What Medical Conditions Get Approved Automatically for Disability?

Metastasized cancers qualify for automatic disability payments.
Image Credit: Gulcan yasemin Sumer/Hemera/Getty Images

For most people, there is no easy way to predict the wait time for a decision on an initial Social Security Disability application because the Social Security Administration has no established timelines for processing either an application or an appeal. However, for people suffering from a terminal illness or a medical condition designated by SSA as especially serious, a decision can be almost automatic.

How SSA Defines Automatic

Social Security Disability benefits are only available to people suffering from long-term medical conditions and severe disabilities. While there are programs for expediting claims processing, there is also a five-month waiting period before Social Security starts paying monthly benefits. The only exception to the waiting period rule is for low-income people applying for Supplemental Security Income who meet the criteria for a presumptive disability. For everyone else, "automatic" means an application receives priority, but not immediate, treatment.

Presumptive Disability

The SSA has the authority to grant immediate disability payments for conditions so serious that an applicant is presumed to be disabled. However, the presumptive disability program applies only to low-income applicants with specific medical conditions. These include disabilities such as total deafness or blindness, Down syndrome, cerebral palsy, a spinal cord injury, amputation of two limbs or of one leg at the hip and severe mental retardation in a child older than 7 years of age. Presumptive benefits last for up to six months, or until application processing is complete.

Terminal Illness Program

Social Security Regulation DI 11005.601 says that application processing must be expedited if it indicates a person is suffering from a terminal illness. The indication can come from an allegation or diagnosis that an illness is untreatable and is expected to end in death. Conditions that qualify include Lou Gehrig's disease, AIDS and many types of cancer identified as having metastasized, reached Stage IV or been deemed inoperable, persistent or recurring following initial therapy. A person already receiving inpatient hospice care or home hospice care also qualifies.

Compassionate Allowances Program

The Compassionate Allowances program identifies more than 165 conditions that Social Security considers severe enough to qualify for expedited processing. With some conditions, such as early-onset Alzheimer's disease and muscular diseases, a diagnosis alone is enough to qualify the person. For other conditions, including leukemia, heart conditions and some types of cancer, criteria define how severe the illness must be for the applicant to qualify. For example, a malignant melanoma, the most serious type of skin cancer, qualifies for a compassionate allowance only if it has metastasized.

references & resources