The word cancer often elicits a very emotional response from people, and for a good reason. While some cancers can be successfully treated, others are terminal and can steal lives very quickly.
Individuals facing a cancer diagnosis are often unable to work. In addition to the fatigue or pain of the illness itself, the necessary treatments are often just as debilitating.
To find out if your specific cancer qualifies for disability benefits, you may want to turn to the Blue Book. The Blue Book is an online resource created by the Social Security Administration (SSA) to help determine which illnesses are serious enough to limit a person’s ability to work.
All of the qualifying medical conditions are listed according to body systems. Each listing included in the Blue Book contains the medical criteria for evaluating the impairments.
How the Blue Book Can Help You Medically Qualify for Disability with Cancer
As there are many different types of cancer, an entire section of the Blue Book is devoted to it. Section 13.00 addresses close to thirty different types or categories of disease ranging from skin cancer to cancers of an unknown origin.
While each type of cancer has its own set of medical criteria needed to be considered for a disability claim, there are certain things that the SSA will want to determine regardless of the type of cancer.
For all cancer, the SSA will want to know the following:
- Origin of the cancer
- Extent of involvement or spread of the cancer
- Duration, frequency, and response to anticancer treatment
- Effects of any post-therapeutic residuals
To evaluate a claim, the SSA uses the origin site of the cancer, if known. For example, if an individual has breast cancer that has spread to the lungs, the SSA will use section 13.10, breast cancer, to evaluate the claim.
The listings in the cancer section of the Blue Book are examples of the types of cancer that the SSA considers severe enough to keep an individual from doing any gainful activity.
However, not all types of cancer are listed in the Blue Book. As such, an individual might have an impairment that meets the criteria of a listing in another body system. If your cancer meets or medically equals a condition in the Blue Book, you will be awarded disability benefits.
In the majority of cases, individuals will only be considered disabled if their cancer therapy is ineffective. If a person’s cancer persists, progresses, or recurs despite medical treatment, they are a likely candidate for disability benefits.
Individuals with aggressive or advanced cancers may qualify for a Compassionate Allowance. Compassionate allowances allow a claim to be reviewed and approved more quickly than a standard application.
As the SSA knows that some types of cancer are life-limiting, compassionate allowances grant certain individuals access to earlier benefits.
What Evidence Do I Need to Win My Cancer Claim?
The cancer section of the Blue Book is particular about the type of detailed medical evidence that is required by the SSA when evaluating a claim.
As mentioned above, the SSA will want documentation of the kind of cancer, the site of primary origin, the extent to which it has spread, and if it has recurred. If a primary location cannot be identified, which is sometimes the case, the SSA will turn to section 13.27 which addresses unknown primary cancer sites.
As the SSA puts more weight on the opinion of medical experts, individuals with cancer will want to have a detailed physical and history from an oncologist.
All of the diagnostic information used to make a cancer diagnosis should be included, such as blood work, biopsies, surgical notes, or needle aspirations.
Medical images such as a CT scan, MRI, or PET scan are often included in a cancer diagnosis. A pathology report is an essential component of your disability application.
For those with advanced cancer, or cancer that has distant metastases, the SSA does not generally require a longitudinal record of evidence.
However, if there are no distant metastases, the SSA will usually want to observe an individual’s response to anticancer therapy before making a disability determination, as some cancer is very responsive to treatment. Documenting the type of treatment received, as well as the response to that treatment is paramount to any cancer claim.
Can A Lawyer Help Me Win My Claim for Cancer?
A new cancer diagnosis often leaves people confused and scared. In addition to trying to understand the next steps in the health care system, those with cancer are often left wondering how or if they will be able to continue to provide for themselves financially. It is during this time that a Social Security lawyer can really help.
An experienced disability lawyer or advocate understands the complex nature of the SSDI application process. Additionally, he or she is well versed in the language of the Blue Book.
A qualified attorney can serve as your advocate for the SSA so that you can focus on your health.
Return to A Guide to Cancer and Social Security Disability Benefits.
