Social Security disability benefits and cancer

If you or someone you love has been diagnosed with cancer, it’s possible that you may need to take time away from work to go through treatments. If you’ll be unable to earn income for 12 months or more, you might qualify for Social Security disability benefits. While each form of cancer will have different medical criteria, anyone with cancer has a chance of qualifying for financial resources that can help pay for medical bills, childcare, daily living expenses and more.

How to determine if you medically qualify

The Social Security Administration (SSA) is the government organization in charge of federal disability benefits. The SSA uses its own medical guide known as the Blue Book to evaluate all applicants and deem disability benefits to those who have illnesses that meet the necessary criteria. Section 13.00 of the Blue Book is dedicated to cancer.

Every form of cancer will have different medical requirements. Some types of cancer, like esophageal and liver cancer, will qualify with just a diagnosis. Others need to be at an advanced stage to qualify. Applicants with breast cancer, for example, need to have medical evidence showing that their cancer has spread beyond 10 regional nodes (such as to the collarbone area), has returned despite treatment, is inoperable or has spread to another organ.

The entire Blue Book is available online, so you can review the listings with your oncologist to see if there’s a way for you to qualify.

How to qualify without the Blue Book

Most cancers need to be advanced to meet a Blue Book listing, but if you are able to prove that you’ll be unable to work for at least 12 months, you could receive disability benefits as well. This special type of approval is known as a Medical Vocational Allowance. If your chemotherapy, radiation, surgeries or other anticancer therapies will keep you from engaging in what the SSA considers substantial gainful activity (SGA) ($1,170 per month in 2017), you might be eligible for a Medical Vocational Allowance.

A Medical Vocational Allowance relies heavily on results from an SSA-standard form known as a Residual Functional Capacity (RFC) evaluation. This form details exactly how much physical work you can do, including, but not limited to:

  • How long you can sit, stand, walk or lay without changing position
  • How much weight you can lift
  • How dizziness or nausea affects your physical activities
  • How many fine/dexterous movements you can perform
  • What environments you need to avoid (hot or cold temperatures)

You can download an RFC form for your oncologist to fill out on your behalf. Keep in mind that applicants age 50+ will have an easier time getting approved for a Medical Vocational Allowance, as the SSA believes that older applicants will have a tougher time getting retrained for a sedentary job that’s easier to keep during anticancer treatments.

Compassionate Allowances and disability benefits

Some forms of cancer are clearly disabling and warrant immediate approval. The SSA started its Compassionate Allowance program to expedite the claims of people who would almost certainly be approved during the typical review process. Cancers that qualify for a Compassionate Allowance with just a diagnosis include:

  • Acute leukemia
  • Esophageal cancer
  • Gallbladder cancer
  • Brain cancer (non-benign)
  • Inflammatory breast cancer
  • Liver cancer
  • Pancreatic cancer
  • Salivary & sinonasal cancers
  • Any small cell cancer
  • Thyroid cancer

Additionally, nearly any form of cancer will qualify as a Compassionate Allowance so long as one of the following conditions is met:

  • Your cancer is inoperable
  • Your cancer has returned despite anticancer treatment (three months is almost always enough to qualify)
  • Your cancer has spread to other organs

You won’t need to file any additional paperwork to qualify for a Compassionate Allowance. The SSA will expedite your claim upon receipt. You could be approved in as little as 10 days, bypassing the sometimes 2+-year waiting period. Unfortunately, this is where the “compassion” ends. Regardless of how quickly you’re approved, you will need to wait at least five months before receiving your first payment, and you will not be eligible for Medicare until 24 months after you cancer became advanced enough to keep you from working. Be sure to keep this in mind if you do not have another insurance option.

Starting your application

The majority of disability applicants can complete the entire application process online. This is the easiest way to apply, as you can save your progress to continue at a later date. If you’d prefer, you can always apply at your closest Social Security office. But don’t just drop by your local office! It’s best to schedule an appointment by calling the SSA toll-free at 1-800-772-1213. Most claims are approved in five months.