Every compassionate-release motion rises or falls on a single phrase: “extraordinary and compelling reasons.” A federal court can reduce a sentence only if such reasons exist. The statute uses the phrase but does not exhaustively define it — the Sentencing Commission’s policy statement does that work, setting out the categories of circumstances that can qualify. Understanding those categories is the starting point of any compassionate-release case.
At Elizabeth Franklin-Best, P.C., we treat the extraordinary-and-compelling-reasons showing as the foundation of every compassionate-release motion we file. Elizabeth Franklin-Best, our principal attorney, carries a 2026 Best Lawyers in America listing as a “Best Lawyer” in Appellate Practice, and Chambers USA’s 2026 guide ranks our firm for Litigation: White-Collar Crime & Government Investigations. Managing Director Christopher Zoukis, a recognized authority on the federal prison system, supplies the institutional knowledge — medical records, programming files, BOP practice — that turns a qualifying category into a documented one. The categories themselves are set out in U.S. Sentencing Guideline § 1B1.13.
This guide explains extraordinary and compelling reasons in depth — what the standard means, the recognized categories under the amended § 1B1.13 policy statement, the “other reasons” catch-all, the role of combined circumstances, and how these reasons are proven. It also covers the May 2026 Supreme Court decisions in Rutherford and Fernandez, which redrew the boundaries of the unusually-long-sentence provision and closed the door on conviction-based arguments. If you are considering compassionate release, start here — this is the foundation on which a motion is built.
What This Guide Covers
Quick Answer
| Question | Answer |
|---|---|
| What are extraordinary and compelling reasons? | The threshold a defendant must meet for compassionate release — serious, significant circumstances of the kind recognized by the Sentencing Commission’s policy statement. |
| Where are the categories defined? | In U.S. Sentencing Guideline § 1B1.13, the policy statement the Commission amended, effective November 2023, to apply to defendant-filed motions. |
| What categories qualify? | Medical circumstances, the defendant’s age, family circumstances, certain abuse suffered in custody, and an “other reasons” catch-all of similar gravity. |
| Do I have to be terminally ill? | No. The medical category covers serious, deteriorating conditions the prison cannot adequately treat — not only terminal illness. |
| Can combined circumstances qualify? | Yes. A combination of circumstances similar in gravity to the listed categories can be an extraordinary and compelling reason. |
| Can a change in the law qualify? | Generally no. In Rutherford v. United States (May 2026), the Supreme Court held that nonretroactive changes in sentencing law cannot be extraordinary and compelling reasons, invalidating § 1B1.13(b)(6) to that extent. |
| What is the first step? | A paid, one-hour initial consultation — we map your circumstances against each § 1B1.13 category and identify the records a credible motion would require. |
Key Takeaways
- “Extraordinary and compelling reasons” is the threshold for compassionate-release eligibility under 18 U.S.C. § 3582(c)(1)(A).
- The categories are set out in the Sentencing Commission’s policy statement, § 1B1.13.
- The Commission amended § 1B1.13, effective November 2023, to apply to motions filed by defendants.
- The medical category covers terminal illness and serious, deteriorating conditions the prison cannot adequately treat.
- The age category focuses on an older defendant with age-related decline who has served substantial time.
- The family-circumstances category targets a genuine caregiving crisis, not ordinary family hardship.
- An “other reasons” catch-all allows circumstances, or combinations, similar in gravity to qualify.
- Proving an extraordinary and compelling reason is a documentary effort — records make the difference.
- In Rutherford v. United States, 608 U.S. ___ (2026), the Supreme Court held that nonretroactive changes in sentencing law cannot supply an extraordinary and compelling reason, invalidating § 1B1.13(b)(6) to that extent.
- Full-year fiscal year 2025 data from the Sentencing Commission show courts granted 14.1% of decided motions — the showing is won with records, not rhetoric.
What the Standard Means
“Extraordinary and compelling reasons” is the threshold a defendant must meet to be eligible for compassionate release under 18 U.S.C. § 3582(c)(1)(A). The phrase has two words doing work, and both matter.
“Extraordinary” suggests a circumstance that is unusual — beyond the ordinary experience of incarceration. “Compelling” suggests a circumstance serious enough to genuinely call for a reduction. Together, the phrase sets a meaningful bar: not every hardship of imprisonment qualifies, but a circumstance need not be unique in all of history. It must be a serious, significant circumstance of the kind the law recognizes.
Critically, establishing an extraordinary and compelling reason is the first step, not the whole case. Even where such a reason exists, the court must still weigh the 18 U.S.C. § 3553(a) sentencing factors and consider whether release is appropriate. This guide focuses on the first step — what reasons qualify — while keeping in mind that a complete motion also addresses the 3553(a) analysis.
The 1B1.13 Policy Statement
The Sentencing Commission’s policy statement, § 1B1.13, is the document that gives content to “extraordinary and compelling reasons.” It identifies the categories of circumstances that can qualify.
The policy statement has an important history. The original version predated the First Step Act and, by its terms, addressed only motions filed by the Bureau of Prisons. After the First Step Act allowed defendants to file their own motions, courts grappled with how much weight to give a policy statement written for a different era. The Sentencing Commission resolved much of that uncertainty by amending § 1B1.13, effective November 2023, so that the policy statement now expressly applies to motions filed by defendants and sets out the categories of extraordinary and compelling reasons.
The amended policy statement — Amendment 814, effective November 1, 2023 — organizes the qualifying reasons into six subsections: medical circumstances under § 1B1.13(b)(1), age under (b)(2), family circumstances under (b)(3), abuse in custody under (b)(4), a catch-all “other reasons” provision in (b)(5), and an “unusually long sentence” provision in (b)(6) that the Supreme Court largely invalidated in May 2026, as explained below. Two framing rules complete the picture. Under 28 U.S.C. § 994(t) and § 1B1.13(d), rehabilitation by itself can never be an extraordinary and compelling reason, although it counts in combination with other circumstances. And under § 1B1.13(e), a qualifying reason need not have been unforeseeable at sentencing — the fact that the court could have anticipated the circumstance does not disqualify it.
Medical Circumstances
The medical category is the most common basis for compassionate release, and it covers more than terminal illness.
The policy statement recognizes four distinct medical situations. Subsection (b)(1)(A) covers terminal illness — a serious and advanced illness with an end-of-life trajectory — and says expressly that a specific life-expectancy prognosis is not required; the Guidelines give metastatic solid-tumor cancer, ALS, end-stage organ disease, and advanced dementia as examples. Subsection (b)(1)(B) covers a serious physical or medical condition, a serious functional or cognitive impairment, or deteriorating health because of aging, where the condition substantially diminishes the defendant’s ability to provide self-care in a correctional facility and recovery is not expected. Subsection (b)(1)(C) — new in 2023 — covers a condition that requires long-term or specialized care the Bureau of Prisons is not providing, where the defendant faces a risk of serious deterioration or death without it. And subsection (b)(1)(D) covers confinement in a facility affected by an infectious-disease outbreak or declared public-health emergency that places an at-risk defendant in unmitigable danger.
The breadth of the medical category is important. A defendant does not have to be dying to qualify. A serious, deteriorating condition that the prison cannot adequately manage — and from which the defendant will not recover — can support a motion. Our guide to medical compassionate release covers this category in detail.
Applied Insight: Families often assume compassionate release on medical grounds is only for the terminally ill. It is not. A serious chronic condition that the Bureau of Prisons cannot adequately treat — one that genuinely undermines a person’s ability to function and from which they will not recover — fits squarely within the medical category. The question is the seriousness of the condition and the adequacy of the care, not whether the illness is fatal.
Age of the Defendant
Age is a separate, recognized category. It reflects the reality that incarceration can become disproportionately harsh as a person grows older and their health declines.
Section 1B1.13(b)(2) sets three elements, and a motion must satisfy all of them: the defendant (1) is at least 65 years old, (2) is experiencing a serious deterioration in physical or mental health because of the aging process, and (3) has served at least 10 years or 75 percent of the term of imprisonment, whichever is less. The “whichever is less” language matters — a 67-year-old who has served 75 percent of an eight-year sentence meets the time element without ever reaching 10 years.
The age category and the medical category often overlap, because age and declining health frequently go together. A motion for an older prisoner can, and often should, present both. Our guide to age-based compassionate release explains this category further.
Family Circumstances
The family-circumstances category recognizes that, in defined situations, a crisis in a defendant’s family can be an extraordinary and compelling reason for release.
This category is built around caregiving, and the 2023 amendment widened it considerably. Subsection (b)(3)(A) covers the death or incapacitation of the caregiver of the defendant’s minor child — or of an adult child who cannot care for themselves because of a mental or physical disability or medical condition. Subsections (b)(3)(B) and (C) cover the incapacitation of a spouse, registered partner, or parent when the defendant would be the only available caregiver. And subsection (b)(3)(D) extends the same protection to any other immediate family member — including a grandchild, grandparent, or sibling — or to someone whose relationship with the defendant is similar in kind to immediate family.
The family-circumstances category is narrower than people sometimes assume — the ordinary hardship that a family suffers when a loved one is incarcerated does not, by itself, qualify. What the category targets is a genuine caregiving crisis where the defendant is uniquely positioned to address it. Our guide to family circumstances compassionate release explains the requirements.
Other Reasons and Combined Circumstances
The policy statement does not limit extraordinary and compelling reasons to a closed list. It includes an “other reasons” provision — a recognition that a circumstance, or combination of circumstances, may qualify even if it does not fit neatly within the medical, age, or family categories.
Under this catch-all, § 1B1.13(b)(5), a court can find an extraordinary and compelling reason where the defendant presents any other circumstance, or combination of circumstances, that is similar in gravity to the enumerated categories — considered on its own or together with the medical, age, family, and abuse categories. After the Supreme Court’s May 2026 decisions, one boundary on (b)(5) is firm: it cannot be used to smuggle in arguments the Court has excluded, such as nonretroactive changes in the law or attacks on the conviction itself. Within that boundary, it remains the provision that keeps compassionate release responsive to genuinely unusual situations.
The point about combined circumstances is especially practical. A defendant whose situation does not, on any single ground, clearly rise to the level of extraordinary and compelling may nonetheless qualify when the circumstances are considered together — a serious health condition, plus age, plus a family caregiving need, viewed as a whole. Effective motions often present the full, combined picture rather than relying on one ground in isolation.
Abuse in Custody — § 1B1.13(b)(4)
One category added in November 2023 had no counterpart in the old policy statement. Section 1B1.13(b)(4) recognizes as extraordinary and compelling the abuse of a defendant while serving the sentence — sexual abuse involving a “sexual act” as defined in 18 U.S.C. § 2246(2), or physical abuse resulting in serious bodily injury — when the abuse was committed by, or at the direction of, a correctional officer, an employee or contractor of the Bureau of Prisons, or any other person with custody or control over the defendant.
The provision carries its own proof requirement. The misconduct ordinarily must be established by a conviction in a criminal case, a finding or admission of liability in a civil case, or a finding in an administrative proceeding. Two exceptions relax that rule: where those proceedings have been unduly delayed, or where the defendant is in imminent danger, a court may act without a completed finding.
In practice, this means the compassionate-release motion is often the second proceeding, not the first. Where a client has been abused in custody, we evaluate the status of any criminal prosecution, civil suit, or administrative finding against the abuser, document the abuse and its aftermath thoroughly, and assess whether the delay or imminent-danger exception applies before filing.
Unusually Long Sentences After Rutherford (2026)
The most litigated piece of the 2023 amendment was § 1B1.13(b)(6). As written, it permitted a court to treat a nonretroactive change in the law as part of the extraordinary-and-compelling analysis for a defendant who had served at least 10 years of an unusually long sentence, where the change produced a gross disparity between the sentence being served and the sentence likely to be imposed today, and only after full consideration of individualized circumstances.
The courts of appeals divided sharply over whether the Sentencing Commission had the authority to adopt it. The Third Circuit in United States v. Rutherford, 120 F.4th 360 (3d Cir. 2024), and the Seventh Circuit in United States v. Black, 131 F.4th 542 (7th Cir. 2025), refused to apply (b)(6) to the First Step Act’s nonretroactive § 924(c) anti-stacking change, and the Sixth Circuit in United States v. Bricker, 135 F.4th 427 (6th Cir. 2025), held the provision invalid outright — while the First, Fourth, Ninth, and Tenth Circuits had long allowed courts to weigh nonretroactive legal changes.
The Supreme Court resolved the split on May 28, 2026. In Rutherford v. United States, Nos. 24-820 and 24-860, 608 U.S. ___ (2026), the Court held, 6–3, that when Congress declines to make a sentencing amendment retroactive — as with the First Step Act’s change to § 924(c) stacking — the resulting disparity cannot serve as an extraordinary and compelling reason under § 3582(c)(1)(A), whether considered alone or in combination with other factors. To the extent § 1B1.13(b)(6) counsels otherwise, the Court held it invalid. The same day, in Fernandez v. United States, No. 24-556, 608 U.S. ___ (2026), the Court held that a prisoner who attacks the validity of a conviction — through claims of innocence, trial error, or investigative misconduct — must proceed under 28 U.S.C. § 2255, not compassionate release. Those arguments belong to federal post-conviction relief, and we evaluate them on that track.
What survives the 2026 decisions matters as much as what fell. Every other § 1B1.13 category — medical, age, family circumstances, abuse in custody, and the (b)(5) catch-all within its proper limits — is untouched. Under § 1B1.13(c), a change in the law may still be considered in deciding the extent of a reduction once a defendant establishes eligibility on other grounds. And retroactive Guidelines amendments follow a different statute entirely, 18 U.S.C. § 3582(c)(2). Because this area moved three times in three years, any motion strategy built before May 2026 should be re-examined now.
Proving Extraordinary and Compelling Reasons
Identifying the right category is the first step; proving the reason is the second. A compassionate-release motion is a documentary case, and the quality of the supporting evidence is decisive.
For a medical reason, this means complete and current medical records, diagnoses, prognoses, and, where helpful, an assessment of the adequacy of the care the prison is providing. For an age reason, it means records documenting the age-related decline and the time served. For a family reason, it means documentation of the caregiver’s death or incapacitation and proof that the defendant is the available caregiver. For an “other reasons” or combined showing, it means assembling each strand of the circumstances with supporting proof.
A motion that simply asserts a serious situation is far weaker than one that documents it. Gathering records — from the prison, from medical providers, from family — takes effort and time, and it is the work that turns a sympathetic situation into a provable extraordinary and compelling reason.
Which Reasons Actually Win: The FY2025 Data
The Sentencing Commission tracks every decided compassionate-release motion, and its full-year fiscal year 2025 data (motions decided October 1, 2024 through September 30, 2025) put numbers on the categories. Courts decided 2,795 motions and granted 394 of them — 14.1%. Half of the people granted relief (50.4%) had originally been sentenced to 20 years or more.
Among the reasons courts cited when granting relief, rehabilitation appeared most often (15.7% of cited reasons) — and in every single case it accompanied another ground, never standing alone. A serious physical or medical condition under (b)(1)(B) accounted for 12.1% of cited reasons, the (b)(6) unusually-long-sentence provision 11.4% — a share that will contract after Rutherford — terminal illness 4.8%, the family-circumstances provisions roughly 9% combined, the age category under (b)(2) 2.3%, and the (b)(1)(C) failure-to-provide-treatment prong 1.5%.
The denial-side data is a checklist of avoidable mistakes. The 18 U.S.C. § 3553(a) factors led (24.8% of cited denial reasons), followed by rehabilitation offered alone (10.4%), failure to establish any qualifying reason (10.1%), and failure to exhaust (8.7%). On exhaustion, the Fourth Circuit held in United States v. Muhammad, 16 F.4th 126 (4th Cir. 2021), that the requirement is a claims-processing rule the government can waive — but hundreds of motions still die on it every year, so we satisfy it precisely and document it. Our guides on filing a compassionate-release motion and responding to a denial walk through both ends of the process.
How Our Firm Builds the Showing
We build the showing the way a judge will read it: category first, records second, narrative third. Elizabeth Franklin-Best litigates the legal framework — which subsection fits, what Rutherford and Fernandez now permit, how the § 3553(a) presentation should be framed — while Christopher Zoukis works the institutional side, where BOP medical records, care-level designations, and program files either prove the category or undercut it.
That framework work draws on a sentencing and post-conviction record built over the long haul. Ms. Franklin-Best’s practice signature is exactly the territory a categories analysis lives in — First Step Act § 404 resentencings and active Amendment 821 and compassionate-release litigation — and her reported decisions reach the hardest end of that work: she served as counsel in Aiken v. Byars, 410 S.C. 534 (2014), the South Carolina decision that ordered resentencing hearings for juveniles serving life under Miller v. Alabama, and as capital habeas counsel in Morva v. Zook, 821 F.3d 517 (4th Cir. 2016), where the mitigation record was the case. Across her career she has appeared in more than 330 federal proceedings, including over 100 appeals, in all twelve federal circuits and at the United States Supreme Court — depth that matters when a single § 1B1.13 subsection, proven or not, decides whether a motion is even heard. Those citations reflect prior representations and do not predict the result in any case.
Our work includes identifying every category that may apply, gathering the medical, institutional, and family records needed to prove each one, presenting combined circumstances as a coherent whole where no single ground stands alone, and framing the showing against the § 1B1.13 policy statement. We then pair it with the 3553(a) presentation that a complete motion requires. We represent federal defendants nationwide.
For related reading, see our compassionate release overview and our guides to medical compassionate release and how to file a compassionate-release motion.
Talk With a Compassionate Release Lawyer
Extraordinary and compelling reasons are the foundation of every compassionate-release motion. The categories are broader than many people realize, and a combination of circumstances can qualify where no single one does. Identifying and proving the right reason is where a motion is built.
Bring us the facts and we will tell you, candidly, whether they fit a category. In a paid, one-hour initial consultation, we review the medical, family, and institutional circumstances against each § 1B1.13 subsection, explain how the May 2026 Supreme Court decisions affect any change-in-law theory, and map the records a provable showing would require. If the honest answer is that no category fits yet, we will say so — and tell you what would change that.
What are extraordinary and compelling reasons?
Extraordinary and compelling reasons are the threshold a defendant must meet to be eligible for compassionate release. They are serious, significant circumstances — beyond the ordinary experience of incarceration — of the kind recognized by the Sentencing Commission’s policy statement.
Where are the categories of qualifying reasons defined?
The categories are set out in U.S. Sentencing Guideline § 1B1.13, the Sentencing Commission’s policy statement. The Commission amended that policy statement, effective November 2023, so that it applies to motions filed by defendants.
What categories of reasons can qualify?
The recognized categories are medical circumstances, age, family circumstances, abuse suffered in custody, and a catch-all “other reasons” provision for circumstances of similar gravity. A sixth category for unusually long sentences affected by changes in the law was held invalid in large part by the Supreme Court in May 2026.
Do I have to be terminally ill to qualify on medical grounds?
No. The medical category covers terminal illness, but it also covers a serious physical or medical condition, a serious functional or cognitive impairment, or deterioration due to aging that diminishes self-care ability and from which the defendant will not recover.
What is the age category?
Under § 1B1.13(b)(2), a defendant qualifies who is at least 65 years old, is experiencing a serious deterioration in physical or mental health because of the aging process, and has served at least 10 years or 75 percent of the term of imprisonment, whichever is less.
What family circumstances can qualify?
The family-circumstances category is built around caregiving — for example, the death or incapacitation of the caregiver of the defendant’s minor or disabled child, or the incapacitation of a spouse, partner, parent, or other immediate family member when the defendant would be the only available caregiver. Ordinary family hardship does not qualify.
What is the “other reasons” category?
The “other reasons” category, § 1B1.13(b)(5), is a catch-all. It allows a court to find an extraordinary and compelling reason where the defendant presents any other circumstance, or combination of circumstances, similar in gravity to the enumerated categories.
Can a combination of circumstances qualify?
Yes. A defendant whose situation does not clearly qualify on any single ground may still qualify when the circumstances are considered together — for example, a serious health condition plus age plus a family need. Effective motions often present the combined picture.
Is establishing a reason enough for release?
No. Establishing an extraordinary and compelling reason is the first step. Even where such a reason exists, the court must also weigh the 18 U.S.C. § 3553(a) factors and consider whether release is appropriate and the defendant poses no danger.
Can a change in the law be an extraordinary and compelling reason?
Generally no. In Rutherford v. United States, decided May 28, 2026, the Supreme Court held that nonretroactive changes in sentencing law cannot make a prisoner eligible for compassionate release, whether considered alone or with other factors. A change in the law may still be considered in setting the size of a reduction once eligibility is established on other grounds.
Can abuse by prison staff qualify for compassionate release?
Yes. Under § 1B1.13(b)(4), sexual abuse, or physical abuse resulting in serious bodily injury, committed by or at the direction of a correctional officer or anyone with custody or control over the defendant, is an extraordinary and compelling reason. The misconduct ordinarily must be established by a criminal conviction, a civil finding or admission, or an administrative finding, unless those proceedings are unduly delayed or the defendant is in imminent danger.
How are extraordinary and compelling reasons proven?
A compassionate-release motion is a documentary case. A medical reason is proven with complete medical records and prognoses; an age reason with records of decline and time served; a family reason with documentation of the caregiver crisis and the defendant’s availability.
Did the policy statement change?
Yes. The original § 1B1.13 predated the First Step Act and addressed only Bureau of Prisons motions. Amendment 814, effective November 1, 2023, rewrote it to apply to defendant-filed motions and to expand the categories of extraordinary and compelling reasons.
How often were compassionate release motions granted in fiscal year 2025?
Full-year Sentencing Commission data for fiscal year 2025 show courts decided 2,795 motions and granted 394 — about 14.1 percent. Half of the people granted release had originally been sentenced to 20 years or more.
How do I know if I have a qualifying reason?
The most reliable way is a structured review with counsel. We compare your circumstances against every § 1B1.13 subsection, account for the May 2026 Supreme Court decisions, and identify the records that would prove the strongest category — or tell you honestly that none fits yet.
Does Rutherford affect my compassionate-release motion?
It depends on the theory. If your motion rests on a nonretroactive change in the law — most often the First Step Act’s end to § 924(c) stacking — Rutherford v. United States (May 2026) now forecloses it, because the Supreme Court held that such a change cannot be an extraordinary and compelling reason, alone or combined with other factors, and invalidated § 1B1.13(b)(6) to that extent. If your motion rests on medical circumstances, age, family circumstances, abuse in custody, or the (b)(5) catch-all, Rutherford does not affect it. Motions built before May 2026 on a change-in-law theory should be re-examined now.