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SSDI Compassionate Allowances program assists seriously ill applicants

Applications of those with illnesses so severe they are automatically considers disabling are processed faster under this program.

 

It is well known that the application process for Social Security Disability Insurance can be long and arduous, especially for severely disabled claimants who are financially strapped because they are unable to work while having to live with the symptoms of serious or fatal illness or injury.

In response to criticism, the Social Security Administration created the Compassionate Allowances program or CAL that expedites agency processing of initial applications when applicants have diseases or medical conditions considered so severe that acceptable proof of diagnoses is sufficient for approval (assuming work history requirements are also met).

According to SSA, CAL decisions are reached "in a matter of weeks instead of months or years." The Montgomery Advertiser reports that as of September 2015, there were 200 CAL-recognized conditions and that since October 2008, almost 200,000 claimants had been approved through the CAL process.

CAL conditions have been chosen as most likely to meet the SSA's definition of disability, which is a severe medical impairment or combination of impairments expected to last at least one year or result in death and that prevents the person from working. SSA held a series of seven public hearings, each focusing on a certain family of illnesses to gather information about likely CAL conditions and also consults with advocacy organizations, medical experts and government agencies. According to the agency website, it plans to continue to expand the list of CAL conditions.

CAL impairments mostly fall within certain categories:

  • Rare diseases like Aicardi-Gourieres syndrome or Angelman syndrome
  • Cancers like acute leukemia, gallbladder cancer, pancreatic cancer or kidney cancer
  • Heart conditions like being on a heart transplant wait list
  • Significant mental impairments like certain dementias and schizophrenia
  • Autoimmune diseases like stiff person syndrome
  • Traumatic brain injury and stroke
  • Others like idiopathic pulmonary fibrosis or malignant multiple sclerosis

CAL is not a separate or special application. Rather, the agency flags for fast tracking the regular applications of claimants with CAL conditions.

It can be game changing to involve the help of an SSDI attorney at the application stage. For those with conditions that qualify for the compassionate allowance program, the sooner the SSA has objective medical evidence of the illness or injury, the faster it can be considered for accelerated processing. A lawyer will understand the type of evidence the SSA requires and can help develop the medical evidence by requesting treating doctor support or consultative examinations.

Legal counsel can also communicate with the agency on the client's behalf, especially if the application should be flagged for compassionate allowance treatment. Should the initial application be denied, the attorney will provide guidance about the appeals process and take care to meet deadlines.

It is not unusual for initial applications to be denied and for benefits to be awarded at one of the later stages of review or appeal, but this is probably less likely for a compassionate allowance case if the supporting evidence is in the file since medical evidence alone should be enough without otherwise required information about education, work history and skill.

Conveniently located in Santa Ana, Downey and Ontario, California, the lawyers of Judith S. Leland, APLC, represent SSDI claimants in Southern California at all stages of the initial application, agency appeals process and federal court review.