A rare form of cancer that can affect individuals of any age but is most commonly seen in children age three and younger, Atypical Teratoid/Rhabdoid Tumor meets the medical requirements disability benefits from the Social Security Administration (SSA). It is, in fact, automatically medically qualified under the SSA’s Compassionate Allowances (CAL) program, though the applicant must still meet the technical eligibility rules of Social Security Disability (SSD) in order to get benefits.
Disability Benefit Programs
The SSA has two disability programs:
- Social Security Disability Insurance (SSDI) – which is available to disabled workers with work credits from their past employment.
- Supplemental Security Income (SSI) – which is only available to disabled individuals that meet the income and financial resources limitations.
Since Atypical Teratoid/Rhabdoid Tumor is most often seen in children, SSI is usually the benefit program through which applicants are approved. However, the disease can affect adults and when it does, they may qualify for SSDI and/or SSI.
No matter how old the applicant is or how advanced the disease, the SSA recognizes the devastating nature of Atypical Teratoid/Rhabdoid Tumor, which is why it is included in the CAL program. CAL designation:
- speeds up the review and approval of disability claims
- minimizes the required medical documentation for proving disability
- virtually guarantees an applicant will not be denied for medical reasons, though technical rules must still be met before benefits are granted.
CAL applications often take only a few weeks to process, while other disability claims can take months, even years before an applicant has a final decision regarding eligibility.
Required Medical Evidence for Atypical Teratoid/Rhabdoid Tumor
Although minimal medical documentation is necessary for proving disability under the CAL program rules, the following central evidence is necessary:
- Detailed clinical history and exam reports, documenting the clinical/diagnostic features of the disease
- A pathology report, confirming the diagnosis
- Operative reports, if surgeries or biopsies have been completed
- Radiological scan reports, like MRIs, CT scans, bone scans, or ultrasounds, showing the extent, location, and size of the tumor(s)
- Results of a bone marrow biopsy or spinal tap, if appropriate
The SSA also uses listings in the Blue Book to review disability claims. The Blue Book is a manual of impairments and the medical evidence necessary for proving a severe disability. The following listings may also be consulted by SSA disability determinations staff:
- Section 13.13A and/or 113.13, when tumors are present in the brainstem, cerebellum, or spinal cord
- Other sections may be consulted when the disease originates in another area of the body, including:
- Section 13.02D, for the neck
- Section 13.15B1, for the mediastinum
- Section 13.19, for the liver
- Section 13.21B, for the kidneys
You can find the Blue Book here, but in most cases, the evidence listed above is sufficient for proving a disability claim under CAL rules.
Submitting an Application
If you’re applying for benefits for a minor child or submitting an application for SSI for an adult, you must schedule an appointment for a personal interview at the local SSA office. Arrange the appointment by calling 1-800-772-1213.
If you’re applying for SSDI benefits, the application can be filled out online, via the SSA’s website. It can also be saved and submitted later, allowing you to collect any information you may not have immediately.
If you apply online though, be sure to follow up by submitting copies of your medical records to the local SSA office just after you submit your application. This will help prevent delays in the processing of your claim, since the SSA will not need to request as many details from your doctor(s) or from you.