What is the Compassionate Allowance Program?
The Social Security Disability program provides monthly benefits to individuals who are unable to return to work for at least 12 months due to a medical condition, or who have a terminal condition. The process for applying for and getting approved for Social Security Disability (SSDI) benefits can be quite long. While it takes about 3 months to receive a response to an initial application, relatively few applications are approved after in the initial review. The vast majority of applications go through at least one appeal, and some must go through additional levels of appeal before they are approved. In fact, it is not unheard of for months or even years to pass before an application is approved. Some applications, of course, do not ever get approved. Recognizing that there some case that need immediate attention, the Social Security Administration (SSA) created the Compassionate Allowance Program (CAL). The Compassionate Allowance Program expedites the application process where the applicants suffer from certain diseases or conditions.
Fast Track Process
In order to qualify for the Compassionate Allowance Program, an applicant must suffer from one of the diseases or conditions on the compassionate allowances list. There is no separate, special application or form to complete. An application will automatically be put into CAL if it qualifies. If an application is processed under CAL it can be approved within a matter of a few weeks instead of months or years. However, in order for an application to be processed and approved as quickly as possible under the program, the applicant must complete the forms correctly and must supply appropriate medical evidence of the condition. Applications which are incomplete will be delayed. Seven percent of initial CAL applications are denied.
Conditions Eligible for the Program
When the CAL program was introduced in 2008 there were 50 conditions and diseases on the list. As of December 6, 2012, there are 200. The most common CAL diagnoses are lung cancer, breast cancer, pancreatic cancer, colon cancer, and liver cancer. In order for a condition to be added to the program the SSA considers input from medical and scientific experts, input from SSA officials, research from the National Institutes of Health, information from public outreach hearings. The public outreach hearings have been critical in determining that certain conditions should be on the program’s list. The first seven outreach hearings resulted in traumatic brain injury, stroke, early-onset Alzheimer’s disease and related dementias, schizophrenia, cardiovascular disease, multiple organ transplants and autoimmune diseases being added to the list. Based on continued input from medical and scientific communities as well as from the public, the SSA plans to add new conditions to the list annually.
While the Compassionate Allowances Program is a positive effort for people who are in dire need of benefits, many applicants who are not eligible for the Compassionate Allowances Program are also suffering and unable to work. As a result they experience financial distress as they await approval from the SSA. What changes should the SSA consider that would speed up the processing of all applications?