September 20, 2017

Triage and the Mass Casualties of Social Security Disability

By Tai Prohaska

In mass casualty situations, such as natural disasters, triage identifies those who will die without immediate care and those whose injuries are less severe. By tending to the most severely injured first, triage saves more lives.

For the Social Security Administration (SSA), the potential mass casualties are the 1.1 million people stuck in the disability hearing backlog, waiting to learn if they will receive benefits. SSA reports that 8,699 people died while waiting for their hearing in fiscal year 2016.

The Compassionate Allowance (CAL) program is one of SSA’s early triage systems, designed to identify and speed up benefits for individuals with the most severely disabling and life-threatening conditions.

But a recent Government Accountability (GAO) report concluded that many people who qualify for the CAL program may be overlooked when they first apply.

People need help when they apply for disability

Most people are denied Social Security Disability Insurance (SSDI) at the application level, and are thrust into a backlog, where they wait through the first appeal level and then an average 596 days for a hearing. The wait is 700 or more days at 20 hearing offices, including Miami (759 days), Philadelphia (737 days) and New York (730 days).

The CAL program includes 228 conditions that qualify for expedited processing, providing disability benefits in a matter of days instead of months or years. However, SSA primarily relies on software that searches for key words in claims to identify applications as eligible for CAL. If claimants include incorrect or misspelled information or don’t describe their condition using just the right words, the software may not flag a CAL condition.  According to the GAO report, SSA frequently has relied on disability advocacy organizations to bring conditions to its attention and may overlook disabling conditions for individuals who have no advocate groups supporting their particular disease.

Get help right away

One way to ensure the right level of triage occurs and allocates resources to those who need it most, is to have help early. Allsup provides a free online screening tool―empower by Allsup®, that immediately helps individuals learn their eligibility and the likelihood of obtaining SSDI benefits, guides them through the application process, identifies eligibility for SSA’s expedited programs such as CAL.

The SSA is working to reduce the backlog. The agency reports that when national hearing wait times reach an average 270 days, they will consider the backlog eliminated. That may be 270 days more than a person with a CAL condition can afford to wait.

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