Qualifying for Social Security Benefits With a Terminal Illness

If you or someone you love has been diagnosed with a terminal illness, your family’s financial situation should be the last thing on your mind. Fortunately, if you require hospice care you’re nearly guaranteed medical qualification for Social Security disability benefits.

The Social Security Administration (SSA) approves millions of applicants for monthly benefits that can help pay for your hospice care, outstanding medical bills, your family’s housing or other expenses, and much more.

In most cases, anyone who has been diagnosed with a terminal disease should qualify for SSDI benefits if the terminal illness prevents them from going to work. In addition to these benefits there are other benefits available too such as auxiliary benefits.

Age and Social Security Disability Benefits

Most people receive Social Security disability benefits during their working years, and these disability benefits convert to retirement payments at age 65. Social Security disability is a separate program from Social Security retirement, and you cannot receive payments from both programs at once.

This means if you’re already receiving retirement benefits and you’ve been diagnosed with a catastrophic illness, you will not be able to apply for additional benefits due to a disability.

Medically Qualifying for Disability Benefits

To medically qualify for disability benefits, you’ll need to meet the SSA’s definition of disability: A condition that prevents an applicant from working for 12 months or more, or results in death. Anyone in hospice care will automatically meet the SSA’s definition of disability, unless you’re still maintaining employment.

The SSA will refer to its own medical guide of qualifying criteria, known as the Blue Book, when evaluating a claim. There are hundreds of listed conditions that require hospice care. For example, someone with ALS will qualify with only a diagnosis that was established using “standard medical procedures,” such as reviewing EMGs, MRIs, and your medical history.

Applicants with any metastatic cancer (cancer that’s spread to other organs) will also medically qualify for disability benefits. The entire guideline for eligibility can be found online, so you can review the criteria with your doctor to determine if you’re eligible if you’re worried your claim will be denied.

If you are diagnosed with a terminal illness, you may qualify for Social Security disability benefits.

Survivors’ Benefits

If you pass away and leave dependent family members behind, they’ll be protected by Social Security disability benefits. The following family members are eligible for survivors’ benefits under your account:

  • A child* under age 18, or under age 19 while still in high school
  • A spouse over age 60
  • A spouse with a disability over age 50
  • A spouse of any age who’s caring for your child under age 16

Your survivors could be entitled to up to 75% of your monthly Social Security disability payments each. These benefits will continue until your children reach adulthood or if your spouse chooses to take Social Security retirement benefits under his or her own account.

Auxiliary benefits

Most people who are eligible to apply for Social Security Disability benefits because they have an illness or condition that is either terminal or prevents them from undertaking work related jobs believe they are the only ones eligible to receive disability benefits.

This isn’t entirely true, as in some cases the family of a disabled worker such as a spouse and dependent children may be eligible to receive benefits too. These benefits are called auxiliary benefits. Those that are eligible have to have a family member who is disabled and who is eligible to receive SSDI benefits.

The value of auxiliary benefits is related to how much tax the disabled family member has paid in the past. If you qualify, you will need to add the beneficiaries’ names when you start your claim for SSDI benefits.

If your spouse wishes to be included, s/he has to be below 62 years and has to be jointly caring for the children with you when you have lived together and the children have to be under 16 years of age.

If you have recently been involved in a divorce with your spouse your spouse might still be eligible for auxiliary benefits from your SSDI as long as you have been married for no less than ten years before your divorce. If your children would like to qualify for auxiliary benefits, they must be aged 18 years and be enrolled in school full time and can’t be married.

What are Retroactive Benefits?

Often there is a delay between applying and receiving SSDI benefit payments. Retroactive payments are made to SSDI applicants for the time that has passed between the onset of the disability to the date that the SSDI application was finally approved. Retroactive payments are paid for 12 months before the date that the application was passed.

Factors Considered for Retroactive Payments

There are three factors considered by the Social Security Administration before finalizing retroactive payments: These are:

  • date of onset of disability;
  • date of application
  • wait period

All SSDI claims require a 5 month mandatory wait period following the onset of the disability. During this wait period nothing is paid. The retroactive payments are only made at the commencement of the sixth month.

An applicant for SSDI benefits is eligible for retroactive payments if:

  • approval has been completed for the disability claim;
  • over 5 months have passed since the EOD
  • there is no reason to withhold payments.
    • The SSDI permits retroactive payments for 12 months maximum before the application date, while taking away the waiting period. That means typically that 17 months will have gone by since the onset date (EOD) and the date the application is approved.

      Retroactive payments may only be made for 12 months maximum. This means that the applicant will not be paid before the considered 17 months are up. It may be possible to get back benefits dating to the commencement of the disabling condition.

      Also, a victim may be due back benefits, dating back to the start of the disabling condition and a lump sum payment if approved.

      Starting Your Application

      The easiest way to apply for Social Security disability benefits is online from the comfort of your own home. If you’re unable to type for extended periods of time, you can ask a family member to fill out the application on your behalf.

      Most people in hospice care qualify for expedited approval. There is nothing additional you’ll need to do when applying—your claim should simply be flagged for quick processing due to your disability. Most people in hospice care will be approved in as little as two weeks.

      Additional Resources