Disability Benefits for Pancreatic Cancer

Pancreatic carcinoma is automatically eligible for disability benefits.

Pancreatic cancer occurs when cells in the pancreas grow out of control. The pancreas is a large organ behind the stomach that has two primary jobs: it secretes enzymes that help the body absorb food (part of the exocrine system), and it regulates how your body metabolizes sugar (part of the endocrine system).

The most common type of pancreatic cancer is called adenocarcinoma of the pancreas. This type of cancer affects the exocrine system. A much rarer type of pancreatic cancer is called islet cell carcinoma, or pancreatic neuroendocrine carcinoma. This type of cancer affects the endocrine glands that secrete hormones, including insulin. People with pancreatic cancer usually have few symptoms until the cancer has progressed and worsened. At that time, symptoms include stomach or back pain, weight loss, diarrhea, loss of appetite, and jaundice.

Qualifying for Disability Under the SSA Official Listing for Pancreatic Cancer

If either of the two categories below apply to your diagnosis of pancreatic cancer, your condition will be considered severe enough to "meet the disability listing" for pancreatic cancer. In other words, if either of the two categories below is applicable to you, you will automatically be considered disabled for SSA purposes. In this case, as long as you meet the general requirements for the disability program you are applying for, your application for benefits should be approved:

  • Pancreatic carcinoma (including adenocarcinoma but not islet cell carcinoma), or
  • Pancreatic islet cell tumor in the endocrine tissues, if it is inoperable (can't be operated on) or unresectable (this means that surgery was performed but the entire tumor could not be removed), and if it produces some type of active hormone (examples of active hormones include gastrin, glucagon, insulin, vasoactive intestinal peptide, and somatostatin).

For more information on the requirements regarding inoperable or unresectable tumors, see our article on when cancer qualifies for disability benefits.

Evidence in Your Medical Record

Although a pathology report detailing the findings of a biopsy that shows the presence of cancer in your pancreas is the only test that can definitively make the diagnosis of pancreatic cancer, your medical record can also include supplemental information like lab tests involving blood, urine or stool samples, CT scans, and ultrasounds. The findings of the pathologist who examined your tissue samples should also be included. If you have had any surgeries related to removing cancerous tissue, the surgeon’s notes should be in your record, including any reports from the microscopic examination of any tissue that was removed in the surgery.

Residual Functional Capacity

Most forms of pancreatic cancer will meet one of the two criteria listed above to “meet the listing.” The one exception is islet cell carcinoma, also called pancreatic neuroendocrine tumors, that don't affect the secretion of hormones (this is called a non-functioning pancreatic tumor). If this is your type of cancer, there is another way to qualify for disability benefits. The SSA will look at your “residual functional capacity,” or “RFC.”

Your RFC is what you are still capable of doing at work, taking into account the limitations from your impairment and from the treatment you have been given. For example, a non-functioning neuroendocrine tumor can cause abdominal pain and back pain. If your RFC limits what you can do to the point where you are not able to perform any prior job, the SSA will look at your age, education and experience and will see if you are able to do any kind of work. (Learn more about RFCs.)

If certain areas of the pancreas have been removed due to islet cell carcinoma, that could affect things like digestion, and could also lead to diabetes. If you have digestive problems or diabetes as a result of your cancer treatment, you should check the criteria under those listings, even if you do not meet the criteria for pancreatic cancer.

Compassionate Allowance with Certain Pancreatic Cancers

Some cancers are so serious that the SSA allows a simple diagnosis to qualify a person for disability benefits, and for the application to be processed very quickly. These are called “compassionate allowance conditions.”

Pancreatic adenocarcinoma is a compassionate allowance condition, and if you are diagnosed with this, the SSA will expedite your application for disability. As long as your medical records support a diagnosis of pancreatic adenocarcinoma through a biopsy, you will be found disabled by the SSA. For more information, see our article on compassionate allowances.

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