Compassionate Allowances: What You Need to Know
Updated August 4, 2022 Social Security Disability
In 2008, the Social Security Administration launched the Compassionate Allowances initiative to quickly identify medical conditions that meet the rigorous standards for Social Security Disability Insurance benefits. This allows the SSA to provide disability benefits as quickly as possible.
6 Facts About Compassionate Allowances
- Speeds Up Approval Process
- Fewer Forms to Fill Out
- More Than 200 Disabilities Qualify
- Receive Payments Sooner
- Back Pay Possible If Application is Delayed
- A Disability Attorney Can Help
Many types of cancers, adult brain disorders, and several rare childhood medical conditions fall into this category. The program helps fast track benefits to those with the most urgent and serious medical disorders who have applied for SSDI or SSI benefits.
If you think you might be eligible for Social Security disability benefits, compassionate allowances may be a way to speed up your approval process and help you receive your benefits as quickly as possible.
When applying for Social Security disability benefits, the process is highly detailed, laborious, and often frustrating. Many disability claims are denied upon first review and must go through the appeals process before a claimant can receive benefits.
But some medical disorders are immediately eligible for Social Security disability benefits – when this is the case, the SSA can quickly decide in favor of disabled individuals under the umbrella of compassionate allowances.
The SSA uses the same criteria when judging a claim for compassionate allowance as when reviewing an application for Social Security Disability Insurance or Supplemental Security Income claims. The Compassionate Allowances initiative allows the SSA to quickly get resources to claimants whose conditions clearly and definitively meet disability insurance standards. There are no additional Compassionate Allowances forms to fill out – if your disability claim meets the right criteria, it is automatically expedited with no extra effort on your part.
Waiting for a Decision
For applications going through the detailed, sequential 5-step process the SSA uses to determine which claimants merit disability benefits, the typical wait time can be anywhere from a few months to a year or more. The process is thorough and rigorous, which simply takes time. This is especially true for applications that are denied during the first round of review and must go through the appeals process – which is what happens to most applications that the SSA receives.
When a Social Security disability claim is denied, a whole new process begins, which stretches the timeline even further. Recognizing that the substantial wait time can be an unnecessary burden to those with the most urgent and debilitating health conditions, the SSA has developed a couple of different options to help fast track applications and get disabled citizens the benefits they need and deserve as quickly as possible.
The first of those fast track options is the Compassionate Allowances program. To determine whether compassionate allowance applies, the SSA identifies cases in which objective medical information clearly meets SSA standards for SSDI benefits. Compassionate allowance decisions usually come fairly quickly. If you believe you qualify and you haven’t heard anything about your application after about a month, it might be a good idea to check with your local SSA field office about your status. This also might be a good time to consider engaging a disability attorney to help guide you through the rest of the process.
Don’t lose heart if your application isn’t granted an SSA compassionate allowance. That simply opens the door to an alternate fast track program – Quick Disability Determination (QDD). The QDD helps applicants with obvious disabilities, but whose conditions don’t qualify for a compassionate allowance.
Navigating between these two processes is yet another area where you may get tremendous value from working with a disability lawyer. In addition to these two processes, the SSA has also instituted a Terminal Illness Program that allows for accelerated disability benefits for terminal patients, along with a presumptive disability program, which doesn’t necessarily speed up the approval process but does allow for a claimant to receive payments while the application is under review.
6 Things to Know About Compassionate Allowances
Let’s look a little more closely at several important facts about Compassionate Allowances.
1. Speeds Up Approval Process
The Social Security disability benefits process is known for being lengthy and often frustrating, sometimes taking a year or more for a final decision. But if you qualify for a compassionate allowance, your application enters an expedited process. In recent years, some applicants have received their Social Security disability decisions in as little as 19 days.
This allows claimants and their families to begin receiving funds as soon as possible while the rest of their application is reviewed. In fact, the compassionate allowance process is so fast that in some cases, a claim can be denied later in the process. When this happens, the claimant is not required to pay back any of the previous benefits received.
2. Fewer Forms to Fill Out
It might sound like getting a compassionate allowance requires filling out additional forms – but that’s not the case. You don’t have to fill out anything at all to qualify for a compassionate allowance. You simply follow the standardized SSA process for submitting your disability claim. The very act of claiming a compassionate allowance condition included on the list automatically puts your application on a fast track for approval. One of the very first steps in the process is for an SSA reviewer to consult the list of medical conditions and disabilities that qualify for compassionate allowances.
If the paperwork provided with your application can document that your condition matches one of the approved medical disorders, you can begin receiving payments as soon as possible. For example, you might submit positive biopsy results to show that you have a diagnosis for a certain type of cancer. It typically takes much less medical documentation to show that a condition qualifies – in some cases, rather than waiting for medical professionals to send requested documentation, an SSA reviewer may simply call your health care provider to discuss your case, which can dramatically accelerate the process.
3. More Than 200 Disabilities Qualify
The Compassionate Allowances List is the SSA’s running list of more than 200 disabilities and health conditions that can immediately qualify for a compassionate allowance. Some types of cancer appear on the list, such as pancreatic cancer, breast cancer, or esophageal cancer, along with musculoskeletal disorders like ALS or other forms of muscular dystrophy.
In some cases, a health condition must be significantly debilitating to immediately be approved for fast track benefits. In those cases, a diagnosis alone isn’t enough to guarantee approval; a level of severity must also be shown. For example, when it comes to breast cancer, a stage IV or a metastasized diagnosis would qualify for compassionate allowance. When your application can show that you are suffering from a condition on the Compassionate Allowances List, your claim can be fast-tracked and approved.
If you have a condition that isn’t on the Compassionate Allowances List but that you believe is severe enough to qualify, the SSA also allows you to submit recommendations for additional conditions. So just because your condition isn’t listed today doesn’t mean it won’t eventually be approved.
4. Receive Payments Sooner
We’ve already explored how much faster it is to receive a compassionate allowance than to wait for the entire Social Security disability review process to be complete. While it would be nice to say that payments begin immediately, that isn’t always the case. But most applicants will begin to receive funds within just a few weeks, and in some cases, the longest they may have to wait is about two months. In fact, that’s the whole point of the process and where the “compassion” comes into play – the SSA doesn’t want claimants with debilitating conditions who legitimately can’t work to have to go for a long time without receiving the disability benefits they deserve.
5. Back Pay Possible If Application is Delayed
If your application for disability benefits is approved, the SSA reviewer will also look back at how long your medical condition or severe disability has prevented you from being able to earn a living. After subtracting a standard 5-month waiting period from the time the disability began, the SSA can choose also to provide SSDI back pay to cover the time between the onset of the medical condition and the approval of your claim. A good disability lawyer can help you through this part of the process, if necessary.
6. Hiring a Disability Attorney Can Help
The disability benefits application process can be complex and cumbersome – if it feels especially daunting to you, you may benefit from seeking expertise early on from a disability attorney. A legal advisor can be a tremendous resource during the entire process, helping organize documentation, complete applications, and advise on appropriate medical evidence to provide. If your original claim is denied, a disability attorney can be an invaluable guide through the appeals process.
Understanding Compassionate Allowances
Every year, thousands of Americans develop medical conditions and disabilities that prevent them from working – which makes them eligible to receive Social Security disability benefits. While the process to be approved for Social Security benefits is often laborious and time-intensive, certain health conditions qualify for a faster review process. When health conditions are urgent and severe enough to clearly meet standards for disability benefits, the Compassionate Allowances Initiative can help expedite the process and get you the benefits you deserve much more quickly.
This Compassionate Allowances program allows the SSA to focus on Americans who are most severely and urgently in need of support to compassionately expedite the determination process for benefits. If you think you might qualify for a compassionate allowance, make sure to do some additional research and consider reaching out to a disability lawyer for counsel. It could mean the difference between waiting for months and getting the support you need within days.
Compassionate Allowances List 2020
Some disabilities qualify for a “compassionate allowance,” which will help you cut the red tape and jump to the head of the line, in regard to the medical evidence requirements. Initially, it listed 50 diseases and other medical conditions—primarily neurological disorders, cancers and rare diseases—that qualify for “fast track” SSD benefit decisions in just days instead of months. Later, the list was expanded to 88 conditions, then to 100, and then again to 113. Now 233 conditions qualify for compassionate allowance fast-tracking.
If your disability is on the list, be sure to let the SSA know about it when you apply for SSD benefits or when you contest a denial. Point out on your document that you have a medical condition that qualifies for a Compassionate Allowance. Here is the most recent list. Note that some illnesses have been renamed. In the list below Hurler Syndrome is now MPS I, Hunter Syndrome is now MPS II, and Sanfilippo Syndrome is now MPS III.
Adrenal Cancer – with distant metastases or inoperable, unresectable or recurrent
Adult Onset Huntington Disease
Alexander Disease (ALX) – Neonatal and Infantile
Alpha Mannosidosis – Type II and III
ALS/Parkinsonism Dementia Complex
Amegakaryocytic Thrombocytopenia
Amyotrophic Lateral Sclerosis (ALS)
Anaplastic Adrenal Cancer – Adult with distant metastases or inoperable, unresectable or recurrent
Astrocytoma – Grade III and IV
Atypical Teratoid/Rhabdoid Tumor
Bilateral Optic Atrophy- Infantile
Bladder Cancer – with distant metastases or inoperable or unresectable
Breast Cancer – with distant metastases or inoperable or unresectable
CACH–Vanishing White Matter Disease-Infantile and Childhood Onset Forms
Carcinoma of Unknown Primary Site
Caudal Regression Syndrome – Types III and IV
Cerebro Oculo Facio Skeletal (COFS) Syndrome
Cerebrotendinous Xanthomatosis
Child Neuroblastoma – with distant metastases or recurrent
Chondrosarcoma – with multimodal therapy
Chronic Idiopathic Intestinal Pseudo Obstruction
Chronic Myelogenous Leukemia (CML) – Blast Phase
Cornelia de Lange Syndrome – Classic Form
Creutzfeldt-Jakob Disease (CJD) – Adult
Early-Onset Alzheimer’s Disease
Ependymoblastoma (Child Brain Cancer)
Farber Disease (FD) – Infantile
Fibrodysplasia Ossificans Progressiva
Follicular Dendritic Cell Sarcoma – metastatic or recurrent
Frontotemporal Dementia (FTD), Picks Disease -Type A – Adult
Fukuyama Congenital Muscular Dystrophy
Fulminant Giant Cell Myocarditis
Galactosialidosis – Early and Late Infantile Types
Glioblastoma Multiforme (Brain Cancer)
Head and Neck Cancers – with distant metastasis or inoperable or unresectable
Heart Transplant Graft Failure
Heart Transplant Wait List – 1A/1B
Hemophagocytic Lymphohistiocytosis (HLH) – Familial Type
Hutchinson-Gilford Progeria Syndrome
Hypocomplementemic Urticarial Vasculitis Syndrome
Hypophosphatasia Perinatal (Lethal) and Infantile Onset Types
Hypoplastic Left Heart Syndrome
Infantile Free Sialic Acid Storage Disease
Infantile Neuroaxonal Dystrophy (INAD)
Infantile Neuronal Ceroid Lipofuscinoses
Inflammatory Breast Cancer (IBC)
Intracranial Hemangiopericytoma
Jervell and Lange-Nielsen Syndrome
Junctional Epidermolysis Bullosa – Lethal Type
Juvenile Onset Huntington Disease
Kidney Cancer – inoperable or unresectable
Krabbe Disease (KD) – Infantile
Large Intestine Cancer – with distant metastasis or inoperable, unresectable or recurrent>
Late Infantile Neuronal Ceroid Lipofuscinoses
Liposarcoma – metastatic or recurrent
Lymphomatoid Granulomatosis – Grade III
Malignant Brain Stem Gliomas – Childhood
Malignant Gastrointestinal Stromal Tumor
Malignant Renal Rhabdoid Tumor
Medulloblastoma – with metastases
Megacystis Microcolon Intestinal Hypoperistalsis Syndrome
Megalencephaly Capillary Malformation Syndrome
Menkes Disease – Classic or Infantile Onset Form
Merkel Cell Carcinoma – with metastases
Merosin Deficient Congenital Muscular Dystrophy
Metachromatic Leukodystrophy (MLD) – Late Infantile
MPS I, formerly known as Hurler Syndrome
MPS II, formerly known as Hunter Syndrome
MPS III, formerly known as Sanfilippo Syndrome
Multicentric Castleman Disease
Myoclonic Epilepsy with Ragged Red Fibers Syndrome
Neurodegeneration with Brain Iron Accumulation – Types 1 and 2
Niemann-Pick Disease (NPD) – Type A
Oligodendroglioma Brain Cancer- Grade III
Ornithine Transcarbamylase (OTC) Deficiency
Orthochromatic Leukodystrophy with Pigmented Glia
Osteogenesis Imperfecta (OI) – Type II
Osteosarcoma, formerly known as Bone Cancer – with distant metastases or inoperable or unresectable
Ovarian Cancer – with distant metastases or inoperable or unresectable
Pelizaeus-Merzbacher Disease-Classic Form
Pelizaeus-Merzbacher Disease-Connatal Form
Peripheral Nerve Cancer – metastatic or recurrent
Peritoneal Mucinous Carcinomatosis
Primary Central Nervous System Lymphoma
Progressive Multifocal Leukoencephalopathy
Progressive Supranuclear Palsy
Prostate Cancer – Hormone Refractory Disease – or with visceral metastases
Retinopathy of Prematurity – Stage V
Rhizomelic Chondrodysplasia Punctata
Severe Combined Immunodeficiency – Childhood
Skin Malignant Melanoma with Metastases
Small Cell Cancer (Large Intestine, Prostateor Thymus)
Small Cell Cancer of the Female Genital Tract
Small Intestine Cancer – with distant metastases or inoperable, unresectable or recurrent
Soft Tissue Sarcoma – with distant metastases or recurrent
Spinal Muscular Atrophy (SMA) – Types 0 and 1
Spinal Nerve Root Cancer-metastatic or recurrent
Stomach Cancer – with distant metastases or inoperable, unresectable or recurrent
Subacute Sclerosing Panencephalitis
Superficial Siderosis of the Central Nervous System
Tay Sachs Disease – Infantile Type
Thanatophoric Dysplasia – Type 1
Transplant Coronary Artery Vasculopathy
Ullrich Congenital Muscular Dystrophy
Ureter Cancer – with distant metastases or inoperable, unresectable or recurrent
Ventricular Assist Device Recipient – Left, Right, or Biventricular
X-Linked Lymphoproliferative Disease
From time to time, other medical conditions are added to the list.
