This post discusses Social Security Disability for Cancer. A diagnosis of cancer is scary but there have been advancements in treatment. Many people diagnosed with cancer receive treatment and go on to live long lives.
If you are unable to work because of your symptoms from your cancer diagnosis, you can call us for a free case review or start online now.
Types of Social Security Disability Benefits
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for Social Security Disability benefits. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards (limited income) in addition to being found disabled under the five steps above. In 2023, SSI is $914.00 per month for an individual and $1,371 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death. Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.
Types of Cancer & Cancer Treatments
According to the National Cancer Institute, bladder, breast, colon and rectal, lung, melanoma and non-Hodgkin Lymphoma are among the most common cancer types diagnosed in the United States. Cancers are grouped roughly into four main types by where they begin in the human body: carcinomas, sarcomas, leukemias and lymphomas (Via Cancer.net).
Carcinomas are the most common form of cancer and usually forms solid tumors which involve organs. The most common carcinomas are adenocarcinoma (prostate cancer, breast cancer, colorectal cancer and pancreatic cancer), basal cell carcinomas (skin cancer), squamous cell carcinoma (skin cancer generally related to sun exposure), ductal carcinoma in situ (breast milk duct cancer) and invasive ductal carcinoma (breast milk duct cancer that has spread to nearby tissue) (Via Cleveland Clinic).
Sarcomas begin in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartilage or bone (the supporting or connecting tissues of the body). There are more than 70 types of sarcomas but bone sarcomas are more prevalent in children while soft tissue sarcomas are diagnosed more in adults (Via Johns Hopkins). Most soft tissue sarcoma in adults are found in the arms and legs which increases the risk of metastasis due to access to the lymph nodes.
Leukemias are cancers of the blood. Healthy white blood cells become abnormal and reproduce out of control. Leukemias are named by the type of white blood cell involved: lymphocytic leukemias (t cells, b cells or natural killer cells) while myeloid leukemias come from granulocytes and monocytes white blood cells (Via MSKCC). In general, there are four types of leukemia: acute lymphocytic leukemia (ALL); acute myelogenous leukemia (AML); chronic lymphocytic leukemia (CLL); and chronic myelogenous leukemia (CML) (via Mayo Clinic). AML and CLL occur most frequently in adults.
Lymphomas are cancers of the lymphatic system (Hodgkin and non-Hodgkin lymphoma). Reed-Sternberg cells (seen under a microscope) indicate Hodgkin’s while their absence is classified as non-Hodgkin’s. Non-Hodgkin is more common than Hodgkin (via City of Hope).
For a more detailed discussion of specific types of cancer look here.
Types of Cancer Treatment
In general, the treatment for cancer involves medications, resection, radiation or chemotherapy.
Medications that treat cancer, like doxorubicin (the red devil), methotrexate sodium or prednisone, have their own short term side effects which can render working impossible while undergoing cancer treatment. Nausea, vomiting, diarrhea, hair loss, loss of appetite, fever, fatigue, bleeding, bone weakness and pain are all potential side effects.
In addition, there can be long term side effects when healthy tissue is damaged by chemotherapy (Via Mayo Clinic). Fighting cancer is tough on its own, but the side effects from these medications may alone be enough to make you disabled.
Radiation prior to resection attempts to shrink a cancer tumor (via Healthline). Cancer detected in the early stages can respond well to radiation and resection. However, radiation can damage healthy cells as well as cancer cells. This can leave a patient cancer-free but with long term side effects including damage to vital organs.
Social Security Disability Benefits for Cancer
Social Security requires medical evidence (medical records) demonstrating a cancer diagnosis that specifies the type, extent, and site of the primary, recurrent, or metastatic lesion. An issue arises when your doctor may “suspect” cancer but testing has not demonstrated the actual location or exact medical condition you have.
If you are unable to work because of your health, you should apply for disability benefits as soon as possible. If it is later determined that you do not have cancer, you can withdraw your claim for Social Security Disability benefits. But if you do not apply, you have no safety net.
In order to be found disabled by the Social Security Administration, it must be shown that you are unable to work because of an illness which is expected to result in death OR which has or can be expected to last for a continuous period of at least 12 months. This is important news for cancer patients because it is possible that your cancer can be treated and in remission within less than a 12 month period.
Unfortunately, not everyone with cancer will be better within 12 months. Some forms of cancer are listed as compassionate allowances by the Social Security Administration. Compassionate Allowances allow Social Security to target the most obviously disabled individuals for allowances based on objective medical information that can be obtained quickly.
As discussed above, bladder cancer, breast cancer, colon cancer, rectal cancer, lung cancer and non-Hodgkin Lymphoma are the most commonly diagnosed cancers in the US. Bladder cancer, breast cancer, large intestine cancer, small cell and non-small cell lung cancer are all on the compassionate allowance list.
As an example, Adult Non-Hodgkin Lymphoma is also on the compassionate allowance list, while Hodgkin Lymphoma is not. After seeing that Adult Non-Hodgkin Lymphoma is on the list, we must then look at the listing (13.05A) itself to determine if the requirements are met:
13.05 Lymphoma (including mycosis fungoides, but excluding T-cell lymphoblastic lymphoma)
A. Non-Hodgkin lymphoma, as described in 1 or 2:
1. Aggressive lymphoma (including diffuse large B-cell lymphoma) persistent or recurrent following initial anticancer therapy.
2: Indolent lymphoma (including mycosis fungoides and follicular small cleaved cell) requiring initiation of more than one (single mode or multimodal) anticancer treatment regimen within a period of 12 consecutive months. Consider under a disability from at least the date of initiation of the treatment regimen that failed within 12 months.
Listing 13.05A requires continued persistent corruption of white blood cells despite cancer treatment OR slow growing lymphoma that requires two anticancer treatments in a year. This listing, as with most listings, is difficult to meet and working has stopped being an option prior to this time.
Even if your cancer is not on the Compassionate Allowance list, the Social Security Administration discusses cancer in the cancer listings: 13.00-Malignant Neoplastic Diseases. This listing covers various parts of the human body but three words are recurrent in this listing: inoperable, unresectable and metastases, none of which a cancer patient wants to hear. If your doctor has told you any of these apply to your cancer, you should apply for benefits as soon as possible.
In addition to the compassionate allowance list and the specific listings found at 13.00, SSA can do a Medical Vocational Allowance under the Grid Rules if you are over age 50 and limited to the sedentary level of exertion in the amount of time you can sit, walk, stand and carry.
No one knows what tomorrow will bring. If you have been diagnosed with cancer and are unable to work, apply for disability benefits as soon as possible. Delay may cause you to lose benefits.
The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Winston Salem, Garner, Greensboro, Greenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095 or start online now.
Also read NC Social Security Disability Lawyer