Everything You Need to Know About SSDI Compassionate Allowances

Getting approved for Social Security Disability Benefits can take anywhere from 3 to 12 months, or even longer. For some severely disabled individuals, this time frame is too long. Thankfully, the Social Security Administration created a streamlined application process for Compassionate Allowances.

The expedited handling of compassionate allowances for individuals seeking Social Security Disability Benefits can take as little as several weeks. When the compassionate allowances program started in 2008, around 50 conditions were listed as compassionate allowances. As of today, there are over 200. These conditions include acute leukemia, breast cancer, early-onset Alzheimer's disease, and even rare conditions like the Maple Syrup Urine Disease. A full list of compassionate allowances can be found on the Social Security website.

If you’re wondering how the SSA compassionate allowance list was formed, it came from a mixture of public feedback, internal discussion at Social Security and Disability Determination Services, medical experts, scientists, public outreach hearings, and the National Institute of Health (NIH). For rare diseases or rare disorders that are not yet considered CAL condition (Compassionate Allowance condition), there is even a way to submit the name of a disabling condition for consideration.

How Long Do I Have to Wait for a Decision?

If a condition you indicated on your SSDI application falls under the list of Compassionate Allowances, you will only need to wait two weeks to two months to receive your benefit payments. However, it could still take longer to receive a decision on your application, even though you have started to receive Compassionate Allowance benefit payments.

Compassionate Allowances

There are several steps to apply for SSDI, beginning with the Social Security Disability Application. Applicants for benefits will need to review the Adult Disability Checklist to see what documents they’ll need to furnish, such as medical records or pay stubs. They will then need to initiate an application either online, in person at their local Social Security Office. The application will be reviewed to make sure basic requirements have been met, such as the applicant having enough SSDI credits based on their work history prior to their condition. If approved, the application will be completed by the state’s Disability Determination Services. The SSA asserts this whole process can take 3-5 months, but it can take longer.

That’s why Compassionate Allowances are so crucial for individuals with a serious medical condition, who need assistance now. Severe genetic disorders and/or potentially terminal cancer can quickly accelerate to a point of preventing an individual from working and draining their financial resources. If for some reason the application is later denied, the family or individual receiving a monthly SSDI benefit is not required to pay back what they have collected.

Easier Application

The Social Security Disability Insurance Application is onerous enough already. Applicants hoping to collect SSDI benefits will need to provide extensive life documentation of their medical condition, financial resources, and work history. Thankfully applying for a Compassionate Allowance does not involve extra work or even filling out a separate application. In fact, the SSA will facilitate this part of the application for you.

As soon as they receive an SSDI application, the SSA looks at the medical condition and sees if it is on the Compassionate Allowances list. If the attached documentation and paperwork confirms this disease or illness, the applicant will begin receiving a monthly benefit payment within a few weeks. Keep in mind that you will still have to furnish some medical evidence or documentation of the condition in order to facilitate the SSA moving forward with a Compassionate Allowance.

Receive Payments Sooner

Compassionate allowances allow you to receive benefits sooner—but not instantly. The number of SSDI applications received by the SSA will have some bearing on how quickly your application begins to be processed, even if a medical condition on the compassionate allowance list means the process will then be expedited after the initial review of the application. Other factors might include a required medical examination or extra documentation. This is why it’s important to obtain as much complete medical documentation as you can when applying for SSDI.

The good news is that Compassionate Allowance benefits will start to be issued anywhere from 2 weeks to two months after the SSDI application has been received. Don’t wait by the mailbox for your compassionate allowance benefits to arrive by check, because the SSA issues SSDI payments electronically, either as a direct deposit to a bank account or through a unique SSA debit card. Recipients of SSDI benefits can choose which payment method works best for them.

Medicare is Excluded and Cannot Be Sped Up

Medicare is state-sponsored healthcare insurance for individuals over the age of 65. younger individuals can also receive Medicare coverage if they have been collecting SSDI for 24 months since what is referred to as the disability onset date, which in most cases is the date that you became disabled as determined by the SSA and substantiated with medical evidence and documentation of your work history. What that means is that even if you have a condition on the Compassionate Allowances list, you will not be covered by Medicare right away. However, some SSDI applicants may already be covered or be eligible for Medicaid, which is an income based state-sponsored type of health insurance.

Retroactive Pay Eligible

For the most part, cases falling under a Compassionate Allowance will find that the issue of SSDI back pay is not relevant. This is because SSDI back pay is issued for every month that the SSA takes to process an application from the time of receiving it, minus five months (which is, incidentally, on the longer end of typical processing times). In this regard, SSDI back pay will not be relevant to someone receiving a Compassionate Allowance, since even if takes the SSA two months to process their application under the expedited rules, that is still less time than the mandatory five-month waiting period all other SSDI applicants must undergo in terms of calculating benefit payments.

However, if an applicant can prove that their disability onset date was earlier than their application date, within twelve months prior to applying, that individual is eligible for retroactive pay. SSDI retroactive pay is benefit payments made to cover a disability before the applicant applied (hence its name). SSDI retroactive pay is typically provided as a one lump sum payment 60 days after your application is approved, and directly deposited into a bank account. Keep in mind that the five-month waiting period is still applicable. So for example, if an applicant’s alleged onset date (the date they assert their disability began) was January 1st, and the SSA agrees, making that date their established onset date, but it takes a year for the application to be approved, that individual can collect seven months of SSDI retroactive pay.

Consider Hiring an Attorney

You might wonder why a Social Security Disability Attorney is helpful in terms of Compassionate Allowance benefit payments. Keep in mind that to be approved for a compassionate allowance, you will still need to furnish documentation and medical records that corroborate the condition you have listed on your application. A disability lawyer can help you put together a convincing application with the documentation you need so that your Compassionate Allowance won’t be delayed.

Remember that even if you granted a Compassionate Allowance, the SSA may end up denying your case. Though you will be able to keep the Compassionate Allowance benefits payments you’ve received, you won’t get any more unless you file an appeal. Having a Social Security disability lawyer lined up and ready to go can speed up the approval process in the appeal and increase your chances of obtaining a favorable outcome.

What is Quick Disability Determination?

The Quick Disability Determination (QDD) is different from the Compassionate Allowances Initiative. While compassionate allowance conditions can overlap with QDD, the latter does not have much to do with the type of disabling condition alleged by the claimant. Instead, special software is used to identify certain disabilities that can be put on the fast track for a quicker decision.

Keep in mind that the Social Security Administration receives millions of applications every year. Even though there are over 60,000 Social Security employees nationwide, that’s still a lot of applications to process. The goal of the SSA is not to deny anyone their Social Security benefits, but they must determine that each Social Security disability claim meets Social Security’s standard for authenticity substantiated by adequate documentation.

Thankfully for the SSA, there is a computer program that assists in processing applications that can assess the statistical probability of an application having all its proverbial ducks lined up. The SSA can move this type of SSDI claim along a fast track to approval, weeding it out from the 70% of applications that won’t get approved, and the smaller percentage that will need to pass through a bureaucratic rigmarole of phone calls, letters, and examinations. If the SSA did not have this analytic tool, it would severely slow down the whole system and prevent many people from getting their SSD benefits.

The upshot of this information is that the more medical evidence you furnish up front, the better chance you have of your application getting approved quickly. If someone has a potentially terminal illness—pancreatic cancer, fibrolamellar cancer, or amyotrophic lateral sclerosis (commonly known as ALS or Lou Gehrig's disease)—providing clear and thorough objective medical information can be the difference between quick approval and months of delay. Put a little work into your application or get the assistance you need to do it because it can make a huge difference. This is especially true for those with rare diseases or rare disorders because the same analytic tool also looks at potential compassionate allowances.

Compassionate Allowances

Social Security Disability Insurance, or SSDI, is meant to provide disabled individuals who were once working with cash assistance to cover their living expenses like rent or mortgage, food, transportation, and other essentials. Unfortunately, some individuals have a serious or worsening condition and might require immediate cash assistance.

For these individuals, the SSA has started a Compassionate Allowance Program to expedite the somewhat lengthy SSDI application process. These individuals can obtain all the application benefits listed above (for example, quicker pay) just by having their indicated illness or disability align with one of the 200 or so conditions on the Compassionate Allowance list.

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Karl Rock
2 years ago

health is wealth

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