The requirements for disability benefits for a person with a terminal illness are the same as the requirements for a person with a non-terminal illness—but the processing time is faster.
Belleville, Ill. (PRWEB) March 26, 2012
The recent death of nationally known hospice pioneer Dr. William Lamers brings to light ways in which those with a terminal illness can receive much-needed assistance, including Social Security Disability Insurance(SSDI) benefits, according to Allsup, which represents thousands of people in the SSDI application process each year.
Dr. Lamers, 80, died last month at his home in Malibu, Calif., as reported in the Marin (Calif.) Independent Journal. In 1974, Dr. Lamers co-founded Hospice of Marin, a nonprofit care facility that acquired Hospice by the Bay and later adopted that name to reflect its growth, the newspaper reported. Since then, hospice care has grown nationwide, and the National Hospice and Palliative Care Organization reported that 1.58 million patients received hospice care nationwide in 2010.
The SSA recognizes hospice care as presumptive eligibility for Supplemental Security Income (SSI), which allows it to pay up to six months of SSI payments before it makes a disability determination. This is based on the finding that there is a high probability that the applicant is disabled. And while the SSA does not provide presumptive disability payments to individuals who have applied for Social Security Disability Insurance (SSDI) benefits, applicants may qualify as a “TERI” case (terminal illness).
SSDI is a federally mandated disability insurance program overseen by the SSA that operates separately from the retirement and SSI programs. SSDI provides monthly benefits to individuals who are under full retirement age (age 65 or older) and who can no longer work because of a terminal illness or a severe disability (injury, illness or condition) that is expected to last for more than 12 months. Individuals pay for the federal insurance program through FICA taxes while working. More details are provided in the SSDI Overview at http://www.allsup.com.
“When the SSA receives TERI applications, it processes the cases as quickly as possible and initiates payments as soon as possible if the applicant is found to be disabled,” said Ed Swierczek, Allsup senior claimant representative. “The terminally ill are entitled to be treated in a special manner. They are nearing the end of their lives. The SSA tries to provide them with assistance as quickly as possible.”
SSDI applicants and their families should be aware that no cash benefits are paid to the family if the claimant dies during the five-month waiting period, which is five full calendar months, for cash benefits to begin or while the disability decision is being established.
In addition, the individual’s medical records or pathology report must reflect that the claimant is terminally ill. In other words, the individual has a condition that medical records indicate is untreatable; that is, the condition cannot be reversed and is expected to end in death. Generally, hospice programs require a doctor’s statement that a person has six months or less to live.
Social Security Disability: Fast-Track Initiatives
Below Allsup outlines a couple of examples of SSA fast-track initiatives that streamline review of Social Security disability applications.
Terminal Illness (TERI) Cases
The requirements for disability benefits for a person with a terminal illness are the same as the requirements for a person with a non-terminal illness—but the processing time is faster. Cases deemed “TERI” means special handling, with carefully prescribed protocols for appointment setting, labeling and flagging of TERI cases, tracking and continuous monitoring of timing to ensure processing without delay.
Applicants with an untreatable impairment must present a credible claim (from the individual, friend, family member, doctor or other medical source). Qualifying claims may include diagnoses, such as ALS (Lou Gehrig’s disease) or AIDS, or a statement that the claimant is receiving in-patient hospice care. Additional qualifying conditions include a bone marrow transplant, any malignant cancer that is metastatic (stage IV), and small cell or oat cell lung cancer, among others.
Quick Disability Determinations
The Quick Disability Determination (QDD) process is designed to analyze data in an SSDI claimant’s file in order to identify those cases that can be fast-tracked for approval of benefits. In QDD cases, the SSA relies on a predictive model to electronically determine claims where there is, according to the agency, a high potential that the claimant is disabled and where evidence of the person’s claim can be quickly and easily obtained. This model relies on scoring criteria to identify cases that qualify for consideration.
The Compassionate Allowances initiative speeds SSDI applications for individuals whose disabilities are so severe that they clearly meet established medical criteria. The original initiative was introduced in October 2008 and targeted 25 rare diseases and 25 cancers. The list now covers 113 conditions.
Unlike QDD, which employs scoring criteria to rank the severity of the disability, Compassionate Allowances affords qualifying claimants expedited review of disability applications based on confirmation of a qualifying diagnosis. Once the diagnosis is confirmed based on minimal objective medical information, the claim is approved in a matter of days—instead of months.
Find a list of conditions that qualify under the Compassionate Allowances program on Allsup.com. In addition, visitors can find more information about SSDI guidelines by type of disability on http://www.Allsup.com.
To find out if you might be eligible for Social Security disability benefits, call the Disability Evaluation Center at (800) 678-3276 for a free evaluation.
Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs more than 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, go to http://www.Allsup.com or visit Allsup on Facebook at http://www.facebook.com/Allsupinc.