Disability Determination for Cancer

An overview of what you need to qualify for Social Security disability benefits based on any type of cancer.

Cancer is a disease where abnormal cells in the body divide uncontrollably. Cancer can affect most organs in the body and may spread from its original source to other areas. Cancers are usually named for the organ or cells in which they originate.  When the abnormal cells begin to grown they clump together and form growths called tumors. (Not all cancers, however, produce tumors; for example, cancers of the blood, such as leukemia, affect the body’s bone marrow and blood.)  

If a tumor is cancerous, it is called “malignant.”  Often malignant tumors can be removed; however, sometimes cells from the malignant tumor migrate into other areas of the body and spread the cancer (when cancer spreads it is said to have “metastasized.”)  

Most cancers that have metastasized or recurred, or were inoperable or unresectable with surgery, are eligible for disability benefits.  For other, aggressive cancers, just a simple diagnosis with that cancer is enough to get disability benefits.  

Can I Get Disability for My Cancer?

When you apply for disability because you can't work due to your cancer, the Social Security Administration will first look to see whether the answer to these questions is no:

  • Is your illness expected to last less than 12 months?  
  • Are you working at the substantial gainful activity (SGA) level? (In 2016, the SSA defined this as earning $1,130 or more per month.)

If you meet these requirements, the SSA must then determine whether your cancer meets one of the listings for cancer set out in the SSA’s Listing of Impairments. If your cancer meets all the criteria of a cancer listing, you will be automatically approved for disability.

What Medical Evidence Do I Need?

Often claimants are denied simply because they have not provided enough information to support a favorable decision.  You will need to provide to the SSA:

  • The symptoms of your cancer
  • Where your cancer is located
  • Detailed biopsy reports  
  • Descriptions of treatments, medications and their side effects  
  • The names and addresses of all physicians that you have seen for treatment  
  • Post-operative reports from any surgeries for your cancer  
  • Names and addresses of the facilities where you received treatment or underwent surgery and the dates of service  
  • Whether your cancer has come back after treatment  
  • Whether your cancer has spread, and
  • X-ray, CT scan and MRI results.

The SSA may also request that you complete an Activities of Daily living (ADL) report. The ADL report is a detailed description of how your cancer, including any treatments and medications, has affected your ability to take care of yourself and to enjoy your life. For example, if you need assistance with housekeeping, grocery shopping, cooking, and personal hygiene you should state this. Often people can no longer participate in activities they once enjoyed such as attending church or visiting family and friends. It is important that you report this to the SSA and describe any other changes in your daily life that have occurred because of your cancer.  Often, applicants do not provide enough detail in the ADL form.

The more information you provide to the SSA at the start of the application process, the more likely you are to be approved. To learn more, see Necessary Medical Evidence for Social Security Disability Claims.

What If My Cancer Doesn’t Qualify Under a Listing?

Even if your cancer does not meet the criteria for automatic approval, it is still possible to win your claim.  If your cancer does not meet the Listing 13.00 requirements, the SSA must then decide whether it feels you can do your past job despite your cancer. If the SSA feels that your cancer prevents you from performing your past work, it will then consider your age, education, past work history and the limiting effects of your cancer on your ability to work.

The SSA will perform a Residual Functional Capacity assessment (RFC) on your file. An RFC is a detailed report that details how the symptoms of your cancer affect your ability to perform basic job functions. Your RFC should discuss any physical limitations in your ability to sit, walk, lift, carry, push, pull, stoop or bend. It should also state whether you have restrictions on your work environment, such as whether you must avoid dust, fumes, heavy equipment or heights.

For example, if you suffer from lung cancer, your RFC should detail how your breathing has been affected, whether you suffer from fatigue that requires rest throughout the day, whether your ability to walk, lift and carry are diminished due to your lung disease, and whether you can work around dust and fumes.

If you have undergone chemotherapy or radiation treatment for your cancer, you may experience ongoing side effects of the treatment even though your cancer is gone. Some people treated with chemo and radiation experience damage to their intestinal tract, nerve damage, chronic bladder infections, and severe swelling in the legs. If you have suffered chronic side effects from chemo or radiation and the side effects cause significant pain that prevent you from working, your RFC must detail this.

Often, chronic pain interferes with a person’s ability to focus on a task and complete a job in a timely manner and cause frequent absenteeism from work. If you can prove that your efficiency would be reduced by 20% because of you cancer or any chronic side effects of treatment, you will likely win your claim for disability.

To learn more, see our overview article, Your Residual Functional Capacity (RFC).

Expedited Disability Determinations for Some Cancers

Many cancers are eligible to be fast-tracked through the Social Security system, meaning that you could get a decision within one month of applying.  

Malignant Neoplastic Disease,  Listing 13.00  

Most cancers are qualifying conditions under Listing 13.00, Malignant Neoplastic Disease.  The listings cover a broad range of cancers, such as:

  • Lung cancer
  • Colon and intestinal cancer
  • Skin cancer
  • Breast cancer
  • Prostate cancer  and  testicular cancer
  • Uterine and ovarian cancer
  • Leukemia  and  lymphoma
  • Kidney cancer  and  bladder cancer
  • Stomach and  esophageal  cancers, and
  • Pancreatic cancer.

If You Need Help

If you need help applying for, or appealing a denial of, Social Security disability benefits, see a qualified disability lawyer. You won't need to worry about the cost, since these lawyers fees are paid out of the winning disability award.

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