Published on: August 2, 2017
A cancer diagnosis can be a life-changing experience for many patients. Depending on the type of cancer you have and how it impacts your overall health, you may be eligible to receive disability benefits from the SSA. There are certain specific criteria through which the SSA determines your eligibility for disability benefits if you have cancer.
Most importantly, the SSA analyzes how your cancer condition prevents you from participating in any substantial gainful activity and if it is expected to last for at least a year, or result in death.This article will explore what you need to know about qualifying for disability benefits with cancer.
When you Automatically Qualify for Social Security Disability Benefits with Cancer
There are certain situations when you can automatically qualify for disability benefits based on the type of cancer that you have been diagnosed with. These situations include:
1. Through the Compassionate Allowances List
The SSA keeps a list of serious medical conditions called the Compassionate Allowances list (CAL) that automatically qualifies applicants for benefits with expedited approval. The conditions on that list are mostly life threatening, and many types of cancer are present on the list. For example, inflammatory breast cancer, mesothelioma, and liver cancer are some types of cancer that can qualify you for benefits based on the diagnosis alone.
In order for you to qualify for automatic approval, your cancer should first of all be listed in the CAL, and it should have distant metastasis (it should have spread out from the original location to other parts of the body), or it should be inoperable or recurrent.
2. Treatment has been unsuccessful
If you have previously attempted to have your tumor surgically removed and the operation was unsuccessful, you will automatically qualify for disability benefits under the SSA’s listings for cancer. The inability for the tumor to be removed is termed as “unresectable.”
In addition, if the tumor is removed but occurs again in a similar or different area, it is termed as recurrent and generally qualifies you for benefits. A tumor that cannot be operated on also leads to automatic granting of benefits.
3. The Cancer has spread
When cancer spreads to other parts of your body far from where it originally began, this condition is referred to as distant metastases and it automatically qualifies you for benefits, even if the original location of the cancer was removed.
4. Qualification through the Blue Book
The SSA keeps another list of medical conditions that automatically qualify you for benefits, called the Blue Book. This Book contains many different types of cancer listed, such as leukemia, skin cancer, and breast cancer. Conditions listed in the Blue Book, however, do not qualify for expedited processing of your disability claim. In addition, the cancer has to be either recurrent, has metastasized, or is untreatable/inoperable for you to automatically qualify for benefits.
Qualification Through a Medical-Vocational Allowance
If you have a cancerous condition that is not listed in any of the SSA lists for automatic approval, you can still qualify for benefits under the Medical-Vocational Allowance. In this area, the SSA considers your age, work history, education and your Residual Functional Capacity (RFC). RFC is an assessment of how your mental and physical abilities are affected by your impairment. Also, the SSA analyzes how your current condition prevents you from working.
If the symptoms of your cancer or side effects of your treatment significantly impact your ability to work or perform residual functions, you will be able to qualify for disability benefits under the vocational allowance.
Harmful Side Effects of Cancer Treatment That Prevent you From Working
In some cases, the cancer treatment could be causing your inability to work even more than the symptoms of the cancer itself. Treatment methods such as chemotherapy and radiation can lead to significant side effects that can interfere with normal activities. Side effects can include nausea, fatigue, weakness, diarrhea, and vomiting. In some cases, mental ailments can also occur.
In order to prove that these side effects are preventing you from working, you must be able to show that the condition has been persistent and can prevent you from working for at least one full year. Therefore, keeping records of these side effects and how they affect your normal activities is important when filing for benefits.
In some cases, you may get long-term side effects from cancer treatment. Chemo and radiation have been known to cause conditions such as heart and liver problems, lung disease, bone weakness and even eye problems. If you gain a long-term condition from cancer treatment, the SSA will review this condition on its own, independent of the cancer.