Some types of cancer are caught early and go into remission quickly with treatment, while others are in their late stages and don’t respond well to invasive techniques like chemotherapy. If your cancer treatment and symptoms keep you from working full-time for at least twelve months, you may qualify for Social Security benefits.
People who’ve been diagnosed with a type of cancer should become familiar with three terms used by Social Security when evaluating disability claims based on cancer:
Depending on several factors—such as what kind of cancer you have and whether it has metastasized or recurred—you may qualify for fast-tracked, automatic approval of your disability benefits. Other types of cancer that haven’t spread or don’t come back after treatment might not meet the standards for immediate approval, but may limit your work ability enough to get benefits under a medical-vocational allowance.
Social Security's Compassionate Allowances List (CAL) is a collection of serious medical conditions, many life-threatening, that will automatically qualify a disability applicant for expedited approval of benefits. If you have a type of cancer on the CAL, you may be awarded disability in as little as a few weeks instead of waiting a year or more.
There are more than 50 different types of cancer on the CAL. Generally, you can qualify for a compassionate allowance if you have a listed cancer that has either spread to other parts of your body or is insufficiently responsive to treatment—for example, the cancer has come back after chemotherapy or can’t be surgically removed.
Some cancers aren’t as immediately life-threatening as those on the CAL, but are still serious enough that Social Security considers them automatically disabling—provided that certain medical criteria are met. These cancers are described in the agency’s “Blue Book” list of impairments. While your application won’t be processed faster like it would be with a CAL condition, if you can establish that you meet a listing, you’ll get benefits without having to show that no jobs exist that you can perform.
Social Security evaluates cancer under Blue Book section 13.00 for malignant neoplastic disease. This section contains listings for over two dozen types of cancer, as well as the medical evidence required to qualify for disability under each listing. You can find more information about the listing requirements for specific cancers by clicking on the links in the grid below.
Simply having a diagnosis of cancer isn’t generally enough to meet the listing requirements—the cancer must have either metastasized or be recurrent, inoperable, or otherwise untreatable.
If your cancer has spread to parts of your body that are far removed from where it originated—for example, you were diagnosed with lung cancer but cancerous cells were later found in your liver—it’s called “distant metastases.” The Blue Book refers to this as “metastases beyond the regional lymph nodes.” You’ll need to provide Social Security with medical documentation of metastases, such as:
Because distant metastasis is considered a serious complication, evidence of a cancer spread is usually enough to meet the listing requirements, even if both the original cancer and metastatic tumor have been removed. Some metastases are expected to go away after chemotherapy or radiation, however. In these cases, Social Security may wait several months to see how well you respond to treatment before making a decision.
Doctors describe a tumor that isn’t able to be fully or partially removed surgically as “unresectable.” If your cancer is unresected or your surgeon finds cancer cells at the edge of tissue that they originally thought was healthy, you’ll qualify for benefits under a cancer listing. Tumors that are considered inoperable (ones that doctors can’t surgically remove) will likewise satisfy a listing.
If your tumor is resected but then returns in an area near the site of the original surgery, or if it comes back after chemotherapy or radiation, your cancer will be considered “recurrent.” Recurrent cancer qualifies you for disability benefits under most of the cancer listings, even if considerable time passed between when you were first treated and the date the cancer returned.
Your cancer treatment may be effective in keeping the tumor from spreading or coming back, in which case you wouldn’t meet the requirements of a disability listing. But common anticancer methods such as chemotherapy or radiation frequently cause severe side effects that can permanently limit your ability to work. If these limitations keep you from performing any kind of work, you may qualify for benefits under a medical-vocational allowance.
Unlike disability awards based on CAL conditions and listed impairments, which only consider your medical evidence, medical-vocational allowances focus on the functional impact your medical conditions have on your ability to do a job. The foundation of a medical-vocational allowance is determined by your residual functional capacity (RFC), an assessment of the most you’re able to do, physically and mentally, despite your limitations.
Most forms of cancer treatment come with significant side effects. Radiation can cause persistent joint pain, lymphedema, and nerve damage. Chemotherapy is virtually always accompanied by nausea, fatigue, and weakness, which can linger even after the treatment has stopped. Cognitive issues, such as memory disorders and slowed thought processes, are commonly reported long-term side effects of cancer treatment.
Social Security takes these side effects into consideration when determining your RFC. For example, if your radiation treatment was successful at eliminating the cancer cells but left you with nerve damage that causes pain when standing or walking, your RFC might contain a limitation to sedentary (sit-down) work. Or if you have trouble concentrating as a result of chemotherapy, your RFC may restrict you to unskilled jobs.
In order to determine whether you should be awarded benefits under a medical-vocational allowance, Social Security compares your RFC with the demands of your past work to see if you could return to that job today. If you can’t, the agency will then need to see if other work exists that you could perform, given the limitations in your RFC.
Social Security considers factors such as your age, education, and transferable skills when deciding if you could do other jobs. Disability applicants 50 years and older may have an easier time qualifying for benefits under the “grid rules,” while those younger than 50 generally need to show that they can’t do the simplest, sit-down jobs in order to get benefits.
Your medical records are the foundation of your disability claim. Let Social Security know the names, dates, and locations of every medical provider where you’ve gotten treatment for your cancer. Ideally, you’ll be able to provide all clinical treatment notes from your oncologist (cancer doctor) as well as a medical source statement containing their opinion on your medical prognosis (expected outlook).
If your oncologist agrees to write a medical opinion for Social Security, ask them to include the following information:
Because treatment for cancer can sometimes cause other conditions to develop, make sure to gather records from your other medical providers in addition to your oncologist. For example, chemotherapy has been associated with long-term disorders of the heart, liver, and lungs. Radiation can cause vision problems, thyroid malfunction, and gastrointestinal distress. Social Security needs to consider all your impairments when determining whether you’re disabled, so it’s important that the agency knows about every symptom that can affect your ability to work.
Social Security doesn’t award benefits for medical conditions that you recover from in less than twelve months, no matter how intense your symptoms are during that time. (In Social Security lingo, this is known as the “durational requirement.”) So if your cancer is successfully treated without residual symptoms within one year, you won’t be eligible for disability.
Once the agency is satisfied that you meet the durational requirement, however, you’re typically entitled to benefits for at least three years if you meet a cancer listing. After that three year period, Social Security will reassess your case to determine whether you still meet the listing criteria. You may have your benefits terminated at this time if your cancer is in remission and you’re able to return to work.
Even if the agency finds that you’re disabled, you’ll need to establish that you’re legally eligible to receive benefits under the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) programs. SSDI eligibility is based on your work history and how much you’ve paid into the Social Security trust fund through taxes, while SSI is needs-based and available to disabled people who have less than a certain amount in resources.
You have several methods to choose from when applying for disability. Many people decide to file online, or if you’d prefer to speak with a representative, you can call Social Security’s national hotline at 800-772-1213 (TTY 800-325-0778 for people who are deaf or hard of hearing) between 8:00 a.m. and 7:00 p.m., Monday through Friday. You can also go in person to your local Social Security field office.
You may want to read up on some preliminary information before you file to make sure you’re ready. The following articles can help:
While some disability claims for cancer are clear-cut and may not require legal assistance (as in cases involving stage IV or terminal cancer), most people will significantly benefit from hiring a lawyer. An experienced disability attorney understands how to prove that your condition meets a listing, or how to demonstrate that the side effects of your cancer treatment prevents you from working. If you’re worried that money will be an issue, it may help to know that disability attorneys generally provide a free consultation and don't charge a fee unless you win your case.
Updated March 7, 2024
]]>Cancer of the large intestine is called colorectal cancer, or colon cancer. Colorectal cancer occurs in the lower part of the digestive tract down to the rectum and anus. Colon cancer is one of the most common types of cancer in both men and women. People who develop polyps are more prone to developing colorectal cancer.
Cancer of the small intestine is rare, and although the exact cause is unknown, people with polyps, Crohn’s disease, and celiac disease seem to be more susceptible to cancer of the small intestine.
Symptoms of colorectal and small intestine cancer include unintentional weight loss, a change in bowel habits, fatigue, and blood in the stool. Occasionally cancer in the small intestine will cause a palpable lump in the abdomen.
The most common treatment for these types of cancers is surgery; however, other therapies such as chemo and radiation are used as well.
When you first apply for disability, the Social Security Administration (SSA) will check to see if you are earning more than about $1,500 per month, in which case you won't be eligible for disability. In addition, your disability from the colon or rectal cancer must be expected to last at least 12 months, and it must cause more than a minimal impact on your ability to work. If you do not meet these basic requirements, the SSA will deny your claim. If you do satisfy the requirements, the SSA will then look at your illness to see if it meets one of the conditions discussed in the SSA’s Listing of Impairments. If your colon or rectal cancer, or small intestine cancer, meets the requirements of one of the digestive disability listings, you will be automatically approved for disability.
If you suffer from cancer of either the small or large intestine, you may be eligible for automatic approval of your disability claim because both are qualifying conditions under the SSA’s disability listings.
If your cancer is located in the large intestine, which includes colon cancer, rectal cancer, and anal cancer, you can qualify for disability automatically if you fit one of the following:
If your cancer is located in the small intestine, you can qualify for disability benefits automatically if:
The listing requirements for cancer of the small and large intestines are complicated; you should review the criteria with your oncologist or treating physician to see if you qualify under the SSA's listings. To learn more about the requirements regarding inoperable, unresectable, recurrent, or metastasized tumors, see our article on when cancer qualifies for disability benefits.
Even though you suffer from intestinal cancer, you may not meet the SSA's listing requirements for large or small intestines cancer. This can happen in applicants whose colon cancer was successfully treated by the removal of their colon. Although these patients must use a colostomy, the SSA does not consider an uncomplicated colostomy to be a disability, because most people with a colostomy can continue their normal activities once they have healed from surgery.
If your intestinal cancer does not meet or equal a listing, and you are still unable to work, the SSA must decide if you can still do your old job with the functional limitations caused by your cancer or your colostomy. For example, if you wear a colostomy bag, you must avoid strenuous lifting or carrying because you could herniate your stoma (the place where the colostomy bag is connected to the body). You may also have environmental restrictions that require you to avoid heat, humidity, or vibration to avoid breaking the seal on your colostomy bag. These restrictions would make it hard for you to perform some jobs.
If the SSA feels you can still do your old job, you will be denied; otherwise, the SSA must determine if there is other work you can do. To make this decision, the SSA will look at your age, education, past work experience, and the effects of your intestinal cancer on your ability to do work-related activities.
It is important that the SSA has access to all the medical records that relate to your intestinal cancer so that the agency knows what your functional limitations are. This means your medical record should include your blood work, biopsies, hospital and pharmacy records, MRI and CT scan results, and doctors’ reports. You should provide the SSA with a Residual Functional Capacity assessment (RFC) prepared by your treating doctor. An RFC is a detailed evaluation of how your ability to work is affected by your disease.
]]>The primary treatment for kidney cancer is removal of the entire kidney or part of the kidney. Other treatments, such as blocking blood flow to the tumor or freezing the tumor cells, can be used when surgery isn’t possible. Prognosis depends on how far along your kidney cancer is when you are diagnosed, your general health, and your medical history.
When you apply for disability, the SSA will look at your illness to see if it meets or equals one of the qualifying conditions in the SSA’s Listing of Impairments. If your illness is a qualifying condition, and you meet all of the criteria of the listing, your claim will be automatically approved.
Kidney cancer is one of the qualifying conditions in the SSA’s Listing. You will be eligible for automatic approval if:
It is important that you provide the SSA with your complete medical history with regards to your kidney cancer. This includes copies of biopsies, CT scans, MRIs, blood tests, hospitalizations, surgical reports, medication lists and side effects, and any reports created by your treating physician.
For more information on the requirements regarding inoperable, unresectable, recurrent, or metastasized tumors, see our article on when cancer qualifies for disability benefits.
If you have a kidney removed because of the cancer, but the other kidney is healthy, you will not meet the listing requirements. However, if complications arise with the remaining kidney, you may be eligible for disability under the kidney and urinary listings, which discuss qualifying kidney conditions.
]]>There are three ways to obtain disability benefits from Social Security if you have breast cancer:
The Compassionate Allowances program was set up by the Social Security Administration (SSA) to quickly grant benefits to individuals who have serious diseases that are likely to qualify for benefits with minimal medical evidence. If your condition qualifies for the Compassionate Allowances program, the SSA will perform expedited processing of your disability claim.
Breast cancer that is diagnosed as having distant metastases (cancer that has spread to other parts of the body) or that is inoperable (surgery not available) or unresectable (not able to be completely removed) qualifies as a Compassionate Allowances condition. Stage IV cancer qualifies as a Compassionate Allowance.
To provide evidence of that your breast cancer qualifies for Compassionate Allowance treatment, the SSA prefers that you send a pathology report and an operative report. If these reports are unavailable, the SSA may use the opinion of your physician.
Learn more about how compassionate allowances get disability benefits faster.
The SSA has created a Listing of Impairments (known as the "Blue Book"), which contains a wide range of specific medical conditions and the requirements needed to prove disability for these conditions. If your condition matches the requirements of one of these disability listings, the SSA will automatically find you disabled. Breast cancer is included as Listing 13.10.
To meet the listing for breast cancer, you need to provide medical evidence showing locally advanced cancer in the breast tissues. You also need to show one of the following factors:
The SSA will want to see medical evidence indicating the type, size, and area of your breast cancer. If you have been hospitalized, the SSA will want a copy of the pathology findings and any other medical reports.
For more information on the requirements regarding inoperable, unresectable, recurrent, or metastasized tumors, see our article on when cancer qualifies for disability benefits.
When you do not meet or equal a disability listing contained in the Listing of Impairments, usually because your breast cancer is not as advanced as the disability listing (above) requires, the SSA will assess your residual functional capacity (RFC) to see if you are unable to work any type of job. Your RFC is the most you can do in a work setting (such as heavy work, medium work, light work, skilled work, or unskilled work). The SSA will determine the length of time you are able to sit, stand, and walk; the amount of weight that you can lift and carry; how well you can use your hands and arms; whether you can understand and follow instructions; and whether you can work with the public and coworkers. The SSA will use your RFC to decide if there are any jobs you can perform. If you are unable to perform any jobs, you will be considered disabled. (Learn about the basics of getting Social Security disability based on your RFC.)
Breast cancer can greatly affect your ability to work. You might be given surgery and radiation as treatment to heal your cancer. These treatments can cause pain, fatigue, headaches, depression, mood swings, and memory loss. If you have moderate pain and fatigue, your RFC might look like the following: can lift and carry less than ten pounds, can sit for six hours out of an eight-hour day, can stand/walk for two hours of an eight-hour day, and can perform only simple unskilled work. This RFC would still allow you to perform only sedentary work. But, if your fatigue is severe, you might be unable to work in a sedentary position because you would be absent too many days during the month. Furthermore, if you have pain in your breast area, that could affect your ability to use your arms, thus reducing the amount of jobs that you can perform. Generally, if you can't perform even sedentary work (unable to sit for six hours a day and stand/walk for two hours a day), you will be found to be disabled. Or, if you are over age 50, it is easier to be found disabled even if your RFC allows you to perform a greater range of work activities.
In addition, depression and memory loss, which affect some patients going through chemotherapy, radiation, and/or surgery, can affect your ability to concentrate on work tasks or follow simple instructions.
To create your RFC, the SSA will gather copies of your medical reports to learn about your symptoms and their severity. To help the SSA form a accurate opinion, it's helpful for you to obtain a detailed medical opinion from your treating doctor regarding your ability to perform work. Most helpful would be if your doctor can fill out an RFC form.
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