Can I Get Social Security Disability Benefits for Breast Cancer?
Can I Get Social Security Disability Benefits for Breast Cancer?
In order to obtain Social Security Disability benefits for breast cancer, the condition must be severe enough to prevent you from engaging in any gainful employment activity.
This is the rule of thumb with regard to Social Security Disability benefits, generally.
Disability benefits are intended to compensate for wages lost to the effects of a debilitating medical condition.
The Social Security Administration is the gatekeeper of these benefits. Even as serious a condition as breast cancer will be reviewed to determine if an award of benefits is appropriate based on the specifics of each individual’s case.
What Conditions Trigger SSD Eligibility?
It is worth noting upfront that Social Security disability benefits are only available for totally disabled people. Therefore, a condition resulting in short-term disability or partial disability will not be one that triggers SSD benefits eligibility.
What does it mean to be “disabled” for SSD benefits purposes?
It means that your condition:
- Has rendered you unable to perform the work you did prior to developing the condition;
- Has rendered you unable to perform other work;
- Will last for at least 1 year or will result in your death.
If you are not working due to your condition and the SSA determines that your condition meets its definition of “severity,” your condition must be one that is included in its list of severe medical conditions.
If your condition is not on the SSA’s list, it must be determined to be as severe as those conditions which are on the list.
Cancers are conditions that appear on the SSA’s list of severe conditions. However, that does not mean that Disability benefits will be automatically granted if you have breast cancer or another form of cancer.
The SSA will review factors including:
- The origin of the cancer;
- The extent of the cancer;
- The duration, frequency, and your response to anti-cancer therapy;
- The post-therapy effects that you may be suffering.
For cancers, the SSA requires evidence of the type, extent, and site of the primary lesion or metastasis to determine severity, as well as evidence of operative procedures, pathology reports, and other medical reports.
A cancer that has metastasized beyond the primary lesion site usually meets the SSA’s severity requirements.
If the cancer or other condition does not meet the SSA’s severity requirement, it will consider whether or not the condition has resulted in a further condition in another body system that may be sufficiently severe.
However, cancers generally may not meet the SSA’s severity requirement unless therapy has not been effective. If the cancerous condition has progressed or has recurred, this is an indication that the severity requirement may be met.
Is Breast Cancer a Triggering Condition?
Breast cancer is included on the SSA’s list of severe conditions.
The SSA reviews bilateral primary breast cancer for a particular level of advancement in the condition. It looks for a locally advanced cancer or a carcinoma that has metastasized to the supraclavicular or infraclavicular nodes or to 10 or more axillary nodes, among other features.
Such growth in the condition will meet the SSA’s requirement for severity and will trigger eligibility for Disability benefits.
A recurring breast cancer carcinoma that remits with anti-cancer therapy, small-cell carcinomas, and secondary lymphedema caused by anti-cancer therapies and treated surgically will also be considered sufficiently severe, the latter for at least 12 months following the surgery.
In addition to these general severity requirements, however, the SSA extends Disability benefits to certain breast cancers as a “Compassionate Allowance.”
This is an allowance for benefits premised upon the survivability rate of certain severe forms of breast cancer.
The question of whether your condition may qualify for Compassionate Allowance is a complicated one and is one of the reasons that you should always discuss your Disability Benefits entitlement with a Florida Disability Attorney.
Does Breast Cancer Impede Your Ability to Work?
If your particular form of breast cancer is sufficiently severe, the further question asked the SSA is whether or not it impedes your ability to work or to engage in what it calls “gainful activity.”
If you are able to perform the work you performed prior to developing breast cancer, the SSA will not agree that you are “disabled.” Benefits will be denied.
Even if you can’t engage in that particular prior form of work, the SSA will also review whether or not you can do any other type of work.
The SSA will review the particular circumstances of not only your medical condition but also your age, education, other prior work experience, and whether or not you have any skills that might be transferable to some other form of work.
What Is Gainful Activity?
If your cancer or other condition enables you to perform some level of work, the SSA may determine that you are able to engage in Substantial Gainful Activity, or “SGA.”
This is the minimum amount of monthly earnings derived from work activity. If you earn more than that amount, you may be determined to be able to engage in SGA and will be denied Disability benefits.
In 2022, the SGA amount for non-blind individuals is $1,350.00 per month.
Thus, if you are suffering from breast cancer and are still able to work and earn income (doing anything, regardless of whether or not it is the same thing you did before developing cancer), you will be denied disability benefits if you earn more than that amount per month.
What Are Some Signs of Breast Cancer?
First and foremost, if you believe that you have any form of cancer, you should consult a medical professional immediately.
Indications that you may need to seek medical advice include:
- Lumps in the breast or armpit;
- Thickening or swelling of the breast, or a part of the breast;
- Irritation of the breast’s skin;
- Red, flaky skin in the nipple area;
- Pain in the nipple area;
- Pain anywhere else in the breast;
- Discharge other than breast milk;
- Changes in size or shape of the breast;
Risk factors include:
- Reproductive history;
- Breast density;
- Family history of breast or ovarian cancer;
- Lack of physical activity;
- Hormone replacement therapy;
- Alcohol intake.
Some of these factors are manageable and some are a matter of genetics. If you have a strong family history of cancer, in particular, you should stay attuned to your body and to any possible changes.
A qualified physician will ultimately render a diagnosis using tools such as ultrasound scans, diagnostic mammograms, breast MRIs, and, eventually, biopsy.
The records of these diagnoses will be highly useful to your Florida Disability attorney in presenting evidence on your behalf to the SSA.
Likewise, the treatment options for breast cancer will be of great interest to your lawyer and to the SSA.
Breast cancer is typically treated in several ways, including surgery, chemotherapy, hormonal therapy, biological therapy, and radiation therapy.
The effectiveness, or lack thereof, of the treatment options offered to you will, as noted above, determine whether or not your particular condition will be deemed sufficiently severe to qualify you for a benefits award.
When Should You Discuss Your Condition with a Florida Disability Lawyer?
Although you will be spinning multiple plates while suffering through the treatment of your breast cancer, it is essential that you contact a Florida Disability lawyer as soon as you suspect that you will be unable to work again.
A Florida Disability lawyer will guide you through and assist you with the collection and presentation of your medical records to the SSA.
A good attorney will also ensure that the Medical Expert and the Vocational Expert appointed to appear as impartial experts at your Disability Hearing are just that: impartial. And sufficiently qualified to render the opinions as to your condition and ability to work that will underly the decision of the SSA and the Administrative Law Judge presiding over the hearing whether or not to grant your application or appeal.
A Florida disability lawyer will prepare you for the sorts of questions that you will be asked leading up to and at your benefits hearing or appeal hearing.
We can and will maximize your odds of success within a system in which the first response to the vast majority of Disability benefits applications is a rejection.
Disability Benefits for Breast Cancer Conclusion
In short, there is no blanket “yes” or “no” answer to the question of whether you can receive Disability benefits for breast cancer. Much will depend upon your particular circumstances—and upon the odds of your hopeful improvement.
At the Law Offices of Shea A. Fugate, PA, we specialize in ensuring that our clients receive the best possible opportunity to receive the Disability benefits that they have paid for their entire working life when they are most needed.
If you are an Orlando-area resident who has been diagnosed with breast cancer or any other severe medical condition, contact us at 407-539-0123 to schedule your free, initial consultation.