What Types of Cancer Qualify for Disability?
Many individuals battling cancer find it too difficult to continue working due to the severity of their illness and the side effects of treatment. In such cases, Social Security Disability benefits can provide much-needed financial support. But what types of cancer qualify for disability? This blog post explains which types of cancer qualify for SSD and SSI benefits, and how the Social Security Administration (SSA) distinguishes between cases severe enough to qualify and those that are not eligible.
Understanding Social Security Disability Benefits
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are two federal programs that provide financial assistance to individuals with disabilities. To qualify for these benefits, an individual must meet specific criteria. While the eligibility criteria for SSDI and SSI benefits are different from one another, they do share one important criterion: how the SSA defines a “disability.”
To qualify for either SSDI or SSI benefits, a claimant must have “a physical or mental impairment that lasted or is expected to last 12 months (or result in death) and which prevents that person from performing ‘substantial gainful activities’ (SGAs).” Substantial gainful activities includes any activity by which someone can earn at least $1,550 per month.
Which Cancer Qualifies for Disability Benefits?
Serious cancers cases, especially those that have metastasized widely, are likely to qualify for disability benefits if they prevent the claimant from working for more than 12 months. The type of cancer is not usually determinative. In fact, the SSA’s Blue Book of Listed Qualifying Impairments includes 30 different kinds of cancer that will qualify for disability benefits.
To qualify for disability benefits due to cancer, the Social Security Administration (SSA) follows a comprehensive evaluation process that considers several factors.
The Social Security Administration puts a great deal of weight on the opinion of medical experts. Consequently, disability claimants with cancer will want to include a thorough, detailed physical history from their healthcare provider, especially from their oncologist. The medical opinions should be accompanied by diagnostic evidence, such as biopsy reports, surgical notes, blood work, and needle aspirations. CT scans, MRIs, or PET scans are also valuable evidence on which the Social Security Administration relies in its “disability” determination.
A pathology report is an essential component of your disability application. The type of cancer is a critical factor in determining disability qualification. Some forms of cancer are inherently more aggressive or debilitating than others. For example, cancers like pancreatic or small cell lung cancer are often considered more severe, increasing the chances of meeting the disability criteria.
Stage of Cancer
The stage of cancer at diagnosis is another important consideration. Cancers that have advanced to higher stages, indicating more significant progression or metastasis, are more likely to qualify for disability benefits. The SSA generally places greater weight on advanced-stage cancers when assessing disability claims.
Treatment and Side Effects
The treatment for cancer, including surgeries, chemotherapy, radiation therapy, and immunotherapy, can cause severe side effects. The SSA considers the impact of cancer treatments on an individual's ability to work. Debilitating side effects such as fatigue, nausea, pain, and cognitive impairments can strengthen a disability claim.
Compassionate Allowances Program
Recognizing the urgency of certain medical conditions, including aggressive forms of cancer, the SSA has implemented the Compassionate Allowances (CAL) program. CAL is designed to expedite the disability application process for individuals with conditions that clearly meet the disability criteria. Some types of cancer, such as esophageal cancer, gallbladder cancer, and inoperable breast cancer, are included in this program, ensuring faster access to disability benefits for those in need.
How to File for Social Security Disability for Cancer
If you are considering filing a Social Security disability claim based on a cancer diagnosis, it is essential that you consult with a knowledgeable professional with a great deal of experience handling such SSDI or SSI claims. The seriousness of your condition means that your claim needs expert attention because you need the confidence of knowing that your claim is presented in the most competent and compelling way possible.
Your Social Security disability attorney or trained advocate will collect all medical records related to your cancer diagnosis, treatment, and prognosis. These documents will be crucial in supporting your disability claim. They will also need to gather and present detailed information about your medical condition, treatment, and work history.
Your healthcare providers need to be aware of your intention to apply for disability benefits. They may need to provide supporting documentation and opinions regarding your condition. If t they are uncertain how best to phrase the medical information in your records, your disability lawyer or advocate can inform them about the clarity required by the SSA when determining whether you qualify for benefits.
It's essential to be aware that disability claims, including those related to cancer, are sometimes denied initially. If your claim is denied, you have the right to appeal the decision. The appeals process typically involves several stages, including reconsideration and a hearing before an administrative law judge. An experienced disability law attorney specializing in disability claims will provide valuable guidance during this process.
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