Social Security Disability Benefits

 

Breast Cancer and Social Security Disability Benefits - Courtesy of Molly Clarke

Breast cancer is one of the most common forms of cancer in the world. Cases can range from incredibly serious to easily curable. There are also many ways to detect breast cancer at early stages; however, as good as doctors have become at detecting breast cancer, it is not always easy to fight. Therapies can be expensive and physically taxing.

If you have been diagnosed with breast cancer and can no longer earn a living, you may be eligible to receive Social Security Disability benefits, from the Social Security Administration (SSA). These benefits are intended to help ease financial difficulty and allow you to focus on fighting your condition. Unfortunately, the application process can be rigorous and complicated—often making it difficult to qualify.

To help improve your understanding of SSD benefits and how to obtain them, follow the step by step guide in the article below.

Step One—Choosing the Right Benefit Program

The Social Security Administration maintains two primary disability benefit programs in the United States: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both have distinct requirements to accommodate different types of applicants.

SSDI is a benefit program intended to provide financial assistance to working adults who become disabled. In order to qualify for SSDI, you must first be considered disabled according to the SSA’s definition of disability—explained here. Because, SSDI payments are funded through Social Security payroll taxes, applicants must also demonstrate that they have worked and paid taxes for a substantial amount of time. Learn more about SSDI eligibility, here: http://www.disability-benefits-help.org/ssdi/qualify-for-ssdi.

SSI, on the other hand, pays benefits to elderly and disabled individuals based on financial needs. Only those who meet strict income and resource limits will qualify for SSI. This program is not funded through Social Security taxes and provides an alternative to those who would not meet SSDI's employment requirements. SSI applicants must also meet the same definition of disabled in order to qualify. Learn more about SSI eligibility here: http://www.socialsecurity.gov/ssi/text-eligibility-ussi.htm.

Step Two—Medical Eligibility

In addition to the program-specific requirements, the SSA also publishes a guidebook, called the Blue Book, of medical listings for each disabling condition. To qualify for disability benefits, applicants must meet the listing associated with their condition or match another listing in severity.

Breast cancer is evaluated under Blue Book listing- 13.10. The requirements under this listing state that applicants must have one of the following types of breast cancer:

A. Locally advanced carcinoma (inflammatory carcinoma, tumor of any size with direct extension to the chest wall or skin, tumor of any size with metastases to the ipsilateral internal mammary nodes); OR
B. Carcinoma with metastases to the supraclavicular or infraclavicular nodes, to 10 or more axillary nodes, or with distant metastases; OR
C. Recurrent carcinoma, except local recurrence that remits with antineoplastic therapy.

Because the Blue Book listings are written using advanced medical terminology, you may want to sit down with a medical professional to discuss your eligibility.

Remember that the Social Security Administration is only concerned with the severity of the condition, not the particular diagnosis. Breast cancer must keep you from working and earning a living in order to receive Social Security Disability benefits.

If you do not meet a Blue Book listing, consult step three.

Step Three—Medical Vocational Allowances

Before the Social Security Administration can deny your claim based on a Blue Book listing, it must first consider the extent to which your condition impairs your functional capacity on a daily basis. In other words, your medical condition, age, education, and work history will be taken into account to determine what level of work (no work, sedentary work, light work, medium work, or heavy work) you are able to perform. This information will be used to determine your residual functional capacity (RFC).

If the SSA finds that you are not capable of doing any type of work, you will likely be approved to receive disability benefits.

Step Four—Compassionate Allowances

The Social Administration also keeps a list of the most obvious and severe disabilities, which are all eligible for an expedited application processing under the Compassionate Allowances program. Applicants with conditions included on the list of Compassionate Allowances can begin receiving benefits in as little as ten days. Advanced breast cancer and inflammatory breast cancer are both considered Compassionate Allowance conditions.

To view these listings, visit the following page: http://www.ssa.gov/compassionateallowances/conditions.htm

Step Five—The Application Process

Before you begin the application, be sure to have all of the appropriate medical and technical documentation needed to validate your claim. This should include diagnosis, medical records, and information about the treatment you've received. You should also ask for statements from doctors and therapists confirming your symptoms and limitations. Remember to also have the financial or employment information required by the benefit program—SSDI or SSI—for which you are applying. A complete list of required documents can be found on the SSA’s website, here: http://www.socialsecurity.gov/disability/Documents/Checklist%20-%20Adult.pdf

When you are ready to apply, you may choose to complete the forms online or in person with a representative from the SSA. In either case, you need to be as detailed as possible on the application; avoid 'yes' or 'no' answers. Keep in mind that in most cases, a diagnosis alone will not be enough to qualify; you need to demonstrate the extent of your impairment,

Step Six—Receiving the SSA’s Decision and Appealing a Denial

Apart from those who are eligible for Compassionate Allowance processing—applicants may not receive a decision for several months. If you are denied benefits—which happens to around two thirds of Social Security Disability applicants—you are entitled to appeal that decision. The appeal must be filed within 60 days of receiving the denial. If you fail to file an appeal within the given time period, you will be required to start the application process all over again.

Although it can be discouraging to receive a denial, it is not the end of the road. Many more applicants are awarded benefits during the appeals process than after the initial application submission. At this stage of the application process, it may be in your best interest to seek the services of a Social Security Disability attorney or advocate. Although you are not required to hire an attorney, a legal professional will have a thorough understanding of the appeals process and will be able to increase your chances of approval.

Unlike other types of lawyers, Social Security Disability attorneys are only paid if their claimant is awarded benefits. If your claim is successful the SSA will deduct the attorney’s fees from your back pay and send it to the attorney. You should also note that the SSA has rules and regulations regarding the amount of money an attorney can charge.

For more information about applying for disability with breast cancer, visit the following page: http://www.disability-benefits-help.org/compassionate-allowances/breast-cancer-and-social-security-disability