How I Got Approved for Disability Using Compassionate Allowance Rules

contemplationgoodjoy-672x372
Art: Robin Mead. Page Updated: June 2019

Social Security has a special list of impairments that can get approved easily and quickly. These are called Compassionate Allowance Conditions, and they are often considered very serious or life threatening.

If you’d like to see if you have one, take a look here: Compassionate Allowance Conditions. Important: Please make sure to click on the name of the condition and read the full page that describes in detail the criteria for your condition. Just having the diagnosis is not enough.

If your condition is not on the Compassionate Allowance list, you can also check to see if it is listed in any Social Security Listings and Rulings. The story below can also be helpful for listings and rulings.

Getting Approved as a Compassionate Allowance Case

If you meet the criteria for a Compassionate Allowance Condition, you can get approved in as little as ten days!

That is how it is supposed to work. Sadly, that is not how it always does work. Some of our readers report spending three years applying, only to have a judge say to them, “You are a Compassionate Allowance Case, you should have been approved years ago.”

Susan took some special and smart steps to make sure her Compassionate Allowance Case was processed quickly and correctly. She was kind enough to share her story to help others.

Susan’s Story

I always thought myself well versed in disability and low-income programs. I’ve cared for my two siblings who have developmental disabilities for over twenty years, plus I had a career as manager at a large health insurer. But when I was recently diagnosed with advanced lung cancer, I figured I’d have to fight for some time for approval, and honestly wasn’t sure if I was up for it.

I’ve followed this site for some time, and while reading about How to Get a Faster Disability Decision, I found mention of Social Security’s Compassionate Allowance, which I had never heard of. I filed and was awarded disability within several months!!

🌷 First I read the Compassionate Allowance criteria for lung cancer on the Social Security Site.

🌷 Then I reviewed my doctor notes for the required specifics.

🌷 I discovered that some of the wording in my medical records was vague. I truly did meet the criteria, it’s just that, especially early on, my medical team seemed to like vague wording.

🌷 I was not shy or embarrassed with my medical team. I told them I was filing for disability, and explained there was a fast track program which covered stage 3b but not stage 3a. I showed them the exact language in the ruling. The required 3b staging criteria I thought I fit my case was t1 n3 m0.

🌷 I asked if they thought I truly met the criteria, and explained that if they did, I needed them to write it out bluntly, specifically and clearly in my office visit notes.

🌷 I also noticed that my Surgeon’s consult notes were vague and said “likely not a good candidate for surgery…” I showed my oncologist the Social Security wording that was needed and asked him to clarify what was written. He clarified that to two words from the Social Security wording: “deemed unresectable.”

🌷 When I felt I was all set with the documentation, I called my local Social Security office and we set up an appointment. I was already in chemo and radiation, so they suggested taking the application by phone. Yes – they suggested it! Amazing.

🌷 During the phone appointment, I brought up Compassionate Allowance. She said: “Yes, it looks like you’d qualify.”

🌷 Three days later, someone from Social Security called and told me to ignore the work history and function forms she just sent. She said she’d received my medical info back and I qualify, so no need for additional forms. (Whew!)

After that, that did take a few months to actually process through the system. They put my onset all the way back to date last worked. There’s a waiting period after onset date of five full calendar months, so I got my first disability check in January.

I was so lucky! I actually got taken care of promptly and courteously. Amazing, as that had very much not been my experience with my sibling’s Social Security cases over the years.

Now i just have to live – ha ha. They say I’m responding well to treatment, although I still do have cancer. Treatment has been challenging, I just hope to have periods (like right now) of feeling good.

Thank you to everyone who contributes to this site for all you do. Please know that what you publish is valuable and often critical. Mostly I wanted to let you know what a fabulous service you are providing with all the explanations and links. You just never know what seemingly insignificant mention will be of great value to someone.


TIPS

Susan had a smart approach by asking her doctor’s to update her medical records. Another equally good approach is to show your doctor a copy of the compassionate allowance criteria and ask them to write a letter pointing out any ways your case matches this criteria. Then you need to do everything you can to make certain the letter gets to the person reviewing your case.

If you think you meet the criteria for a Compassionate Allowance Condition but your case has been denied or has not been properly labeled, please see the bottom of this page for more tips on how to make sure your case is processed quickly and correctly: How to Get a Faster Disability Decision,

If your condition is terminal but it does not meet the criteria for a condition on the Compassionate Allowance list, you may be eligible for a quicker disability decision a different way. These rules are called Terminal Illness (TERI) Cases.

LEARN MORE

🌷 This page is part of the free online guide: The Sleepy Girl Guide to Social Security Disability 

🌷 You can learn a whole lot more about this topic here: How to Use the Social Security Blue Book and Rulings.

🌷 Art on this page by Robin Mead and Elizabeth D’Angelo.

🌷 Page Updated: 7/1/19

WHAT DO YOU THINK? 

🌷 Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working. 

🌷 If you found this page helpful, please share it with others by pressing one of these magic little buttons: 

 

9 thoughts on “How I Got Approved for Disability Using Compassionate Allowance Rules”

  1. JonS – I applied in Feb 2020, and I was never aware of the five month rule. So I can expect it in July the earliest?

    Great, great blog.

    Like

  2. Hi there! It’s been wondeful to have your posts when needed. However, I’ve been trying to unsubscribe for weeks and have had continuous failed attempts. Can you assist?

    Like

    1. I’m sorry the subscriptions are a wordpress feature. We aren’t involved in them and have no idea how they work. Perhaps you can look up how to unsubscribe to a wordpress blog?

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s