The Compassionate Allowances (CAL) program provides a faster path toward Social Security disability benefits for those with the most serious disabilities. The program allows reviewers to quickly identify medical conditions that meet the SSA’s statutory standard for disability benefits. The expedited process helps reduce waiting time for applicants while making sure those with the most serious medical conditions can quickly be approved for the financial benefits they need.
- Get Paid Sooner
- Faster Approval
- No SeparateApplication Process
- Retroactive Payments Possible
- Available for Both SSDI and SSI
The process of applying for Social Security disability benefits is known for being time-consuming and often frustrating, often characterized by long wait times and potentially unfavorable decisions. This creates financial hardships for applicants who are unable to work because of a disability. For those with the most severe or terminal conditions, the long wait can result in additional hardships.
But in recent years, often by using advanced technology and data analysis, the Social Security Administration has been able to identify and prioritize some of the most serious medical conditions. This allows the SSA to reduce the waiting time for getting valuable financial benefits into the hands of those who need them the most. The process allows the SSA to quickly recognize injuries and medical conditions that, according to objective medical evidence, would qualify under the SSA’s Listing of Impairments. These applicants may begin receiving anticipated benefits while their applications continue through the formal review process.
There are several benefits you should understand about compassionate allowances. We’ve listed some of the most important below.
While you won’t necessarily start receiving benefits immediately, you can expect to begin receiving benefits under the Compassionate Allowance Program anywhere from a couple of weeks to two months after your initial disability claim is received and reviewed. This means you can receive valuable financial assistance while your claim moves through the full review and decision process. The best way to expedite the process is to make sure that your initial disability benefits claim is as clear and complete as possible, making it easy for the SSA to understand the full extent of your medical condition. A disability lawyer can help you make sure your application meets these criteria.
The process of applying for SSDI or SSI benefits is well known to be lengthy and often frustrating. To reach a decision, SSA reviewers must examine countless pieces of medical documentation and evidence, and the review process often takes 6-12 months, sometimes longer. However, with Compassionate Allowances, you can expect to be approved for benefits fairly quickly while your disability claim goes through the remainder of the review process.
In some cases, benefits may be denied, even after a claimant has begun receiving a compassionate allowance. When this happens, the claimant is not required to return any of the benefits already received. If you disagree with the decision, you may want to hire a qualified disability attorney who can help you appeal a denial.
One of the CAL program’s most attractive qualities is that you don’t need to apply for it separately – whether you’re applying for SSDI or SSI benefits. Your claim is automatically considered for the Compassionate Allowances program in the earliest stages. In fact, one of the first things a reviewer will do is compare your claim to the SSA’s list of disabilities that are eligible for Compassionate Allowances.
If your claim shows a qualifying medical condition, you may begin to receive benefits while your disability claim remains under full review. SSA reviewers examine each claim to see if it contains language flagged as eligible for the CAL program, so there’s no need to indicate that you’d like your file to be considered.
As part of its standard review, the SSA will consider how long a claimant was disabled before their claim was reviewed. In cases where the claimant has been disabled longer than the required five-month waiting period, the SSA may award retroactive payments that cover the time period before the disability claim was submitted.
Compassionate allowance options are available for both SSDI and SSI claims. It’s important to remember that the Compassionate Allowance Program doesn’t exist separately from SSDI and SSI. Instead, the CAL program allows for an expedited process as claims are considered for either program.
Even if your illness is on the list for Compassionate Allowances, keep in mind that all other eligibility rules still apply. For SSDI, that means earning enough work credits. For SSI, that means meeting income and asset requirements.
Remember that your disability claim must clearly show that your medical condition warrants disability benefits. All the same eligibility rules for both programs remain in place – Compassionate Allowances simply provides a different path for consideration. The CAL program allows for you to receive compensation while your claim moves through the full review process, rather than having to wait until the end of the SSA’s review.
The Social Security Administration has invested countless hours of research to determine which conditions are included in the Compassionate Allowance Program. The administration has gathered input from the public through various outreach meetings, from medical and scientific specialists, and through research conducted in partnership with the National Institutes of Health. The list is frequently updated – the SSA continues to take input on conditions that should be added to its list.
To date, the SSA maintains a listing of more than 200 medical conditions that qualify for compassionate allowances. Some of the most common medical conditions that qualify are specific genetic disorders, Adult Non-Hodgkin Lymphoma, and forms of cancer like pancreatic or lung cancer, especially when they are terminal. In some cases, the SSA has identified specific parameters for eligibility around a particular disease or medical condition. For example, breast cancer must be in stage IV or have metastasized to qualify for Compassionate Allowances.
If your specific medical condition isn’t currently on the SSA’s listing, you can submit it for CAL consideration through the SSA’s website. You should take this step if you believe your condition is severe and pervasive enough to meet the SSA’s criteria for Compassionate Allowances. If you’re working with a qualified disability attorney, your lawyer can also help with this process. Since the CAL program is designed to funnel benefits to the claimants who need them urgently, only the most severe medical conditions will make it into the SSA’s listing.
The process of applying for Social Security disability benefits can take a long time. With the traditional review process, you may have to wait anywhere from six months to a full year before you hear a decision regarding your claim. And that doesn’t include the appeals process if your initial disability claim is denied. That’s why expedited review programs like the Compassionate Allowance program are so important. For some of the most severe, and sometimes terminal, medical conditions, the CAL program can reduce wait times down to as soon as a few weeks.
The Compassionate Allowance Program isn’t the only fast-track program available for claimants seeking Social Security disability benefits. There are also Quick Disability Determinations, which uses a computer-based predictive model, as well as Presumptive Disability payments for SSI claims.
There is also the Quick Disability Determinations program, which uses predictive modeling to identify applications with the highest probability of being approved, based on the available medical evidence.
Since 2008, the QDD process has helped identify priority claims for expedited processing. Once these files are identified through the predictive modeling program, they are routed to a Quick Disability Determination group for review and determination. In many cases, a disability benefits claim could receive a decision as quickly as 15 to 20 days after submitting the initial claim.
The Social Security Administration may also expedite the process for patients with medical conditions believed to be terminal – defined by the SSA as “a medical condition that is untreatable and expected to result in death.” Terminal illness, or TERI, cases are expedited during each stage of the SSA review, and reviewers are trained extensively to recognize and flag specific descriptors within a claim that may indicate that the medical condition is terminal. Once a claim is flagged as potentially TERI, it is expedited for review, ideally no later than the next business day.
When it comes to SSI benefits, the Social Security Administration may grant immediate, temporary payment of disability benefits under the Presumptive Disability program. This descriptor applies to claims of disabilities so serious that the applicant generally is “presumed” to qualify for disability benefits.
Approved presumptive disabilities may include conditions like Down syndrome, amputation of a limb, total blindness or deafness, spinal cord injuries, end-stage renal disease, cerebral palsy, and several others. As long as an applicant meets the non-medical qualifications for SSI benefits, they may receive presumptive benefits payments for up to six months as their claim completes the full review process.
If you’re dealing with a severe medical condition that you believe may qualify you for Compassionate Allowances, it’s important to understand the full process and what you can expect once you can submit your claim.
The information presented here can help give you a broad idea of how the process works, along with a general understanding of whether your particular claim may apply. However, to ensure your claim meets the expedited program’s requirements, it’s always a good idea to have a qualified and knowledgeable disability attorney examine your claim.