Compassionate Allowances Starting Before Election

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, today announced the national rollout of the agency’s Compassionate Allowances initiative, a way to expedite the processing of disability claims for applicants whose medical conditions are so severe that their conditions obviously meet Social Security’s standards.

“Getting benefits quickly to people with the most severe medical conditions is both the right and the compassionate thing to do,” Commissioner Astrue said. “This initiative will allow us to make decisions on these cases in a matter of days, rather than months or years.”

Social Security is launching this expedited decision process with a total of 50 conditions. Over time, more diseases and conditions will be added. A list of the first 50 impairments -- 25 rare diseases and 25 cancers -- can be found at www.socialsecurity.gov/compassionateallowances.

Before announcing this initiative, Social Security held public hearings to receive information from experts on rare diseases and cancers. The agency also enlisted the assistance of the National Institutes of Health.

Compassionate Allowances is the second piece of the agency’s two-track, fast-track system for certain disability claims. When combined with the agency’s Quick Disability Determination process, and once fully implemented, this two-track system could result in six to nine percent of disability claims, the cases for as much as a quarter million people, being decided in an average of six to eight days.

"This is an outstanding achievement for the Social Security Administration," said Peter Saltonstall, President of the National Organization for Rare Disorders. "It has taken Social Security less than a year to develop this much-needed program that will benefit those whose claims merit expedited consideration based on the nature of their disease. Disability backlogs cause a hardship for patients and their families. Commissioner Astrue and his staff deserve our thanks for a job well done.”

“Unfortunately, many hardworking people with cancer may not only face intensive treatment to save their lives, but they may also find themselves truly unable to perform their daily work-related activities and as result, may face serious financial concerns, such as the loss of income and the cost of treatment,” said Daniel E. Smith, president of the American Cancer Society Cancer Action Network. “The Social Security Administration’s Compassionate Allowances program will help streamline the disability benefits application process so that benefits are quickly provided to those who need them most.”

“This is America, and it simply is not acceptable for people to wait years for a final decision on a disability claim,” Commissioner Astrue said. “I am committed to a process that is as fair and speedy as possible. The launch of Compassionate Allowances is another step to ensuring Americans with disabilities, especially those with certain cancers and rare diseases, get the benefits they need quickly.”

I wish I could call this an "outstanding achievement", but it is pathetic. I have been practicing Social Security law for 29 years. There is only one disease on the list that I have seen in my practice, Amyotrophic Lateral Sclerosis (ALS), and it is absurd that I have seen two cases of ALS denied at the initial level. I expect that the ALS cases are being paid quickly now anyway. That does not mean that all the other diseases on this list are all that rare. It means they have always been paid quickly by Social Security.

If anything, this arbitrary list may make it harder for those whose disease is not on the list to get a quick decision when that is justified. Got metastasized prostate cancer. Go to the back of the line. Got multiple myeloma that is progressing rapidly despite treatment. Go to the back on the line. Why would you have Creutzfeldt-Jakob Disease on the list but not metastasized lung cancer? Is it because most lung cancer comes from smoking? If you are going to have such a list, it should be much, much longer, but there is no need for such a list to begin with. Trust the people at the operational level. For decades they have been recognizing cases that deserve a quick allowance without this sort of unnecessary direction from above.

I do not think that Astrue is hustling to get this out before the election in order to have an effect upon the election. This is way too small for that. I think he is getting it out now because he does not expect to be around after the election and he wants this to be his legacy. I predict that after Astrue leaves, compassionate allowances will meet the same fate as former Commissioner Barnhart's legacy project, Disability Service Improvement (DSI). Astrue made a quick -- and sensible -- decision to cancel that one shortly after taking office. But before that, Barnhart made a quick decision to cancel Hearing Process Improvement (HPI), her predecessor's legacy project. At least, Compassionate Allowances will not have anything like the deleterious effects that HPI and DSI had on the agency.