Mesothelioma and Social Security Disability

Social Security Disability for Mesothelioma

Mesothelioma is a kind of lung cancer that can be challenging to diagnose because it has symptoms that mimic those from benign conditions. It is a rare form of cancer that develops in the lining of the lungs (also known as the mesothelium).

Exposure to asbestos is the leading cause of this particular form of cancer. If you have been diagnosed with this particular kind of cancer, you probably have worked in an industry where asbestos was used, such as shipbuilding, automotive painting, insulation, or construction.

You have had to undergo extensive testing to get a confirmed diagnosis of mesothelioma. Your symptoms usually don’t manifest or become evident until years after your exposure to asbestos (usually 20 to 50 years following the exposure at your job). If you suffer from pleural mesothelioma, you may experience coughing, chest pains, and shortness of breath.

Peritoneal mesothelioma can make you experience weight loss, swelling, or abdominal pains. Other symptoms you may experience (with either kind of mesothelioma) are blood clots, fever, bowel obstructions, anemia, difficulty swallowing, pain and swelling of the face and neck.

If you have been diagnosed with mesothelioma, you may be eligible for Social Security disability benefits because of your inability to work. The Social Security Administration (SSA) oversees the Social Security Disability Insurance (SSDI) program. In order to be eligible for SSDI, you must have earned sufficient credits and have paid enough taxes to the SSA. These requirements are usually based on your last 10 years of employment.

Your cancer may qualify you for disability benefits

The Cost of Treating Mesothelioma

Of course you know any cancer diagnosis means you are going to have to spend a lot of money on your medical care. Mesothelioma requires extensive medical care that includes recurring doctor visits, prescriptions, treatments, and hospitalizations. The approach and treatment can depend on your case and how advanced your cancer is when it is found.

According to CostHelper.com, an eight-week chemotherapy regimen can cost as much as $30,000 with an initial treatment costing as much as $7,000. The average cost of a surgical procedure for mesothelioma is $40,000.

The cost for the lifetime treatment of this form of cancer can cost you anywhere from $100,000 to $250,000 depending on when the cancer is diagnosed and the length of your lifespan after your diagnosis.

The Medical Qualifications Set Forth by the SSA

The SSA has a medical guide, which is called the Blue Book, which sets specific criteria for different medical conditions in order to qualify for benefits. When using the Blue Book criteria, getting approved for disability benefits because of mesothelioma is quite simple. The mesothelioma diagnosis criteria indicate that for SSDI approval, you must provide medical documentation that shows:

  • Malignant mesothelioma of the pleura OR

  • Malignant tumors that have spread to the pleura OR

  • Malignant primary tumors of the mediastinum, not controlled by therapy that has been prescribed

If your cancer diagnosis meets any of these criteria, you have met the medical requirements for SSDI and should be quickly approved for benefits. You should consult with your physician before applying for benefits to ensure all of your medical records are gathered, detailed and have the information needed to support your case.

In order to prove your claim, you must have provided detailed medical documentation that has evidence of the kind of lesion and its location, if it has spread, and the extent of the cancer (including its stage). When you provide the proper documentation, your odds of being approved for benefits are improved significantly. Documentation is the key to having a successful claim.

Your medical records should include pathology reports, any treatment records, details about medications and any side effects that are caused by them, documentation that shows how your ability to work has been impacted, and any physician notes. The opinion of your treating physician is given utmost consideration when filing a SSDI claim.

If you have been diagnosed with mesothelioma, your odds of being approved for SSDI benefits are good as long as you provide all of the information that proves your condition and your diagnosis. As mentioned earlier, providing the required documentation is the key to a successful disability claim. The application must be completed in detail with every question answered.

Qualifying with a Medical-Vocational Allowance

Mesothelioma usually meets the Blue Book requirements for benefits approval, but if your case does not you may be eligible for benefits using a medical-vocational allowance. This process involves focusing on your treatment plan and a residual functioning capacity (RFC) form. The RFC gives specific details about your restrictions and limitations.

As an example, your physician may indicate that you have to reposition yourself every hour, or you may not be able to stand more than two consecutive hours. Because of cancer treatments, you may be fatigued or suffer from severe nausea that prevents you from bending over or walking long distances. You may not be able to lift more than 5 pounds on a periodic basis and you may not be able to carry items.

By looking at all of your limitations, the Disability Determination Services can see how you are impacted by your cancer and its treatments. By having your treating physician fill out an RFC, you can gain some ground toward approval because the SSA pays extra attention to the recommendations and comments of the physician who treats you because he or she is familiar with your condition.

Applying Specific Medical Tests

In order to prove your claim for disability because of mesothelioma, you have to provide all of the documentation that shows what tests confirmed the diagnosis. This shows Disability Determination Services that you have mesothelioma, the stage or severity of your cancer, and your prognosis. Medical tests and pathology reports are important in proving your case.

It is not uncommon for the SSA to order evaluations at their expense to confirm your diagnosis and the severity of your cancer. Medical evaluations are ordered at a physician chosen by the SSA. These evaluations are not for medical treatment, but for informational purposes only to help with deciding your claim.

After a cancer diagnosis, you may suffer from anxiety or depression. These mental issues must be considered as well. Sometimes a mental evaluation is ordered by the SSA to see if your mental state is impacting your ability to work. Documentation and evidence are key to winning approval for your disability claim.