Social Security Disability Benefits and Breast Cancer
By Molly Clarke
According to the American Cancer Society, breast cancer is the second most common cancer among women in the United States. That being said, breast cancer affects everyone differently—including men. Depending how advanced an individual’s breast cancer is, will determine the limitations that he or she will face.
Breast cancer and breast cancer treatments can cause serious side effects that may limit an individual’s ability to work and earn a living. As a result, loss of income and lack of health insurance can cause significant financial distress. If you have been diagnosed with breast cancer and can no longer work, you may be eligible for Social Security Disability benefits.
The following information will provide you with a brief overview of the disability benefit program and will help you prepare to begin the application process.
Social Security Disability Technical Requirements
The Social Security Administration—or SSA—governs two separate programs that offer disability benefits. To be considered eligible for either program, applicants must meet the SSA’s definition of disability. This means that you have a health condition or disability that is expected to keep you from participating in Substantial Gainful Activity (SGA) for at least one year. In 2013, SGA is $1,040 per month. In addition to these basic requirements, each of the two disability programs has their own set of qualifying criteria.
SSDI- The first program—Social Security Disability Insurance—is funded by income taxes paid by workers all over the country. Therefore, eligibility for this program is determined, in part, by an applicant’s work history and the amount of taxes they’ve paid. To simplify this, the SSA assigns “work credits” to each quarter a worker pays taxes. Then, they require a certain amount of work credits to qualify for SSDI. Learn more about work credits and SSDI, here: http://www.disability-benefits-help.org/glossary/work-credits.
SSI- The second program that offers disability benefits is the Supplemental Security Income program—or SSI. SSI is a needs-based program. This means that, for an applicant to qualify, he or she cannot exceed certain financial limits. SSI does not take work credits into account—therefore this program is a good option for individuals who may not have enough work credits to qualify for SSDI. Learn more about SSI, here: http://www.disability-benefits-help.org/ssi/qualify-for-ssi.
It is important to note that once an applicant is awarded benefits from either program, they may also become eligible for Medicare or Medicaid. In some cases, applicants may be able to qualify for both SSI and SSDI benefits.
Social Security Disability Medical Requirements
To gauge the severity of an applicant’s condition, the SSA consults what is referred to as the “blue book”. The blue book is essentially a list of disabling conditions as well as specific qualifying criteria for each. The cancer listings in the SSA’s blue book are all quite similar to one another. If you have been diagnosed with breast cancer, and the cancer has spread to other areas of the body, recurs after treatment, or is inflammatory, you will likely be considered eligible under the breast cancer listing.
If you do not meet these requirements, but your symptoms or treatments make it impossible for you to keep working, you may still be able to qualify for benefits under a medical vocational allowance. Essentially, this means that even though you don’t meet the blue book listing, the SSA recognizes that breast cancer makes it impossible for you to work.
Because breast cancer affects everyone differently, the SSA recognizes that individuals with advanced stage breast cancer cannot be expected to wait the standard processing times to receive disability benefits. For this reason, they have added advanced stage breast cancer to the list of compassionate allowances (CAL).
The CAL program allows individuals with serious conditions to be approved for disability benefits in as little as ten days. The SSA states that if you have stage four breast cancer or if your breast cancer is inoperable, you may qualify for expedited processing through the CAL program. It is important to note that you do not need to fill out additional paperwork to qualify for the compassionate allowance program—the SSA will determine whether or not your condition matches CAL standards and will expedite your claim accordingly.
Preparing to Apply for Social Security Disability Benefits
Prior to beginning the application procedures, it is extremely important that you collect medical documentation to support your claim. The SSA will use this documentation to determine whether or not you meet their requirements. Medical documentation should include records of your diagnosis, your treatments, your response to treatments, lab results, hospitalizations, and even personal notes from your doctor. In addition to these records you should also have copies of financial and work related records.
Once you are ready to begin, you can submit your initial application online or in person at your local Social Security office. It is important to remember that many initial applications are denied. If you find yourself in this situation, do not panic. You are allowed to appeal this decision.
Keep in mind that Social Security Disability benefits are available to help you. It’s important that you don’t give up—no matter how difficult the process may seem. Once you are awarded benefits you can focus on your health, not your finances.