Huntington's Disease Added To Social Security's List of Compassionate Allowance Conditions on March 1, 2010!

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Compassionate Allowances

www.socialsecurity.gov

Social Security Adds 38 New Compassionate Allowance Conditions

New Compassionate Allowance Conditions (effective 3/1/10)
1	Alstrom Syndrome
2	Amegakaryocytic Thrombocytopenia
3	Ataxia Spinocerebellar
4	Ataxia Telangiectasia
5	Batten Disease
6	Bilateral Retinoblastoma
7	Cri du Chat Syndrome
8	Degos Disease
9	Early-Onset Alzheimer’s Disease
10	Edwards Syndrome
11	Fibrodysplasia Ossificans Progressiva
12	Fukuyama Congenital Muscular Dystrophy
13	Glutaric Acidemia Type II
14	Hemophagocytic Lymphohistiocytosis (HLH), Familial Type
15	Hurler Syndrome, Type IH
16	Hunter Syndrome, Type II
17	Idiopathic Pulmonary Fibrosis
18	Junctional Epidermolysis Bullosa, Lethal Type
19	Late Infantile Neuronal Ceroid Lipofuscinoses
20	Leigh’s Disease
21	Maple Syrup Urine Disease
22	Merosin Deficient Congenital Muscular Dystrophy
23	Mixed Dementia
24	Mucosal Malignant Melanoma
25	Neonatal Adrenoleukodystrophy
26	Neuronal Ceroid Lipofuscinoses, Infantile Type
27	Niemann-Pick Type C
28	Patau Syndrome
29	Primary Progressive Aphasia
30	Progressive Multifocal Leukoencephalopathy
31	Sanfilippo Syndrome
32	Subacute Sclerosis Panencephalitis
33	Tay Sachs Disease
34	Thanatophoric Dysplasia, Type 1
35	Ullrich Congenital Muscular Dystrophy
36	Walker Warburg Syndrome
37	Wolman Disease
38	Zellweger Syndrome

http://www.ssa.gov/compassionateallowances/newconditions.htm

POMS Section: DI 23022.015

Social Security Online

Effective Dates: 10/24/2008 - Present

TN 1 (10-08)

DI 23022.015
Compassionate Allowance (CAL)DDS Instructions

The CAL initiative is designed to quickly identify diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal, but sufficient, objective medical information. If the condition does not meet these strict criteria, it will not be designated as a CAL case.

All CAL-identified conditions are entered into the Predictive Model (PM) and are selected for CAL processing based solely on the claimant’s allegations listed on the SSA-3368 (Disability Report—Adult) or SSA-3820—(Disability Report—Child).

Like Quick Disability Determinations (QDD), CAL cases will receive expedited processing within the context of the existing disability determination process.

CAL cases are similar to Terminal Illness (TERI) claims, although not all CAL cases involve terminal illness. For example, a person with a spinal cord injury could qualify as a compassionate allowance – even if he or she is expected to live for many years.

http://policy.ssa.gov/poms.nsf/lnx/0423022015

POMS Section: DI 23022.455

www.socialsecurity.gov

Effective Dates: 02/26/2010 - Present

TN 3 (02-10)

DI 23022.455 Mixed Dementia

MIXED DEMENTIAS
ALTERNATE NAMES	Dementia due to multiple etiologies; Vascular dementia Alzheimer’s disease (VaD); Parkinson’s dementia; Diffuse Lewy-Body dementia; Frontotemporal dementia (Pick’s disease); Huntington’s dementia; Prion dementia; Progressive Supranuclear Palsy (PSP)
DESCRIPTION	Mixed Dementias are conditions with more than one etiology for the dementia. The combination of Vascular dementia and Alzheimer’s disease (VaD) is the most common form. The Vascular component is characterized by focal ischemic infarcts (strokes) and subcortical ischemic vascular disease, and has the potential to cause substantial focal neurological deficits such as aphasia, apraxia, or agnosia and motor manifestations such as paralysis, gait impairment, or Parkinsonian syndrome. The Alzheimer’s component is characterized by a progressive decline of memory and other cognitive abilities relative to a previous level of functioning. Mixed dementias are characterized by progressive and persistent intellectual decline compromising at least two spheres of cognition (i.e. memory, language, orientation, attention, executive abilities, etc). These individuals may also have motor and gait impairment, affective disturbances, sleep disturbances, and incontinence.
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING	The diagnoses of mixed dementias are based on a clinical history of cognitive decline, neurologic and cognitive/neuropsychologic examination, and neuroimaging. Pertinent clinical information includes history of onset and description of cognitive and functional impairments at home and at work. History of a previous stroke(s) adds to the likelihood of the diagnosis, but is not required. Currently, there is no specific clinical or laboratory test for the diagnosis of Alzheimer’s disease and its diagnosis can only be confirmed by brain biopsy or postmortem examination of the brain. Neuroimaging, i.e. computerized tomography (CT) or magnetic resonance imaging (MRI) is useful to demonstrate vascular lesions such as infarcts and lacunes, and to exclude other causes of dementia, some of which may be treatable. ICD-9 Code: 290.4
ONSET AND PROGRESSION	Individuals diagnosed with mixed dementias experience a gradual, yet relentless, decline in cognitive functioning over a period of many years, approximately a decade. The vascular component of the disease may be marked, although not necessarily, by episodes of abrupt deterioration or shortening of the course of the disease.
TREATMENT	Currently there is no treatment to cure or slow the progression of the Alzheimer’s component of mixed dementia. Treatment is therefore symptomatic and may include drugs that increase cholinergic transmission, antioxidants, glutamate receptor blockers, antipsychotics or neuroleptics, sedatives, and antidepressant and anxiolytic agents. Management of high blood pressure and other risk factors for cerebrovacular disease appears as a more effective approach to prevent brain infarcts and mixed dementias.
SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation: Clinical information documenting a progressive dementia is critical and required for disability evaluation of mixed dementias. The preferable sources of this information are the clinical records from the treating primary physician, neurologist, or psychiatrist. Documentation of dementia by standardized testing: Clinical Dementia Rating (CDR) scale with a score of =1, Mini-Mental State Examination (MMSE) with a score of = 20, or equivalent test is helpful but not required. Activities of daily living report completed by relative or caretaker Work activity or performance report completed by supervisor or co-worker Neuroimaging studies, i.e., computerized tomography (CT) scan or magnetic resonance imaging (MRI) demonstrating brain infarcts, lacunae, or atrophy constitute helpful supportive evidence, but are not required
Suggested Listings for Evaluation:
DETERMINATION	LISTING	REMARKS
Meets Listing	12.02 A & B
Medical Equals	12.02 A & B 11.04 A & B 11.06 11.17B

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.

http://policy.ssa.gov/poms.nsf/lnx/0423022455

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