Applying for Disability Benefits with Breast Cancer
It has been estimated that around 12% of all American women (or one in eight) will develop an invasive form of breast cancer over the course of her lifetime. Around 246,660 new cases are expected to be diagnosed in 2016 alone, making it one of the most common forms of cancer in the United States today.
If you have been diagnosed with breast cancer, your condition may leave you unable to work. This creates added stress because breast cancer often requires chemotherapy, radiation and/or surgical treatment, which is expensive without insurance. Fortunately, the Social Security Administration (SSA) has financial resources available for men and women whose breast cancer has progressed to the point that they can no longer hold down employment.
What Disability Benefits Are Available?
The SSA has two types of financial benefits available to those with a disabling medical condition. Although the medical eligibility criteria are the same, each one serves a different applicant profile,
- Social Security Disability Insurance (SSDI): Based on work history, SSDI is for those who have worked long enough to pay a certain amount of Social Security taxes, therefore earning SSA ‘work credits’.
- Supplemental Security Income (SSI): SSI is needs based and intended for those who have limited income and assets, such as children and seniors.
Medically Qualifying with Breast Cancer
Breast cancer is specifically referenced in the Blue Book, which is the SSA manual of qualifying disabilities. Under Listing 13.10: Cancer-Breast, you will be considered disabled if you have been diagnosed with breast cancer and meet one of the following requirements:
- A locally advanced carcinoma that has extended to the chest, skin, or internal mammary nodes
- A carcinoma that has spread above and below the collarbone, extended to 10 or more armpit nodes, or spread to distant areas of the chest
- A carcinoma that recurs after anticancer therapy
- Small-cell (oat cell) carcinoma
Breast cancer must typically be Stage III-B or above to qualify for disability benefits. When you apply, your application has to be accompanied by medical documentation that includes:
- A confirmation of your cancer diagnosis
- Test results that reveal how far it has spread (i.e. mammograms)
- Records that document that frequency and duration of your anti-cancer treatments (radiation, surgery, chemotherapy) as well as your response to them and any residual effects
- Pathology report for any biopsies
- Operative notes if the cancer was treated surgically
Your treating physician will also have to fill out a residual functional capacity (RFC) form, which allows the SSA to determine the extent of your disability and whether or not it prevents you from doing the type of work you are trained and qualified for.
The Compassionate Allowances Program
Having breast cancer can qualify for the SSA’s Compassionate Allowances program. In most instances applicants must wait months for approval, but conditions that qualify for a Compassionate Allowance can have the applications processed and approved in as little as 10 days.
If you have metastatic breast cancer (otherwise known as Stage 4, in which the cancer has spread to distant organs) or inflammatory breast cancer, an aggressive and rare form in which the cancer cells obstruct lymph vessels in the breast, you will be approved for a Compassionate Allowance.
Receiving Benefits Without Meeting a Listing
What does this mean for women with earlier stages of breast cancer? Early stages of breast cancer do not meet a Blue Book listing, but you can still qualify for disability benefits via a medical vocational allowance. You will need to be able to prove that you expect to be unable to work for at least 12 months, and your treatment will prevent you from performing any work you are qualified for. Doctor’s reports, hospital records, and a completed RFC for will be necessary to prove the extent of your disability. You can download an RFC for your doctor to fill out online.
For more information about SSA disability benefits and how to apply when you have breast cancer visit the SSA’s website, visit your nearest SSA office, or call 1-800-772-1213. Living with breast cancer is challenging enough, so the sooner you qualify for and receive your disability benefits, the sooner you can focus on your recovery.
This article was provided by Disability Benefits Help. For any additional assistance, the SSDHelp team can be reached at [email protected]
About the Author: Deanna Power
Director of Outreach, Disability Benefits Help
Director of Outreach, Disability Benefits Help
Deanna Power is the Director of Outreach at Disability Benefits Help, an independent organization dedicated to helping people of all ages receive disability benefits. She first began working with people with disabilities by volunteering with Best Buddies throughout college, and now specializes in helping families determine whether or not they medically qualify for Social Security benefits. If you have any questions about the application process, she can be reached at [email protected]