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Helpful Information on Social Security Benefits and Cancer

Posted on March 23rd, 2017

Qualifying for Social Security Benefits With Cancer

If you or a loved one has been diagnosed with cancer, you may be concerned about making ends meet financially if you’ll be out of work while going through chemotherapy and other treatments. Fortunately, there could be resources available for you and your family. The Social Security Administration (SSA) offers disability benefits for people in need. Thousands of people receive disability benefits after a cancer diagnosis every year.

Medically Qualifying for Disability Benefits With Cancer

A cancer diagnosis alone will not qualify for disability benefits. The SSA will need evidence that you’ll be out of work for at least 12 months due to your cancer’s complications or treatment, or that your cancer is terminal.

Every form of cancer will qualify differently. For example, esophageal cancer will qualify with just a diagnosis, as will any form of cancer that has spread to another organ. Breast cancer, on the other hand, usually need to be advanced to Stage III-B or further to qualify.  Some cancers that are highly treatable, such as prostate cancer, will not qualify unless they’ve spread to another organ, returned despite treatment, or are an aggressive form of cancer, such as small-cell cancer.

The SSA uses its own medical guide known as the Blue Book to evaluate your specific cancer diagnosis. The entire Blue Book can be found online, so be sure to review it with your doctor to determine if you’ll medically qualify.

Compassionate Allowances and Social Security

The average Social Security disability claim takes about five months to be approved, but sometimes up to 2 years if your initial application is denied. Fortunately, this is not the case for people with advanced forms of cancer. The SSA started its Compassionate Allowance initiative in 2008 to help people with clearly disabling conditions get approved for the resources they need quickly. Cancers that will qualify as a Compassionate Allowance with just a diagnosis include:

  • Esophageal cancer
  • Gallbladder cancer
  • Brain cancer
  • Inflammatory breast cancer
  • Liver cancer
  • Pancreatic cancer
  • Salivary and sinonasal cancers
  • Thyroid cancer

 

If you don’t have one of the above diagnoses, you could still qualify for a Compassionate Allowance. So long as one of the following is true, your claim will be expedited:

  • Your cancer has returned despite treatment (3 months or more usually qualifies)
  • Your cancer is inoperable
  • Your cancer has spread to other organs.

There are no additional steps you need to take when filling out your Social Security application when applying with a Compassionate Allowance, nor is there any additional paperwork for you to fill out. When you submit your application, the SSA will automatically flag your application for expedited review. Instead of waiting for 5+ months to hear back from the SSA, you could be approved in as little as 10 days.

Keep in mind that even if you qualify for a Compassionate Allowance, your benefits will not start within 10 days. Unfortunately, the SSA still requires that disability recipients wait five months to receive their first payments.

What Disability Benefits Are Available?

The SSA has two types of disability benefit programs. The medical criteria for qualifying with cancer are the same for both, but each one is intended for a different type of applicant.

  • Social Security Disability Insurance (SSDI): SSDI pays benefits to disabled workers and their eligible dependents. To qualify, you must have worked a certain number of years and earned a sufficient number of work credits prior to becoming disabled. It is funded through payroll taxes, and recipients are eligible for Medicare coverage after two years.
  • Supplemental Security Income (SSI): SSI is a needs-based benefit program intended for children, the elderly and disabled applicants with limited assets and financial resources. To qualify, your family’s combined income and resources must be no more than $3000. SSI recipients also qualify for Medicaid and even food stamps.

It is possible to qualify for both SSDI and SSI at the same time. This happens if your awarded SSDI benefits are lower than the SSI monthly maximum payment, which is $735 in 2017.

Starting Your Disability Application

Most applicants can complete the entire Social Security application entirely online. This is the easiest way to apply for disability benefits, as you can save your progress and complete the application at a later date.

If you’d prefer to apply in person, you’ll need to make an appointment with a Social Security field office. There are more than 1,300 offices nationwide, and every state has at least four offices. Regardless of how you apply, be sure to fill out your application as carefully as possible. If the SSA cannot locate your biopsy reports, surgical notes, or other medical records, you may be denied benefits due to a technicality!

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

Compassionate Allowances: https://www.ssa.gov/compassionateallowances/conditions.htm

Apply Online: https://www.ssa.gov/disabilityssi/

SSA Field Offices: http://www.disability-benefits-help.org/social-security-disability-locations

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