If cancer has made it impossible for you to work and support yourself or your family, you might qualify for Social Security benefits. Unfortunately, filing a claim for Social Security benefits is a long and difficult process and denials are common. However, you are not alone. For help getting Social Security disability for cancer in Raleigh, call Lunn & Forro, PLLC at 888-966-6566.

How does the Social Security Administration evaluate cancer?

The Social Security Administration (SSA) evaluates disability using the criteria contained in its Blue Book. The requirements for getting Social Security disability for cancer are in Section 13.00.

Here are some examples of the medical criteria for certain types of cancer:

13.02: Cancer of the Soft Tissue of the Head and Neck

Must be inoperable or unresectable; non-responsive to initial anticancer therapy; recurrent after initial anticancer therapy; metastasized beyond the lymph nodes in the region; small cell (oat cell) carcinoma; or treated with multimodal anticancer therapy.

13.03: Skin Cancer

Must be sarcoma or carcinoma that has metastasized to the regional lymph nodes or beyond them; or the carcinoma must have invaded deep tissues other than the skin, such as skeletal muscle, cartilage, or bone.

13.05: Lymphoma

Impairments include:

  • Aggressive non-Hodgkin lymphoma that persists or recurs after the initial cancer treatment; or indolent non-Hodgkin lymphoma that requires more than one regimen of anticancer treatment within 12 months; or
  • Hodgkin lymphoma that fails to go into complete remission, or that recurs within 12 months of completing the initial regimen of anticancer therapy; or
  • Lymphoma that required a bone marrow or stem cell transplant; or
  • Mantle cell lymphoma.

13.06 Leukemia

Impairments include:

  • Acute leukemia; or
  • Chronic myelogenous leukemia that is either in accelerated/blast phase or chronic phase.

13.07: Multiple Myeloma

Your condition must fail to respond or progress after the initial anticancer therapy; or you must have received a transplant of bone marrow or stem cells.

A doctor must confirm the diagnosis of multiple myeloma using appropriate testing, such as serum or urine protein electrophoresis or bone marrow testing.

13.10: Breast Cancer

  • Locally advanced cancer; or
  • Carcinoma that has metastasized to nodes (supraclavicular or infraclavicular), or to axillary nodes (10 or more), or has metastasized to distant locations; or
  • Recurrent carcinoma, unless it is a local recurrence that goes into remission with anticancer therapy; or
  • Small-cell (oat cell) carcinoma; or
  • Breast cancer with secondary lymphedema resulting from anticancer therapy.

13.14: Lung Cancer

  • Non-small-cell carcinoma — inoperable, unresectable, recurrent, or metastatic to or beyond the hilar nodes;
  • Small-cell (oat cell) carcinoma; or
  • Carcinoma of the superior sulcus for which the patient has received multimodal anticancer therapy.

What if my cancer is not on the List of Impairments?

Your condition not appearing in the Blue Book is not an immediate disqualification.

To be eligible for benefits, you must be able to prove that your condition, which must last a year or longer or be expected to result in death, is disabling enough to keep you from working.

What factors does the SSA consider?

The SSA considers multiple factors, including:

  • Where did the cancer originate?
  • What is the extent of involvement of the cancer?
  • How much anticancer therapy has the patient had, and how has the cancer responded to it?
  • Are there any residual conditions following anticancer therapy?

Is meeting the medical requirements enough?

No. Even if you have a cancer that meets the medical criteria for the listed impairment, you will still have other requirements you must meet in order to qualify for Social Security disability insurance (SSDI) benefits. Here are the additional requirements you must meet:

  • You will have to prove that you are unable to do any kind of gainful employment. You can prove this by establishing that you earn less than $1,170, the 2017 earning limit.
  • You must have enough work credits. This means you must have worked and paid into the Social Security system for a long enough time period.

What if I have not worked long enough to qualify for SSDI benefits?

There is one more possible source of benefits for you. Supplemental Security Income (SSI) is a safety net for people who have not worked long enough to qualify for SSDI. You must be determined disabled to the extent that you cannot work. Your income and assets must be below the limit.

What if the SSA does not approve my claim?

Just because your medical condition, financial portfolio, and work history meet the requirements does not mean the SSA will approve your claim. The SSA initially denies the vast majority of worthy claims. Do not despair. You have options.

If you believe the SSA wrongfully denied your claim for cancer benefits, you can file an appeal asking the SSA to reverse its decision. However, you must do this quickly. You only have 60 days from the date you received your denial to appeal.

As with the claims process, the appeals process is complex and difficult and results in denial, especially for those who work without legal help. The disability lawyers at Lunn & Forro, PLLC will handle the process and fight for the benefits you deserve.

Call us today at 888-966-6566 to schedule your free, no obligation consultation.