The Social Security Disability application process is designed to ensure that benefits are provided to those who genuinely need them and to prevent fraud. However, those safeguards can contribute to the time it takes to receive a decision on an SSDI claim.
The average wait time for a decision on an SSDI application is around 225 days (about 7 and a half months). And if an applicant decides to appeal a denial, the process could take additional months or even years. In addition, there’s a mandatory five-month waiting period after approval to receive SSDI benefits. While that timeline may work for most applicants, there are circumstances under which waiting that long isn’t an option.
Fortunately, the Social Security Administration has programs to identify and respond to those cases, which could result in your claim being processed in days or weeks rather than months or years. This article outlines these programs, how they work, and how to qualify for them.
The Social Security Disability Application Process
To understand the SSA’s expedited programs, it’s helpful to know the steps in the typical disability evaluation process.
- Initial Application: Submit your application online, by phone, or in person and provide detailed information about your medical condition, work history, and functional limitations. This step can take a while, depending on the number of sources and complexity of your claim.
- Medical Review: The Social Security Administration reviews your medical records and assesses whether your condition meets the criteria outlined in The Blue Book (officially known as “Disability Evaluation Under Social Security”).
- Consultative Examinations: If necessary, the SSA may schedule a consultative examination with a medical professional to determine the severity of your disability.
- Functional Assessment: The SSA evaluates your ability to perform work-related tasks. They consider factors like mobility, communication, and daily activities.
- Decision: The SSA decides based on medical evidence and functional assessments. Once completed, you will receive a notice regarding approval or denial of benefits.
- Appeals: You can appeal the decision if your claim is denied. The appeals process includes reconsideration, a hearing, and further appeals if necessary.
Expedited Programs
Expedited programs are special procedures within the SSDI framework designed to streamline and accelerate the processing of disability claims for individuals under certain medical conditions or circumstances.
Fast-Track Processing
Fast-track processing has two components: Compassionate Allowance and Quick Disability Determination.
Compassionate Allowance (CAL)
Compassionate Allowance, or CAL, is designed to speed up disability claim processing for individuals with severe medical conditions.
The SSA uses special criteria and guidelines to identify and prioritize CAL cases. In general, conditions that qualify for CAL have extremely high morbidity rates or debilitating symptoms and are so severe that they clearly meet the SSA’s definition of disability.
Examples of such conditions include certain types of cancer, such as acute leukemia and pancreatic cancer, rare genetic disorders, such as Huntington’s disease and Duchenne muscular dystrophy, and severe neurological disorders, such as ALS and Alzheimer’s disease.
The SSDI Compassionate Allowance List provides information on all medical conditions that qualify for CAL. The SSA regularly updates and expands the list of CAL conditions based on medical advancements and emerging health concerns.
Quick Disability Determination (QDD)
Quick Disability Determination, or QDD, uses a sophisticated computer algorithm to analyze specific data points within disability applications to identify cases that require quick judgment and are likely to be approved based on objective medical evidence, diagnosis codes, and other indicators of disability severity.
Terminal Illness (TERI) Program
While there may be overlap with both QDD and CAL, the terminal illness program is a separate initiative for terminally ill individuals unable to work due to their condition. It is intended to provide expedited review of disability claims to deliver essential support and alleviate financial burdens associated with end-of-life care.
To be eligible to participate in the TERI program, individuals must have a terminal medical condition with a prognosis indicating a life expectancy of six months or less. Eligible terminal illnesses include advanced-stage cancers, end-stage organ failures, severe neurological diseases, and other conditions where the prognosis is grave and life expectancy is limited.
Applying for CAL, QDD, and TERI
There is no special application process for CAL, QDD, or TERI. Instead, eligible people should automatically experience faster processing times and, if they qualify, receive benefits more quickly. The best thing applicants can do to receive expedited processing is to ensure that their application includes all qualifying conditions, clear diagnostic evidence, and objective medical documentation supporting the severity of their disability.
Other Expedited Processing Criteria
In addition to programs related to specific medical conditions, other circumstances can qualify applicants for expedited processing.
Homelessness
The Social Security Administration flags applicants experiencing unstable housing or homelessness “if he or she does not have a fixed, regular, and adequate nighttime residence.” The definition also includes people who are experiencing or fleeing domestic violence. In addition to indicating that the application should receive expedited processing, the homeless flag includes special considerations regarding the applicant’s ability to respond to correspondence and make it to Consultative Examinations.
Veterans with 100% Permanent and Total Disability
Veterans with a 100% Permanent and Total (P&T) disability rating from the Veterans Administration (VA) receive expedited processing of their applications. To receive expedited processing, Veterans should identify themselves as a “Veteran rated 100% P&T” when initiating the application and provide a VA rating notification letter to SSA.
Wounded Warriors
Veterans who received disabling mental or physical injuries while on active duty on or after October 1, 2001, are eligible for expedited application processing through the Wounded Warriors initiative. The injury did not have to occur during combat operations. Veterans should inform the SSA that their injury occurred while on active duty when initiating the application process.
Risk to Personal or Public Safety
If there is evidence that an applicant is suicidal or homicidal, the SSA will expedite the claim. Evidence of suicidal or homicidal ideations may come from any source, including the applicant, treating physicians, collateral sources, SSA employees, or law enforcement officials. If it is determined that an applicant is a threat to either themselves or others, the SSA will contact the appropriate authorities and provide referral services for local physicians, community service centers, suicide prevention programs, or other appropriate medical facilities.
Dire Need
If you have a pending hearing with an Administrative Law Judge and do not have the resources to get food, medical care, or shelter, the claim may be expedited as a “dire need” case. You can submit a “dire need” letter to the SSA explaining why waiting for a hearing might have dire consequences. You do not need to provide specific evidence to support the allegation of dire need, though the SSA may require proof if there is evidence that contradicts your claim.
Conclusion
Expedited programs are critical in providing fast access to resources for individuals with severe medical conditions and other qualifying circumstances. These programs streamline the claims process, providing faster decisions and crucial financial support to those in need.
With decades of specialized experience in social security law, we can help you submit the required documentation to maximize your chances of qualifying for expedited programs. We have multiple locations throughout Louisiana and Mobile, Alabama to serve you. Contact us today.
Attorney, Former Social Security Judge
Prior to entering private practice as a social security disability attorney in 1997, Peter J. Lemoine served as a Social Security Administrative Judge for seven years. His practice is devoted entirely to social security disability law, and he has helped thousands secure social security disability benefits.
