Social Security to fast-track some disability claims

  • Wed Dec 5th, 2012 9:58pm
  • News

Associated Press

WASHINGTON — In an effort to ease the burden of being stricken with a debilitating condition, the Social Security Administration is expanding a program that fast-tracks disability claims by people who get serious illnesses such as cancer, early-onset Alzheimer’s and Lou Gehrig’s disease — claims that could take months or years to approve in the past.

While providing faster benefits, the program also is designed to ease the workload of an agency that has been swamped by disability claims since the economic recession a few years ago.

Disability claims are up by more than 20 percent from 2008. The Compassionate Allowances program approves many claims for a select group of conditions within a few days, Social Security Commissioner Michael Astrue said. The program is being expanded Thursday to include a total of 200 diseases and conditions.

Many of the conditions are rare; all of them are so serious that people who suffer from them easily meet the government’s definition of being disabled, Astrue said. With proper documentation, these are relatively easy cases for the agency to decide, too easy to put through the usual time-consuming process that other applicants face, he said.

“Why for someone who is going to die within 15 months do we need 15 years of medical records?” Astrue said in an interview. “If somebody’s got a confirmed diagnosis of ALS, you know that in essence, it’s not only a disability, it’s a death sentence, and there is no use in burdening them with paperwork.”

High demand during the sour economy has made it difficult for Social Security to reduce disability claims backlogs and wait times for decisions. About 3.2 million people have applied for disability benefits this year, up from 2.6 million in 2008, the agency said.

Disability claims usually increase when the economy is bad because people who managed to work even though they had a disability lose their jobs and apply for benefits. Others who have disabilities may not qualify for benefits but apply anyway because they are unemployed and have nowhere else to turn.

Two-thirds of initial applications are rejected, according to the agency. If your benefit claim is rejected, you can appeal to an administrative law judge but the hearing process takes an average of 354 days to get a decision. In 2008, it took an average of 509 days, according to agency statistics.

Judge Randy Frye, president of the Association of Administrative Law Judges, said judges have been working hard to reduce backlogs while some decide more than 500 cases a year. But, Frye said, his group was not consulted on the Compassionate Allowances program.

“We want claimants that are worthy of the benefits, that meet the definitional standard for disability, to be paid as quickly as possible,” said Frye, who is an administrative law judge in Charlotte, N.C. “On the other hand, I think we are not interested in seeing programs designed to simply pay down the backlog. Whether this is that kind of program or not, I don’t know.”

Social Security’s standard is to award benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death.

More than 56 million people get Social Security benefits. Nearly 11 million beneficiaries are disabled workers, spouses and children. Benefits for disabled workers average $1,112 a month, or about $13,300 a year.

The Compassionate Allowances program is designed to render decisions in 10 days to 15 days. It was started in 2008, about a year after the agency did an internal review of how it handled initial applications from people with a handful of serious but rare conditions.

In about 40 percent of the cases studied, the agency mishandled the claim, either rejecting valid claims or taking too long to approve them, Astrue said. Among the conditions studied was ALS, also known as Lou Gehrig’s disease, a debilitating condition that causes people to lose muscle strength and coordination, eventually making it impossible to do routine tasks such as walking up steps, standing or even swallowing.

Since the Compassionate Allowances program was started, 200,000 people have received expedited benefits, Astrue said. On Thursday, the agency is scheduled to announce that it is adding 35 more diseases and conditions to the program, bringing the total to 200.

The program includes some well-known conditions, including many kinds of cancer such as acute leukemia, adult non-Hodgkin lymphoma and advanced breast cancer that has spread to other parts of the body.

Others are more obscure, such as Alpers disease, a progressive neurologic disorder that begins during childhood, type 2 Gaucher disease, an inherited disorder in which the body accumulates harmful quantities of certain fats, and Menkes disease, a genetic disorder that affects the development of hair, brain, bones, liver and arteries.

“Some of the (conditions) aren’t killing you, some of them are just keeping you to the point where you can’t physically work,” said Peter Saltonstall, president and CEO of the National Organization for Rare Disorders. “But you’re still alive and breathing, and in that case you need to buy groceries, you need to be able to support yourself in some fashion. And so this is a program that helped solve that problem.”

Robert Egge, vice president of public policy for the Alzheimer’s Association, said the program is a godsend for people who have just received diagnoses that promise to be extraordinarily difficult for patients and their families.

“This is difficult for anybody to negotiate,” Egge said of the disability claims process. “But by the nature of the disease it can often be especially difficult for this community, as they are dealing with not only a terrible diagnosis but then the nature of the disease makes it very hard to go through this year-by-year process of getting the benefits they are entitled to under the law.”

The Social Security Administration is expanding its Compassionate Allowances program, which is designed to provide decisions on disability claims within several days — instead of months or years — for people with a select group of diseases or conditions. The agency is adding 35 conditions to the program on Thursday, bringing the total to 200.

1 Acute leukemia

2 Adrenal cancer – with distant metastases or inoperable, unresectable or recurrent

3 Adult non-Hodgkin lymphoma

4 Adult-onset Huntington disease

5 Aicardi-Goutieres syndrome

6 Alexander disease (ALX) – neonatal and infantile

7 Allan-Herndon-Dudley syndrome

8 Alobar holoprosencephaly

9 Alpers disease

10 Alpha mannosidosis – type II and III

11 Alstrom syndrome

12 Alveolar soft part sarcoma

13 Amegakaryocytic thrombocytopenia

14 Amyotrophic lateral sclerosis (ALS)

15 Anaplastic adrenal cancer – with distant metastases or inoperable, unresectable or recurrent

16 Angelman syndrome

17 Aortic atresia

18 Aplastic anemia

19 Astrocytoma – grade III and IV

20 Ataxia telangiectasia

21 Batten disease

22 Beta thalassemia major

23 Bilateral optic atrophy – infantile

24 Bilateral tetinoblastoma

25 Bladder cancer – with distant metastases or inoperable or unresectable

26 Breast cancer – with distant metastases or inoperable or unresectable

27 Canavan disease (CD)

28 Carcinoma of unknown primary site

29 Caudal regression syndrome – types III and IV

30 Cerebro oculo facio skeletal (COFS) Syndrome

31 Cerebrotendinous xanthomatosis

32 Child neuroblastoma – with distant metastases or recurrent

33 Child non-Hodgkin lymphoma – recurrent

34 Child T-cell lymphoblastic lymphoma

35 Chondrosarcoma – with multimodal therapy

36 Chronic myelogenous leukemia (CML) – blast phase

37 Congenital lymphedema

38 Cornelia de Lange syndrome – classic Form

39 Corticobasal degeneration

40 Creutzfeldt-Jakob disease (CJD) – adult

41 Cri du chat syndrome

42 Degos disease, systemic

43 DeSanctis cacchione syndrome

44 Dravet syndrome

45 Early-onset Alzheimer’s disease

46 Edwards syndrome (Trisomy 18)

47 Eisenmenger syndrome

48 Endometrial stromal sarcoma

49 Endomyocardial fibrosis

50 Ependymoblastoma (child brain tumor)

51 Erdheim Chester disease

52 Esophageal cancer

53 Ewing sarcoma

54 Farber’s disease (FD) – infantile

55 Fatal familial insomnia

56 Fibrodysplasia ossificans progressiva

57 Follicular dendritic cell sarcoma – metastatic or recurrent

58 Friedreichs ataxia (FRDA)

59 Frontotemporal dementia (FTD), Picks disease – type A – Adult

60 Fryns syndrome

61 Fucosidosis – type 1

62 Fukuyama congenital muscular dystrophy

63 Fulminant giant cell myocarditis

64 Galactosialidosis – early and late infantile types

65 Gallbladder cancer

66 Gaucher disease (GD) – type 2

67 Glioblastoma multiforme (adult brain tumor)

68 Glioma grade III and IV

69 Glutaric acidemia – type II

70 Head and neck Cancers – with distant metastasis or inoperable or unresectable

71 Heart transplant graft failure

72 Heart transplant wait list, 1a/1b

73 Hemophagocytic lymphohistiocytosis (HLH), familial type

74 Hepatoblastoma

75 Hepatopulmonary syndrome

76 Hepatorenal syndrome

77 Histiocytosis syndromes

78 Hutchinson-Gilford progeria syndrome

79 Hydranencephaly

80 Hypocomplementemic urticarial vasculitis syndrome

81 Hypophosphatasia perinatal (lethal) and infantile onset types

82 Hypoplastic left heart syndrome

83 I cell disease

84 Idiopathic pulmonary fibrosis

85 Infantile free sialic acid storage disease

86 Infantile neuroaxonal dystrophy (INAD)

87 Infantile neuronal ceroid lipofuscinoses

88 Inflammatory breast cancer (IBC)

89 Jervell and Lange-Nielsen syndrome

90 Junctional epidermolysis bullosa, lethal type

91 Juvenile-onset Huntington disease

92 Kidney Cancer – inoperable or unresectable

93 Krabbe disease (KD) – infantile

94 Kufs disease type A and B

95 Large intestine cancer – with distant metastasis or inoperable, unresectable or recurrent

96 Late infantile neuronal ceroid lipofuscinoses

97 Left ventricular assist device (LVAD) recipient

98 Leigh’s disease

99 Leiomyosarcoma

100 Lesch-Nyhan syndrome (LNS)

101 Lewy body dementia

102 Lissencephaly

103 Liver cancer

104 Lowe syndrome

105 Lymphomatoid Granulomatosis – grade III

106 Malignant brain stem gliomas – childhood

107 Malignant gastrointestinal stromal tumor

108 Malignant germ cell tumor

109 Malignant melanoma – with metastases

110 Malignant multiple sclerosis

111 Mantle cell lymphoma (MCL)

112 Maple syrup urine disease

113 Mastocytosis type IV

114 MECP 2 duplication syndrome

115 Medulloblastoma – with metastases

116 Menkes disease – classic or infantile-onset form

117 Merkel cell carcinoma – with metastases

118 Merosin deficient congenital muscular dystrophy

119 Metachromatic leukodystrophy (MLD) – late infantile

120 Mitral valve atresia

121 Mixed dementias

122 MPS I, formerly known as Hurler syndrome

123 MPS II, formerly known as Hunter syndrome

124 MPS III, formerly known as Sanfilippo syndrome

125 Mucosal malignant melanoma

126 Multicentric Castleman disease

127 Multiple system atrophy

128 Myoclonic epilepsy with ragged red fibers syndrome

129 Neonatal adrenoleukodystrophy

130 Nephrogenic systemic fibrosis

131 Neurodegeneration with brain iron accumulation – type 1 and type 2

132 NFU-1 mitochondrial disease

133 Niemann-Pick disease (NPD) – type A

134 Niemann-Pick disease -type C

135 Non-ketotic hyperglcinemia

136 Non-small cell lung cancer – with metastases to or beyond the hilar nodes or inoperable, unresectable or recurrent

137 Obliterative bronchiolitis

138 Ohtahara syndrome

139 Ornithine transcarbamylase (OTC) deficiency

140 Orthochromatic leukodystrophy with pigmented glia

141 Osteogenesis imperfecta (OI) – type II

142 Osteosarcoma, formerly known as bone cancer – with distant metastases or inoperable or unresectable

143 Ovarian cancer – with distant metastases or inoperable or unresectable

144 Pancreatic cancer

145 Paraneoplastic pemphigus

146 Patau suyndrome (Trisomy 13)

147 Pearson syndrome

148 Pelizaeus-Merzbacher disease – classic form

149 Pelizaeus-Merzbacher disease – connatal form

150 Peripheral nerve cancer – metastatic or recurrent

151 Peritoneal mesothelioma

152 Peritoneal mucinous carcinomatosis

153 Perry syndrome

154 Phelan-McDermid syndrome

155 Pleural mesothelioma

156 Pompe disease – infantile

157 Primary cardiac amyloidosis

158 Primary central nervous system lymphoma

159 Primary effusion lymphoma

160 Primary progressive aphasia

161 Progressive multifocal leukoencephalopathy

162 Progressive supranuclear palsy

163 Pulmonary atresia

164 Pulmonary kaposi sarcoma

165 Retinopathy of prematurity – stage V

166 Rett (RTT) syndrome

167 Rhabdomyosarcoma

168 Rhizomelic chondrodysplasia punctata

169 Roberts syndrome

170 Salivary tumors

171 Sandhoff disease

172 Schindler disease – type 1

173 Severe combined immunodeficiency – childhood

174 Single ventricle

175 Sinonasal cancer

176 Small cell cancer (of the large intestine, ovary, prostate or uterus)

177 Small cell lung cancer

178 Small intestine cancer – with distant metastases or inoperable, unresectable or recurrent

179 Smith Lemli Opitz syndrome

180 Spinal muscular atrophy (SMA) – types 0 And 1

181 Spinal nerve root cancer – metastatic or recurrent

182 Spinocerebellar ataxia

183 Stiff person syndrome

184 Stomach cancer – with distant metastases or inoperable, unresectable or recurrent

185 Subacute sclerosing panencephalitis

186 Tabes dorsalis

187 Tay Sachs disease – infantile type

188 Thanatophoric dysplasia, type 1

189 The ALS/Parkinsonism dementia complex

190 Thyroid cancer

191 Transplant coronary artery vasculopathy

192 Tricuspid atresia

193 Ullrich congenital muscular dystrophy

194 Ureter cancer – with distant metastases or inoperable, unresectable or recurrent

195 Usher syndrome – type I

196 Walker Warburg syndrome

197 Wolf-Hirschhorn syndrome

198 Wolman disease

199 Xeroderma pigmentosum

200 Zellweger syndrome

Source: Social Security Administration

Online: www.socialsecurity.gov/compassionateallowances