Compassionate Allowances - More to come?

In today's Federal Register, the Social Security Administration served notice of an upcoming hearing regarding the identification of Compassionate Allowances for Cardiovascular Disease and Multiple Organ Transplants. For those that may not be familiar with the term, Compassionate Allowances are a way for Social Security to issue favorable decisions on "easy" cases by identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate Allowances allow Social Security to quickly target the most obviously disabled individuals for benefits based on objective medical information that can be obtained quickly.

Currently there are 88 such allowances ranging from Acute Leukemia to Early Onset Alzheimer's and a variety of cancers. Originally the list of allowances was 50, and the list has extended now to 88. Cardiovascular Disease and Multiple Organ Transplants will be the subject of these latest hearings.

This is significant on a couple of fronts. Compassionate Allowances are made for the purpose of eliminating the time and resources spent on evaluating certain conditions that are "slam dunks". However, this latest set of maladies has it's own features that will definitely affect their suitability for inclusion on this list. For example, many Organ Transplants will almost certainly require at minimum a closed period of disability while recovery occurs. Transplants are typically not offered where there is to be no lifestyle improvement for the patient. As such, it would seem that Social Security will be forced to review each of these cases closely at some point in the case's progression. By swapping "sooner" for "later", is there any additional benefit?

Also, cardiac cases are a difficult category to evaluate. For example, Blue Book Listing 4.02A(1) contains what appears to be a very objective standard (<30%) regarding a left ventricular ejection fraction. I have had numerous clients demonstrably meet this standard over time, and meet the requirements in 4.02B, yet still be forced to qualify by gridding out, or by demonstrating that their symptoms erode their vocational base to zero. The essence here is that cardiovascular cases historically appear to have objective standards, but do not seem to be consistently evaluated as such. With this in mind, it is this practitioner's hope that any cardiac Compassionate Allowances made will be straightforward in their requirements and granted as such.

For questions about Social Security Disability contact Thomas O'Brien at Feiler & Associates.