Disability Benefits for Prostate Cancer

Recurring, progressive, and advanced prostate cancer will quality you for Social Security disability benefits.

Prostate cancer occurs when cells in the prostate grow out of control. The prostate is a small walnut-shaped gland that wraps around the male urethra. In men over age 75, prostate cancer is the most common cause of death from cancer.

Symptoms of Prostate Cancer

In the early stages of prostate cancer, there are usually no symptoms. Once the prostate begins to swell, or if the cancer spreads (“metastasizes”) to other parts of the body, symptoms may include: a frequent need to urinate, delayed or weak urination, a painful or burning feeling during urination or ejaculation, blood in the urine or semen, weakness in lower limbs, or pain and stiffness in the lower back and pelvis.

Getting Disability Benefits for Prostate Cancer

In order to be eligible for disability benefits, your inability to work must have lasted, or be expected to last, at least one year. To judge whether you are unable to work and entitled to disability, Social Security will look at how much your prostate cancer has progressed and how well it has responded to treatment.

Qualifying for Disability Under the Listing for Prostate Cancer

Social Security publishes a "blue book" of disability listings with criteria for each medical condition to qualify for benefits. If either of the two categories below apply to your diagnosis of prostate cancer, your condition will be considered severe enough to “meet the listing” for prostate cancer. In that case, you will automatically be considered“disabled for Social Security's purposes.

  • Progressive prostate cancer. This means there is at least one new tumor even though you're taking hormonal treatment.
  • Recurrent prostate cancer. This means your cancer has returned despite the initial hormonal treatment. “Progressive prostate cancer” means that there is at least one new cancer.
  • Prostate cancer with visceral metastases. This means that the cancer has spread to other soft internal organs, such as the intestines, liver, or brain. In order to prove this has occurred, a biopsy is not needed; imaging that shows the cancer, such as CT or MRI, should be sufficient.

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

Evidence in Your Medical Record

Your doctor’s diagnosis should document that your primary cancer tumor is located in your prostate tissue and that you had a positive biopsy for prostate cancer. The findings of the pathologist who examined your tissue samples must be included.

A common screening test for prostate cancer is the PSA test, or prostate specific antigen test. This is a blood test that measures the amount if PSA in the blood. While abnormally high levels of PSA are an indication of prostate cancer, a biopsy is needed for an accurate diagnosis of prostate cancer. Although PSA tests do not diagnose prostate cancer, results of PSA tests should still be included in your medical records. Changes in PSA levels over time are important to show whether or not the cancer is controlled.

If your cancer has spread, there should also be documentation of these secondary, metastatic tumors. While a biopsy is required for the diagnosis of the primary prostate cancer, if your diagnosis is prostate cancer with visceral metastases, you will not need biopsies of the visceral metastases. This means if your prostate cancer has spread to your liver, for example, as long as appropriate imaging, such as CT or MRI, shows the cancerous lesions in your liver, you will not need a biopsy of your liver to support that diagnosis.

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

If you have a diagnosis of prostate cancer, but do not meet either of the three criteria listed above to meet the listing for prostate cancer, the SSA will look at your “residual functional capacity,” or “RFC” to see if you are disabed. When determining your RFC, the SSA will look at your medical records, what you wrote on your application about how your symptoms limit your ability to function, and others’ statements.

Your RFC assessment is used by the SSA to determine what you are still capable of doing in an employment situation, taking into account the limitations from your impairment and from the treatment you have been given. For instance, if you have a frequent need to urinate and weakness in your legs, these limitations affect the types of jobs you can do.

If the SSA finds that you are capable of performing your prior job, the SSA can deny your claim, because the agency feels you should be able to return to that kind of work. But if your RFC limits what you can do to the point where you are not able to perform your prior job, the SSA will look at your age, education and experience and will see if you are able to do other work. If the SSA determines that your impairment and the symptoms associated with your impairment and treatment are so limiting that there is no job you can perform, you will be awarded benefits under what is called a “medical-vocational allowance.”

Note that although prostate cancer treatments may place you at risk for impotence, since impotence does not affect your employment-related abilities, it is not taken into consideration when the SSA determines your RFC.

Delays for Treatment

Because prostate cancer is stimulated to grow by the presence of testosterone, the cancer may be successfully treated by lowering testosterone levels, either by hormone treatments or by removing the testes. The Social Security Administration (SSA) will often wait at least three months from when you begin treatment to make a decision on whether your cancer is expected to respond to the treatment and be in remission before the end of the 12-month durational requirement, or whether the treatment was not successful in suppressing your cancer.

Compassionate Allowance for Certain Prostate Cancers

Some impairments are so serious the SSA has determined that a a simple diagnosis of the condition automatically means the person has met the disability standards and the application will be processed quickly. These impairments are called “compassionate allowance conditions.”

Small cell prostate cancer is a compassionate allowance condition and if you are diagnosed with this, the SSA will expedite your application for disability. Small cell cancer of the prostate is very rare, fortunately, and accounts for less than 1% of all prostate cancers.

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