What Are SSDI “Compassionate Allowances”?

Social Security Disability Insurance is a type of insurance that covers workers who become temporarily or permanently disabled. To qualify, you need to meet certain medical and work requirements.

Typically, a worker must meet three basic criteria to be considered for Social Security Disability Insurance:

• The worker has to have a medically determinable (e.g., recognizable by a doctor) disability.
• The disability must prevent the worker from doing “substantial gainful work” (e.g., any job that pays at least $1,170 per month).
• The disability is expected to last 12 months or end in the death of the worker.

Then, after meeting the medical requirements, the worker must also meet the work requirements. (These requirements are the recent work test and the duration of work test).

However, the process is different in the SSA Compassionate Allowances program. Today, we’re going to talk about Compassionate Allowances, including what they are, how they affect your claim, and how to qualify.

What Are Compassionate Allowances?

The Social Security Administration’s (SSA) Compassionate Allowances program is designed to identify conditions that “clearly meet Social Security’s statutory standard for disability.”

The SSA determines which conditions qualify for the Compassionate Allowances program by receiving information from the public, advice from medical/scientific experts, research from the National Institutes of Health, and other sources. (To submit a condition for consideration, visit this page.)

Using this information, the SSA periodically updates the list of conditions that qualify for the program. (They added several diseases in 2018.)

What Types of Medical Conditions Are Included?

Basically, Compassionate Allowances include conditions that are so severe that they automatically qualify you for SSDI benefits. Currently, there are dozens of conditions on the list. They are primarily cancers, adult brain disorders, and rare conditions affecting children. However, not all of them fall into this category.

Here are a few of the medical conditions the SSA includes in Compassionate Allowances:

• Acute Leukemia
• Adult Non-Hodgkin Lymphoma
• Adult Onset and Juvenile Onset Huntington’s Disease
• ALS/Parkinsonism Dementia Complex 
• Cancer (Adrenal, Bladder, Breast, Kidney, Liver, Lung, Ovarian, Pancreatic, Small/Large Intestine, Gallbladder, Thyroid, Bone, etc.)
• Child Lymphoma
• Creutzfeldt-Jakob Disease
• Early-Onset Alzheimer’s Disease
• Endomyocardial Fibrosis
• Lewy Body Dementia
• Malignant Multiple Sclerosis
• Osteogenesis Imperfecta
• Pulmonary Atresia
• Tay Sachs Disease

For some conditions, a diagnosis alone is enough to qualify for a compassionate allowance. For others, the condition must meet certain criteria for severity. (Some of the cancers, for example, must have metastasized or be inoperable to qualify. Other conditions, like Osteogenesis Imperfecta, must be a certain type to qualify.)

Also, its’s important to note that not all serious conditions are on the list. In addition, the SSA expedites terminal illnesses through a different process: Terminal Illness Process (TERI). 

Here is a full list of the conditions in SSA’s Compassionate Allowances.

How Does a Compassionate Allowance Affect Wait Time?

The Compassionate Allowances program was designed to identify conditions that are so severe that applicants should receive benefits as quickly as possible. In short, this program allows the SSA to target the most clearly disabled applicants to get them benefits first.

This is important for people facing serious conditions, because the wait time for SSDI benefits can be long. The wait time for a normal SSDI claim can be several months. Further—due to a hiring freeze and a backlog of cases—if you have to appeal your claim, you may wait up to two years. (This is in addition to the required 5-month wait between the disability onset date and when you may begin getting benefits.)

However, in 2018, the average processing time for a compassionate allowance claim was just 19 days. (For the SSA, that’s practically light speed!)

If you or a loved one have a condition that qualifies for a compassionate allowance, don’t hesitate to take advantage of this program. A successful claim should get you your benefits faster. This can make all the difference when you are facing disability-related medical bills, lost wages, and other hardships.

Contact Us for Help

Employing a qualified attorney may mean the difference between a successful and a denied claim. That’s because the SSDI claims process is complex, and many people who go it alone have seen their claims denied thanks to missing paperwork, improperly filled out forms, and other mistakes. This leads to appeals and a longer wait time that might have been avoided.

At Casper & Casper, we’re here to help disabled workers get the SSDI benefits they need and deserve. Our SSDI attorneys have the experience and knowledge to get the best possible outcome for your claim.

If you have questions about filing an SSDI claim or need help filing your claim, contact us today. We’ll set up your free consultation to talk about your claim, answer your questions, and start the process.