Expedited Disability Decisions for Terminal Illness Claims

The Social Security Administration (SSA) expedites disability decisions for applicants with terminal illnesses through its Terminal Illness Program (TERI) program. Terminal illness cases are those that are expected to result in death; the DDS (Disability Determination Services, the state agency that determines disability for SSA) is expected to handle these cases quickly and with sensitivity to the claimant's condition.

How Are TERI Cases Selected?

SSA and the DDS are alerted to possible TERI cases by any of the following situations:

• An allegation (for example, from the claimant, a friend, family member, doctor, or other medical source) that the illness is terminal.
• The claimant is receiving inpatient or home hospice care (for example, in-home counseling or nursing care).
• An allegation or diagnosis of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, or
• An allegation or diagnosis of acquired immune deficiency syndrome (AIDS).

What Conditions Qualify for TERI?

Some examples conditions that qualify for TERI treatment include, but are not limited to, the following:

• Dependent on a cardiopulmonary life-sustaining device.
• Candidate for a heart, lung, liver, or bone marrow transplant (excludes kidney and corneal transplants).
• In a coma for 30 days or more.
• Chronic pulmonary failure or heart failure with home oxygen and an inability to care for personal needs.
• Newborn with a lethal congenital or genetic defect.
• Cancer that is:
  • metastatic (the cancer has spread)
  • diagnosed as Stage IV
  • persistent (recurrent following therapy), or
  • inoperable or unresectable.
• An allegation or diagnosis of any of the following illnesses:
  • cancer of the esophagus
  • cancer of the liver
  • cancer of the pancreas
  • cancer of the gallbladder
  • mesothelioma (cancer of lung or intestinal lining caused by asbestos)
  • small cell or oat cell lung cancer
  • cancer of the brain, or
  • acute lymphocytic leukemia (ALL) or acute myelogenous leukemia (AML).

Except for fast processing, TERI cases are treated like other disability cases; for instance, SSDI recipients still have a five-month waiting period following the onset of their disability for which they can't collect benefits. And like all disability claims, including Compassionate Allowance cases, a medical consultant is required to review the file before the disability claims examiner at DDS (Disability Determination Services) makes a TERI determination.

If you think your claim, or the claim of a loved one, may be a TERI case, you should tell SSA that when first applying for disability benefits. That way, the claim will be expedited from the very start.

Other Expedited Programs

Note that QDD (Quick Disability Determination) cases and CAL (Compassionate Allowance) cases do not necessarily imply terminal illness, although they could involve such a prognosis. Sometimes these expedited programs overlap, and your claim might fall into two or three of the programs. In that case, you have an even better chance of a fast decision from Social Security.