Social Security Benefits for Brain Cancer Patients

Applying for Social Security Disability with Brain Cancer

If you are diagnosed with Brain Cancer, you are likely to qualify for financial assistance from the Social Security Administration (SSA). You must prove that you are both medically as well as financially eligible in order to qualify for benefits.

The Brain Cancer Listing

The SSA maintains a manual known as the Blue Book, which contains listings of disabling conditions. The brain cancer listing appears in Section 13.13 and requires that your cancer is:

• Malignant, which means it must be grade II or higher

And

• Progressive or recurs even after initial treatment

Compassionate Allowances

It s important to note that certain types of brain cancer qualify for expedited review and processing under the SSA’s Compassionate Allowances (CAL) program. These include:

• Ependymoblastoma – For more information visit: http://www.disability-benefits-help.org/compassionate-allowances/ependymoblastoma-and-social-security-disability

• Glioblastoma Multiforme – For more information visit: http://www.disability-benefits-help.org/compassionate-allowances/glioblastoma-multiforme-and-social-security-disability

Medical Evidence Required

The SSA needs to see extensive medical evidence to determine the severity level of your brain cancer. That evidence should include:

• physician notes from doctor’s appointments
• clinic notes after diagnostic tests and other procedures were completed
• radiology reports from imaging exams, documenting the tumors present and their comparative size
• lab work reports, documenting markers pertinent to your case
• biopsy results, including the report and notes from operations
• a statement from your doctor that includes information on your diagnosis and prognosis

Concurrent Conditions

Brain cancer often causes complications. These may include psychological or intellectual impairments and neurological issues. The SSA needs to see medical records related to these conditions and will take concurrent conditions into account when making a determination on your claim for benefits. Any complications are evaluated according to the listings for the affected body system.

• Neurological complications are reviewed under the appropriate listings in Section 11.00 of the Blue Book.
• Intellectual and psychosocial complications are evaluated under the applicable listings in Section 12.00.

Qualifying without Meeting a Listing

Even in cases where brain cancer does not meet the SSA’s listing or does not qualify under the CAL program, Social Security Disability (SSD) benefits may still be granted.

In order to be approved without meeting a listing, you must show your “residual functional capacity” (RFC) is so profoundly affected by your cancer and by the treatments you must undergo that you are unable to maintain gainful employment in any position for which you would otherwise be qualified.

Thorough documentation from your doctor regarding the affects of your cancer and your treatments is essential. RFC report forms completed by you and by your doctor will give the SSA much of the information they need. Other details necessary for RFC analysis will be obtained through a thorough review of your medical records.

If your RFC analysis shows you are severely limited in your daily activities, including typical job functions, then you can be granted SSD benefits under what is known as a medical vocational allowance.

The SSA’s Benefit Programs

There are two benefit programs for which you may qualify with brain cancer:

• Social Security Disability Insurance (SSDI) – which is available to qualified disabled workers.
• Supplemental Security Income (SSI) – which is a need-based program available to disabled individuals who have very limited income and other financial resources.

In general adults can qualify for both SSDI and SSI, whereas children will only qualify for SSI due to their lack of work history. For more information on qualify for the different SSD programs, visit: http://www.ssa.gov/disability/

Applying for Benefits

If you are applying for an adult, an application can be submitted either online (http://www.socialsecurity.gov/applyfordisability/) or in person. Applications for children will have to be submitted in person.

In person applications are completed through an interview process at your local SSA office. Online applications can be completed at any time via the SSA’s website. Online application is usually the fastest method. Either way, you should submit copies of as many of your medical records as possible to your local SSA office at the time you apply or shortly after submitting your application.

If you are applying with a compassionate allowance exception, you should receive a decision on your claim within a few weeks. If not, be prepared to wait between 3 and 6 months for a decision. It is not uncommon for initial applications to be denied by the SSA. There is an extensive appeals process through which you can go through in order to be approved for benefits.

Article by Ram Meyyappan
Social Security Disability Help
Email Questions/Comments to ram@ssd-help.org