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The Social Security Administration’s Compassionate Allowance List

Like many social security disability applicants, one of your biggest frustrations with the system is how long it takes to reach a decision.  Especially if this is not your first application for disability benefits.  You might wonder if it takes this long for everyone.  The answer is no.  There are some medical conditions that are so serious that anyone who suffers them will unmistakably meet a listing for disability benefits.  For these types of medical conditions, the Social Security Administration gives these applicants a fast track for their applications as a “compassionate allowance.”

How It Works

The Social Security Administration grants compassionate allowances for certain diseases and other medical conditions.  These conditions are granted compassionate allowance because they can be identified as meeting the criteria for one of the Listings of Impairments from even minimal objective medical information.  The ability for Social Security disability examiners to quickly obtain objective medical information that shows a person meets an impairment Listing permits the examiner to grant disability benefits on short notice.  As a result, disability applicants with medical conditions that are eligible for a compassionate allowance may receive a decision on their disability claim in a matter of weeks, as opposed to years for ordinary applications.

The compassionate allowance program is an ordinary part of the Social Security Administration’s disability and disability insurance programs.  Social Security Administration representatives determine which conditions should be added to the compassionate allowance program based on public input.  This input comes from National Institutes of Health (“NIH”) research, advice from medical and scientific experts, information from advocacy groups, and information from public outreach hearings held by the Administration.  These outreach programs are held through teleconferences and webinars.  The Social Security Administration states it is not planning on holding additional hearings over the near future (at least through Fall of 2016) due to budget constraints.  The Social Security Administration states that they are working with the NIH to identify certain medical “tipping points” that will pinpoint when an impairment will meet a listing with certainty based solely on medical data.

Specific Conditions

Medical conditions that meet the requirements for consideration as a compassionate allowance include certain forms of rare diseases, cancers, traumatic brain injury, severe strokes, early-onset Alzheimer’s disease and related dementias, cardiovascular diseases coupled with multiple organ transplants, certain types of schizophrenia, and certain types of autoimmune diseases.  A list of these medical conditions can be found here.

While the compassionate allowance program does speed up the application process, the Social Security Administration does not take many steps to provide noticeably special treatment for these applications.  The Social Security Administration does not provide any special applications or forms that an applicant can fill out for special considered under the compassionate allowance program.  Instead, people with debilitating medical conditions that are on the compassionate allowance list are still expected to apply for the same disability and disability insurance programs as all other disability applicants.

While the Social Security Administration will internally place a rush on people with medical conditions designated compassionate allowance program, the SSA will not even notify applicants if their claim is selected for fast-tracked review and processing.  Instead, the SSA will only contact the applicant if the Administration needs additional medical evidence and/or once it has made a final decision on the applicant’s claim.  Finally, and most basically, the Social Security Administration does not pay any extra benefits above the standard rate to applicants who are eligible for the compassionate allowance program.  A faster review period does lead to an earlier granting of disability benefits.  Still the applicant only receives the same amount of assistance that others receive under the Social Security Disability Insurance and Supplemental Security Income disability programs.

One step the Social Security Administration has taken to assist compassionate allowance program participants is to reduce the paperwork requirements they face.  The SSA determined in 2011 that people suffering conditions that are eligible for compassionate allowances should not need to fill out all the information required for the work and education history sections of the application.  Work and education information are required for determinations at later steps of the disability review process.  At the later steps, a Social Security disability decision maker analyzes the applicant’s medical impairments, past work history, and other criteria to determine the applicant’s ability to perform the same or similar jobs.  Since a Social Security disability applicant would be eligible for a compassionate allowance based upon the severity of their medical condition, the information required to make decisions at a later part of the process is not likely to be relevant.

The Social Security Administration also states that they are performing more outreach work with certain disease-oriented groups to make information about the program more broadly available.  The SSA states that they are working with many disease-oriented organizations to determine how to improve the disability application process for people suffering from debilitating medical conditions.  The SSA also states that it is working with a number of organizations so the organizations themselves can prepare lists of frequently asked questions to help potential Social Security disability applicants.

Timing

The actual time it takes a Social Security Administration representative to complete review of a claim that is eligible for a compassionate allowance varies based on a number of factors.  The most important of these is the amount of time it takes for the SSA representative to get information from your medical sources.  These sources include doctors’ and psychiatrists’ opinions, medical test results, medication lists, and other medical records.  This is an area where your Social Security disability attorney can be of value even when the disability application process will be abbreviated.  Another relevant factor for the length of time it takes to review your application is whether additional medical examinations are needed to obtain sufficient evidence to support your claim.  Finally, if the Social Security Administration randomly selects your application as part of their quality assurance review process, this will certainly add additional time to resolution of your application.  While your Social Security disability attorney can do little about this type of delay, their ability and experience working with government administrators can keep you informed about your application’s progress.

If you or someone you know suffers from a truly debilitating medical impairment that could qualify for a compassionate allowance, be sure to contact a Social Security disability attorney promptly to be sure government benefit payments can be made where they are needed as soon as possible.