Social Security Disability Benefits for Terminal Illness (TERI) Patients

Because of the urgency involved when handling disability applications for people with terminal illnesses, the Social Security Administration (SSA) has a method to quickly identify and process what the agency calls "TERI cases."

The TERI program allows Social Security to award benefits for people with terminal illnesses quickly, and with special sensitivity—for example, the SSA doesn't use the words "terminal" or "terminal illness" on any material that's sent to the applicant.

What Is a Terminal Illness (TERI) Case?

Terminal illness cases are those that are expected to result in the death of the disability applicant ("claimant"). Social Security has a list of diagnoses that will flag the application for potential expedited processing as a TERI case:

• Stage IV inoperable terminal cancers that have metastasized (spread to other parts of the body) and keep coming back despite treatment
• cancers of the esophagus, liver, pancreas, gallbladder, brain, and lung (small cell)
• acute myelogenous leukemia or acute lymphocytic leukemia
• amyotrophic lateral sclerosis (Lou Gehrig's disease), and
• acquired immunodeficiency syndrome (AIDS).

Additional factors that can flag an application as a TERI case include:

• when the claimant has been in a coma for 30 days or more
• if the claimant is on a life-support system, such as a ventilator
• if the claimant has chronic heart or lung failure that requires continuous oxygen and caregivers
• If the claimant is receiving in-home palliative or hospice (end-of-life) care
• when the application is on behalf of a newborn with a fatal congenital or genetic defect, and
• when the claimant is awaiting a liver, lung, heart, or bone marrow transplant.

Before the claims examiner at Disability Determination Services (DDS) can make a decision on whether a claim qualifies for fast processing as a TERI case, the examiner must ask a medical consultant (a doctor who provides opinions for Social Security).

How Does Social Security Identify Terminal Illness Cases?

Claimants don't have to state on their applications that they have a terminal illness to qualify for expedited processing under the TERI program. Field office representatives or claims examiners at DDS can designate an application as a TERI case when a doctor, family member, or friend states that the illness is expected to result in death or when the claimant is receiving inpatient hospice care or home hospice care.

How to Qualify for Terminal Illness Social Security Benefits

Even though the SSA can flag a potential TERI case based on an allegation or diagnosis of a terminal illness, the agency still needs to see medical documentation of the illness before the application can be approved. For example, an application for benefits based on terminal cancer will need to contain medical tests, imaging, and treatment from the claimant's oncologist (cancer specialist).

As with every disability application, TERI claimants need to meet the financial eligibility requirements for the type of disability program they're applying for, whether Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or both.

Other Expedited Disability Determination Programs

Some cases that are in the TERI system could also qualify for expedited treatment through the Presumptive Disability program for SSI (such as patients in hospice), the Compassionate Allowances program (for cancers that aren't covered under the TERI program), or the Quick Disability Determination program.

_{Updated November 7, 2022}