Compassionate allowance list 2018: every condition added and why it matters

Last updated 2026-07-09

What is the Compassionate Allowances list and how does it work?

Compassionate Allowances (CAL) is SSA's fast lane for people whose diagnosis is so severe that approval is almost a formality. The logic is plain. Certain diagnoses meet the Social Security definition of disability on their face. Pushing those claims through the standard three-to-six-month pipeline helps no one.

SSA started CAL in 2008 after a run of public hearings that gathered medical and scientific input ^[1]. From launch through 2017, the agency added conditions in batches, usually right after each new hearing. Hearings covered rare diseases, aggressive cancers, and early-onset neurological conditions. Each batch dropped dozens of diagnoses onto the list at once.

When a claim names a CAL condition, SSA's systems are supposed to flag it automatically from the application text and any attached records. The file jumps to the front of the line. SSA's own guidance says a confirmed CAL case can be decided in as few as 10 days once the medical evidence lands, though real timing swings wider than that ^[2]. The five-month SSDI waiting period still applies. SSI has no waiting period at all, so knowing which program you're in changes what you can expect. See What Is SSDI? and SSDI vs SSI for the ground-floor differences.

CAL is not a separate program. You apply for SSDI or SSI the normal way. The flag happens on SSA's end, not yours. The best move you can make is to hand over clear, complete records that confirm the diagnosis up front.

Did SSA update the Compassionate Allowances list in 2018?

No. SSA added no new conditions to the Compassionate Allowances list in 2018, and no public CAL hearing was scheduled or held that year.

That surprises people hunting for a "2018 Compassionate Allowances list" and expecting a fresh batch. What they find is the list exactly as it stood after the last update, which came in 2017 when SSA added 52 conditions following a hearing on cancers and rare diseases ^[3]. That pushed the total to 233.

SSA holds these hearings on no fixed schedule. Years can pass between rounds. The agency added conditions in 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2016, and 2017, then went quiet. Updates picked back up in 2020 and 2021, with the 2021 round covering more rare cancers and neurological disorders and pushing the list past 250 ^[4].

Here's the thing that actually matters. The year printed on a list means less than whether your specific diagnosis appears on the current version. SSA keeps a searchable, alphabetical list at ssa.gov/compassionateallowances that reflects every addition to date ^[1].

What conditions were on the Compassionate Allowances list as of 2018?

As of 2018, the CAL list held 233 conditions across several broad groups. The table below shows the major categories with representative examples. It is not the full list. All 233 entries live on SSA's alphabetical page.

Category	Representative Conditions
Aggressive cancers	Esophageal cancer, small cell lung cancer, inflammatory breast cancer, pancreatic cancer, gallbladder cancer, sinonasal cancer
Brain/CNS tumors	Anaplastic astrocytoma, glioblastoma multiforme, ependymoblastoma, pineoblastoma
Rare pediatric disorders	Alexander disease, Batten disease, Canavan disease, Krabbe disease, Niemann-Pick disease
ALS and related	Amyotrophic lateral sclerosis (ALS), early-onset Parkinson's, Huntington disease
Heart and organ failure	Heart transplant graft failure, liver disease (end-stage), pulmonary arterial hypertension
Blood disorders	Acute leukemia, Myelodysplastic syndrome (advanced), aplastic anemia (severe)
Rare genetic conditions	Cri du Chat syndrome, Wolf-Hirschhorn syndrome, Pallister-Killian syndrome
Immune/autoimmune	HIV/AIDS (in advanced stages meeting specific criteria)

The 52 conditions from the 2017 hearing are baked into this list, so the 2018 list carries that full set ^[3]. Many of the 2017 additions were specific cancer types (bladder cancer, breast cancer variants, head and neck cancers) that cleared the severity threshold. The 2016 hearing added early-onset Alzheimer's disease, among others ^[4].

One practical point decides a lot of cases. SSA matches your diagnosis against CAL using the exact medical terminology in your records. "Brain cancer" is not enough. Your records have to name the histological type, such as glioblastoma multiforme or anaplastic astrocytoma. Get your pathology report and clinical notes into the file.

How fast does SSA actually approve CAL claims?

SSA's goal is to decide a CAL case the moment medical evidence confirms the diagnosis, and some cases close in as few as 10 days ^[2]. Real approval times beat standard claims but don't always hit that goal. It depends almost entirely on how fast the records arrive.

For comparison, a standard initial SSDI application has historically taken 3 to 6 months at the initial level ^[10]. Hearing-level appeals run well over a year. CAL claims skip the drawn-out evidence development because the diagnosis itself does most of the work.

The catch is confirmation. If SSA has your application but your records haven't shown up, the CAL flag speeds up nothing. The examiner still needs proof of the diagnosis. The fastest CAL approvals happen when:

• You submit pathology reports, MRI or CT reports, or other definitive diagnostic records with the initial application.
• Your treating physician's notes use the exact terminology SSA's system scans for.
• There are no open questions about work credits (SSDI) or income and resources (SSI).

If your records are scattered across hospitals and specialists, request them before you apply and upload everything at once. For the bigger picture on how eligibility gets judged, How to Qualify for SSDI walks through the full five-step sequential evaluation.

How has the Compassionate Allowances list grown from 2008 to today?

SSA built the CAL list one hearing at a time, with each hearing producing a round of additions. Here's the growth path based on SSA's published records ^[1][4]:

Year	Conditions Added	Running Total
2008 (launch)	50	50
2009	25	75
2010	38	113
2011	12	125
2012	35	160
2013	7	167
2014	14	181
2016	11	192
2017	52	233 (this is the 2018 list)
2020-2021	20+	254+

Note: exact post-2017 figures shift a little as SSA reorganizes entries. The numbers above come from SSA's historical hearing records and press releases. Always check the current total at ssa.gov/compassionateallowances ^[1].

The 2021 expansion, which people often search alongside the 2018 list, focused on more rare cancers and autoimmune neurological conditions. If your condition missed the 2018 list, it may well have landed since. See our piece on the social security compassionate allowances expansion for everything that has changed since 2017.

Does having a CAL condition guarantee approval?

No. A CAL condition flags your claim for expedited review, but SSA still runs you through the same two-part test every disability claimant faces: (1) do you have the condition, and (2) does it stop you from performing substantial gainful activity.

For most CAL conditions, part two isn't a real fight. A glioblastoma multiforme diagnosis is disabling almost by definition. But SSA still needs medical confirmation. Without a pathology report or equivalent, the examiner can't verify the diagnosis and the case stalls out.

The other eligibility rules apply in full. For SSDI, you need enough work credits (typically 40 credits, 20 earned in the last 10 years, though the count shifts by age at onset) ^[5]. For SSI, you have to meet the income and resource limits. Neither requirement is waived for CAL conditions. See SSDI Work Credits Explained if credits worry you.

Here's where CAL claimants get tripped up: the condition is confirmed, but the records arrive late or arrive incomplete. The examiner delays the case or closes it while waiting. Don't let that be you. Gather everything before you file or right after.

Can children qualify under the Compassionate Allowances list?

Yes. Many CAL conditions are pediatric by nature. Krabbe disease, Batten disease, Tay-Sachs disease, Canavan disease, and dozens of other rare genetic disorders hit children hardest. SSI is the program that fits here, because children have no work history and SSI carries no work credit requirement ^[6].

For a child's SSI claim on a CAL condition, the steps don't change. Apply through SSA, submit documentation confirming the diagnosis, and the CAL flag should trigger expedited review. SSI's income and resource rules reach the whole household, more than the child, so parents' finances count.

If you're filing for a child, push to get the genetic test results, specialist notes, and hospital records in with the initial application. Rare pediatric diagnoses often follow long diagnostic odysseys with records spread across several institutions. Pulling them together first shaves real time off the decision.

How do you apply if you have a Compassionate Allowances condition?

You use the same application everyone else uses. For SSDI, apply at ssa.gov/applyfordisability or call SSA at 1-800-772-1213. SSI works the same way. There is no separate "CAL application." The flag happens inside SSA's processing system ^[9].

Here's how to grease the wheels:

1. Name the exact diagnosis on your application using the precise medical term. If your condition is anaplastic astrocytoma grade IV, write that, not "brain tumor." 2. Gather your diagnostic records before you apply. Pathology reports, genetic test results, imaging reports, specialist letters confirming the diagnosis. Upload or mail these with your initial application. 3. Sign SSA's medical release forms completely. SSA can request records for you, but that takes time. 4. Tell SSA you believe you have a Compassionate Allowances condition. Note it in the remarks section, or call the field office after you file.

If pulling the documentation together feels like too much on top of a serious illness, a service like DisabilityFiled walks you through intake and helps you organize your claim summary before you submit.

For more on the standard application process, see the SSDI application guide.

What happens if SSA denies a CAL claim?

It happens, and more often than it should. The usual reasons for a CAL denial:

• Insufficient medical documentation (the diagnosis isn't confirmed in the records on file)
• A work credit shortfall for SSDI
• SSI resource or income limits not met
• The specific diagnosis in the records doesn't match a CAL list entry

If you're denied, you can appeal. Step one is a Request for Reconsideration, filed within 60 days of the denial notice. If that's denied, you request a hearing before an Administrative Law Judge (ALJ). A CAL case should still move faster through appeals once the documentation gap gets fixed at reconsideration.

Many CAL denials flip on reconsideration or at the ALJ level once complete records are in the file. Don't give up. An SSDI lawyer who handles disability cases usually works on contingency, so there's no upfront cost to you.

SSA's POMS section DI 23022.001 spells out CAL policy and procedures for examiners ^[2]. Knowing that document exists matters when you need to argue your claim should have been flagged as CAL in the first place.

How does the CAL list compare to the SSA Blue Book?

The Blue Book (formally the Listing of Impairments) is SSA's published set of medical criteria that define, condition by condition, what severity level counts as disabling ^[7]. It covers hundreds of conditions. Matching a Blue Book listing means you meet or equal SSA's definition of disability at step three of the five-step evaluation.

CAL and the Blue Book overlap without being the same thing. Plenty of CAL conditions also appear in the Blue Book. The difference is speed. A Blue Book match still travels the standard timeline. A CAL flag is supposed to jump the queue on day one.

Some CAL conditions aren't in the Blue Book as named listings but are severe enough to meet or equal one. SSA's CAL guidance tells examiners to find the right listing match for each CAL condition. So CAL claimants generally get approved under the Blue Book, just faster.

If your condition is in the Blue Book but not on the CAL list, you can still qualify. You just don't get the expedited review. For a breakdown of what counts as a disability under SSA's definition, that article covers the full sequential evaluation.

When were conditions added to the CAL list after 2018?

SSA resumed adding conditions in 2020 and 2021 after the quiet stretch that swallowed 2018 and 2019. Those additions included conditions such as TARP syndrome, Pfeiffer syndrome types 2 and 3, and several more aggressive cancers ^[4]. The list crossed 250 with those updates.

People searching for the "compassionate allowance list 2021" usually want to know what changed after the long gap. The short answer: SSA added roughly 20 conditions across those two years, weighted toward rare genetic syndromes and cancers that advocates and medical groups had pushed to include.

SSA adds conditions through public hearings where medical societies, patient advocacy groups, and researchers present evidence. Any organization or individual can nominate a condition. SSA's Office of Disability Programs then reviews the submissions and decides which to bring forward.

If you have a rare condition you think belongs on the list, SSA takes nominations through its CAL program page. The agency says it plans to keep expanding the list, though it publishes no fixed timeline ^[1].

What should you do right now if you have a CAL condition?

If your condition is on the CAL list and you haven't filed, speed is the whole game. SSDI carries a five-month waiting period from your established onset date, and SSI carries none, but nothing accrues until you file. Every month you wait is a month of back pay you may never get back.

Here's the practical order:

1. Confirm your condition is on the current CAL list at ssa.gov/compassionateallowances. 2. Request your complete medical records, especially pathology reports, genetic tests, and specialist notes that confirm the exact diagnosis. 3. Apply online at ssa.gov or at your local office. File for SSDI if you have work history. File for both SSDI and SSI at once if you're uncertain. 4. Note on the application that you believe your condition qualifies as a Compassionate Allowances condition. 5. Follow up with your field office to confirm the CAL flag actually triggered.

If you want help organizing documentation and making sure the claim summary is complete before you submit, DisabilityFiled offers guided intake built for exactly this. This is not legal advice. Complex cases and appeals are worth a qualified disability attorney.

Once you're approved, your payments follow the standard SSDI calendar. The SSDI payment schedule 2025 shows when your deposits land based on your birth date.

Frequently asked questions

How many conditions were on the Compassionate Allowances list in 2018?

The CAL list had 233 conditions in 2018, and no new conditions were added that year. The 233rd came from the 2017 expansion, which followed a public hearing on cancers and rare diseases. SSA held no CAL hearing in 2018 or 2019. The list grew past 250 after additions in 2020 and 2021.

What new conditions did SSA add to the Compassionate Allowances list in 2017?

SSA added 52 conditions in 2017, bringing the total to 233. The 2017 round leaned heavily on specific cancer types, including bladder cancer, certain breast cancer variants, and head and neck cancers, plus more rare pediatric and neurological conditions. This was the largest single addition since the program launched in 2008.

Does a Compassionate Allowances condition mean automatic approval?

Not automatic, but close for most cases. SSA still needs medical documentation confirming the diagnosis. Work credits must be met for SSDI, and SSI income and resource rules still apply. In practice, most CAL claims with complete records get approved fast. The main reasons for denial are missing documentation or unmet eligibility rules, not any dispute over whether the condition is disabling.

How do I know if my condition is on the CAL list?

Search the alphabetical list at ssa.gov/compassionateallowances using the exact medical terminology from your diagnosis. "Pancreatic cancer" is listed as such, but brain tumors are listed by their specific histological type. If you're unsure of your exact terminology, ask your treating physician for the formal diagnostic name used in your pathology or clinical report.

Can I apply for Compassionate Allowances separately from SSDI or SSI?

No. There is no standalone CAL application. You apply for SSDI or SSI through the normal process at ssa.gov or at a field office. SSA's internal systems flag your claim as CAL based on the condition you report and the documentation you submit. You can note on the application that you believe your condition qualifies under CAL, which alerts the examiner.

How long does a Compassionate Allowances decision take?

SSA aims to decide CAL cases as fast as possible once medical confirmation arrives, with some resolved in as few as 10 days. In practice, timing hinges on how quickly complete records land. Claims filed with full documentation up front decide fastest. Standard claims average 3 to 6 months at the initial level for comparison.

What happens to the five-month SSDI waiting period for CAL conditions?

The five-month waiting period is not waived for CAL conditions. SSDI benefits still begin in the sixth month after your established onset date. SSI has no waiting period. If your condition was disabling well before you applied, SSA can set an onset date in the past, but SSDI back pay is capped at 12 months before your application date regardless.

What conditions were added to the CAL list in 2021?

SSA added roughly 20 conditions across 2020 and 2021, including TARP syndrome, Pfeiffer syndrome types 2 and 3, and several aggressive cancers. These followed advocacy from rare disease organizations and medical groups who submitted evidence to SSA. The 2021 updates pushed the total past 250. Check ssa.gov/compassionateallowances for the current complete list.

Can a child's SSI claim qualify under Compassionate Allowances?

Yes. Many CAL conditions are pediatric rare diseases, including Krabbe disease, Batten disease, Canavan disease, and Tay-Sachs disease. Children have no work history, so SSI is the program that applies. The same expedited review kicks in. SSI eligibility for children weighs household income and resources. Submit genetic test results and specialist diagnostic records with the initial application.

What if SSA denies my CAL claim?

You can appeal. File a Request for Reconsideration within 60 days of the denial. The most common reason CAL claims get denied is missing or incomplete records. Add complete documentation at reconsideration and many cases get approved there. If not, an ALJ hearing is the next step. Disability attorneys usually handle these on contingency, so there's typically no upfront cost.

Is ALS on the Compassionate Allowances list?

Yes. Amyotrophic lateral sclerosis (ALS) has been on the CAL list since the program launched in 2008. Congress passed a law in 2020 waiving the five-month SSDI waiting period specifically for ALS claimants, the only condition with that particular waiver. SSA processes ALS claims as CAL and applies the waiver automatically.

Does the CAL list cover mental health conditions?

A small number of CAL conditions are psychiatric or neurological, such as early-onset Alzheimer's disease (added in 2016). Most CAL conditions, though, are physical illnesses, cancers, and genetic disorders. Standard severe mental health conditions like schizophrenia and bipolar disorder are evaluated under SSA's Blue Book listings but generally are not on the CAL list.

How does SSA decide what conditions to add to the CAL list?

SSA holds public hearings and invites medical societies, patient advocacy groups, and researchers to submit evidence. It looks for conditions where the diagnosis itself is definitive proof of disability under its rules. After each hearing, SSA's Office of Disability Programs reviews submissions and picks conditions to add. Anyone can nominate a condition through SSA's CAL program page.

Where can I find the official Compassionate Allowances list?

The official list is published at ssa.gov/compassionateallowances. It's alphabetical and updated after each expansion. For conditions added since the last update, SSA also publishes press releases. POMS section DI 23022.001 holds SSA's internal policy for how examiners handle CAL cases, and it's publicly accessible at ssa.gov/poms.

Sources

1. SSA, Compassionate Allowances program home page: SSA maintains the official alphabetical CAL list and launched the program in 2008
2. SSA POMS, DI 23022.001 - Compassionate Allowances: CAL cases are to be decided as quickly as possible once medical evidence confirms the diagnosis; POMS DI 23022.001 governs CAL examiner procedures
3. SSA, Press Release: SSA Adds 52 Conditions to CAL List (2017): SSA added 52 conditions in 2017, bringing the total to 233
4. SSA, Compassionate Allowances hearing history and condition additions: CAL list growth by year from 2008 launch through 2021 additions exceeding 250 conditions
5. SSA, Publication No. 05-10029: How You Earn Credits: Standard SSDI work credit requirement is 40 credits with 20 earned in the last 10 years, varying by age at onset
6. SSA, SSI for Children: SSI has no work credit requirement; children with qualifying disabilities may receive SSI based on household income and resources
7. SSA, Disability Evaluation Under Social Security (Blue Book): The Blue Book contains SSA's listing of impairments defining severity thresholds for qualifying conditions
8. SSA, ALS Disability Benefits and Five-Month Waiting Period Waiver (enacted 2020): Congress waived the five-month SSDI waiting period for ALS claimants in 2020; ALS has been on CAL since 2008
9. SSA, Apply for Disability Benefits: SSDI and SSI applications are filed at ssa.gov/applyfordisability; no separate CAL application exists
10. SSA Office of Inspector General, reports on Compassionate Allowances processing: OIG has examined SSA CAL processing times; standard initial SSDI claims average 3 to 6 months compared to expedited CAL timelines