What Can I Do To Help My Cancer Claim Succeed?

Submitted by Deanna on Mon, 11/06/2017 - 12:13

A cancer diagnosis is an experience that nobody wants to face. In addition to attending medical appointments and treatment therapies, you must deal with the emotional ramifications of such a significant medical issue. While life has permanently changed for you, the financial responsibilities of life do not disappear.

Some people may choose to continue working after receiving a cancer diagnosis, but for others, work may no longer be an option. The impact of cancer on work-life varies from person to person. While some individuals may be unable to hold a job due to consistently missed work as a result of frequent treatments, others may be too ill to continue working. If you can prove that you are unable to work for a year or more, you may qualify for benefits from the Social Security Administration (SSA).

The Importance of the “Blue Book”

The SSA uses a medical guide, known as the Blue Book, to determine whether your cancer is severe enough to warrant disability payments. Each condition in the Blue Book lists specific criteria and symptoms that you must have in order to be approved.

Cancer, as a general category, is listed in Section 13.00 of the Blue Book. The SSA carefully considers several factors about your cancer, including where it began, if it has spread, the type of treatment that you require, and how you respond to your necessary treatments.

Ensuring your Social Security claim is approved

One example, of many, listed in the Blue Book is breast cancer. The SSA evaluates each individual with breast cancer based on several factors, including the type of breast cancer, how advanced the cancer is, if it has spread to particular lymph nodes, and if it has come back despite treatment. The more advanced your breast cancer, or the more resistant it is to treatment, the higher your likelihood of benefit approval.

Here's a little more information on how to qualify for disability benefits via the Blue Book with a specific cancer diagnosis.

What If I Don’t Meet All the Criteria Listed in the Blue Book?

Not everyone with cancer will meet all of the criteria listed in the Blue Book. However, you may still qualify for benefits. If you remain too ill to work due to complications from your illness that are expected to last at least a year, you can still qualify for disability benefits should you continue to pursue a claim.

The key to winning your cancer claim is to provide thorough and accurate medical documentation about your condition, your treatments, and any experienced side effects related to your care. It is imperative that your application is complete and includes an assessment on your ability to function since your diagnosis. It is essential that you work closely with your oncologist to gather this information.

What Is the Residual Functional Capacity Form? (RFC)

Not everyone who deserves disability benefits will be awarded them based on his or her condition alone. However, it is possible that you still may be unable to work. The Residual Functional Capacity (RFC) form helps the Social Security Administration understand your ability to work that remains after taking into account your medical condition.

The RFC form addresses your capabilities such as your ability to stand, your need to sit or lie down during the day, your ability to utilize stairs, your reaching and grasping capabilities, and your ability to travel alone.

While the SSA will file an RFC on your behalf, it is extremely beneficial to have one completed by your physician at the beginning of the application process. Upon initial diagnosis, you may not meet the criteria in the Blue Book, but you may still be suffering and unable to perform as well as you have in the past. Your medical team knows your specific case very well, and therefore can speak to your capabilities in greater detail. Having an RFC filed early in the process may help you to win your cancer claim.

If you don't meet a Blue Book listing, you may want to learn a little more on how to file an RFC.

What Is a Compassionate Allowance?

The Social Security disability program was designed to help those in need of financial assistance due to a health need. Unfortunately, the application process can be long and cumbersome, sometimes taking up to six months, or longer, for a decision.

For those who are extremely ill, a Compassionate Allowances (CAL) may speed up the decision-making process. CALs are quick ways to identify those conditions that are severe enough to meet the Social Security’s standards for disability benefits. Of the approximately 200 CAL conditions listed, many include cancer, such as acute leukemia, esophageal cancer, and brain cancer, just to name a few.

Steps You Can Take to Win Your Cancer Disability Claim

As you begin your application process, remember that medical evidence listed in the Blue Book is arguably the most important factor in your Social Security disability claim for cancer.

The entire Blue Book is available online, so you may want to review the cancer section, 13.00, with your oncologist to determine what medical records you have on hand, and what may need to be supplemented in order to be approved. You may also want to request that your physician complete an RFC form on your behalf.

While you can certainly navigate this process alone, a Social Security disability attorney or advocate can assist you with your claim. Having an attorney who has experience with disability claims for cancer can be extremely beneficial. Remember that consultations are free and disability lawyers are only paid if you win your claim.

You can speak with a Social Security attorney or advocate by filling out our Free Disability Evaluation.

Return to A Guide to Cancer and Social Security Disability Benefits.