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SSA applicants’ wait time reduced by expanded Compassionate Allowances list

Last year, the Social Security Administration (SSA) added 12 more conditions to its Compassionate Allowances Program list (CAL) which affects individuals who are applying for disability benefits from Social Security Disability Insurance (SSDI) or Supplemental Security Income Programs (SSI).

The latest additions to the CAL brought the total number of serious disabilities listed to 278. This is significant for persons diagnosed with disorders named on the CAL, because the SSA expedites the lengthy claims process due to the severity of the illnesses. It is understandable that time is of the essence when an adult or a child is suffering through a debilitating or life-threatening condition.

It is important to note that an individual must have a disability to be eligible for SSDI, but having a disability is only required to be eligible for SSI if the individual is not blind or age 65 or older. If the individual is blind or age 65 or older, he or she may qualify for SSI without having a disability. Additionally, SSDI is tied to one’s work history, whereas SSI depends on one’s assets and income. An individual may be “concurrently” eligible for benefits under both the SSDI and SSI programs at the same time. Since Texas is an SSI/Medicaid linked state, eligibility for SSI automatically qualifies one for Medicaid, however, many are bewildered to learn that eligibility for SSDI only qualifies one for Medicare two years later. Although the severity of any one of the conditions on the CAL requires immediate monetary support through SSDI, one must still wait two years to receive health insurance through Medicare.

There is no difference in the application process. However, when the agency receives a claim with one of the listed conditions, it’s fast tracked through the system in order to provide a determination within weeks rather than months or years. The benefits received as a result can make a world of difference to the disabled person’s quality of life and care.

No one plans to have a catastrophic illness, like congestive heart failure or Alzheimer’s Disease. Yet, when disability strikes, it usually takes a huge toll on a person’s or family’s time and finances. For instance, an adult child quits her job to stay home and care for an ill parent; or an employed person who has had a heart attack can often no longer work, and therefore can’t pay his bills. These are just two examples of an incapacitating illness’s numerous consequences.

The agency determines which ailments to include on the CAL by researching the National Institutes of Health and conducting public outreach hearings. Additionally, anyone can submit the name of a condition for consideration to be placed on the CAL through the SSA website. Using the comments collected from them and medical and scientific experts’ advice, the agency expands the list as necessary.

Though many of the illnesses listed by the CAL are rare, like Joubert Syndrome, a genetic disorder affecting intellectual and developmental capacities, others on the list include Leukemia, Non-Hodgkin Lymphoma, Pancreatic, Ovarian and Prostate cancers, and dementia associated with Alzheimer’s, Parkinson’s and Huntington’s diseases. To see the full list, visit https://www.ssa.gov/compassionateallowances/conditions.htm.

In addition to the CAL, the agency fast tracks applications from veterans considered 100 percent disabled by the Department of Veterans Affairs. SSA benefits, including SSDI and SSI, for vets are awarded in addition to disability compensation awarded by VA.

When time is of the essence, expert legal advice could make an important difference in the speed and efficiency of the SSA’s determination. Receiving these vital benefits can improve the care of a person suffering from a devastating illness.

Nothing contained in this publication should be considered as the rendering of legal advice to any person’s specific case but should be considered general information.