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



 

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On March 1st 2010, Huntington's Disease (HD) was added to the “Compassionate Allowances” (CAL) conditions list by Social Security under Mixed Dementia! 

The following is taken from the SSA website:  "Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

Compassionate allowances are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate allowances allow Social Security to quickly target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly."  (http://www.ssa.gov/compassionateallowances/)

 


Compassionate Allowances

SSA logo: link to Social Security Online home

Social Security Adds 38 New Compassionate Allowance Conditions

New Compassionate Allowance Conditions (effective March 1, 2010)
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


Phil Hardt  phardt1@cox.net  602-309-3118
 


 

 
 
         
   

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