Applying for Social Security Disability Benefits with Cancer

Applying for Social Security Disability Benefits with Cancer
September 14, 2016 Alene Nitzky
Social Security Disability Benefits with Cancer | Cancer Harbors Survivorship Care Plan and Program

Applying for Social Security Disability Benefits with Cancer

If you’ve been diagnosed with cancer and are now unable to continue working at your current job, there may be resources available to you. The Social Security Administration (SSA) offers Social Security disability benefits to help cover the costs of everyday expenses to those who suffer from a disabling condition and are unable to work. If your cancer keeps you from working, you may qualify for disability benefits.

Forms of Disability Benefits Available to Cancer Patients

There are two types of disability benefits available through the SSA: Social Security Disability Insurance and Supplemental Security Income.

Understanding Social Security Disability Insurance

Social Security Disability Insurance (SSDI) benefits are only available for people who have worked throughout their lives, because SSDI is funded by taxpayers. Your total SSDI benefit will be based on your work history and how much you earned at your past jobs. The more income you earned and contributed to taxes, the higher your monthly benefit will be. To qualify for SSDI benefits, you must:

  • Be an adult between the ages of 18 and 66
  • Have worked enough to earn a certain amount of “work credits.” A work credit is an amount of taxable income earned, $1,260 in 2016.

If you are approved for SSDI benefits, you will be enrolled into Medicare 24 months after the SSA establishes you became disabled. This point will be known as your “Established Onset Date,” and will typically be the time at which your cancer progressed to the point that you could no longer work, or you began receiving treatments and were unable to work.

Understanding Supplemental Security Income

Supplemental Security Income (SSI) is need based and not affected by your work history. People of all ages can qualify for SSI benefits, which means that parents can apply for SSI on behalf of a child with cancer. To qualify for SSI benefits, an adult must:

  • Own less than $2,000 in assets (or $3,000, if you are married)
  • Have a very low household income

Children are not expected to have as strict income limits, although the SSA will evaluate parents’ income when determining whether or not to approve a child with cancer for SSI. In most states, people with cancer will be automatically enrolled onto Medicaid as soon as they’re approved for SSI benefits.

Most adult applicants will be applying for SSDI, not SSI. This is because the work credits needed to qualify are not strict. Working for any five of the past 10 years will be enough to qualify. On the other hand, SSI income limits are very strict. Medically qualifying for the two programs with cancer is the same.

Medically Qualifying for SSDI or SSI with Cancer

There are many forms of cancer that vary in severity. The SSA keeps a list of all forms of diseases that may prevent someone from working called the Blue Book. Most forms of cancer fall under Section 13 of the Blue Book.

Every Blue Book cancer listing has different test results necessary to be approved for SSDI or SSI benefits. For breast cancer to qualify for Social Security, it must have spread past regional lymph nodes of the breast and moved toward the collarbone or other distant areas to qualify. Breast cancer will also qualify if it is inflammatory.

A pancreatic cancer diagnosis will automatically qualify for disability benefits regardless of its stage. The only exception to this is if you’ve been diagnosed with “islet cell” pancreatic cancer, which typically responds better to treatment. In this case, your islet cell pancreatic cancer will need to be active and inoperable to medically qualify.

Finally, any form of cancer that is diagnosed as a “small cell” cancer will automatically medically qualify, because cancer originating in this type of cell is typically more aggressive.

The SSA requires certain medical evidence regarding your cancer for your application. This medical evidence could include:

  • Where the cancer originated
  • How the tumor formed and grew
  • How you responded to treatment
  • Operation notes and pathology reports of any biopsies or tests
  • Any symptoms associated with your cancer post-treatment
  • A summary of your hospitalization and all medical treatment

The more medical evidence you have available, the better your chances of getting approved for benefits.

Compassionate Allowances and Disability Benefits

If you’ve been diagnosed with an advanced or aggressive form of cancer, you can expect to be approved much quicker than the average applicant. This is because the SSA expedites the approval proves for people with a condition that warrants immediate approval. This is known as a Compassionate Allowance.

Some forms of cancer will qualify for a Compassionate Allowance immediately. As soon as you’re diagnosed, gallbladder cancer, liver cancer, and thyroid cancer are three examples of cancers that will qualify for a Compassionate Allowance upon diagnosis.

If you have another form of cancer, you will almost always qualify under a Compassionate Allowance if one of these three conditions is met:

  • Your cancer has spread beyond its local region of origin
  • Your cancer is inoperable
  • Your cancer has returned despite a round of anti-cancer therapy.

If your cancer qualifies as a Compassionate Allowance, you can expect to be approved for benefits in as little as ten days.

Qualifying Without Meeting a Blue Book Listing

But what if your cancer hasn’t spread to other regions of your body, and it additionally does not meet a Blue Book listing?

If your cancer hasn’t spread, the SSA may also take your Residual Functional Capacity (RFC) into account. This is a form that your doctor or oncologist can fill out that determines how much work you can reasonably be expected to perform with your disability, if any. The SSA will look at the jobs you have had in the past, along with your age and education level, to see if there is a new job you can learn that would allow you to work with your cancer.

Your RFC assessment should give a detailed account of your symptoms and any side effects of your treatment that make it difficult for you to work or perform normal tasks. The job history you have can help your chances of getting approved through an RFC.

For example, skin cancer could make it so that you are unable to work outdoors, but if you are older, have no college degree, and have only been employed at construction jobs in the past, you may be more likely to be approved for benefits. If you are a teacher and your brain cancer causes you to have ongoing cognitive and memory issues, the SSA could approve your application due to your inability to work in your specific industry.

Applying for Social Security Disability Benefits

If you are applying for SSDI benefits, you can apply online through the SSA’s website. You can also apply in person at your local SSA office. If you are applying for SSI benefits for yourself or on behalf of a child, you can start the application online, but you will need to complete the process at your closest SSA office. You can schedule an appointment with an SSA representative by calling the SSA toll-free at 1-800-772-1213.

The approval rate for the average initial application is around 30%, but this is including applications for all disabilities. A cancer diagnosis is typically more likely to be approved than an intellectual disability, mood disorder, or many other illnesses. With thorough medical records, you will hopefully be approved shortly and can focus on what’s truly important: treatment and recovery.

This post was written by Deanna Power, Director of Outreach at Disability Benefits Help. She began working with people with disabilities by volunteering with Best Buddies as a student at Emerson College in Boston, where she graduated with a degree in Marketing Communications. She now specializes in helping people of all ages determine whether or not they medically qualify for Social Security benefits. Disability Benefits Help provides free assistance.  If you have any questions on the Social Security disability application process, she can be reached at drp@ssd-help.org

2 Comments

  1. Irma Carmona 10 months ago

    Good evening!! Just a question,how about if I’m a retired educator??
    I retired in June 2017,and was diagnosed with breast cancer in january 2018?? Can I apply for SSI disability??

  2. Author
    Alene Nitzky 9 months ago

    You would need to check with the Social Security Administration (SSA) for that information.

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