Social Security Disability Benefits for Brain Cancer
If you are unable to work because you have been diagnosed with brain cancer, you may be eligible to receive Social Security Disability benefits. The Social Security Administration (SSA) oversees Social Security Disability Insurance (SSDI), which is designed to help those who are disabled by providing monthly benefits to help ease their financial burden. SSDI is designed to help those who are completely disabled, and certain specifications have to be met in order for you to be eligible for benefits.
In order to get SSDI, you have to have earned a sufficient number of credits and paid in an adequate amount of taxes to the SSA. These credits mean you need to have worked the equivalent of five years of full-time work during the last 10 years. Therefore, it is imperative to file your claim for benefits as quickly as possible so you don’t risk losing out on your eligibility.
There are many kinds of cancer that qualify for benefits, including brain cancer. After you have been diagnosed with brain cancer, there are several ways that you may approach your claim to qualify for benefits.
If your brain tumor is inoperable, is spreading, or it is not properly responding to treatment, you clearly meet the medical requirements for benefits. You will have a good chance at a fast approval without having to go to a hearing before an administrative law judge.
If your condition does not meet those guidelines, you may still qualify for benefits if you are unable to perform full-time work because of the condition itself or because of the treatments you are undergoing for the cancer. The SSA must have a completely detailed file, including medical records, treatment responses, surgical notes, employment history, income, assets, and how your life has changed after the illness.
The Cost of Treating Brain Cancer
Treating serious medical conditions, especially cancer, can be very expensive. The cost can cause financial devastation for a family.
According to CostHelper.com, the average coast of brain tumor treatment for patients without insurance can be less than $50,000 if the tumor is benign and in a location that enables it to be treated solely by surgery, or it can be more than $700,000 for a malignant tumor that requires a treatment combination involving surgery, radiation, and chemotherapy.
Brain surgery alone ranges from $50,000 to $150,000, which is dependent upon the hospital, the physician, and the location of the tumor and its size. If your surgical procedure involves complications, that can add as much as $100,000 more onto the bill very easily.
Recurring tumors may require additional treatments, which can easily add $100,000 more onto the bill. The cost of chemotherapy is dependent upon the drug used and the number of treatments that are required.
The SSA Evaluation and Medical Qualifications
The Social Security uses a Blue Book, which is a medical guide that has specific criteria that you need to meet in order to medically qualify for benefits. Neoplastic diseases, including brain cancer, has the following requirements for brain cancer, or central nervous system cancers:
Highly malignant tumor of the brain, spinal cord, or spinal root that has progressed or recurred after initial treatment has been completed.
Examples of highly malignant tumors cited by the SSA include gliobastoma multiforme, medulloblastoma or PNET with documentation of spreading, astrocytomas in grades III and IV, ependymoblastoma, primary sarcomas, and diffuse intrinsic brain stem gliomas. The SSA will make the decision from looking at your medical records and the evidence and documentation that you present on behalf of your case.
Meeting the Requirements of a Vocational-Medical Allowance
If you do not meet the medical requirements for SSDI, you may still be eligible for benefits using the medical-vocational allowance. This is another way to prove that you are disabled and unable to work full-time. Basically, this approach considers all of your medical conditions and how they impact your daily life and your ability to perform work duties on a full-time basis.
This approach involves using a residual functioning capacity (RFC), which can be completed by your treating physician. This form details your limitations and restrictions so it is made clear as to what you can and cannot do and how your abilities to perform tasks have changed since the onset of your medical condition.
As an example, if you have brain cancer you may not be able to focus for long periods of time or your eyes may not be able to look at a computer screen for more than an hour or two. That should be indicated on the RFC. If your chemotherapy treatments have weakened you and you are unable to stand more than two hours without readjusting, that should also be noted.
Limitations regarding walking, lifting, grasping or gripping, bending, and reaching should also be noted. If your treatments make you nauseated and cause severe fatigue, that should also be indicated so it can be considered during the claims process. In order to determine if you are eligible for benefits, the SSA Disability Determination Services team must be made aware of all of your limitations and restrictions so they can determine you are unable to work.
Applying Medical Tests
Because you are applying for benefits on the basis of brain cancer, you will need to include all tests and findings that detail your diagnosis, the size of the tumor, the prognosis, and the treatment plans. It should also indicate any treatment plans that you have undergone and those results.
If you have undergone surgery, those notes should be included. If your tumor is non-operable, that should be stated as well.
The SSA needs all of the evidence available to prove your condition and confirm your diagnosis. It is not uncommon for the SSA to schedule a medical evaluation with the physician they choose at no expense to you. This visit will not be for any kind of medical treatment, but for informational purposes only.
Sometimes a mental evaluation is ordered as well to determine if you are suffering from depression or anxiety resulting from your condition. Any kind of mental disorder must be considered when your claim is being considered.
The SSDI claim process can take several months. You may be denied benefits twice, and you can appeal these rulings. Your final step would be to request a hearing before an administrative law judge for a ruling on your case and to determine if you meet the requirements of being disabled.