Compassionate Allowance - Endometrial Stromal Sarcoma

As an exceedingly rare and form of uterine cancer that spreads rapidly and often recurs following treatment, Endometrial Stromal Sarcoma (ESS) is designated as qualified for Social Security Disability (SSD) benefits under the Social Security Administration’s (SSA’s) Compassionate Allowances (CAL) program.

CAL provides expedited review and approval processes for any application filed on a diagnosis that falls under the program’s guidelines. The purpose of the program is to significantly reduce the wait for benefits for those who need them most.

Documentation Requirements

While ESS is qualified for expedited processing under CAL guidelines, you must still prove the severity level of your condition through the medical records and other documentation your application contains.

The SSA has specific information they look for to prove your diagnosis and to substantiate the severity level of your condition.

Only ESS in its advanced stages qualifies under the CAL program. Grade III or IV or high grade ESS must be the diagnosis on your application for benefits. Undifferentiated Uterine Sarcoma is also an acceptable formal diagnosis for evaluation under the ESS CAL listing.

Documentation required for supporting a definitive diagnosis of ESS includes any or all of the clinical diagnostic and physical findings:

  • Cellular evaluation results, from cells collected during endometrial biopsies, D&C procedures, or hysteroscopies
  • Pelvic MRI and/or CT scan results showing the presence of masses in the abdomen
  • Vaginal bleeding or spotting in postmenopausal women
  • Abnormal bleeding in premenopausal women
  • Anemia resulting from persistent and chronic loss of blood
  • Enlargement of the uterus
  • Abdominal and/or pelvic pain
  • Vaginal cramping and/or discharge

The SSA defines the minimum evidence required for approving an application for disability with an ESS diagnosis as:

  • A clinical history and examination notes that document and describe the features of your condition, including physical features and symptoms you experience
  • Pathology reports that show the presence of stroma cells in your endometrial tissues, with a biopsy being the standard method of retreating and examining cells
  • Imaging test results and/or notes following surgery that document the spread of your cancer

Applying for Benefits

To ensure your application is processed as quickly as possible, collect your medical records in advance and submit them at the same time you turn in your application. You can apply online via the SSA’s website, or at your local SSA office, through an in person interview.

If you apply in person, call ahead to schedule an appointment or you will be turned away, with an appointment date that you should return. There can be a wait for an available appointment date, and online application is often the fastest method for initiating a claim.

Most disability applicants must wait at least four months for a decision on their application. You should hear something within just a few weeks, especially if you ensure your medical records are thorough.