Additions to CAL Program Provide Faster SSDI Benefits

The Social Security Administration has announced the edition of five conditions to its Compassionate Allowances program.

The five new health conditions added to CAL are:

• Fibrolamellar Cancer
• Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS)
• Megalencephaly Capillary Malformation Syndrome (MCAP)
• Superficial Siderosis of the Central Nervous System
• Tetrasomy 18p

Fibrolamellar Cancer is a rare liver cancer that usually occurs in adolescents; Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare congenital condition characterized by abdominal dissension; Megalencephaly Capillary Malformation Syndrome (MCAP) is a disorder characterized by overgrowth of several tissues in the body; Superficial Siderosis of the Central Nervous System is a rare condition that involves brain bleeding; Tetrasomy 18p is a genetic chromosome condition characterized by multiple medical and developmental concerns.

The Compassionate Allowances (CAL) program allows victims of severe health conditions to apply for expedited benefits. The CAL program began in 2008 and now lists 233 eligible conditions. The fast-track approval process allows patients suffering from severe conditions, including brain disorders and many types of cancers, to obtain benefits more quickly. Approval of SSDI benefits can happen in weeks, instead of the months or even the years that it often takes to secure disability benefits from the federal government.

The Social Security Administration provides a complete list of CAL qualifying conditions, which include leukemia, ALS, lymphomas, early onset Alzheimer’s, liver cancer, pancreatic cancer, mesothelioma, and thyroid cancer.

Compassionate Allowances Provide Faster SSDI Benefits in Massachusetts

SSDI lawyers in Boston know the CAL program is a vital lifeline for many patients suffering with progressive or terminal disease. Faster help with medical and living expenses can permit families to focus on quality-of-life, instead of dealing with the insufferable bureaucracy and endless delays that have come to define the SSDI system.

As we reported in April, SSA received additional funding to clear a backlog of claims in the Boston area. A spending bill passed by Congress and signed by President Trump allocated an additional $100 million to reduce the backlog of disability claims. Currently there is an average wait time of nearly 600 days for a hearing before an Administrative Law Judge (ALJ).

Such hearings are often an SSDI claimant’s first real chance at securing benefits. In testimony on the issue, Vermont Senator Bernie Sanders noted 10,000 applicants died while awaiting benefits during the year Congress debated the issue.

An understanding of why ALJ hearings are so important also highlights why having an experienced Massachusetts SSDI attorney can be critical from the start of the process.

• Claimants usually obtain applications for disability benefits in person, by telephone, by mail, or by filing online.
• The field office reviews applications to verify non-medical eligibility (i.e. age, employment history, etc.)
• Disability Determination Services (DDS), an arm of the federal government, reviews medical information, and may request an independent consultative examination (CE).

The review process often results in denial, at which point a claimant most amend an application and/or restart the process. Many SSDI advocates believe firmly this is primarily a stall-and-discourage tactic routinely employed by the Social Security Administration. Although there are also a significant number of applications that are filled out incorrectly, or that contain insufficient or incorrect proof or documentation. Having experienced legal help is likely to reduce delays on both counts.

Only once your claim is denied, can you request a hearing before an Administrative Law Judge. And it’s at this stage that many claimants are most likely to secure benefits, particularly with a solid application and experienced legal help. Government statistics show the approval rate for disability applications that make it through the hearing stage vary from 80 percent for serious conditions like multiple sclerosis, to 30 percent or less for conditions that are less disabling and/or harder to prove.

To Social Security claims examiners, medical consultants, and judges, a disability applicant’s diagnosis is usually far less important than the severity of the functional limitations that the applicant’s condition causes. Having adequate documentation can be critical when it comes to proving your claim and successfully obtaining the benefits to which you are entitled.

An experienced disability law firm can help you expedite the process and determine all of the benefits to which you are entitled.  In general, your SSDI benefits will be determined based on your history of prior earnings. The federal program is funded through payroll taxes and uses your Average Indexed Monthly Earnings and Primary Insurance Amount.

Faster Disability Benefits in Massachusetts

While the CAL program benefits those relative few with qualifying conditions, it was made necessary by long wait times and a growing case backlog as thousands of disabled workers wait months or even years for benefits.

Once beneficiaries finally receive an approval letter from the Social Security Administration, they are typically entitled to back payment of benefits. In most cases, your disability lawyer will be paid fees from a portion of this amount, meaning disabled Massachusetts workers can typically hire experienced legal help with no out-of-pocket costs. In addition to payments back to your initial application date, you can get 12 months of back payments for the year prior to your date of application. This is another reason to make contact with an experienced disability law firm in Massachusetts at the earliest stages of your case.

Approval for SSDI benefits will also allow claimants to receive federal Medicaid coverage to pay for medical expenses. In some cases, disability payments may be offset by other benefits, like workers’ compensation. But most private insurance payments or veterans benefits will not be impact your SSDI benefits.

If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at (617) 777-7777.