Social Security’s Programs for Fast-tracking Disability Claims The SSA determines disability based on a detailed medical chart review. Their CAL and QDD programs speed up claims processing for the severely disabled.
Any kind of disability can be distressing and bring about considerable financial hardships. Fortunately, the SSA (Social Security Administration)’s disability benefit programs provide coverage for medical expenses, and some part of the wages lost due to your inability to work. To ensure that the benefits are paid only to deserving candidates, the SSA conducts a chart review or evaluation of all relevant medical records of the applicant. An unbiased review will be able to identify the exact nature of the applicant’s disability and how it prevents him/her from engaging in their routine job.
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Attorneys handling disability cases usually associate with a professional medical record review company to get help with the review process and obtain solutions such as medical case chronology. This is a chronologically arranged summary that provides a clear view of the various medical encounters relevant to the case. Once the claim is filed with the SSA, the disability determination process may take some time. However, there are a number of health conditions that may qualify the claimant for expedited processing of the disability claim. This speeding up may be possible for both SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income); the latter is meant for low-income people who are disabled, blind or above the age of 65. SSA’s Compassionate Allowance List (CAL) The
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Compassionate Allowance List (CAL) of the SSA. If you qualify for this, the SSA may approve your claim with a relatively small amount of objective medical data. To speed up the process for those who qualify under CAL, a claims examiner will often call the claimant’s treating physicians rather than writing to them. For very severe conditions, the determination may be made even within 10 days. You can find the Compassionate Allowance List at https://www.ssa.gov/compassionateallowances/conditions.htm. There are about 240 disabling conditions on this list, which include neurodegenerative and immunesystem diseases, fast-moving cancers, rare genetic disorders and other illnesses that prevent sufferers from working and are likely to result in death. In 2018, they added five conditions -- fibrolamellar cancer, megalencephaly capillary malformation syndrome (MCAP), megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS), superficial siderosis of the central nervous system, and tetrasomy 18p to the CAL. The SSA uses a software system to identify claims citing conditions of the CAL list. The claim is approved based on the diagnosis and its severity. SSA’s Quick Disability Determination (QDD) Process The QDD process is another electronic system the SSA uses to screen SSDI and SSI applications that are filed online. The process scans for phrases and keywords that signify that a claim is highly likely to be approved, and it ensures that the application is filed along with all the required documentation. These applications are then marked for expedited processing. Those claims that are not filed electronically are reviewed by claims examiners,
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who will then flag them for fast-track status. The SSA has been using QDD nationally since February 2008. Considering the severe nature of many of these diseases, these claims are mostly allowed based on just medical confirmation of the diagnosis. Up till now, more than 500,000 people with serious disabilities have been approved through SSA’s fast-track processes. While the use of advanced technology allows the SSA to easily identify potential Compassionate Allowances and make speedy decisions, for disability claims not covered under CAL, the SSA utilizes the efficiency and speed of electronic health records to speed up the disability determination process. With EHR systems, Social Security can quickly obtain the claimant’s medical information, perform a chart review, and make a quick determination. It is important to remember that for all SSDI claims, including those that are fast-tracked and approved, there is a waiting period to receive benefits. The earliest payments may start five months from the date that the SSA determines the claimant’s disability began, based on the medical evidence provided. For SSI payments, there is no waiting period involved.
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