Disability Benefits for Colon or Rectal Cancer

If your cancer has spread or come back after a colostomy or ileostomy, you may qualify for disability.

By , Attorney · Seattle University School of Law

Colon cancer, also known as colorectal cancer, occurs when abnormal cells develop in segments at the end of the digestive tract. The cancerous cells start to grow in the longest part of the large intestine—the colon—down to the rectum and anus. Colon cancer is one of the most common types of cancer in both men and women.

Treatment for colon cancer may involve a surgical procedure to create an external opening (stoma) in the abdominal wall to remove or bypass the cancer. When part of the small intestine (ileum) is connected to the stoma, the procedure is known as an ileostomy, and when the colon is connected to the stoma, it's called a colostomy. After an ileostomy or colostomy is performed, doctors attach a plastic pouch (colostomy bag) to the stoma to collect redirected fecal matter.

Getting Disability Benefits With a Stoma, Ileostomy, or Colostomy

A colostomy or ileostomy can be temporary (typically lasting three to six months) or permanent. Social Security awards disability benefits to people who've been unable to work full-time for at least twelve months, so if you're able to return to work after a temporary ileostomy or colostomy, you might not qualify.

But if symptoms from colon cancer have caused significant limitations in your daily routine for more than one year—including treatment you've received before getting a stoma and time spent recuperating after surgery—you could be eligible for disability benefits.

Symptoms of Colon Cancer

Common symptoms of colon cancer include diarrhea or constipation, bloody stool, abdominal cramping, weakness, fatigue, and unintentional weight loss. Occasionally, cancer in the small intestine will cause a lump in the abdomen that can be felt on external examination.

Treatment for Colon Cancer

Creation of a stoma by way of ileostomy or colostomy is the most frequent treatment for colon, rectal, or other intestinal cancers. Chemotherapy, radiation, medication, and ablation (use of high-energy radio waves to destroy small tumors) may also be used.

When Symptoms and Treatment Cause Disabling Functional Limitations

Colon cancer can significantly interfere with your ability to function at work and at home. Side effects from chemotherapy can make you too exhausted to complete basic chores. Abdominal cramping can be painful enough to keep you bedridden for days, or you might not leave the house because you need to be close to a bathroom. Social Security must consider these limitations when determining whether you meet the agency's definition of disability.

Is Having a Stoma or Colostomy Bag Considered Enough to Qualify for Disability?

Colostomies and ileostomies can be quite effective at treating colon cancer, so solely having a stoma surgically created won't be enough to qualify for disability benefits. Instead, you'll need to show either that the cancer is medically disabling—meaning that it's inoperable or has spread (metastasized) to other parts of your body—or that your functional limitations keep you from working at any full-time job.

Meeting the Medical Listing for Colon Cancer

Social Security has a special category (the "listing of impairments") for medical conditions that the agency considers especially severe. If you meet the requirements of a listed impairment, you can qualify for disability automatically without needing to prove that you can't do any job.

Disability claims for colon cancer are evaluated under listing 13.18 for neoplastic diseases of the large intestine. In order to get disability by meeting the listing, your application needs to contain medical documentation of one of the following:

  • adenocarcinoma (a type of cancer that forms in the glandular tissue of the intestine) that can't be treated or removed by surgery, or that returned after remission
  • squamous cell carcinoma (a type of cancer that forms in the outer layer of skin cells) of the anus that returns after surgical intervention
  • cancer that has metastasized beyond the regional lymph nodes (organs near the large intestine that play a key role in your immune system), or
  • small-cell or oat-cell carcinoma (a rare, but aggressive, type of cancer).

Social Security also has a listing for cancer of the small intestine, listing 13.17. Small intestine cancer is rare, but appears to be more prevalent in people with intestinal polyps, Crohn's disease, and celiac disease. The requirements of listing 13.17 are very similar to those of listing 13.18, except you can't qualify due to squamous cell carcinoma of the small intestine.

If your colon cancer has spread farther into your body ("distant metastases"), can't be surgically treated or removed ("inoperable" or "unresectable"), or keeps coming back ("recurrent"), you may qualify for expedited approval under Social Security's Compassionate Allowance program. The program allows you to get benefits faster—sometimes in as quickly as several weeks.

Showing That Your Functional Limitations Keep You From Working

Not everybody with a diagnosis of colon, rectal, or intestinal cancer will be able to meet the requirements of a medical listing. This is often the case when the cancer is successfully treated by colostomy, ileostomy, or colon removal. Social Security doesn't usually consider having a colostomy to be disabling on its own, because most people can resume their normal activities after surgery with relatively minor adjustments.

But the agency can't make that determination without reviewing your medical records to determine what you can and can't do at work, a process called assessing your residual functional capacity (RFC). Your RFC is a set of restrictions that reflect the most you're able to do safely in a work environment.

For example, if you use a colostomy bag, your RFC could say that you're unable to lift more than 20 pounds or engage in repetitive bending because you could irritate your stoma. Your RFC could also restrict you from jobs that involve exposure to heat, humidity, or vibrations that might rupture the seal on your colostomy bag.

Social Security compares the restrictions in your RFC with the duties of your past jobs to see if you could still perform that work today. If not, the agency will need to determine whether other jobs exist that you could do, taking into account your age, education, transferable skills, and RFC. Having too many limitations in your RFC can rule out all full-time work, which will qualify you for disability benefits.

Medical Evidence You Need to Get Disability For Colon Cancer

Medical documentation is the most important part of a disability claim. Social Security can't award you benefits if you don't provide evidence of doctor's visits, treatment, and objective tests appropriate for someone with a cancer diagnosis. This means your medical record should contain the following information:

  • lab tests
  • blood work
  • X-rays, MRIs, and CT scans
  • biopsy results
  • hospital intake and discharge reports
  • clinical notes from your doctors, preferably your oncologist (cancer doctor), and
  • medication lists.

Ideally, your doctor will provide a medical source statement containing their opinion about your cancer prognosis (expected outlook), your functional limitations, and whether you meet one of the cancer listings. You can also submit witness statements from friends, family members, and former employers with first-hand experience of your limitations.

Preliminary Disability Eligibility Requirements

When you first apply for disability, Social Security needs to know that you're legally eligible to receive benefits before beginning the review of your medical records. The agency administers two kinds of benefits—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)—with different eligibility requirements. SSDI is based on your past work history and how much you've paid into the system via payroll taxes, while SSI is needs-based and subject to certain income and asset limits.

Additionally, the agency will need to see that you're not engaged in substantial gainful activity (SGA). SGA is an earnings threshold—around $1,550 per month—that Social Security considers to be "full-time work." Even if you made the entire SGA amount in one week and were hospitalized for the rest of the month, in Social Security's eyes, you were working full-time and therefore not disabled in that month. You must have a 12 month period of earnings below SGA before you can qualify for disability benefits.

How to Apply for Disability Benefits for Colon Cancer

Social Security provides several easy methods for you to choose from when starting your application for disability benefits:

  • File online at Social Security's official website.
  • Call 800-772-1213 (TTY 800-325-0778 if you're deaf or hard of hearing) from 8 a.m. to 7 p.m., Monday through Friday, to schedule an appointment with a Social Security representative.
  • Go in person to your local Social Security field office.

If you'd prefer to get some help with your application, consider hiring an experienced disability attorney. Disability lawyers generally provide free consultations, and can give you a good sense about the strengths and weaknesses of your claim. For more information that can help you make the most of your consultation, see our article on getting disability benefits for cancer.

Updated April 19, 2024

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