Expedited Disability Determination Programs

Dec 30, 2016

Expedited Disability Determination Programs

Applying for and receiving approval to collect Social Security Disability Insurance (SSDI) benefits is a time-consuming process. This can be especially stressful for those who have been diagnosed with serious illnesses and need medical care and living expenses right away. Recognizing this dilemma, the Social Security Administration (SSA) created a few different expedited disability determination programs, including the Compassionate Allowance (CAL) Initiative and the Quick Disability Determination (QDD) program, which fast track SSDI applications for people who have been diagnosed with certain serious diseases or conditions. This initiative can go a long way towards helping eligible applicants receive the benefits they deserve, so if you live in Charlotte and have a serious illness, it is critical to contact an experienced SSDI attorney who can explain the application process and ensure that you do not skip any procedural requirements or deadlines.

Compassionate Allowance Initiative 

The CAL initiative is an integral part of the SSA’s goal of quickly identifying medical conditions that will undoubtedly qualify under the SSA’s list of impairments and so expedite the application process for eligible individuals. This program allows the SSA to serve the most obviously disabled individuals by not requiring them to go through the process of satisfying disability criterion. Although CAL applicants still need to meet other SSDI criteria, the process goes much quicker.

Covered CAL conditions are chosen based on the following guidance:

  • Information obtained at public outreach hearings;
  • Advice from advocacy groups;
  • Comments received from the Social Security and Disability Determinations Service communities;
  • Counsel from medical and scientific experts; and
  • Research from the National Institutes of Health.

After reviewing information, the SSA considers the conditions that are most likely to meet the current definition of disability. To date, the SSA has approved over 200 conditions for coverage by the CAL initiative.

The public outreach hearings in particular have proved instrumental in determining which illnesses are covered. For example, the SSA recently held seven CAL public outreach hearings that were focused on the following conditions:

  • Rare diseases;
  • Cancers;
  • Traumatic brain injury and stroke;
  • Early-onset Alzheimer’s disease and related dementia;
  • Schizophrenia (with a focus on homelessness);
  • Cardiovascular disease and multiple organ transplants; and
  • Autoimmune diseases.

Although no new hearings are planned for the immediate future due to budget constraints, the SSA continues to meet with advocacy groups via webinars and teleconferences.

The Application

The CAL initiative does not require the completion of a special application. Instead, those with one of the listed CAL conditions simply apply for benefits using standard SSA procedures for filing SSDI claims. These applications can be completed online, in a local field office, or by calling the SSA’s toll-free number. Applicants with a listed CAL condition will have their applications expedited, as a result of which, they may receive a decision on their claim within a few weeks, instead of months or even years. However, the speed at which the SSA sends an answer depends on a series of factors, including:

  • How quickly they obtain medical evidence confirming the applicant’s diagnosis;
  • Whether a medical exam is necessary to support the applicant’s claim; and
  • Whether the claim is randomly selected for quality assurance review.

Still, the amount of paperwork for those with a listed CAL condition has been significantly reduced. For example, applicants no longer need to complete the work and education history portions of the application. Unfortunately, being diagnosed with a CAL condition does not mean that an applicant will receive funds in addition to what he or she is eligible for under the SSDI program.

Quick Disability Determination 

The Quick Disability Determination program is another method used by the SSA to expedite certain claims. An applicant cannot refer his or her own claim to the QDD. Instead, the decision will be made internally through the use of a predictive computer modeling program, which analyzes an applicant’s electronic file. If the program picks up certain factors that indicate a high probability that the applicant will be considered disabled, the application is sent to a special QDD group for review. If a disability claims examiner approves an application, he or she does not have to request the opinion of a medical consultant, which is a requirement in the regular SSDI determination process. However, if an examiner denies benefits through the QDD system, he or she is required to ask a medical consultant to review the claim prior to the final decision.

If approved under the QDD program, an applicant could receive an answer within a few weeks of submission as long as his or her medical records were complete and the date of the onset of the disability can be easily determined. However, if a disability started more than a few months prior to the submission of the application, the QDD examiner may choose to put the claim through the standard process.

An application will also be sent back through the regular determination process at the Disability Determination Services if one of the following actions are taken:

  • The QDD disability examiner doesn’t recommend a claim for approval;
  • The examiner doesn’t agree with the alleged date of onset;
  • The disability examiner and the medical consultant do not agree on whether the claim should be approved.

In these cases, the claim starts over and the applicant may receive an answer within a few months.

Contact a Dedicated Charlotte SSDI Attorney 

The SSA is notorious for taking a significant amount of time to review SSDI claims. Fortunately, there are a number of programs that enable certain claimants with serious disabilities to expedite their applications. This in turn, allows eligible applicants to begin receiving benefits earlier, so if you or a loved one have a listed CAL disease,  please contact the law firm of Ted A. Greve & Associates, P.A. by completing one of our contact forms, including your name, phone number, email address, and a brief description of your case and a member of our legal team will help you set up a free consultation with an experienced Charlotte SSDI attorney who can help ensure that your application is completed correctly and that you have all of the medical documentation necessary for your claim.