TN 9 (06-13)

DI 23022.010 Compassionate Allowances and Quick Disability Determinations Fast-Track Processes

Citations:

20 CFR §§ 404.1602, 404.1619, 416.1002, 416.1019

A. Fast-track processes for Compassionate Allowances (CAL) and Quick Disability Determinations (QDD) cases

Our two fast-track processes, CAL and QDD, use technology to identify claimants with impairments that significantly affect their ability to function and allow us to expedite our determinations on those cases.

There are three removal reasons that apply to CAL and QDD fast-track cases:

  1. All claims in the case are denials,

  2. All claims in the case are disability determination services (DDS) “no determinations”, and

  3. Non-fast-track action or development is required.

NOTE: Fast-track processing (i.e., CAL or QDD) does not apply to continuing disability review (CDR) cases.

B. Definition and selection criteria of CAL and QDD cases

1. CAL case

A CAL case is an Electronic Disability Collect System (EDCS) case identified electronically by CAL selection software, or manually by the DDS, as having alleged diseases or other medical conditions that invariably qualify under the Listing of Impairments based on minimal, but sufficient, objective medical information. Do not designate the case as CAL if the condition does not meet these strict criteria.

CAL selection software identifies cases for CAL processing based solely on the claimant’s alleged medical condition(s) listed on the SSA-3368 (Disability Report – Adult) or SSA-3820 (Disability Report – Child). If the claimant alleges a medical condition (by name, synonym, or abbreviation) that is on the CAL list, the selection software identifies the case for CAL processing.

The Office of Disability Programs (ODP) CAL website provides more information on CAL, and houses the Impairment Summaries.

2. QDD case

A QDD case is an initial EDCS case identified electronically using a Predictive Model (PM). These cases have a high degree of probability that:

  • the claimant is disabled;

  • evidence of the claimant’s allegations is readily available; and

  • the DDS can process the case quickly.  

C. CAL and QDD basics

1. CAL cases

Adjudicators can manually identify CAL cases at Initial, Reconsideration, Hearing, and Appeals Council adjudicative levels. Most CAL cases are identified by the selection software upon EDCS transfer to the DDS at the initial adjudicative level.

Designated employees in the DDS, the Office of Quality Review (OQR), and the Office of Disability Adjudication and Review (ODAR) can manually add, remove, and reinstate a CAL indicator to a case per DI 23022.055. Field office (FO) employees cannot add, remove, or reinstate CAL cases. Like QDD, Terminal Illness (TERI) cases and presumptive disability (PD) or presumptive blindness (PB) claims, the FO must initiate full non-medical development for a CAL case.

NOTE: The FO workload management information (WMI) listings do not capture these manual additions, reinstatements or removals. For CAL cases that are not already identified as QDD, when an adjudicator adds, removes, or reinstates a case from the CAL process an EDCS action item automatically notifies the FO. FOs regularly monitor EDCS action lists to identify any case where the adjudicator sets a CAL indicator after transfer.

CAL cases are:

  1. assigned to designated disability examiners who have the knowledge, training, and experience to effectively carry out the fast-track process, and meet the qualifications set forth in DI 23022.020;

  2. processed as expedited cases; and,

  3. designated simultaneously (as applicable) as a TERI case, PD or PB claim, and QDD case to ensure continued priority handling if the adjudicator removes the case from the CAL process.

NOTE: CAL cases are similar to TERI cases, although not all CAL cases involve terminal illness. For example, a person with a spinal cord injury could qualify as CAL – even if he or she expects to