Terminal Illness and Disability Benefits
Health & Benefits
One of the clichés you frequently may hear is: there are two certainties, taxes and death. We all have to pay taxes, and we all have to die. We spend a lot of time learning about taxes but rarely do we take time to consider the complexities of dying. There is a lot to know. For example, the Texas Health and Human Services and the Social Security Administration (SSA) have programs and benefits that are designed to help people who have terminal illnesses.
Disability
Millions of Texans have a disability of one kind or another. Some people are challenged by disabilities from a young age. Others develop disabilities as they age. Still others become disabled after becoming terminally ill.
Texas Health and Human Services and the SSA provide a range of benefits to those that are disabled. Benefits might include monthly benefit payments, help paying health care expenses, or supplemental food benefits.
Whether it is Medicare, Medicaid, Social Security, Supplemental Security Income (SSI), or Supplemental Nutrition Assistance Program (SNAP), help is available.
And there are special programs for those that become disabled due to a terminal illness as well.
Social Security Disability for Terminal Illness
People that are limited in one or more major life activities (for example: hearing, seeing, thinking or memory, walking or moving) can get help by applying for Social Security disability benefits. Unfortunately, for a variety of reasons, the processing time for establishing those benefits can take time.
But when a person becomes disabled due to a terminal illness, their application for benefits is expedited and processed through the terminal illness program (TERI).
What is a TERI case?
The SSA defines a terminal illness as a medical condition that is untreatable and expected to result in death. These TERI cases are identified by SSA’s Disability Determination Services.
What types of illnesses are eligible for expedited TERI processing?
Anyone that has a terminal illness is eligible for TERI processing. Some examples include:
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Cancer that is metastatic, Stage IV, recurrent following therapy, or inoperable
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Various specific forms of cancer, such as liver, pancreas, or brain
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Mesothelioma
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Certain forms of leukemia
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Awaiting liver, lung, heart, or bone marrow transplant
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HIV
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ALS
Is there a way to get benefits while the disability application is being processed?
Yes. The SSA also offers the ability to file for presumptive disability benefits, which allows you a monthly cash benefit while the agency processes the application.
Essentially, there are certain conditions that allow the SSA to presume that the person is disabled, and that presumption allows SSA to begin paying benefits immediately and for up to six months.
What conditions allow presumptive disability?
The following conditions are eligible for presumptive disability and immediate benefits:
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Symptomatic HIV/AIDS
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Total Blindness
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Total Deafness
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Down Syndrome
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Amputation of two limbs or of one leg at the hip
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Spinal cord injury that includes inability to walk without a walker
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Stroke that results in difficulty walking or using hands/arms
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Multiple dystrophy, cerebral palsy
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Severe intellectual disorder
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End-stage renal disease
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Low birth weight
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Confinement to bed and required use of a wheelchair or walker (due to long term condition
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Terminal illness
What is the Compassionate Allowance Initiative?
Some cases may have a high probability of disability but may not be TERI cases because they do not meet the specific criteria. Some non-TERI cases may be eligible for the Compassionate Allowance Initiative (CAL). The CAL is another program that is designed to allow the SSA to quickly identify diseases and medical conditions that always meet SSA’s disability standards. The point is to reach a decision point quickly so that benefits can begin as quickly as possible.
What type of condition qualifies for the Compassionate Allowance Initiative?
Typically, the conditions that will qualify for this type of consideration are going to be cancers, brain disorders, and certain childhood disorders. Most forms of breast cancer qualify only if the cancer has progressed.
A complete list of CAL conditions is detailed on the SSA’s website at: Compassionate Allowances Complete List of Conditions (ssa.gov)
How long do the expedited processes take?
Every case is different, but generally the SSA can process a TERI case in about 30 days.
Is there someone I can reach out to for help?
You can download the Your Texas Benefits app to learn about and manage your benefits. You can also contact Texas Health and Human Services at their website: Your Texas Benefits - Learn
You can also get information from SSA at: Compassionate Allowances Website Home Page (ssa.gov).
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