Securing SSDI for Cancer: A Guide to Disability Benefits

A cancer diagnosis can profoundly impact every aspect of life, including the ability to maintain employment. The physical and emotional toll of the disease, combined with the debilitating side effects of treatment, often creates significant work limitations. For individuals in this situation, Social Security Disability Insurance (SSDI) can provide essential financial support.

Navigating the cancer disability benefits process requires a clear understanding of the Social Security Administration’s (SSA) criteria. This guide outlines the key elements of a successful cancer disability claim, from initial eligibility to the evidence required for approval. The attorneys at Chermol & Fishman, LLC, are experienced in handling these complex cases and can help you build a compelling application for the benefits you have earned.

What is Cancer?

Cancer is a disease that can initially have no notable symptoms, and many people with controlled forms of cancer can receive treatment without a significant disturbance in their daily routine. However, more advanced stages significantly impair the ability of a sufferer to complete routine tasks. Treatment options for cancer that is advanced and has spread are known to cause serious side effects that could render a person unable to work. When this occurs, it may be time for an individual to research whether they qualify for Social Security Disability Insurance (SSDI).
Cancer is a term that is used for any situation in which the cells in the body uncontrollably divide. These abnormally dividing cells attack tissues in the body, and it can spread to other parts of the body. The cells can form in parts of the body, including:

Symptoms vary according to type, severity, and whether it has spread to other parts of the body. Common symptoms include weight loss that cannot be explained by diet, chronic fatigue, persistent fever, and pain. One can also observe bleeding, swelling, or sores in the area that is affected by cancer cells, and some cases of cancer involve internal bleeding. Cancer that is treated by radiation therapy can cause serious side effects. Side effects of treatment include fatigue, pain, hair loss, anemia, and increased susceptibility to infection.
It is estimated that 40 percent of all people will develop some form of cancer in their lifetime.

Is Cancer A Disability?

If you have been diagnosed with cancer, this question must be disturbing your mind. Cancer is a fatal disease and can trouble anyone. But, when it comes to getting social security disability benefits for cancer, not all cancer patients can qualify for these benefits.
The SSA (Social Security Administration) has specified different eligibility criteria for each cancer type in the Blue Book. Some cancer patients can easily qualify, while some have to show many documents to prove their disability.
The papers can include biopsy reports, medication details, or notes by a certified physician, which states that the type of cancer you suffer from has caused disability. Or it can cause impairment in further stages. So, the type and stage of cancer matter a lot.
SSA’s medical guide is open to all, and you can see the list of cancer types online. Here are some types of cancer that may qualify you for SSD benefits;

• Brain cancer
• Esophageal cancer
• Gallbladder cancer
• Any small cell cancer
• Thyroid cancer
• Pancreatic cancer
• Salivary tumors
• Sinonasal cancer
• Inflammatory breast cancer
• Liver cancer

It is not like; if you are not suffering from any of the above cancer, then you will not get any benefits. Other types of cancers will need a piece of additional evidence to prove the disability.
Medical evidence is a must. An oncologist will support you in such cases. If you feel hassled, contact a reliable social security attorney in your area.
Some cancers are historically hard to treat and tend to become aggressive in later stages. If you have been diagnosed with any such cancers, you will be automatically qualified for social security disability benefits.

Eligibility Criteria for Cancer Disability Benefits

To qualify for SSDI, a claimant must meet both technical and medical eligibility requirements. A cancer disability impairment alone is not sufficient; you must have a qualifying work history and prove your condition is severe enough to prevent you from working.

Technical Eligibility: Work Credits

SSDI is an insurance program funded by FICA taxes. To be “insured,” you must have earned a sufficient number of work credits through your employment history. Generally, you need 40 credits, 20 of which must have been earned in the 10 years before your disability began. The number of credits required may be lower for younger individuals. You can review your work history and estimated benefits by creating a my Social Security account at SSA.gov.

Medical Eligibility: Proving Disability

The core of your cancer disability claim is proving that your condition prevents you from engaging in Substantial Gainful Activity (SGA). The SSA defines a disability as a medically determinable physical or mental impairment that:

• Has lasted or is expected to last for a continuous period of at least 12 months; or
• Is expected to result in death.

This requirement means that even a severe cancer diagnosis may not qualify if the condition and treatment-related limitations are not expected to keep you out of work for a full year.

How the SSA Evaluates Cancer Disability Claims

The SSA uses a structured, five-step sequential evaluation process to make a cancer disability determination. For cancer claims, this assessment typically follows one of three primary pathways.

1. Compassionate Allowances (CAL) Program

Certain aggressive or advanced-stage cancers are included in the SSA’s Compassionate Allowances list. This program expedites the processing of claims for conditions that are so severe they obviously meet disability standards. If your diagnosis is on this list—such as metastatic lung cancer, esophageal cancer, or mesothelioma—your claim may be approved on an expedited basis with minimal documentation beyond the initial pathology report.

2. Meeting a Blue Book Listing (Section 13.00)

The SSA maintains a “Blue Book,” or List of Impairments, which contains specific medical criteria for various conditions. Cancers are covered under Section 13.00, Malignant Neoplastic Diseases.

To meet a listing, your medical records must show that your cancer matches the specific criteria outlined for its type. For example, a listing may be met if the cancer:

• Is inoperable or unresectable.
• Has metastasized (spread) to distant parts of the body.
• Has recurred after initial therapy.
• Is of a particularly aggressive type, like small cell carcinoma.

3. Medical-Vocational Allowance (RFC Assessment)

If your condition does not meet a CAL or Blue Book listing, you may still qualify for benefits based on a Medical-Vocational Allowance. The SSA will conduct a Residual Functional Capacity (RFC) assessment to determine the most you can do in a work setting despite your cancer medical impairment.

The RFC assessment considers all your limitations, including those from the cancer itself and the side effects of treatment (e.g., fatigue, nausea, pain, cognitive dysfunction, neuropathy). The SSA will then use your RFC, age, education, and work experience to determine if there are any jobs you can perform in the national economy. If there are no such jobs, your claim will be approved.

When Can You Get Disability for Cancer?

The word ‘cancer’ is enough to scare any person. The number of cancer patients is increasing rapidly throughout the world. When doctors are not able to treat your cancer after multiple efforts, then you can get disability benefits. Apart from this, many other factors that make you eligible for disability benefits. Here are some more details about when SSA can approve your disability request-

• When cancer has spread to multiple body parts-

This condition is also termed as “distant metastases.” In this condition, the cancerous cells tend to cover until very distant body parts from where it originated. As per the cancer listing for SSA, you may get eligible for benefits in such circumstances

• When your cancer treatment or surgery is not successful-

When surgery for tumor removal remains unsuccessful, the cancer is termed as unresectable. If you are facing a similar situation, then the Social Security Administration will qualify you for disability benefits.

• Cancer treatment side effects hinder you from working-

Cancer treatment is a combination of radiation therapy, chemotherapy, immunotherapy, medications, stem cell transplantation, etc. These procedures sometimes show severe side effects. Many patients become unable to work or perform daily core functions as a result. Hence, if a person is suffering badly from cancer treatment side effects, SSA can approve their disability claim.

These side effects last longer than expectations like months and even years. Long-term side effects of cancer treatment include-

• Heart, liver and lung problems

• Cataracts

• Bone weakness

• reproductive disorders

• eye problems

• hypothyroidism

• intestinal problems

• cognitive dysfunction, etc.

If you are suffering from any of the above conditions due to your cancer treatment, then the Social Security Office will evaluate the impairment.
If you have become disabled due to cancer treatment and are not able to earn or perform necessary daily functionalities, SSA will consider your disability claim. But you should have proper proof to show your disability due to cancer. The following are some factors for which SSA will be concerned before issuing your benefits;

• When the doctor first noticed your symptoms

• Which type of cancer and stage you are suffering

• cancer origin

• To which extent, cancer has spread

SSDI Payment Amounts for Cancer

SSDI benefits are not a fixed amount. The monthly payment is calculated based on your average lifetime earnings on which you paid Social Security taxes. It is not based on household income or the severity of your disability.

Your specific benefit amount is known as the Primary Insurance Amount (PIA). While the national average SSDI benefit changes annually, your individual payment will depend entirely on your personal earnings record. You can get a personalized estimate of your potential disability benefits by accessing your Social Security Statement through your my Social Security account online.

Key Documentation for Your Cancer Disability Claim

A strong cancer disability claim is built on thorough and consistent medical evidence. Comprehensive cancer disability documentation is critical for demonstrating the severity and duration of your impairment. Essential documents include:

• Pathology and Biopsy Reports: These confirm the type, grade, and origin of the cancer.
• Imaging Scans: MRI, CT, and PET scans that show the location and size of tumors and any metastasis.
• Surgical Notes: Reports from any operations to remove tumors.
• Treatment Records: Detailed logs of chemotherapy, radiation, immunotherapy, and other treatments, including start/end dates, frequency, and your body’s response.
• Physician Statements: Notes and opinions from your oncologist detailing your diagnosis, prognosis, and functional limitations caused by the disease and treatment side effects.
• Hospitalization Records: Summaries from any inpatient stays related to your cancer or treatment complications.

Applying for Social Security Disability Cancer

Do you know, the American Cancer Society has revealed more than 200 types of cancer, and almost 1.7 million new cancer cases are coming up every year. Isn’t this an eye-opening fact? Many types of cancer that are non-malignant. This type of cancer never spreads, is non-invasive, easy to treat, and does not require any kind of supervision.
While some forms of cancer are malignant. It spreads aggressively, requires immediate attention, and requires aggressive cancer treatment methods like chemotherapy, immunotherapy, surgery, etc.
Experts have said that any cancer, with any grade, and stage can cause disability to the patient at any point in time. Even non-malignant tumors can cause trouble. Treatment procedures cause adverse physical and psychological effects.  Some people may recover soon, but some may stay away from work for months or even years, sometimes this wait to work may last a lifetime. Depending on the situation, SSA approves the cancer disability benefits.

Does Cancer Qualify for Disability?

While we all know that cancer causes disability, the Social Security Administration will not approve all cancer-related benefits applications. SSA follows a strict procedure to approve cancer disability claims. It demands the applicant to suffer from a disability or terminal illness, preventing you from earning a living for a minimum of 12 months or more.
Disability benefits can be like a blessing for the applicant and his/her family members. It helps in meeting everyday living expenses, paying medical bills, and many other vital tasks.

How Chermol & Fishman, LLC Can Help

Securing SSDI benefits for cancer involves navigating a complex regulatory system. An experienced disability attorney can be your most valuable asset. The legal team at Chermol & Fishman, LLC, focuses exclusively on Social Security disability law.

We help our clients by:

• Ensuring your application is complete, accurate, and compelling.
• Gathering all necessary medical evidence and expert opinions.
• Building a legal strategy aligned with SSA regulations.
• Representing you at all stages of the process, including hearings and appeals.

If you are dealing with a chronic illness disability from cancer and are unable to work, contact Chermol & Fishman, LLC, for a consultation. We can help you pursue the cancer long-term disability support you need to focus on your health.

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