A Closer Look at Compassionate Allowances and Disability Benefits

Published on: September 30, 2020

The primary goal of Social Security disability benefits is to provide aid to disabled Americans who need it the most and in a timely fashion. While there are many different disabilities that people struggle with on a daily basis, there also are some severely disabling conditions that warrant patients to receive assistance as soon as possible. When patients have such severe impairments that they cannot wait the long time it takes to qualify for Social Security disability, “Compassionate Allowances” help expedite the process to get these dire cases their benefits as soon as possible. 

The Compassionate Allowance (CAL) program was established in 2008 by the SSA to flag dire SSDI or SSI claims in which the claimant’s medical condition is so dire that they automatically qualify for Social Security benefits. The qualifying list of Compassionate Allowances conditions includes pancreatic cancer, leukemia, and amyotrophic lateral sclerosis (ALS), to name just a few. 

A Guide To The Compassionate Allowances Program 

The Social Security Administration (SSA) keeps a list of medically disabling conditions that can allow you to immediately qualify for disability benefits. This is referred to as the Compassionate Allowances program (CAL). The SSA established CAL in response to the lengthy period that it takes for individuals to receive benefits under normal circumstances. In fact, most regular applicants for disability benefits have to wait three to four months for their applications to be approved.

This waiting period can prove costly to patients who need disability assistance the most. With Compassionate Allowances, patients who are medically diagnosed with certain severely disabling conditions can have their applications undergo expedited processing. All that is required for such patients to qualify for benefits is a medically confirmed diagnosis.

As of 2019, the Compassionate Allowances list of qualifying illnesses spans over 230 medical conditions. These conditions include cancers (liver, pancreatic, and leukemia), Primary Effusion Lymphoma, Endomyocardial Fibrosis, Hepatoblastoma, and Leigh’s Disease, among many more.

This number of qualifying medical conditions may continue to grow since the SSA is still identifying new conditions that can be submitted via its website. Additionally, the SSA continues to work closely with the National Institutes of Health (NIH), the Social Security and Disability Determination Service communities, and other medical association professionals to identify disabling conditions that warrant to be added to the compassionate allowances list. In 2019 alone, four new medical conditions were announced to be added to the list of qualifying Compassionate Allowances illnesses. 

How Compassionate Allowances Compare to Social Security Disability 

The Compassionate Allowances program is not entirely separate from Social Security disability; rather, it is a program designed to get disability benefits into the hands of the most severely impaired as quickly as possible. So, while it may take months for a typical disability claim to be processed, it will likely only take weeks - or even days -  for Social Security Compassionate Allowances to be approved. 

Disability benefits under CAL are paid out as either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. As you may know, SSDI benefits are based on a person’s work credits. This means that the amount you receive in benefits is proportional to how much you paid into Social Security while you were working. 

On the other hand, SSI is paid out to persons who have limited income and resources. People claiming SSI benefits may or may not have sufficient work credits for SSDI. The main qualification criteria are based on need as there are certain minimum amounts of income and assets that you need to have in order to qualify for SSI.

How To Apply For Compassionate Allowances

There is no separate application process that is required by the SSA for Compassionate Allowances. All applications are received and reviewed for the medical conditions that the patient reports. The SSA will then determine which applications have disabilities that qualify for CAL. In most cases, applicants only need a diagnosis of a medical condition that is on the list (that can be proved via medical records).

Typically, Disability Determination Services (local Social Security field offices or agencies that decide on disability cases) only requires basic medical information that confirms the diagnosis for a particular condition. It helps to submit medical records along with your application so the DDS doesn’t have to contact your doctor or hospital to request medical records. This can lengthen the processing time of your application, especially if your doctors take a long time to respond to requests from the SSA.

For example, various forms of cancer commonly enable someone to become eligible CAL candidates. If you’re applying for disability benefits based on a cancer diagnosis, you will typically need a biopsy report and a letter from the hospital specifying the stage of cancer as well as your symptoms.

How Long Can You Expect To Wait After Applying?

Compared to the months that it takes for regular disability applications, CAL disability cases can be processed in as little as a few days to two weeks. However, for SSDI benefits, the mandatory five-month wait period is not waived, even if your application is approved for expedited processing. Several factors will impact how fast you receive benefits, such as the number of other applications, the speed of submitted medical evidence, and any further required examinations that may delay your time to receive benefits. 

To ensure that your application is processed on time and that you get the best chance for being approved, it is important to work with experienced advocates, like Disability Experts of Florida. We can provide critical advice on the application process for SSDI and SSI and help you get the benefits that you truly deserve.

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