The Compassionate Allowance (CAL) program has been one of SSA’s most successful initiatives.  SSA has put together a list of diseases that are so severe that they are almost always approved within weeks of application with minimal objective evidence required for approval

SSA is always amending the list  and adding new diseases.  There are currently over 160 CAL conditions including:

Pancreatic cancer;

Small cell lung cancer;

Batten disease;

Angelmen syndrome; and

Adult Onset Huntington Disease.

 

 

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SSA will expedite claims based upon a terminal illness.  SSA calls these claims “TERI Cases”.  SSA will never mark a case as terminal, but will always refer to the claim as a TERI case.  A claim will be identified as a TERI case when

the claimant, the claimant’s friends or family or the claimant’s physician states that the condition is terminal;

the claim is based upon a diagnosis of Amyotrophic Lateral Sclerosis (ALS), also knows as Lou Gehrig’s Disease;

the claimant is enrolled in hospice (either in home or inpatient);

the claimant has an ongoing need for life support;

the claimant is on a waiting list for a heart, lung, liver or bone marrow transplant;

the claimant has chronic pulmonary or heart failure that needs continuous home oxygen and cannot care for his or her personal needs;

the diagnosis is cancer that has metastasized, is stage IV, recurs after treatment or is inoperable;

the claimant has been in a coma more than 30 days; or

the claimant is a newborn who is born with a fatal genetic or congenital defect.

 

Other terminal conditions may also qualify.  It is best to obtain a statement from a physician and submit that as proof of the terminal nature of the disease.

If there is evidence that a claimant is suicidal or homicidal, SSA will expedite the claim.  Evidence of suicidal or homicidal ideation can come from any source including:

the claimant

treating physicians or psychiatrists

family or friends

law enforcement officials

SSA employees

If it is determined that a claimant is a threat to himself or others, SSA will contact the appropriate authorities to ensure that everyone’s safety.  SSA should be advised immediately if a claimant expresses suicidal or homicidal ideation.

Over the next few weeks, I will provide information about the ways that the Social Security Administration can expedite a claim.  Dire Need is one way to show that a claim can be moved along.  To show dire need, a person has to show that he or she does not have the resources to get food, medicine or shelter.  If you fit into this category, you need to let SSA know.

Food:  If you cannot afford food and have no other access to food, you need to let SSA know immediately.

Medical Care:  Tell SSA immediately if you do not have access to the medicine or the medical care you need.

Shelter:  Tell SSA if your home lacks basic utilities due to an inability to pay your bills or if you are homeless.  If you are facing eviction or foreclosure or you have reached the limit on the number of days you can stay in a homeless shelter, let SSA know.

You should attempt to  provide SSA with specific evidence that supports your allegation of Dire Need.  While you do not have to provide specific evidence of your claims, if SSA discovers evidence to the contrary, it may require additional proof of your situation.  Of course, any claims you make to SSA that are untrue will impact your credibility.

Evidence of Dire Need – Examples

An eviction notice

Notice of mortgage foreclosure

Letter from a homeless shelter stating you are no longer eligible for services

Pharmacy records showing the costs of needed medication

Copies of medical bills

Estimates from medical providers of future costs

Be sure to let SSA know if you are without the basic needs of food, medical care and shelter.  If your situation worsens after you file, you can go to the SSA office to let a representative know of the changes in circumstances.

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