Yes, you may automatically qualify for the disability benefits if you are struggling with Stage IV or terminal cancer. If it is a very severe cancer diagnosis, you may also qualify for the Compassionate Allowance program. Through this program, your claim for the Social Security Disability Benefits will be expedited and you will start receiving monthly payments faster. 

How Does The SSA Define Cancer?

The SSA has no specific definition of cancer. They have listed all the types of cancer that may qualify for the benefits in the listing 13.00. However, there is an exception that cancer associated with HIV will be covered in a separate section. 

Cancer is a group of diseases that is accompanied by the uncontrollable growth and division of abnormal cells in the body. These abnormal cells can form tumors or invade nearby tissues and spread to other body parts through the bloodstream or lymphatic system.

Is Cancer a Disability?

If you are struggling with cancer, the law will consider it a disability. It means you will not be considered less favorably owing to your medical condition in comparison to people who do not have cancer. Moreover, an individual suffering from cancer will not be discriminated against in any way. People who have cancer are protected under the Americans with Disabilities Act (ADA).

Cancer itself is a medical condition and not automatically classified as a disability. However, the impact of cancer on an individual’s ability to function and work can lead to disability in certain cases. Whether cancer is considered a disability depends on how it affects a person’s daily life, ability to work, and overall functioning.

The term “disability” is often used in the context of eligibility for disability benefits or accommodations under various disability-related laws and programs. In the United States, the Social Security Administration (SSA) recognizes that some individuals with cancer may qualify for disability benefits if their condition meets the SSA’s definition of disability.

Types Of Cancer

Cancer can develop in almost any part of the body, and there are numerous types of cancer based on the particular organs or tissues where they originate. Some common types of cancer:

  • Breast Cancer: Cancer that begins in the breast tissue, primarily affecting women but can also occur in men.
  • Lung Cancer: Cancer that starts in the lungs, commonly associated with smoking but can also occur in non-smokers.
  • Skin Cancer: Cancer that develops in the skin, including basal cell carcinoma, squamous cell carcinoma, and melanoma.
  • Bladder Cancer: Cancer that forms in the bladder, the organ that stores urine.
  • Kidney Cancer: Cancer that originates in the kidneys.
  • Pancreatic Cancer: Cancer that starts in the pancreas, an organ involved in digestion and insulin production.
  • Ovarian Cancer: Cancer that affects the ovaries in women.
  • Cervical Cancer: Cancer that develops in the cervix, the lower part of the uterus.
  • Leukemia: Cancer of the blood and bone marrow, characterized by the abnormal production of white blood cells.
  • Brain Tumors: Cancer that forms in the brain or nearby structures.
  • Liver Cancer: Cancer that originates in the liver.

Symptoms Of Cancer

Cancer symptoms can vary depending on the type and stage of cancer, as well as the affected organs or tissues.  It may also lead to anxiety, depression, and other types of disorders. Some common signs and symptoms of cancer include:

  • Unexplained weight loss: Significant and unintentional weight loss without diet or physical activity changes could be a warning sign, especially if it’s rapid and unexplained.
  • Fatigue: Persistent, extreme tiredness or fatigue that doesn’t improve with rest can be an early sign of some cancers.
  • Pain: Continuous or recurring pain in a particular area, that doesn’t improve with usual treatments, may warrant further investigation.
  • Changes in the skin: Changes in the size, shape, color, or texture of moles or the appearance of new skin lesions should be checked by a doctor, as they could indicate skin cancer.
  • Persistent cough or hoarseness: A cough that doesn’t go away, hoarseness, or difficulty swallowing may indicate cancers of the lung, throat, or esophagus.
  • Swelling or lumps: New or growing lumps, bumps, or swelling under the skin, in the breasts, testicles, or lymph nodes should be examined by a doctor.

Types Of Disability Programs

The Social Security Administration (SSA) provides disability benefits through two main programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

  • Social Security Disability Insurance (SSDI): To be eligible for SSDI benefits based on cancer, you must have worked and paid Social Security taxes for a sufficient period, earning enough work credits. The number of work credits needed depends on your age when you become disabled. 
  • Supplemental Security Income (SSI): SSI is a needs-based program that benefits individuals with limited income and resources who are disabled. If you have cancer but do not have enough work credits to qualify for SSDI, you may be eligible for SSI benefits if you meet the financial eligibility requirements. 

What Other Benefits Can I Claim If I Have Cancer?

Apart from SSDI and SSI, the applicants can apply for other benefits that may help them handle their day-to-day expenses. It includes compensation for prescription costs, medical bills, and other healthcare expenses. According to the Blue Book, Cancer is considered a mentionable disability and you may know how to apply for disability benefits. 

Financial Coverage for Cancer Patients

Some disability programs will provide financial coverage for applicants who are diagnosed with cancer. This may cover medical bills, chemotherapy, medications prescribed by the doctor, radiation therapy, and other expenses. 

The patients can also apply for private short-term (STD) or long-term disability (LTD) plans. in the STD plans, you will get financial coverage for 3 months, and in LTD you will get financial assistance for 6 months. 

Compassionate Allowance By SSA

According to the compassionate allowance or CAL, you will be provided with a quick evaluation of individuals suffering from cancer and their eligibility. Fundamentally, people who are suffering from aggressive cancer may be found eligible for the CAL program.  You must meet the following eligibility criteria mentioned below:

  • Your cancer is recurrent even after proper medical treatment
  • You are struggling with inoperable cancer
  • You are struggling with unresectable cancer that has spread to other body parts

Eligibility Criteria For Getting Disability With Cancer

To be considered a disability by the SSA, cancer or any other medical condition must meet the following criteria:

  • Severity: The cancer must be severe enough to significantly impair the individual’s ability to perform substantial gainful activity (SGA). SGA refers to the ability to engage in work that pays a certain income level as defined by the SSA.
  • Duration: The cancer must be expected to last for at least 12 months or more.

How Does The SSA Evaluate Cancer Claims?

To evaluate your eligibility for disability benefits based on cancer, the SSA will consider the following factors:

  • The type and stage of cancer you have been diagnosed with.
  • The extent of involvement of the cancer and how it affects your physical and mental functioning.
  • The treatments you have undergone or are undergoing and their impact on your ability to work.
  • Any side effects of cancer treatments that limit your functional capacity.
  • Medical evidence from doctors, hospitals, and other healthcare providers supports your disability claim.

It is important to note that the SSA has specific criteria and a list of impairments, commonly known as the “Blue Book,” which outlines medical conditions that may qualify for disability benefits. Cancer is listed in the Blue Book under specific conditions based on its type and severity. 

Cancer Conditions That Qualify For Accelerated Approval

The Social Security Administration (SSA) provides an expedited or accelerated approval process for disability benefits in certain cancer cases. This process is known as Compassionate Allowances (CAL). 

Compassionate Allowances are a list of conditions considered medically disabling and automatically qualify individuals for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. CAL was designed to streamline the approval process for individuals with severe medical conditions, including certain types of cancer. Some of the cancer conditions that may qualify for Compassionate Allowances include:

  • Acute Leukemia
  • Bladder Cancer 
  • Gallbladder Cancer
  • Inflammatory Breast Cancer (IBC)
  • Liver Cancer
  • Lung Cancer – Small Cell
  • Mesothelioma
  • Pancreatic Cancer
  • Peritoneal Mesothelioma
  • Pleural Mesothelioma
  • Primary Central Nervous System Lymphoma
  • Stage IV Breast Cancer
  • Esophageal Cancer
  • Liver Cancer 
  • Ovarian Cancer
  • Salivary Tumors
  • Small Cell Cancer of the Thymus
  • Stomach Cancer

What To Do If My Cancer Meets The SSA’s Criteria?

The next step is to apply for the social security disability benefits. Some of the steps to apply are as follows:

  • Gather Medical Documentation: Collect all relevant medical records, test results, pathology reports, doctor’s notes, and any other evidence that supports your cancer diagnosis
  • Complete the Application: The online application is generally the most convenient option. During the application process, you must provide detailed information about your medical condition, work history, and other relevant personal details.
  • Submit Medical Evidence: With your application, submit all the medical documentation you gathered earlier. 
  • Await Decision: The SSA will evaluate your application, medical records, and other evidence to decide. 

What If My Cancer Doesn’t Meet The Criteria?

If your cancer doesn’t meet the specific criteria for a Compassionate Allowance (CAL) condition, it doesn’t mean you automatically do not qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. 

The SSA evaluates disability claims on a case-by-case basis, considering various factors, including the severity of your medical condition and its impact on your ability to work.

How To Appeal If Your Application Has Faced Denial?

The SSA may receive thousands of applications every day. Among those, there may be 60% to 70% disability claims that are rejected. If your claim has been denied, you must feel discouraged. You may hire an experienced disability lawyer who can provide you right legal guidance. Moreover, search online for Social Security Benefits For Cancer Patients and develop an understanding of the same. 

A cancer patient must be mentally and physically devastated. Therefore, you may be unable to think and gather all the documents required by the SSA. You can appeal if your initial application has been rejected and you have 60 days from the date of rejection. In this appeal, you need to provide all the missing or incorrect information that may prove your disability. An expert can also help you by giving written documentation of the illness and what problems you are experiencing. 

What If My Cancer Spreads To Other Parts Of The Body?

When your cancer spreads to other parts of the body than the actual area, it is popularly known as distant metastases. In such cases, a tumor develops in the other body parts. 

In such a scenario, the SSA may be keen to get medical reports on how your cancer has spread. Some other documentation that they may need are an X-ray, CT scan, MRI, and other reports.

Only the diagnosis of secondary cancer may not automatically qualify an applicant for the benefits. After the doctor confirms that you are struggling with a distant metastases condition, you will receive medical treatment such as chemotherapy or radiation. 

Apart from all these eligibility criteria, the Social Security Administration has also stated in the Blue Book that cancer-diagnosis patients may also apply for the benefits. However, they must meet the SSA’s definition of disability.

How Much Is a Disability Check For Cancer?

In 2022, the neoplasm’s average disability check was $1,729.82. If your cancer qualifies for Social Security disability benefits, an applicant can get up to $3,822 monthly from SSDI, and for SSI up to $943 per month in 2024. However, the maximum amounts for SSDI and SSI are made according to the law and are usually similar for every medical condition. 

The disability check for every individual may vary depending on various factors such as work history if they apply for SSDI and income sources if applying for SSI. Some applicants may also qualify for both SSI and SSDI in certain situations. 

Will I Qualify For Disability With Cancer In Remission?

If your cancer prevents you from doing work, you may qualify for disability benefits. There may be a situation if you are in partial remission. You may still apply if your symptoms are making it hard for you to work. 

If you are confused about whether to apply or not, you must consider getting help from an attorney. However, you must start with the application process as it is complex, time-consuming, and may take up to 2 years or even more. If someone has already applied for the benefits, remission may not impact your benefits immediately. The SSA will reevaluate your eligibility if your cancer is disabling or not. 

Are Your Disability Benefits Denied? Contact a Lawyer

If your disability benefits were denied, don’t give up. Experienced Social Security disability lawyers may help to appeal the decision and fight for the benefits. They will guide you through the process and work tirelessly to protect your rights.