Social Security Administration/Compassionate Allowances Initiative

The Social Security Administration’s disability workloads have grown significantly in recent years as the baby boom generation started to reach their disability-prone years.  In fiscal year 2011 alone, we received nearly 3.3 million disability claims.  This has resulted in backlogs and delays in processing claims, with pending cases averaging close to 700,000 in 2011.  On average, an initial application takes two to three months for a decision.  We are committed to providing benefits quickly to individuals whose medical conditions clearly meet our standards.  Our Fast-Track processes (Compassionate Allowances and Quick Disability Determinations) use advanced technology to enhance service to the disabled population and improve operational efficiency.  Through our Fast-Track processes, we provide a much quicker disability determination (days rather than months) to claimants with severely disabling conditions.

We began piloting the QDD predictive model in August 2006 and rolled it out nationally by February 2008.  We automatically identify and flag disability cases for expedited processing through the use of a computer-based statistical (predictive) model, which reads and evaluates the information on an application in less than ½ second.

We developed the predictive model by data mining adjudicated claims and by identifying case characteristics that were most highly associated with claims that we allowed and processed quickly.  The case characteristics can include any data found in an individual’s electronic disability folder, including age, education, work history, and alleged medical conditions.  We used the technical skills of IBM contractors, particularly their expertise in text analytics, in the design and development of the predictive model.

We launched the Compassionate Allowances (CAL) initiative in 2008.  CAL is a way of quickly identifying diseases and other medical conditions that meet our disability standards based on minimal objective medical information.  We select CAL conditions through extensive outreach, including public hearings and discussions with advocacy groups and the SSA community.  We have worked closely with the National Institutes of Health (NIH) to ensure that the conditions we select for CAL are based on sound up-to-date medical science.

We currently have 165 conditions on the CAL list.  The CAL list includes cancers, dementias, neurological diseases, and rare diseases affecting children.  We post our CAL conditions on our public website at www.socialsecurity.gov/compassionateallowances.  We also have impairment summaries for each CAL condition that provides guidance to our adjudicators when making a disability determination.  We automatically identify and flag these cases for expedited processing by using selection software (SS) that selects cases based on the condition alleged by an individual on his or her application.  Medical conditions identified as CAL (i.e., acute leukemia) have been loaded into the SS by name, alternative names, and abbreviation.

In 2010, the Alzheimer’s Association awarded Commissioner Astrue its humanitarian award in recognition of his exceptional leadership in creating the CAL initiative and the decision to include early-onset Alzheimer’s disease and other dementias in that initiative.  In 2011, the Partnership for Public Service awarded one of our executives the coveted Citizen Services Medal for creating the CAL Initiative.  Our agency strategic plan and annual performance plan recognizes CAL and QDD as two of our greatest successes in recent years towards providing better service to our claimants with severe conditions.  Congress also recognizes the innovative nature of our fast-track processes.  In 2012, Congress passed the National Defense Authorization Act for Fiscal Year 2012 that requires the Department of Defense, in consultation with Veterans Affairs, to: Report on the feasibility and advisability of establishing a process to expedite the determination of disability with respect to members of the Armed Forces; and Evaluate elements of programs for expedited determinations of disability that are currently carried out by other departments and agencies of the Federal Government, including the Quick Disability Determination program and the Compassionate Allowances program of the Social Security Administration.

As a result of this provision, we have met with the Department of Defense’s Office of Wounded Warrior Care & Transition Policy, to provide a presentation on our Fast-Track processes and our electronic disability claims process.

 

Social Security Administration

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