Compassionate allowances program an initiative for expedited disability determination

Compassionate Allowances Program -- An Initiative for Expedited Disability Determination

Programs such as the CAL are designed to ensure that vulnerable Americans obtain faster access to disability benefits they rightly deserve.

Medical Record Review

When a disabling condition such as Alzheimer’s disease or cancer affects a person, it can be really catastrophic. Conditions such as these can drain one financially and emotionally.

Fortunately, the government has disability benefit programs to support people who experience incapacitating illnesses.

The Compassionate Allowance Program of the Social Security Administration has been introduced with the objective of quickly identifying diseases and other medical conditions that would qualify under the Listing of Impairments on the basis of minimal objective medical information. Programs such as this are designed to ensure that vulnerable Americans obtain faster access to disability benefits they rightly deserve. The CAL initiative is a way to speed up the processing of SSDI and SSI disability claims for applicants whose medical conditions are very severe and obviously meet SSA (Social Security Administration)’s definition of disability. It is not a separate program from the SSDI (social security disability insurance) and SSI (supplemental security income).

In 2014, the SSA added 25 more conditions to its CAL (Compassionate Allowances) program list, which brings the total number of serious disabilities listed to 225, which range from terminal diseases to mental illnesses. The new conditions include disorders that affect the digestive, neurological, immune, and multiple body systems. You can access the complete list here at SSA’s official website.

Meeting the SSA’s Definition of Disability How does the SSA select CAL conditions? For this they use information obtained at public outreach hearings, comments received from the Social Security and Disability Determination Services communities, advice of medical and scientific experts and their research with the NIH (National Institutes of Health). They consider which conditions are most likely to meet their definition of disability.

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Social Security pays benefits only for total disability. An individual meets the SSA’s definition of disability if: 

He/she cannot do work they did before

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The SSA decides that the applicant cannot adjust to other work because of his/her medical condition (s) and

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The applicant’s disability has lasted or is expected to last for at least one year or to result in death.

The information DDS (Disability Determination Services), the state agency that makes disability determinations for the SSA, needs is really nominal – just sufficient information to establish an accurate diagnosis. A number of CAL cases involve cancer and in this case the most important document is the biopsy report. This report along with a hospital discharge summary or letter from the treating doctor would be sufficient proof to obtain a disability approval through the CAL program, provided the particular cancer type and stage of cancer is on the list of CAL conditions.

Disability Lawyers Can Help File Applications and Appeal Denials Social security disability lawyers can help applicants with more information about the CAL program, and also help determine whether a candidate’s condition is severe enough to qualify for disability benefits under the SSA. Whether to file a claim, or to appeal a denial, it is vital to develop medical evidence from the claimant’s medical records. In this lawyers are assisted by medical record retrieval and medical record review services. Review professionals help lawyers find evidence to prove factors such as: 

The applicant has a medically determinable disability

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There is a relationship between the symptoms and functional limitations

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That the disability meets or equals a CAL listing

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1-800-670-2809



The treatment history of the claimant

The client’s disability will be established with substantial evidence that meets the requirements of the SSA. Denials are rare since the detailed review process would ensure that the doctors’ notes are complete, professional and neatly typed and describes the applicant’s complaints in minute detail. The notes would include all examinations undergone by the patient, their results, treatments provided, instructions given and prognosis.

There is no special application form to apply for the CAL program. Application is to be made using the standard SSA process of applying for SSDI and SSI benefits. The Administration typically expedites the applications of those with a CAL condition. An applicant found to have a condition that qualifies him/her for the program will be notified and usually the approval process will be completed in a few days instead of months or years. This applies to senior citizens (age 65 and above), or blind, or disabled persons including children with limited income/resources who may be eligible to receive SSDI and/or SSI disability programs.

The CAL program considerably shortens the amount of time involved in processing social security disability claims. Even so, claim processing time may vary depending on factors such as how quickly the medical evidence is obtained from a doctor or other medical source; whether a medical examination is necessary so as to obtain evidence in support of the claim and if the claim is randomly selected for QA review of the decision. A social security disability attorney would work to ensure that the client’s application is complete and accurate in all respects and aptly expedited through the system.

www.mosmedicalrecordreview.com

1-800-670-2809