Social Security Disability Benefits for Breast Cancer

Far too many of the over 200,000 people diagnosed with breast cancer each year are eventually unable to maintain gainful employment due to the condition and/or treatment. This blog shares expert information on the Social Security Disability benefits available to ease the financial burden of those with breast cancer unable to work.

A diminished ability to work has predictable and negative results. Bills pile up, some of them medical, and without a steady income there is no way to pay them. However, if you have been diagnosed with breast cancer and are expected to be out of work for at least 12 months, you may be eligible for Social Security Disability benefits.

The Social Security Administration (SSA) will consider you disabled and eligible for benefits if your condition:

• Is anticipated to last at least a year or end in death;
• Prevents you from doing any work that you are trained and qualified for; and
• Makes it unreasonably difficult for you to master a new occupation.

The SSA has two different benefit programs available to support people with disabilities and serious health conditions. Each offers financial help to a different group of people.

• Social Security Disability Insurance (SSDI): for people who have worked for a certain number of years and paid FICA Social Security taxes. After receiving SSDI for two years, you become eligible for Medicare.
• Supplemental Security Income (SSI): a means-tested program, meaning it is oriented around financial need and not work history. To qualify, you must be low-income and have less than $2,000 in assets (or $3,000 for a couple). SSI recipients are also eligible for Medicaid.

When you apply for SSDI or SSI, you have to meet certain medical requirements found in the Blue Book, the SSA manual of disabling physical and mental conditions. Breast cancer appears under Listing 13.10, which states that you will be considered disabled if your condition meets any of the following criteria:

• Locally advanced carcinoma that has spread to the internal mammary nodes, chest, or skin;
• Carcinoma that has reached at least 10 armpit nodes, spread around the collarbone, or advanced to distant regions of the chest;
• Carcinoma that keeps recurring after treatment (except local recurrence that ceases with antineoplastic therapy); or
• Small-cell carcinoma.

Sarcoma of the breast (SSA Blue Book Listing 13.04) requires one of the following criteria to be met for eligibility:

• Ongoing and soft tissue sarcoma that keeps coming back after treatment; or
• Soft tissue sarcoma with local or distant metastases.

With your application, you must include medical documentation of your breast cancer diagnosis. For example:

• Mammogram images and other test results that document how far the cancer has spread;
• Pathology reports; and/or
• Records for chemotherapy, radiation, surgical procedures and other treatments.

 Your doctor will need to fill out a Residual Functional Capacity (RFC) form, to describe the extent of your disability. The SSA uses this document to determine if having breast cancer is preventing you from working.

SSI applicants must also provide financial details and be interviewed by a SSA representative.

The Compassionate Allowances program enables applicants with certain, severe medical conditions to have their claims processed more quickly. For breast cancer these include:

• Stage 4 (metastatic) breast cancer (it has spread to distant organs), OR
• An inoperable cancer, OR
• An inflammatory form of breast cancer, which obstructs lymph vessels in the breast.

If you do not meet a Blue Book listing, you may still be able to receive disability benefits under a Medical Vocational Allowance. This program is intended for those who are genuinely disabled but do not meet a listing for some reason.

For more information about qualifying for SSA disability benefits when you have been diagnosed with breast cancer, visit the SSA website at https://www.ssa.gov/, go to your nearest SSA office, or call 1-800-772-1213.

Disability benefits may help you cope with demands on your financial resources and let you concentrate on your health.

This article was contributed by The Outreach Team at Disability Benefits Help.