With advanced or recurrent prostate cancer, disability approval is automatic. Highly aggressive forms of the disease, like oat cell carcinoma, are quickly approved by the Social Security Administration (SSA) as well.
When the disease is caught early and can be successfully treated though, benefit approval may be more challenging but is still possible, particularly for men who experience severe residual impairments cancer and the required treatments. These individuals may qualify for benefits, even when they don’t SSA’s standard prostate cancer disability requirements.
What Impairments Prevent Employment?
The frequent urge to urinate is a common first sign of prostate problems. Cancer, even in its early stages, can lead to constant bathroom breaks, something not practical when on the job.
Pain, weakness, and stiffness in the back, hips, thighs, and pelvic area can make sitting, standing, walking, climbing, and other activities difficult or impossible, essentially getting in the way of nearly every normal task required in physically active as well as sedentary jobs.
When undergoing hormone therapy or chemo and radiation, side effects become a major impediment to gainful employment. These treatments only last so long however, and if successful, many men are able to go back to work without significant issues.
Long-term and permanent residual impairments that come from prostate cancer and treatment however may have left you unable to accomplish many essential job duties. These impairments virtually destroy your employment options.
When this is the case, approval for disability under a medical vocational allowance may be possible after the SSA looks at how compromised you are functionally.
The Financial Cost of Prostate Cancer
Receiving a cancer diagnosis is one of the most devastating things you can experience, and trying to figure out how to balance treatment and associated costs can be overwhelming. Even with insurance there are still costs that will be incurred throughout treatment, including medication costs and copays.
Each visit with a doctor could mean a new copay, and every lab test, imaging scan or chemotherapy appointment will also require a copay. Medication can also be very expensive, and when you’re suddenly faced with all of these expenses it can be a challenge to pay for it all when you’re not able to work.
When you are too sick to work, whether it’s from the prostate cancer itself or the side effects of treatment, it makes going to work an almost impossible task. You might run out of sick time to get to your appointments and so you won’t receive compensation for the time missed from work.
If the effects of your prostate cancer are making it impossible for you to meet the demands of your job, then applying for Social Security disability benefits might be an option for you.
What Records do You Need, and do You have Them?
Your disability application must contain specific medical records before SSA approval is granted. These records include test results, documenting the diagnosis of your prostate cancer, like digital rectal exam (DRE) notes and prostate-specific antigen (PSA) results.
Treatment records, including surgical reports and anti-cancer regimens, are important as well and explain how you responded to treatment, including any residual impairments you’ve developed that affect your ability to work.
The SSA uses standard disability listings to evaluate eligibility. For automatic qualification, your medical records must show you’re a match to the prostate cancer listing. When your records don’t match this listing precisely, the SSA will conduct other reviews, including looking at your residual functional capacity (RFC). If you must be approved via an RFC, then the residual effects of your cancer and cancer treatments must be well documented within your medical history.
Steps to Take before Starting Your Application
A disability benefit application pulls together details from all aspects of your life. These include not just medical history information but employment, financial, and education and training details too.
A recent tax return and old pay stubs offer important financial facts, and bank statements will be necessary too. You’ll need the contact information for former employers and all of your medical care providers and information on former job duties as well as any formal education and training you’ve undergone.
You’ll want your records handy before beginning your application, but you’ll also want to ensure your doctor and possibly a disability attorney or advocate are on board too.
Your doctor will be a partner throughout the application and review processes, communicating with the SSA as needed and providing access to medical records. A disability lawyer may assist you from start to finish. He or she can advise you on filing your claim and can handle your case even if you’re denied initially and must file an appeal.
Qualifying with Prostate Cancer through Medical-Vocational Allowance
In some cases, your diagnosis will not meet the criteria to receive disability benefits in the Blue Book, but that doesn’t mean that you are out of options. In that case, a medical-vocational allowance might be the right choice for you.
The medical-vocational allowance is used when an applicant’s diagnosis does not fit the disability guidelines but the applicant is unable to perform the demands of the job. To make this determination, the SSA will evaluate your age, work history and experience, your education and your residual function capacity (RFC). The RFC is the maximum amount of work you are able to perform given your condition, taking into consideration the demands of your job and the ability to perform modified tasks.
The SSA will use the medical-vocational guidelines to evaluate the exertional (walking, standing, sitting, lifting, carrying, pushing and pulling) and nonexertional (mental, postural, manipulative, visual, communicative and environmental) demands of your job to determine if an adjustment can be made to accommodate the maximum amount of work you are capable of performing, either in your current position or in general.
If the SSA determines that you could perform a similar task with some adjustments, then you will not qualify for the medical-vocational allowance. However, if no accommodations can be made, then you could qualify for disability benefits because at that point you would no longer be able to keep up with the demands of your job or work in a similar field.
Keep in mind that in some cases the treatment of a condition, such as chemotherapy, radiation or hormone therapy for prostate cancer, can be debilitating in and of itself. The side effects can make you so sick that you are unable to work. The SSA will evaluate your diagnosis as well as the treatment, and so it is very important that you include as much information in your application as possible so that the SSA can evaluate the claim accordingly.
Start Your Application
There are three ways to file your application for disability benefits. You can apply online, via mail or in person at your local Social Security Administration branch office.
Applying online requires that you create an account on the SSA website, and then you open the application and start working through it. When you file online, the date that you begin the application is the date that will be used should you qualify to receive back payments, rather than the date you submit the application.
If you prefer using a paper application, you can pick one up at the SSC branch office or you can print one from the website. If you know that you will be filing an application in the future, you can submit a written protective filing statement that reserves the date of the statement as the date you started, so that your back payment date would align with that date rather than the date you submit your application. This applies to both mailed application and those submitted in person.
Once your paper application is complete, you can submit the application via mail or you can drop it off at your local SSA branch office. Make sure you keep a copy of everything that you submit in case something is lost.
Should you need to speak with someone about your application, you can reach the SSA via phone or by scheduling an appointment at your local SSA branch office.
Consult with a Social Security Attorney
Applying for Social Security disability benefits can be a daunting task. Between the application itself and providing all of the required medical documentation, there is a lot that needs to be done and it can be quite overwhelming.
The SSA has a toll free number for any questions you might have, but they won’t walk you through the application if you are in need of additional help. You can certainly work with family and friends to complete the application, and it helps when you have a trusted friend or relative act as an advocate on your behalf when you need additional help.
Sometimes, though, you might not have anyone who can help with the application, or your case has a lot of documentation required and you want to make sure everything is done properly. In that event, you might consider retaining a Social Security disability attorney.
Hiring a Social Security attorney does not guarantee that you will win your case, but it can certainly increase your chances for approval because a lawyer who deals in these claims all of the time knows exactly what must be included, what to emphasize, and what additional information you should include to increase the chances of being approved.
Some Social Security attorneys work on a contingency basis, meaning you only pay if you win your case. Others work on an hourly or flat rate basis, so make sure that you understand the fee structure before retaining your attorney.