Sunday, January 3, 2010

Social Security's New "Compassionate Allowances" - Are They Really Going to Speed Up the Process?

This week, Michael Astru, the Commissioner of Social Security held hearings on a "Compassionate Allowances" program. The proposed program is aiming to get children and adults with serious, rare diseases on disability benefits much faster. This is quite a change, considering the Administration has been notorious for prolonged wait periods and strict guidelines on disability determinations. The December 2007 Compassionate Allowances hearings were the first of the public outreach hearings that the Administration plans to hold on this topic over the year.

The hearings were held in Washington, D.C. and experts from all over the country convened to speak on rare diseases, new technology and how they effect the Social Security adjudication process. Speakers from the National Organization of Rare Disorders, NIH (National Institute of Health) Office of Rare Diseases, Professors, Doctors and prominent attorneys all shared their opinions. The purpose for the hearings was to advise on methods for identifying serious, rare diseases early in the disability determination process.

For those that have been following SSA's promises for faster turn around times, this new program sounds similar to older fast-track models that have not made much of a difference for most applicants. For example, a year ago the Administration set up a model program called "Quick Disability Determination (QDD)" which was supposed to identify severe cases early and award them within 21 days. The model has been in operation in the Boston region for some time now, and according to SSA has worked so well that it will be implemented nationwide. Statistics showed that 97 percent of the cases identified by QDD were decided within 21 days, with an average decision time of 11 days. However, this didn't change wait times or efficiency for most applicants overall because less than 3 percent of all new disability cases ever even became part of the QDD process. The problem has been that the QDD model looks at very specific illnesses, and a variety of other disabling conditions that deserve quick determinations are never even considered.

Though the Administration has not released exactly what narrow field the QDD looks at, we can assume that perhaps its limited scope triggered the recent hearings on rare diseases and the Compassionate Allowances program. Again, Commissioner Astrue has made the same promise for a faster turn around, stating that the "compassionate allowances initiative will allow the Social Security Administration to make decisions on cases involving certain categories of conditions in days or weeks instead of months or years." Still, the details on which diseases will be on this compassionate allowances list have not been disclosed.

There had been talk that certain illnesses, such as acute leukemia and ALS (Amyotrophic Lateral Sclerosis), were going to be part of the proposed program. In these cases, allowances would be made as soon as the diagnoses were confirmed, with minimal objective medical evidence. In any case, the Administration has a long way to go and probably several more hearings before the Compassionate Allowances program is ready for implementation. In the meantime, several health organizations such as the Tourette Syndrome Association, have been adding their comments at these hearings in order to get specific diseases added to Social Security's newest fast-track model.

Shaneela Khan is an expert on Social Security Law and has been working in the Field for the past 15 years. For more information on Social Security Benefits please visit:

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