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More on Compassionate Allowances and Quick Determinations

Posted Oct 17 2010 9:11am

Compassionate allowances and quick disability determinations On October 13, 2010, SSA announced new rules effective on November 12, 2010 that will allow SSA personnel to fast track disability claims.   Now there are two programs that will allow SSA personnel to quickly approve cases there the medical evidence for disability is overwhelming.

The first program is called the "compassionate allowance" program, and it identifies specific diseases that produce work activity limitations that meet SSA's definition of disability – in other words, if someone has one of these medical conditions, they would not be able to engage in substantial gainful activity and the symptoms will last 12 consecutive months or result in death.  I discussed the compassionate allowance program in a previous blog post , and you can review the diagnoses on the list by clicking on the link.

The second and newer program is called the Quick Disability Determination (QDD) program.   This program uses a computer program to analyze the electronic claim files to identify "cases where there is a high likelihood that the claimant is disabled" so that a claims representative within Social Security can approve a case without the need to review the claim with a medical or psychological consultant.  In a regular claim adjudication the claims rep, or "Adjudicator" must get a medical or psychological consultant to sign off on an approval, a process that takes time and can yield inconsistent results.

The QDD program only applies to adult claims at this point – not child SSI cases.

At this point SSA has not released any information about the computer program it uses to evaluate electronic claims or what information therein will trigger a QDD.   However, the presence of this program would suggest to me that a claimant with a significant medical problem would benefit from taking actions to insure that his medical file is as complete as possible as early as possible.   Specifically I would:

  • make sure that the names, addresses and phone numbers of treating physicians and hospitals is accurate and readable on the application forms
  • alert treating physicians that SSA will be contacting them for medical records
  • provide treating doctors with a copy of SSA's "blue book" of disabling medical conditions so that your records will contain wording that tracks SSA's requirements
  • providing the Adjudicator with accurate and up to date medication lists
  • clearly identify on SSA's disability reports the specific symptoms that prevent you from engaging in competitive work

Post from: Social Security Disability Blog

More on Compassionate Allowances and Quick Determinations

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