Living life with cancer is difficult, to say the least. The physical and emotional stresses of the disease, as well as the treatment side effects, may make it impossible to work while fighting the disease. It feels disabling to receive a diagnosis of any type, grade, and stage of cancer. You may not be able to work during your course of treatment. And you can experience residual side effects, and for months afterward you may not be able to return to work. We understand these factors can create a debilitating financial situation. But, what are the regulations regarding Social Security disability benefits and cancer? Does cancer qualify as a disability?
Quick Breakdown of Qualifications
Qualifying for benefits (such as SSDI and SSI) for particular types of aggressive cancer can be straightforward such as pancreatic, liver, thyroid, mesothelioma and esophageal. For other kinds, you need to provide the Social Security Administration with sufficient evidence that your cancer fulfills the official SSA listing and that the symptoms and treatments limit you so much that you cannot work. Inoperable cancers or those unresectable with surgery, or if the condition recurs after treatment, or that metastasized to other places are eligible for benefits.
Surgery or Treatment is Not Successful
- Unresectable: If you had surgery and it was not able to completely remove the tumor, it is termed unresectable. Furthermore, if your surgical margins are positive following surgery, it will also be deemed unresectable. Therefore, you will qualify for benefits under most of the cancer listings.
- Recurrent: If you have a tumor removed and it comes back in an area near the original site, or if it returns after chemo or therapy it is considered recurrent under the SSA listings for cancer. Included under the SSA listings are cancers of the lung, colon, kidneys, prostate, testicular, uterine, and ovarian. It is applicable even if there is a considerable time lapse between the first occurrence and the second. The exception to the rule is carcinoma of the breast.
- Inoperable: If you are diagnosed inoperable, you are eligible for most of the cancer listings.
- Lymphedema: If you have had surgery, and you experience lymphedema, your condition is therefore evaluated under the musculoskeletal or cardiovascular listings. Lymphedema is a chronic swelling of an arm or leg, and can occur after any cancer surgery, but especially breast cancer and melanoma.
The Cancer Has Spread
Distant Metastasis is cancer that spreads to other parts of your body.
The SSA’s lists this complication as metastases beyond the regional lymph nodes. In this instance, the applicant qualifies for automatic approval, even after the removal of the original lesion or tumor. However, if the prognosis is that the secondary tumors will respond to treatment, the SSA may wait to approve until they see the outcome. You must still provide appropriate medical documentation in support of your claim.
Debilitating Side Effects
Many patients can undergo chemotherapy or radiation and continue to work and function in daily life. However, for others, cancer treatment totally knocks them down. Side effects include nausea, vomiting, diarrhea, fatigue, weakness, skin, and mental ailments. Unfortunately, you will find it difficult to qualify solely for this. Often the side effects are temporary and will not meet the SSA’s time requirement. If you do experience side effects for an extensive period, you will need to have documented the side effects in a journal. It is also helpful to provide statements from people who have witnessed your journey.
Long-Term Side Effects
There are long-term impairments associated with chemotherapy and radiation. Interestingly, you may qualify for SSDI because of the effects the treatment have on other parts of your body. Such impairments include:
- heart problems
- liver problems
- lung disease
- bone weakness
- cataracts, and
- reproductive disorders
- intestinal problems
- cognitive dysfunction
Hence, if you develop any of these conditions as a result of your cancer treatment, the SSA then evaluates the impairment on its own, without considering cancer.
Three Year Rule
If your initial cancer treatment is successful, and you have no recurrence for three years, your illness no longer meets the SSA’s disability listing. However, the three-year rule also means that your SSDI decision stands for a minimum of three years. And, most noteworthy, even if cancer has been successfully treated before the end of the three years.
Finally, in conclusion, the one-year time requirement to qualify for disability benefits is the same for cancer, just as any other medical condition. The topic of Social Security disability benefits and cancer is quite complicated. Contact Disability Support Services and we can help. Schedule an appointment today.