Social Security's Compassionate Allowances List

Certain serious and easily provable conditions are eligible for expedited approval through the Compassionate Allowance List.

By , Attorney · UC Law San Francisco

The Social Security Administration (SSA) offers a Compassionate Allowances program for disabled workers who have applied for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits. The program was developed in response to complaints about long delays getting disability decisions, particularly for very serious illnesses.

What Is the Compassionate Allowance Program?

The Compassionate Allowances program provides benefits quickly to disability applicants whose medical conditions are so serious that it's clear they would qualify for disability under an SSA impairment listing. The program allows Social Security to quickly target the most obviously disabled applicants and grants them benefits soon after applying.

Claiming to have a disability or disease that's on the Compassionate Allowance list (CAL) is enough to put your application for benefits on the fast track for approval. Your medical records need to support your claim, but if Social Security finds you have a Compassionate Allowance condition, you will almost always automatically qualify for disability benefits.

Fast Decisions for Serious Impairments

If you have a condition that's been designated as a Compassionate Allowance, the SSA will approve you for disability benefits based on a relatively small amount of objective medical data, such as a diagnosis or a biopsy result. And you can receive a positive award decision in as little as 10 days from when you first filed your application. The average processing time for Social Security to process a compassionate allowance case is 19 days.

Because it can take weeks or months for medical providers to send records to Social Security, if you have a CAL claim, a claims examiner will often call your treating doctors, rather than writing to them, and will request the records be sent right away. But submitting medical records that prove your diagnosis (such as a biopsy report for cancer) with your claim can help fast-track your application.

Which Conditions Qualify as Compassionate Allowances?

The conditions that qualify as Compassionate Allowances include many cancers, ALS, some types of muscular dystrophy and muscular atrophy, early-onset Alzheimer's disease, and several other illnesses. For some conditions, you only need to have a diagnosis (with supporting evidence like a biopsy or blood test result) to qualify you for a compassionate allowance. A diagnosis alone is required for:

  • small cell cancer of the lungs, prostate gland, or female genital tract
  • esophageal cancer (carcinoma or sarcoma)
  • some types of pancreatic cancer, or
  • ALS.

Other conditions on the list have specific criteria for how severe the illness must be; for example, malignant melanoma qualifies for a compassionate allowance only if it has metastasized. And most forms of breast cancer qualify for a compassionate allowance only if the cancer has progressed.

Not all severe or potentially fatal illnesses are on the list; for example, AIDs is not a compassionate allowance condition (instead, you must fulfill the complex severity requirements of the HIV/AIDs listing to qualify for benefits).

A complete list of conditions that qualify for Compassionate Allowances can be found on the Social Security website.

Does Social Security Add to the Compassionate Allowance List?

The SSA usually adds a handful of conditions to the compassionate allowance list every year or so. In 2023, Social Security added 12 new conditions, all rare, to the CAL:

  • 1p36 Deletion Syndrome
  • Anaplastic Ependymoma
  • Calciphylaxis
  • Cholangiocarcinoma
  • FOXG1 Syndrome
  • Leber Congenital Amaurosis
  • Metastatic Endometrial Adenocarcinoma
  • Paraneoplastic Cerebellar Degeneration
  • Pineoblastoma – Childhood
  • Primary Omental Cancer
  • Sarcomatoid Carcinoma of the Lung – Stages II-IV, and
  • Trisomy 9.

Is There a Compassionate Allowance Waiting Period?

While the Compassionate Allowance program helps get a disability determination more quickly, SSDI beneficiaries still have to wait five months after their disability onset date to begin receiving benefits (and 24 months after their onset date before Medicare benefits begin). This time period is called the SSDI waiting period.

But, if you were disabled for five or more months before applying for benefits, you won't have to wait for benefits at all after Social Security approves you for benefits. Your waiting period will have already happened. Learn more about the disability onset date and five-month waiting period.

Also, there's one exception to this five-month waiting period for SSDI: benefits start right away for applicants with ALS (amyotrophic lateral sclerosis), no matter when they apply.

SSI recipients don't have a waiting period; their benefits can start the month after they submit their application.

Can Compassionate Allowance Claimants Get Retroactive Payments?

Compassionate Allowance benefits are paid out as either SSDI benefits or SSI benefits. SSDI recipients can get retroactive payments, but SSI recipients can't.

If you apply for SSDI, Social Security will look for evidence in your file to find out when you became unable to work. Some claimants (applicants) are actually disabled six months to a year before they apply for disability benefits. When this happens, they can get retroactive benefits going back to the date they became disabled. The full amount of "back pay" they'll receive will be for the months between when the disability began and when the application is approved (minus the five-month waiting period).

How to Apply for a Compassionate Allowance

You apply for a compassionate allowance condition the same way as anyone would apply for SSDI or SSI benefits.

You can file:

The SSA will automatically flag your application if it mentions a compassionate allowance condition and will expedite it.

Other Expedited Disability Determinations

Compassionate Allowances (CAL) and Quick Disability Determination (QDD) are two separate processes that can overlap as your case is being decided. Compassionate Allowances naturally follow a fast track, and Quick Disability Determination is another method that Social Security uses to process other serious claims quickly. QDD uses a computer program to identify claims that are likely to qualify for benefits by matching the SSA's listings. Learn more about Quick Disability Determinations.

Social Security also expedites claims where the impairment is a terminal illness. Learn more about the terminal illness program (TERI).

In addition, some SSI disability applicants' impairments qualify as "presumptive disabilities," meaning those applicants can start to get monthly SSI benefits even before their disability claim is approved or denied. Learn more about the Presumptive Disability Program for SSI.

Updated August 16, 2023

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