedited review, the SSA still encourages adjudicators to obtain additional information from the claimant after receiving medical records from the health care provider who provided the diagnosis. This can include information about pending medical appointments, activities of daily living and, in rare cases, a request for a consultative examination.

However, assessment of the applicant's work history is not required do to the SSA's acknowledgment that an established CAL condition will not allow future work of any type. A final determination of a CAL case can take less than a month, much shorter that the SSDI process for a person with a chronic back injury, mental illness or other condition that requires substantial documentation and the likely necessity of an appeal.

Social Security Disability Advice About Serious Impairments and Other Conditions

A potential SSDI or SSI applicant who has received a medical diagnosis of a CAL condition may not be burdened with the larger challenges of other disability claims. Nonetheless, a consultation with a knowledgeable SSDI lawyer can provide answers to a host of related questions.

Many claimants have questions about the tax implications of SSDI benefits, benefits eligibility for family members and the amount of benefits a person is likely to receive. A seasoned disability benefits attorney can provide dependable answers based on each client's unique circumstances, as well as years of experience with SSA practices and processes.

Even after a successful determination of Social Security disability benefits eligibility, the SSA might need to resolve issues regarding back pay and associated workers' compensation claims before monthly benefits begin. By entrusting all aspects of the SSDI or SSI claims process to a disability law firm, claimants with serious illnesses can concentrate on their health, focus on family relationships and alleviate stress during a difficult time.