Integrating Social Security and Medicare for Cost-Effective Solutions

GAO’s Compassionate Allowance Recommendations Highlight Key Challenges with Important SSDI Program

Belleville, Illinois — Nov. 28, 2017 — The most severely ill workers may not have the quick access to their disability benefits as promised, according to a report by the U.S. Government Accountability Office (GAO). Flaws in the Social Security Administration’s Compassionate Allowance initiative (CAL) spotlighted deficiencies that trip up eligible, first-time applicants and slow confirmation of their eligibility, according to True Help, a division of Allsup, the nation’s premier disability representation company.

The Social Security Administration’s (SSA) Compassionate Allowance initiative gives priority status to claimants with certain medical conditions—like particular cancers and rare disorders affecting children—moving them to the front of the overall queue of disability claims. There are more than 200 conditions that qualify for CAL. The GAO found gaps and weaknesses in the program that result in applicants being overlooked and delayed in getting benefits quickly.

“The CAL program had been considered an important and helpful program to fast track those who are very sick, so they can access disability benefits they paid for while working,” said Mike Stein, Allsup assistant vice president.  

“Now we learn that some who should speed right through are, in fact, missed by the system, including those applicants who don’t know that the SSA refers to their disease differently than their own doctor,” Stein said. “That’s completely unreasonable and runs counter to the intent of the program—and its name.”

The GAO’s report highlights eight key recommendations to improve the SSA’s processes for gathering information on potential CAL conditions, communicating criteria for designating CAL conditions, using available data to ensure accurate decision making, and more. The GAO found that between 2 percent to 5 percent of disability claims qualify as Compassionate Allowance claims.

“Overlooking a CAL claimant means instead of a few weeks, an applicant could wait months to learn if he or she is eligible–if the error is not caught by SSA staff,” Stein said. “A big concern is that these individuals may get trapped in the current massive backlog of appeals.”

More than 1 million Americans are waiting an average of 605 days for a hearing before an administrative law judge and to find out whether they can receive the benefits they need to survive. Thousands die every year while on the waitlist, and efforts to lessen the backlog have not tamed rising wait times.

“If you or a loved one believe your claim could qualify as a Compassionate Allowance, contact an experienced representation organization today,” Stein said. “Access to quality information and professional assistance from the start means your claim will be identified and monitored as a CAL.”

The online tool empower by Allsup® offers a simple assessment for Social Security Disability Insurance eligibility and will flag any individuals who qualify under the Compassionate Allowance program.

 

ABOUT ALLSUP

Allsup and its subsidiaries provide nationwide Social Security disability, veterans disability appeal, return to work, exchange plan and Medicare services for individuals, their employers and insurance carriers. Allsup professionals deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. Founded in 1984, the company is based in Belleville, Illinois, near St. Louis. Visit TrueHelp.com or connect with Allsup at http://www.facebook.com/allsupinc and @Allsup.

Contact:

Rebecca Ray

(800) 854-1418, ext. 65065

r.ray@allsup.com

or

Tai Venuti

(800) 854-1418, ext. 68573

t.venuti@allsup.com