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Everything You Need to Know About Social Security Compassionate Allowance Programme

Everything You Need to Know About Social Security Compassionate Allowance Programme

The Compassionate Allowance List allows for accelerated clearance for certain significant and easily proven ailments.

In response to complaints about long delays in getting disability decisions, the Social Security Administration (SSA) now offers a Compassionate Allowances programme for disabled employees who have filed for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) payments.

Compassionate Allowance Programme (CAL) for Disability

The Compassionate Allowances programme expedites disability payments for applicants who have medical conditions severe enough to qualify for disability under an SSA impairment listing. The method enables Social Security to quickly target the most obviously disabled applicants and pay them promptly after they apply.

Having a disability or condition on the Compassionate Allowance list (CAL) is sufficient to get your benefits claim accepted swiftly. Medical documentation is required to support your application, but if Social Security finds that you have a Compassionate Allowance condition, you will almost always be accepted for disability benefits right away.

Fast Decisions for Seriously Disabling Impairments

If you have a Compassionate Allowance condition, the Social Security Administration will approve you for disability benefits based on a little amount of verifiable medical proof, such as a diagnosis or biopsy result. Furthermore, you might get a favourable award decision as soon as 10 days after completing your application. A compassionate allowance case at Social Security takes an average of 19 days to process.

Because medical providers may take weeks or months to transmit material to Social Security, if you have a CAL claim, a claims examiner will typically call your treating doctors, rather than writing to them, and insist on receiving the documents immediately. However, submitting medical documentation that establishes your diagnosis (such as a cancer biopsy report) with your claim might help speed up the process.

Which Conditions Qualify as Compassionate Allowance?

Many cancers, ALS, different types of muscular dystrophy and atrophy, early-onset Alzheimer's disease, and a variety of other illnesses qualify for Compassionate Allowances. A diagnosis (together with supporting evidence such as a biopsy or blood test result) is all that is necessary for some conditions to qualify for a compassionate allowance. Only a diagnosis is necessary for:

  • - Cancers of the small cell lung, prostate, or female genital tract,
  • - Esophageal cancer (carcinoma or sarcoma),
  • - Some types of pancreatic cancer, or
  • - ALS

Other conditions on the list have specific requirements about the severity of the illness; for example, malignant melanoma qualifies only if it has metastasized. Furthermore, most types of breast cancer qualify for a compassionate allowance only if the disease has progressed.

Not all severe or potentially fatal disorders are on the list; for example, AIDS is not a compassionate allowance condition (you must fulfil the high severity criterion of the HIV/AIDS listing to qualify for benefits).

Does Social Security Add to the Compassionate Allowance List?

Every year or so, the SSA adds a few ailments to the compassionate allowance list. In 2022, Social Security added 12 additional, all-rare conditions to the CAL:

  • -T-cell lymphoma with angioimmunoblastic features
  • -Dendritic Cell Blastic Plasmacytoid Neoplasm
  • -The Gerstmann-Straussler-Scheinker Syndrome
  • -Microvillus Inclusion Syndrome
  • -Syndrome Mowat-Wilson
  • -Myelodysplastic Syndrome with excess blasts
  • -Carcinoma of the NUT
  • -Types II and III Pfeiffer Syndrome
  • -Hypoplasia of the Pontocerebellum
  • -Atrophy of the Posterior Cortex
  • -Sarcomatoid Mesothelioma with Renal Amyloidosis - AL Type

What About Compassionate Allowance Waiting Period?

While the Compassionate Allowance programme expedites disability findings, SSDI claimants must still wait five months after the beginning of their ailment before they may begin receiving compensation (and 24 months after their onset date before Medicare benefits begin). This is referred to as the SSDI waiting period.

If you were disabled for at least five months before claiming for benefits, you will not have to wait for payments once Social Security recognises you. Your waiting period will have ended.

Furthermore, there is one exception to the five-month waiting period for SSDI: benefits begin immediately for ALS (amyotrophic lateral sclerosis) applicants, regardless of when they apply.

There is no waiting period for SSI recipients; benefits can begin the month after they submit their application.

Retroactive Payments for Compassionate Allowance

Compassionate Allowance money can be used to supplement SSDI or SSI benefits. SSDI recipients can get retroactive benefits, while SSI recipients cannot.

When you apply for SSDI, Social Security will check your records for evidence of your inability to work. Before claiming for disability benefits, some claimants (applicants) are handicapped for six months to a year. Individuals may be entitled for retroactive compensation beginning on the day they become disabled. They will get the full amount of "back pay" for the months between the start of their impairment and the approval of their claim (minus the five-month waiting period). 

Which Medical Conditions Qualify for TERI?
Onset Day or AOD for SSDI
 

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Wednesday, 07 December 2022