Medical Qualification for Disability Benefits with Cancer


Some cancers respond to treatment quickly. Others are highly aggressive or more advanced at the time of diagnosis. The level of disability for patients with cancer varies greatly from one case to the next. The cancer type determines how the Social Security Administration (SSA) considers your application for benefits. You may have a form of the disease that qualifies for automatic approval, or the type of cancer with which you’ve been diagnosed may be one that doesn’t always get approved for disability. If you can prove you are eligible, disability benefits ensure steady income, and since there are multiple ways to achieve a disability approval, you shouldn’t lose hope.

Disability Listings and Medical Qualification

The Social Security Administration (SSA) maintains standard disability listings that can help you and your doctor understand the medical qualification rules related to various forms of cancer. These listings appear in a manual called the “Blue Book,” which is found on the SSA’s website.

Each listed condition includes a description of how severe cancer case must be to meet “automatic” approval requirements. Lung cancer, breast cancer, lymphoma, kidney cancer, and soft tissue cancers, are only a few of the forms that can potentially qualify for benefits.

Medical Documentation and Disability Approval

Information on the SSA’s medical evidence requirements appears in the beginning of the Blue Book section on cancer. Although automatic approval is guaranteed in some cases, every claim must still be backed up with appropriate medical records, so you’ll want to ensure your medical history satisfies the SSA’s criteria. The best way to do this is to have your oncologist review the requirements and compare those requirements with your medical records. Your doctor can address any gaps in your documentation by ordering additional tests, if necessary, or by writing up a detailed report, describing your specific case.

Cancers that Qualify at the Time of Diagnosis

Some forms of cancer are difficult to beat and take a long time to go into remission, even when they respond to treatment. The SSA knows this, which is why some qualify for benefits almost immediately after diagnosis. With Leukemia for example, you’ll be approved for benefits for at least one year.

Highly aggressive, advanced, metastatic, and untreatable forms of cancer meet automatic approval requirements as well, and are often eligible for expedited review and approval under the Compassionate Allowances program. If your cancer has spread, returned after initial treatment, or is not treatable due to limitations of modern medicine, you can get approved for disability quickly and with minimal medical evidence to back up your claim.

Medical Vocational Allowance Approval

Even when cancer responds to treatment, achieving a cure or remission often comes at a tremendous cost. Invasive surgical procedures and harsh cocktails of anti-cancer therapies leave many people with long-term or permanent impairments that can prevent gainful employment. If this is the case for you, you may not qualify under a disability listing, but you may still be able to get approved for a medical vocational allowance. For this kind of approval though, the SSA must review your residual functional capacity (RFC) to determine you cannot work due to your physical and/or mental limitations.

Applying for Benefits

Whether you get approved after an RFC or under a standard listing in the Blue Book, medical evidence is the key to a successful disability claim. Before you submit your application, let your doctor know you’re going to apply and ask him or her to partner with you to boost your disability approval chances. When you’re ready to complete your application, you may do so online or by visiting your local SSA office.

Resources:

SSA Website: https://www.ssa.gov/

Carson Tahoe Health: https://www.carsontahoe.com/

Breast Cancer: https://www.disabilitybenefitscenter.org/social-security-disabling-conditions/breast-cancer

Cancer Blue Book: https://www.ssa.gov/disability/professionals/bluebook/13.00-NeoplasticDiseases-Malignant-Adult.htm

Compassionate Allowance: https://www.disabilitybenefitscenter.org/how-to/disability-compassionate-allowance

Apply Here: https://www.ssa.gov/benefits/disability/