Whether you have been newly diagnosed with cancer or have come out of remission, you may find yourself unable to work and in need of financial assistance in the form of Social Security Disability (SSD) benefits. Before applying, here’s what you need to know about cancer and SSD benefits.
Cancer as a disabling condition
Cancer is characterized by the uncontrolled growth and spread of abnormal cells. It can be caused by external factors (and thus are partially within our control), such as tobacco use, infectious organisms and unhealthy diets, as well as internal factors (and thus outside of our control), such as genetic mutations, hormones and immune conditions. And it’s impact is huge – in 2016 alone, the American Cancer Society estimated that there would be 1.68 million new cancer diagnoses, and 595,690 cancer-related deaths.
The Social Security Administration (SSA) classifies cancer as a disabling medical condition that could qualify patients for SSD benefits. The SSA’s list of disabling conditions covers all cancers (for a total of 28), except certain cancers associated with HIV, which are evaluated under a different set of criteria.
Yet simply being diagnosed with cancer isn’t enough to qualify for SSD benefits. Like all disabilities, to qualify for SSD benefits the cancer and/or its treatment must negatively impact your ability to engage in substantial gainful activity. In addition, your disability must be total, and it must last, or be expected to last, at least 12 months.
Many cancer patients can continue working, albeit with some interruptions, while undergoing treatment. Others may be unable to work at all while undergoing treatment due to side effects, but this interruption is only temporary, i.e., expected to last less than 12 months. Neither of these scenarios would qualify an applicant to receive SSD benefits.
Evaluation of cancer for SSD benefits
Each of the 28 cancers included as disabling conditions have specific criteria that must be met. When conducting an evaluation, the disability examiner (the person who initially reviews the application for SSD benefits) will consider the following:
- The origin of the cancer, i.e., such as the breast, liver, skin, etc.;
- The extent of involvement;
- The duration, frequency and response to any treatment, and;
- The effects of post-therapeutic residuals, i.e. side-effects.
As with all SSD applications, the SSA requires medical evidence documenting the cancer – a simple note from your oncologist indicating “The patient was diagnosed with skin cancer” will not satisfy the listing requirement. You must provide evidence that supports the type, extent, and site of the primary, recurrent or metastatic lesion. Such evidence may include physician notes/reports, MRI, X-ray or other diagnostic imaging, and any operative notes and pathology reports (if the cancer was treated by surgery, including a biopsy or needle aspiration).
Because the effects of anti-cancer therapies and their toxicity vary among patients, the residual effects of such treatment may be sufficient to qualify for SSD benefits. Evidence of unsuccessful treatments and/or periods of progression of recurrence may also meet the listing requirement. Therefore, medical records should include the following information regarding your treatment:
- Drugs prescribed and their dosage;
- Frequency of administration;
- Plans for continued administration;
- Extent of surgery, and;
- Schedule and fields of radiation therapy.
The disability examiner will also need a description of the complications or adverse effects of therapy, either that you have experienced or that you may possibly experience due to treatment, including:
- Continuing gastrointestinal symptoms;
- Persistent weakness;
- Neurological complications;
- Cardiovascular complications, and;
- Reactive mental disorders.
Providing as much of this information as possible will allow the disability examiner to determine the extent the cancer and its treatment has on your ability to continue working, and how long that inability to work is expected to last.
Cancer and SSD benefits success story
Our office successfully represented an applicant who sought SSD benefits based on complications she experienced due to cancer treatment. Her application was denied at both the initial and reconsideration stages. Upon appeal to an administrative law judge (ALJ), we proved that following removal of a tumor, complications caused the patient to develop numbness and decreased strength in her arm, making it difficult to lift and reach – necessary functions for her work as a travel consultant, as well as any other type of office work. In addition to these complications, she suffered from a variety of other mental and physical ailments which, when taken together, made it impossible for her to continue to work in any capacity. The ALJ overturned the previous denials and approved her application for benefits.
Resources for cancer patients
If you have been diagnosed with cancer, there are many resources available to help support you through your journey.
The American Cancer Society’s website has information and resources on everything from diagnosis to treatment options to living with cancer, and includes information on every type of cancer. In addition, there is a 24/7, toll-free hotline to call and speak with cancer specialists for information and support; you can also search for a local chapter if you prefer in-person support.
The Cancer Support Community has a variety of resources on many topics concerning living with cancer, and is searchable by cancer type. It also has an online support group, a toll-free support number, and a searchable feature to locate in-person support groups in your area.
If you have cancer or know someone who has cancer and is looking to apply for SSD benefits consider the Law Office of Neil H. Good for your representation. Call #(847) 577-4476 or complete our online form for a free case evaluation.