Critical Illness Cases Can Be Expedited

June 8, 2019

There is also a way to get a quicker hearing date if a claimant has a critical illness. This occurs when a claimant’s illness is terminal and referred to as a “TERI case” (short for Terminally ill). In this instances the inevitably the claimant will end up passing away. Due to their sensitive time frame TERI cases are given evaluation priority for as soon as possible. Critical illness case claims will still be subject to the regular evaluation process.

The regulation states:

I-2-1-40.

Critical Cases

  • A. General The Office of Hearings Operations (OHO) determines a case is “critical” and requires special processing in the following situations:

    1. Terminal Illness (TERI) A case is designated critical when the claimant’s illness is alleged or identified as terminal (i.e., untreatable, irreversible, and expected to end in death). TERI cases are identified by:

    • The case characteristic TERI in the Case Processing and Management System (CPMS); and

    • A TERI Flag (form SSA-2200) in a paper case, or, in an electronic case, by the “TERI flag” in eView.

    • A TERI designation may be added at or before the hearing level, and TERI designations are monitored by the OHO regional office (RO) to ensure the case is expedited. For examples of TERI situations, or more information on the situations or conditions field offices (FO) and Disability Determination Services (DDS) use to designate a TERI case, see Program Operations Manual System (POMS) DI 11005.601C and DI 23020.045 B.

The regulation however does add an important disclaimer:

  • NOTE: The presence of TERI criteria does not mandate a finding of disability. An adjudicator must evaluate the claim under the sequential evaluation process.

This means that being identified as a critical case does not automatically mean your case will be approved. Social Security must still thoroughly evaluate the evidence, but the hearing, to obtain this decision, may be obtained more quickly.

If you potentially have a critical illness case that can expedite the evaluation process of your Social Security claim, contact Margolius, Margolius, and Associates to explore your options.

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