As a rare form of cancer that most often occurs in children, Hepatoblastoma (HB) is a condition the Social Security Administration (SSA) recognizes as qualified for Social Security Disability (SSD) benefits. It is additionally a condition that is included in the SSA’s Compassionate Allowances (CAL) program, which ensures any application filed with the diagnosis is reviewed more quickly than the average SSD application, which typically takes four or more months to proceed just through the initial review.
Although CAL designation for HB automatically qualifies the condition medically for SSD benefits, this does not get rid of the application or burden of proof requirements for receiving disability benefits. You must still complete the full application and you must also ensure that your child’s medical records thoroughly document the disease and its effects.
Medical Evidence Requirements
The SSA must see certain information in your child’s application and medical records in order to approve your son or daughter to receive benefits. A definitive diagnosis, established through standard medical practices is one of the items that must be satisfied for eligibility to be granted. Specific medical records must also be present in your child’s file in order to meet the evidentiary requirements for establishing the level of severity necessary to prove disability.
To document a definitive diagnosis, the SSA needs to see:
- Liver enzyme level test results
- CBC counts with differential analysis
- Imaging results that show the extent of the disease, which may include:
- Ultrasound or x-rays of the abdomen
- CT scans
- Bone scans or PET scans, if the cancer has spread
- Biopsies and pathology reports, documenting the form of the cancer and its origination in the liver
Other medical evidence documenting the effects of the disease, its progression, the treatments received, and the implications and effects of treatment should also be included:
- Reports from all treatment providers, including hospitals, specialists, and the primary care doctor
- Reports from physical examinations that document the symptoms and their consistency with the diagnosis of HB
- Clinical history reports that show the onset and progression of the disease
For the purposes of evaluating applications filed on the basis of HB, the SSA may also utilize listings in the Blue Book. These listings include Sections 13.19 and 113.03.
SSD Benefit Programs
Children must commonly qualify for SSD benefits under the SSA’s Supplemental Security Income (SSI) program. Adults who are diagnosed with HB may qualify for SSI and/or Social Security Disability Insurance (SSDI).
Each of these programs requires medical eligibility is established, but each also has financial and technical qualification criteria as well.
- SSDI pays benefits to qualified disabled workers and in certain circumstances, their dependents. To qualify, the disabled worker must have sufficient work history and work credits from his or her previous employment. Additionally, he or she must be unable to earn a gainful living, which the SSA sets at $1,130 per month for 2016.
- SSI pays benefits to qualified disabled adults and children who have significant financial need. It has strict income and financial resource limitations.
Applying for Benefits
To apply for benefits with Hepatoblastoma for yourself, you can visit the SSA’s website, or call the main helpline at 1-800-772-1213 to schedule an appointment to file your application in person. If applying for benefits on behalf of a minor child however, you must schedule an appointment to complete an interview at your local SSA office, where the application will be completed with the assistance of an SSA representative.