Compassionate Allowances Initiative

In October of 2008, the Social Security Administration (SSA) announced the commencement of the national Compassionate Allowances Initiative, a means to expedite the processing of disability claims for applicants whose medical conditions are so severe that their conditions obviously meet the Social Security’s standards.  According to the Commissioner of Social Security, Michael Astrue, “getting benefits quickly to people with the most severe medical conditions is both the right and the compassionate thing to do.  This initiative will allow us to make decisions on these cases in a matter of days, rather than months or years.”

Before announcing the initiative, the SSA held public hearings to receive information from experts on rare diseases and cancers.  The agency also sought assistance from the National Institutes of Health. As a result, the SSA initially launched the expedited decisions process with a total of 50 conditions that included 25 cancers and 25 rare diseases.  The SSA vowed that, over time, more conditions would be added to the list. 

True to their word, in February of this year, the SSA announced that early-onset Alzheimer’s disease, as well as four related dementias have been added to SSA’s Compassionate Allowances Initiative.  The four related dementias include: frontotempral dementia (FTD) – Pick’s disease, Creutzfeldt-Jakob disease, mixed-dementia, and primary progressive aphasia.  To determine which diseases and conditions to include, the SSA held several public outreach hearings throughout the country that included testimony from medical experts as well as testimony from those directly affected by the disease and conditions.  The July 2009 Compassionate Allowance Initiative Hearing on Early-Onset Alzheimer’s Disease and Related Dementias held in Chicago included testimony from the CEO of the Alzheimer’s Association, several of the nation’s top Alzheimer’s disease researchers, and care givers and individuals with early-onset Alzheimer’s disease who discussed the challenges they face during the disability application process. 

During the day-long hearing, SSA officials heard about the terminal nature of Alzheimer’s disease, the disabilities that often prohibit work in even the earliest stages of the disease, and the lack of effective treatments to modify or halt the progression of the disease.  The Alzheimer’s Association praised the SSA for understanding that cognitive impairments caused by Alzheimer’s disease leave individuals unable to maintain gainful employment and deserving of an expedited disability determination.  The Association reiterated that Social Security benefits are important to those with early-onset Alzheimer’s disease and related dementias who are unable to work and have no other source of income.  Individuals with early-onset Alzheimer’s disease and related dementias who apply for Social Security benefits are often initially denied, but usually win on appeal.  The problem is that the appeals process can take years.  Until now, individuals with early-onset Alzheimer’s disease have faced a myriad of challenges when applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), including a long decision process, initial denials, and multiple appeals.  According to the Alzheimer’s Association, the recent decision by the SSA to add these conditions will simplify and streamline the SSDI/SSI application process and significantly decrease the wait time to receive much-needed benefits.

In the words of Michael Astrue: “This is America.  It is simply not acceptable for people to wait years for a final decision on a disability claim.  I am committed to a process that is as fair and speedy as possible. The launch of Compassionate Allowances is another step to ensuring Americans with disabilities, especially those with certain cancers, and rare diseases, get the benefits they need quickly.”
For more information on the Compassionate Allowances Initiative and/or on Alzheimer’s disease, please go to or


Oast Hook has been providing quality legal services in Southeastern Virginia and North Carolina for more than 80 years. The attorneys at Oast Hook can assist clients with their estate, financial, insurance, long-term care, veterans’ benefits and special needs planning issues. Visit their website at for more information.

Sandra Smith

Sandra L. Smith joined the firm in 2003. She practices primarily in the areas of elder law, estate planning, estate and trust administration, special needs planning, asset protection planning, long-term care planning and Veterans’ benefits. Ms. Smith is certified as an Elder Law Attorney (CELA) by The National Elder Law Foundation (NELF).

In 2008, Ms. Smith was named as a Rising Star by Virginia Super Lawyers magazine. Rising Stars names the state’s top up-and-coming attorneys.

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