As a young breast cancer patient, I found that I could not do many of the things I had done before cancer. At the age of 31, the chemotherapy treatments and bilateral mastectomy created a major challenge.
With bills piling up and not working, I hoped to apply for social security benefits. I was not sure if there was a way to get disability benefits for breast cancer patients.
After searching, I found out I could apply for disability online.
Unfortunately, I learned that I was not able to get social security benefits for breast cancer based on my individual situation.
Fortunately, there are some ways to claim disability for breast cancer. This blog post shows how to get social security disability benefits for breast cancer.
In order to determine if your breast cancer qualifies for disability benefits, there are five ways that breast cancer patients can qualify for social security disability benefits. In addition, you can find out how to appeal a denial for social security disability.
The following is a guest post by Lauren DiCenso.
Table of Contents
Steps To Qualify For Social Security Benefits For Breast Cancer
Getting Social Security Disability Benefits for breast cancer involves a series of steps.
- Qualification: According to the Social Security Administration’s Blue Book, you must prove that your breast cancer is severe enough to be considered a disability. This typically applies to women with stage IIIB breast cancer or beyond. The SSA provides a manual on disability approval which you can review to understand the medical criteria for qualification.
- Application: You can apply for disability benefits online. The application will require you to provide detailed information about your condition, including medical records and a statement from your doctor. If you’re applying for benefits with a Medical Vocational Allowance, you’ll need to fill out an additional form.
- Duration of Condition: To qualify for SSDI benefits or SSI based on breast cancer, your condition must have been present for at least one year or be expected to last for a year or more. If you’ve been unable to work for at least a year after receiving a diagnosis of breast cancer, you might qualify for Social Security disability benefits.
- Rejection: It’s important to note that not all applications are approved. Many women with breast cancer do not qualify for SSDI or SSI because their condition is not expected to last more than a few months.
Remember to have your Social Security number handy when you call to inquire about your potential benefits.
For more detailed information, consider contacting the SSA directly or seeking advice from a legal professional who specializes in disability claims.
Qualifying for Social Security Benefits with Breast Cancer
Breast cancer is a disease in which malignant cancer cells form in the tissues of the breast. It is the most commonly diagnosed cancer for women, with over 200,000 women being diagnosed per year.
Although you will be facing some tough challenges, if you have been diagnosed with breast cancer, there may be resources available for your family to make things a little easier.
A diagnosis of breast cancer will almost always require surgery and/or radiation. Most breast cancer patients will also require chemotherapy.
Without insurance, the costs of these treatments can be astronomical.
Social Security Benefits for Disability
While a breast cancer diagnosis will not always “automatically” qualify, cancer is the third most-commonly approved condition for Social Security benefits.
How to Appeal Denial for Social Security Disability
However, if you apply for disability and find that your claim was denied, don’t worry!
You can file an appeal online. The Social Security Administration (SSA) will take a second look at your application. It is more likely you will be approved during this stage than the initial one.
The financial assistance you receive through disability benefits means that you can focus on you and your health!
If your application for Social Security Disability benefits is denied, you have the right to appeal the decision. Here’s a step-by-step guide:
- Request for Reconsideration: The first step in the appeals process is to file a Request for Reconsideration. This must be done within 60 days of receiving the denial notice. You can do this online at the Social Security Administration’s website or by contacting your local SSA office.
- Administrative Law Judge Hearing: If your request for reconsideration is also denied, you can request a hearing with an Administrative Law Judge (ALJ). This request must also be made within 60 days of receiving the reconsideration denial. At this hearing, you’ll have the opportunity to present new evidence and have witnesses testify on your behalf.
- Appeals Council Review: If the ALJ denies your claim, you can ask for a review by the Social Security’s Appeals Council. The council will either decide your case itself or return it to an administrative law judge for further review.
- Federal Court Review: If the Appeals Council also denies your claim or decides not to review your case, the final step in the appeal process is to file a lawsuit in a federal district court.
It’s essential to meet all deadlines in the appeal process. If you miss a deadline, you may have to start over from the beginning.
It’s also highly recommended to seek legal advice when appealing a denial of Social Security Disability benefits.
An experienced attorney can help you navigate the complex appeals process and improve your chances of a successful appeal.
Medically Qualifying and Filing for Disability With Breast Cancer
Is Cancer a Disability?
The Social Security Administration will use the Blue Book to determine if your breast cancer qualifies for disability benefits.
Also known as the “Listing of Impairments,” the Blue Book lists various health conditions that might qualify for disability benefits.
Social Security Disability Requirements
However, you have to meet the specific criteria listed for the SSA to consider your breast cancer for disability benefits. Here are five ways to qualify for disability benefits for breast cancer patients:
- Cancer that’s “locally advanced,” meaning it’s spread to your chest or distant mammary nodes.
- Cancer that’s spread to your collarbone
- Your cancer has returned despite anticancer therapy —surgery, chemotherapy, and radiation will all qualify.
- You have small-cell breast cancer
- Cancer with secondary lymphedema requiring surgery to restore functioning to an arm—this will qualify for at least 12 months after surgery
Typically breast cancer that’s Stage III-B or beyond will qualify, but there are some exceptions. Women with earlier stages of breast cancer can still qualify if they can prove both of the following:
- Their cancer treatments (surgeries, chemotherapy, radiation, etc.) will last for at least twelve months
- They will be unable to earn at least $1,170 per month in 2017 ($1,180 in 2018) due to the symptoms or side effects of treatment. The SSA considers $1,170 to be a “gainful living,” so if you’re able to work part-time during treatments or return to work within one year, you will not qualify.
The entire Blue Book is available online, so you can review the breast cancer listing with your doctor to determine if you might qualify.
Steps To Fill Out The Forms For Social Security Disability Benefits Due To Breast Cancer
Step 1: Start Your Application Visit the Social Security Administration’s website and select the option to apply for disability benefits. You can also apply in person at your local SSA office or over the phone.
Step 2: Complete the Disability Benefit Application This form asks for basic information such as your name, Social Security number, and contact information. It will also ask about your medical condition, your treatment history, and how your condition affects your ability to work.
Step 3: Fill Out the Adult Disability Report This report collects more detailed information about your medical condition and how it affects your daily life. Here, you’ll need to provide:
- Detailed information about your medical conditions, illnesses, or injuries.
- Information about your treatment, including the names, addresses, and phone numbers of your doctors, therapists, hospitals, clinics, and other specialists.
- Names and dosages of all medications you are taking.
- Medical tests you’ve had and who sent you for them.
- How your conditions limit your ability to work.
Step 4: Complete the Authorization to Disclose Information Form (SSA-827) This form gives your healthcare providers permission to share your medical records with the SSA. Make sure to sign and date this form.
Step 5: Review and Submit Your Application Once you’ve filled out all parts of the application, review it thoroughly to ensure all information is accurate. Then, submit the application online, by mail, or in-person at your local SSA office.
The more detailed and accurate your application is, the better your chances of being approved for benefits. If you need assistance, consider reaching out to a social worker, an attorney specializing in disability benefits, or a patient advocate.
Social Security Compassionate Allowances and Breast Cancer
Compassionate allowances are a way to expedite the process of receiving Social Security disability benefits for individuals with severe health conditions, including metastatic breast cancer.
Initiated in 2008, the Compassionate Allowances program recognizes that certain conditions are inherently debilitating and warrant swift attention.
Breast cancer with distant metastases, or inoperable or unresectable forms, is included in the list of conditions that qualify for Compassionate Allowances.
This means that individuals diagnosed with such conditions are automatically eligible for disability benefits from the Social Security Administration (SSA).
The key advantage of being included in the Compassionate Allowances list is the reduced waiting time. Typically, the process of applying for and receiving disability benefits is lengthy, often taking several months.
With a condition listed under Compassionate Allowances, the application is fast-tracked, enabling the individual to receive benefits more quickly.
Despite the automatic qualification, it’s still important to present comprehensive medical documentation when applying. This should include a clear diagnosis, treatment plans, and notes on how the condition impacts daily life and ability to work.
Financial stress can be a significant burden for those dealing with metastatic breast cancer.
Hence, the expedited process through Compassionate Allowances provides monetary relief and allows individuals to focus more on their health and less on bureaucratic processes.
The Compassionate Allowances program is a crucial resource for those battling metastatic breast cancer, providing them with quicker access to much-needed Social Security disability benefits.
How to Get Social Security Disability Benefits If You Don’t Qualify for the Blue Book Listing
So, if you don’t qualify for the Blue Book listing, you can still get disability benefits another way.
You will qualify for a Compassionate Allowance if you have either IBC or metastatic breast cancer. There’s nothing additional you need to do when applying—the SSA will automatically process your claim quickly.
If your breast cancer qualifies as a Compassionate Allowance, you could be approved in as little as 10 days.
Unfortunately, you still will need to wait a full five months to begin receiving your payments.
Other Ways to Get Social Security Disability for Breast Cancer
If you meet one of the following criteria, the SSA will expedite the process of your social security disability claim with the potential to receive a response within 10 days:
- If chemotherapy does not work and the cancer returns
- Your cancer is inoperable or unresectable
- If you have IBC or metastatic breast cancer
How to Get Social Security Benefits for Early Stage Cancer
The SSA will also consider applicants who have an early stage of cancer if they’re able to prove that they’re completely unable to work for at least 12 months due to cancer treatments.
Applicants who have physically challenging jobs will have a much easier time qualifying at an early stage than someone who has a desk job.
You’ll also have an easier time qualifying if you’re over age 50. At that point, the SSA does not expect you to become completely re-trained for a new career that’s less physically demanding.
How to Apply for Disability
The easiest way to start is to apply for disability online from the comfort of your own home.
If you’d prefer, you can also apply in person with the help of a Social Security representative at your closest Social Security office. To make an appointment to apply in person, simply call the SSA toll free at 1-800-772-1213.
You should hear back from the SSA regarding your claim within five months, but anyone with IBC or metastatic breast cancer should be approved within a couple of weeks.
Breast Cancer Disability Secrets
Here are some tips that might not be as commonly known when it comes to securing disability benefits for breast cancer.
Many people don’t realize they can apply for disability benefits as soon as they’re unable to work and their condition is expected to last at least a year. You don’t have to wait until you’ve been out of work for a year.
Detailed Medical Records
The more detailed your medical records are, the better chance you have of being approved.
Make sure your doctor includes not just your diagnosis and treatment details, but also notes on how your condition affects your ability to perform daily tasks and work-related activities.
Residual Functional Capacity (RFC)
If your breast cancer doesn’t meet the SSA’s listing requirements, another “secret” route to approval is through an RFC assessment.
This evaluates your remaining ability to do work despite your medical condition. It’s important to include any limitations you have, such as fatigue from chemotherapy, in this evaluation.
Your age, education, and past work experience can all play a role in your disability determination.
For example, if you’re over 50, have a limited education, and have only done physically demanding work in the past, the SSA may determine that there’s no other work you can reasonably do and approve your claim, even if your cancer doesn’t meet a listing.
In some severe cases of breast cancer, such as inflammatory breast cancer or with distant metastases, you might qualify for a Compassionate Allowance.
This allows the SSA to expedite the review process and provide benefits more quickly.
The Benefits of Representation
Having a disability attorney or advocate can significantly increase your chances of approval. They know the ins and outs of the process, can help gather and present evidence, and can represent you in any hearings.
Every case is unique, and what works for one person might not work for another. It’s always a good idea to consult with a professional who can guide your situation.
Hopefully, you found this information helpful. If you have any questions, please leave comments or send me an email and I will try to get your questions answers about getting social security disability benefits for breast cancer.
Next: If you’re looking for post-matectomy recovery shirts, see this article on Post Mastectomy Clothing Recovery Shirts to Wear After Breast Cancer Surgery and see the collection of discounts and free stuff for breast cancer survivors.
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Rachel is an Austin blogger, educator, mom, wife, young breast cancer survivor writing about health, saving money, and living a happy life in Austin, Texas.
Rachel has written for HuffPost and Hometalk and has been featured on KXAN, Studio 512, Fox 7 Austin, and CBS Austin.