Leukemia and Social Security Disability

Applying for Social Security Disability Benefits with Leukemia

Leukemia is one of the most serious forms of cancer in the US. There are over 325,000 Americans living with the illness or in remission, according to the Leukemia Research Foundation. Out of the more than 54,000 people diagnosed with the disease each year, leukemia takes the lives of about half.

If you or a loved one has been diagnosed with leukemia, there may be help available. The Social Security Administration (SSA) gives financial support for those who can’t work because of debilitating conditions, such as leukemia. You may also be eligible for assistance if your child has been diagnosed with leukemia.

The Financial Costs of Leukemia

There are a number of routes to go for leukemia treatment, but none of them are cheap, even with insurance. Everyday Health revealed that a transplant alone—bone marrow and stem cell transplants are both common for leukemia—can cost upwards of $500,000.

After the surgery, as many as 50 or more drugs and three doctor’s visits per week may be necessary to keep you or your child healthy, which can be an additional hundreds in copays.

Leukemia also often requires some mixture of chemotherapy, radiation therapy, and immunotherapy drugs. According to Livestrong, chemotherapy can range from $100 to $30,000 depending on the types of drugs used and the frequency of treatment. Often newer drugs are mixed with less expensive drugs, driving up the cost.

Immunotherapy is no less, with one of the most expensive drugs costing $178,000 per treatment, Bloomberg reported.

Depending on the severity of your cancer, you may have to take a considerable amount of time off work, which can result in thousands of dollars in lost income and problems with healthcare coverage.

Medically Qualifying for Benefits with the Blue Book

To qualify for disability benefits, you will need to meet a listing found within the SSA’s Blue Book. The Blue Book is the SSA’s official list conditions that qualify for disability benefits. Leukemia can be found in Section 13.00—Cancer (Malignant Neoplastic Diseases) for adults and Section 113.00 for children.

For leukemia to qualify in both adults and children, you must have medical evidence showing at least one or more of the following:

  • All types of acute leukemia, including lymphoblastic lymphoma and juvenile chronic myelogenous leukemia (JCML) in children and T-cell lymphoblastic lymphoma in adults.
  • Chronic myelogenous leukemia, with either:
    • Accelerated or blast phase, which means immature white blood cells make up 10 percent or more of your blood count.
    • Chronic phase, which means your blood count is less than 10 percent immature blood cells, up to 12 months after a transplant or a progression of the disease after anticancer treatment.

In most cases, the SSA will consider leukemia a disability only until 24 months after the date of diagnosis or relapse, or at least 12 months from the date of bone marrow or stem cell transplantation, whichever is later. Afterward, the SSA will judge the eligibility of any residual impairments under the affected parts of the body.

If you have any questions about the SSA’s listing or if you think your leukemia may be severe enough to qualify, talk to your doctor about your specific cancer and your chances of being approved. Generally, your cancer has to be severe or recurrent.

Compassionate Allowances and Leukemia

When an applicant has a disability so serious that there’s little doubt of approval and they can’t wait years before receiving benefits, the SSA can expedite the process. In addition to the Blue Book, the SSA created the Compassionate Allowances List (CAL) so those with severe conditions can be approved for benefits in as little as a few weeks.

This disability application is not only very long, but also involves a lot of paperwork. CAL claimants typically need to submit less medical evidence to the SSA. As long as they can provide a qualifying test or detailed oncologist’s report showing that the condition does, in fact, meet CAL requirements, a CAL applicant will be approved quickly.

Leukemia qualifies for a Compassionate Allowance when it meets either or both of the following conditions:

  • All types of acute leukemia, including lymphoblastic lymphoma and juvenile chronic myelogenous leukemia (JCML) in children and T-cell lymphoblastic lymphoma in adults.
  • Chronic myelogenous leukemia in an accelerated or blast phase, which means immature white blood cells make up 10 percent or more of your blood count.

When applying for CAL, it’s imperative to have a blood count test showing blast percentage and type of leukemia, or a note from your oncologist. If you don’t have either of these tests, talk to your doctor. The faster you submit them to the SSA, the faster your claim will be approved.

Qualifying Without Meeting a Medical Listing

If you have been diagnosed with a form of leukemia not listed in the Blue Book, you may still be eligible for disability benefits. If you are unable to work the job you worked at before or work any job that meets the SSA’s substantial gainful activity limit of $1,130 per month in 2016, and your condition is expected to keep you out of work for 12 months or longer, there is another way to be approved.

The SSA also approves disability benefit claims through a physical Residual Functional Capacity (RFC) evaluation. This long form, filled out by your doctor, takes into account your health and your education, skills, and work history.

Once the SSA finishes its evaluation, they will determine what level of work they believe you can do—sedentary, light, medium, heavy, and very heavy. If you place in the first three categories, you may be awarded disability benefits if there is are no jobs in your category that you can do with your skill set. However, the SSA may find you’re able to do sedentary work even if your symptoms are severe.

When applying through as RFC, the SSA has specific grid rules for those 45 and over, but younger applicants need to argue they can’t perform even sedentary work. With leukemia you may say that your frequent doctor’s appointments require too much time off or your treatment makes you too weak to stand for periods of time or lift things.

If you didn’t attend college or complete any other formal education, and worked physically demanding jobs such as landscaping or construction you will be much more likely to be approved than someone with a degree.

If applying for a child, you can only apply for Supplementary Security Income (SSI), which has financial limits, as well as medical requirements. You need to show that your child is seriously limited in his abilities to perform daily living activities by himself and his condition is expected to last a year.

How to Apply for Social Security Disability Benefits

Speak with your oncologist about your chances of getting approved via the Blue Book or an RFC. The application process can take up to two years, so you may not want to apply if you aren’t likely to be approved.

The fastest way to get approved is to gather all of the medical evidence yourself, so the SSA doesn’t have to take the time to do it. Some important pieces to submit would include:

  • Bone marrow biopsy results
  • Peripheral blood smear results
  • Complete blood count (CBC) test results
  • Examination of the cerebral spinal fluid
  • Testicular biopsy results
  • Chromosomal analysis
  • Initial and follow-up pathology reports
  • Reports from your oncologist and surgeon
  • A history and timeline of treatments you’ve received, such as chemotherapy, radiation therapy, immunotherapy, and surgeries.

You can apply for disability benefits either online or in your local SSA office. If you’re applying for SSI for a child, you must apply in person at an SSA office. Whether applying online or in person, make sure you have the entire medical, personal, and tax information you need. The SSA’s website has checklist for both adult and child applications. Make sure to double check your information before you submit it, because an accidental mistake may cause a delay or denial of your application.

If your leukemia worsens, you are hospitalized, you start new treatment or your condition changes in any way during the application process, let the SSA know immediately. This can affect the outcome of your claim.

If you are approved for disability benefits, your spouse and children could also qualify for benefits. To learn more about the different forms about disability benefits, visit our pages on Social Security Disability Insurance and Supplemental Security Income.