Last year in 2021, during the height of the Coronavirus Pandemic, Acting Social Security Commissioner Kilolo Kijakazi announced the addition of twelve new conditions to the expedited Compassionate Allowances List (CAL). This is good news to residents of the greater Memphis metro area and the mid south region of Mississippi, Arkansas and Louisiana. Mr Heermans, of Heermans Social Security Disability Law Firm, says that he has helped several families with loved ones suffering with these newly added conditions. Mr. Heermans also says, fortunately the new expedited application process has helped shorten the social security response time for these disability applications.
“Everyone who is eligible for benefits under the programs we administer should receive them,” Kijakazi said. “Our Compassionate Allowances program helps us address barriers by helping accelerate the disability application process for people who are likely to get approved for benefits due to the severity of their medical condition,” she added. The rare disorders on the CAL often affect children, she emphasized.
About 700,000 people have received benefits through the CAL program.
Qualifying for CAL
Usually, initial SSDI determinations take several months. The initial answer for standard disability applications is often, no – not approved. CAL initial determinations usually take several weeks. Furthermore, the initial answer is typically – yes, if the applicant meets the basic qualifications.
Since the CAL process is rushed, the qualifications in addition to the diagnosis are generally few. Disability Determination Services officers usually just fast-track CAL applications.
They do look for a recent diagnosis of a listed condition. Recency is a balance. If the diagnosis is too old, the DDS officer usually asks for confirmation. If the diagnosis is too new, a waiting period may apply. As of August 2022, about 250 conditions are on the CAL. So, it’s way too long to reprint here and can be found on the Social Security Administration website.
About fifty kinds of cancer are on the list. The others are extremely rare conditions. In either case, the medical outlook is generally bleak. Although cancer survival rates have shot up since the 1990s, being stricken with cancer still has a very high fatality rate – even if treated. Extremely rare conditions, like neonatal ALX, Congenital Zika Syndrome, Gerstmann-Straussler-Scheinker Disease, and Mixed Dementias, are difficult or impossible to treat. Expedited SSDI approval gives these people much-needed benefits, and perhaps more importantly, some much-needed good news that financial support is on its way. This is often the boost that family and friends need during the beneficiary’s last days or months.
We mentioned the recency qualification above. Severity is a related qualification. If the disease is advanced or the cancer is metastasizing, CAL expedited approval is more likely.
Medical misdiagnosis sometimes comes into play as well. Rare conditions, like X-Linked Lymphoproliferative Disease and Hydranencephaly, are difficult to diagnose. If delayed diagnosis made a condition essentially untreatable, a Social Security Disability attorney may consider filing an injury claim against the doctor. Physicians have a great deal of experience and training, and as the old saying goes, with great power comes great responsibility. This is especially true in the medical field when it comes to a cancer diagnosis.
The Application Process
Most SSD applicants must have a listed condition or a substantially similar condition. Almost half of approved SSD applications are in that second category. However, CAL conditions must be listed conditions. There’s no substantially similar loophole.
Technically, the CAL application process is no different from the regular application process. The SSA uses processing software that spots keywords and moves applications onto the CAL track or the regular processing track. No computer software is perfect. The people who operate this software aren’t perfect either. This is why the power of a Heermans disability lawyer is so important to anyone applying for social security disability benefits. They ensure that an application is on the right track, and stays on the right track. This is especially important since the Covid-19 boom in disability applications.
The same basic qualifications apply. The applicant must have sufficient work credits to qualify and the condition must be disabling according to the SSA. This qualification does not apply to children.
In terms of work credits, most CAL and non-CAL applicants must have at least twenty recent work credits (forty overall). Most full and part-time workers accumulate about four credits a year. Different work credit rules do apply to disabled children and a few other applicants. The qualifying disability requirements are:
- Not “Working:” We put quotation marks around the W-word because it has a specific meaning in this context. The SGA (substantial gainful employment) cutoff is usually $1,350 a month. In other words, many people are working but not “Working” – according to the income guideline, if that makes sense.
- Severity: We discussed severity in the context of CAL applications. Severity is also an overall disability application factor. According to the SSA, “Your condition must significantly limit your ability to do basic work-related activities, such as lifting, standing, walking, sitting, or remembering – for at least 12 months.”
- Alternative Work: The “severity” factor addresses the medical aspects of a disability. Disabilities also have educational, vocational, and other factors. A serious back problem might be disabling to someone who sits a lot, but not disabling for someone who moves around a lot. So, the person must be incapable of finding new employment.
A Heermans, Social Security disability lawyer can obtain life-changing benefits in these cases, like monthly cash and Medicare/Medicaid access. Heermans also provides a free Disability Evaluation. The road to benefits is often long and winding. Fortunately, final awards can sometimes include monies from prior months of illness. So, in many cases, applicants who prevail on appeal might also receive thousands of dollars in Social Security back pay.
The CAL Benefits Process
If DDS officers deny these claims, then your Heermans attorney will quickly respond to the denial and request a CAL condition review. These matters can turn around fairly quickly if the criteria are met.
Technically, if a person has a CAL condition, the DDS officer is supposed to expedite the claim and verify the diagnosis and documentation. However, as mentioned, to err is human and bureaucrats may not properly red-flag CAL claims, leaving them to go into the denial file. Additionally, if the DDS officer asks for verification or additional documentation and the claimant misses the deadline, the officer could deny the CAL claim. Here again is another reason to have a Heermans attorney by your side. If you or a loved one is sick with a CAL condition, you are probably suffering and unable to stay on top of claim response demands.
We see a lot of these technical denials. People and families dealing with fatal illnesses usually don’t prioritize things like sending medical records to the Social Security office by next Monday.
A Heermans attorney can provide the requested paperwork or satisfy other technical requirements, so the CAL case won’t need to be appealed. However, if there’s a substantive issues, like a question about the recency or severity of the condition, the DDS officer might refuse to relent and you will be glad you have an attorney by your side.
If that happens, try not to worry. Heermans, SSA appeals lawyers have a much different attitude about CAL claims. Basically, there’s a presumption that these individuals are entitled to benefits because of the way they are acknowledged as an urgent priority by the SSA. So, contested CAL matters often settle with favorable outcomes.
For more information about the SSDI claims process, contact the disability lawyers in Memphis at Heermans Disability Law Firm. If your disability claim has been denied, contact us ASAP for a free Disability Claim Evaluation. Call or text 24/7 at (901) 244-0057. More value added FREE information can be found in our online article library.
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