Anyone want to take a stab at answering these questions?Can someone please explain how Compassionate Allowances work and for which medical conditions they are used?
Even after reading Social Security's material, I don't think I fully understand how Quick Disability Determination (QDD) and Compassionate Allowance (CA) differ.
I am a Capitol Hill staffer and I might have to answer questions about these initiatives, so I'd like a deeper understanding.
Many thanks.
Jan 29, 2009
Some Reasonable Questions
Here is a slightly edited version of a comment that was posted below:
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See below for an excerpt from some internal material, slightly modified to clean up some proofreading errors. I've got to get back on the clock, so there's no time to look around for anything that describes the various criteria
"On October 27, 2008 the agency implemented the Compassionate Allowance (CAL) initiative. They are similar to the QDD cases, and are actually processed the same way as a QDD. The biggest difference between the CAL and QDD is the predictive model criteria [are] simpler for a CAL."
JOA.
I've found a few more minutes. See below for a link to the public POMS, at DI 23022.017. This is titled "Compassionate Allowance (CAL) and Quick Disability Determination (QDD): Similarities and Differences." This POMS section includes some internal links. If you chase these far enough, you can get to the CAL site, which has at least some information about the criteria.
https://secure.ssa.gov/apps10/poms.nsf/lnx/0423022017
JOA
I am the original poster.
Many thanks for those excerpts. I read that POMS site and some of the links it contained.
It sounds as if compassionate allowances are the most straight-forward cases, looking at a single piece of information: the alleged disability.
The QDD process, in contrast, uses more pieces of information (I'd be curious to know what they are) to feed the predictive model.
I saw the list of conditions that trigger a compassionate-allowance designation. Can anyone share insight about what conditions might trigger a QDD designation?
Thanks again.
The agency refuses to release any information whatsoever as to what would result in a QDD designation on a case.
It is a software review conducted once, at the time a case is transferred to the DDS, using an unknown set of criteria scoring.
The claims reps really hate them, because they don't find out about the QDD designation until the case is transferred. Then, they have to immediately recontact the claimant to complete full case development (which could have been done in the first place had they known the case was QDD).
A Congressional staffer should know to contact the Disability Insurance Program Staff in the Office of Legislative and Congressional Affairs for this sort of information, and know not to rely on a partisan blog and a rogue SSA employee to provide information.
Congressional staffer - I work there and I too would like to know the difference. You will find that SSA management likes creating multiple lables and programs based on things like "hey look at what we can get this antiquated computer system to do for us - we can use this to code case and come up with yet another program to add to our collection of accomplishments." They are very good at what they do.
Seriously, your inquiry is promising and welcome.
Here is an example of the kind of instructions SSA staff has to work with regarding this question. It shows how complicated it can get when new procedures are added onto existing ones for purely political reasons to make it look like the agency is being responsive to concerns about delays in processing.
From POMS DI 11005.604B:
CAL and QDD similarities and differences --
Process CAL cases in much the same manner as QDD cases.
1. Similarities include:
Most CAL cases are identified by the PM upon Electronic Disability Collect System (EDCS) transfer to the disability determination services (DDS) at the initial claim adjudicative level. CAL and QDD do not apply to Continuing Disability Review (CDR) classification cases.
CAL cases are processed in the DDS by adjudicators who meet the qualifications set forth in DI 23022.020.
Expedited processing applies to all CAL-identified cases.
CAL cases can be removed from the CAL process; however, the reasons for taking such action on a CAL case are very limited, as set out in DI 23022.055B.
In certain circumstances, cases removed from the CAL process can be reinstated, as set out in DI 23022.055C.
Cases determined to be CAL could also meet the criteria for QDD, and would be designated both QDD and CAL. For example, the case could meet the scoring criteria for QDD and also have an allegation of a CAL condition.
If the PM identifies a case as both QDD and CAL, the case can be removed from QDD yet maintain its CAL status, and vice versa.
2. Differences include:
The PM criteria for CAL are simpler than the criteria for QDD. A CAL case is identified solely on a claimant’s allegation of a disease or other medical condition that matches a disease or condition loaded in the PM (by name, synonym or abbreviation). No scoring or threshold criteria are necessary for CAL selection. For example, a case must have a high enough score from the PM to be considered a QDD. For CAL, the PM only needs to see the allegation of a condition on the CAL list.
Designated employees in the DDS, the Office of Quality Performance (OQP), and the Office of Disability Adjudication and Review (ODAR) can manually add a CAL indicator to a case which is not an available function in the QDD process. Similar to QDD designated employees can remove and reinstate a case from the CAL process. FO employees cannot add or delete CAL cases. For information on Adding Removing and Reinstating Compassionate Allowance (CAL) cases, see DI23022.055.
NOTE: The FO workload management information (WMI) listings do not capture these manual additions, reinstatements, or removals.For CAL cases that are not already identified as QDD, the FO is automatically notified when a case is added, reinstated, or removed from the CAL process via an EDCS action item for electronic claims. FOs regularly monitor EDCS action lists to identify any case where a CAL indicator is set after transfer to initiate a full non-medical development of the case.
Unlike QDD, there are very few reasons for removing a case from CAL processing (these are addressed in DI 23022.055). The most significant difference is a CAL case can be processed to a denial.
If a case is identified as CAL and QDD, continue to follow expedited QDD processing guidelines, even if the DDS removes the case from QDD processing. For example, if you have a QDD case that you cannot complete within the QDD timeframe, or if the claimant moved out of State, you do not need to remove the case from CAL processing.
A new Compassionate Allowance page can be accessed by selecting a hypertext link labeled [CAL] in the top right hand frame of the Electronic Folder (EF) in eView. The CAL link will display [CAL: Y] or [CAL: N.]
CAL cases can be identified at the Initial, Reconsideration, Hearing, and Appeals Council adjudicative levels.
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