Social Security Disability and Cancer
April 20, 2023
The Social Security Administration (SSA) offers a program for those who suffer from a disability that keeps them from working that will provide a financial cushion, but qualifying is often a challenge. The program is called Social Security Disability Insurance (SSDI). The turndown rate, at least upon initially filing a claim, runs well over 50 percent, but there are reconsideration and appeals processes that can often result in approval.
Suppose you are diagnosed with cancer, and you begin treatment. The side effects of both the disease and the treatment make it difficult for you to work. Will that automatically qualify you for SSDI?
That depends. Though cancer appears on the SSA’s list of “Compassionate Allowances,” meaning your condition might jumpstart your claim, your symptoms and side effects must last more than 12 months to qualify. The effects of cancer treatments can be temporary and may last only a few months. This is a major factor that claims examiners will take into consideration.
If you have cancer and are seeking SSDI, or worse, you are suffering from cancer and you have been denied SSDI benefits in or around Raleigh, North Carolina, contact me at the Lloyd King Law Firm PLLC.
I am a former Social Security Disability Judge, and I know the ins and outs of how the SSA administers SSDI. I can help you navigate the system to get the benefits you deserve. I also proudly serve clients in Roanoke Rapids, Fayetteville, and Greensboro.
Qualifying for SSDI With Cancer
Though cancer is a condition that is viewed as a somewhat swifter path to SSDI consideration under the administration’s list of Compassionate Allowances, that does not mean qualifying is a slam dunk. You must meet these SSA requirements:
First, you must meet the SSA’s definition of disability. The SSA has a fairly strict definition of disability, which requires that your mental or physical condition must prevent you from any substantial gainful activity (SGA) for 12 months or more, even until death.
There is also a requirement that you have sufficiently accumulated enough work credits to qualify. A work credit derives from the income you pay taxes on either at work or through self-employment. In 2023, you accumulate one work credit for every $1,620 earned. You can earn four work credits each year. Qualifying for SSDI requires a sufficient number of work credits, which is determined by your age. For instance, at 27 you would need 12 work credits during the previous 6 years; at 31, you would need 20 credits over the past 10 years; and at 54 you would need 32 work credits over 8 years.
In addition, if you are able to earn more than $1,470 a month in “substantial gainful activity” (SGA), you will not qualify for SSDI.
Does Your Condition Qualify?
Cancer and other severely disabling conditions are considered part of the administration’s Compassionate Allowances list, which earns claimants a sort of fast track to approval.
The SSA website states: “Certain cases that usually qualify for disability can be allowed as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrig’s disease (ALS), and pancreatic cancer.” Other cancers are also included on the list, including liver, thyroid, mesothelioma, and esophageal.
Even if your cancer does not appear on the list, you can still qualify if your symptoms or treatment limit you so much that you can’t work. But, remember that here too, the 12-months-or-longer condition still applies. The side effects of some treatments may last only a few months, and the symptoms too may be ameliorated before the 12-month threshold is reached.
Metastatic cancer also qualifies for automatic approval. For instance, lung cancer can often spread to the liver. The SSA's cancer listings refer to this complication as "metastases beyond the regional lymph nodes."
What if Your Claim Is Denied?
If your initial claim is rejected (a word the SSA will never use), you can ask for a reconsideration. The medical and other evidence you submitted will then be evaluated by a different SSDI examiner with no prior knowledge of your case. You can also get your doctor to complete and submit what is called a Residual Function Capacity (RFC) form, which will help show that you are unable to work.
If the reconsideration is still negative, you can request a hearing with an administrative law judge (ALJ). You can bring witnesses and submit new evidence to support your claim. If the ALJ rules against you, the decision will be sent to an Appeals Council, which is like an appellate court in a civil or criminal case.
The council is composed of ALJs not familiar with your case, who will weigh the pros and cons of the evidence presented in the hearing. You will not be able to submit new evidence. The council can approve the ALJ’s decision, overturn it, or send it back for reconsideration.
Throughout this process, from submitting the initial claim through reconsideration and on to the hearing level, having an experienced Social Security disability attorney at your side can significantly enhance your chances of approval.
Turn to Strong and Compassionate Legal Assistance
Facing cancer can be frightening and traumatic enough, but then having your very livelihood threatened because of an adverse decision by the Social Security Administration can only make your life more unsettled.
If you’re facing cancer and can no longer work in or around Raleigh, North Carolina, reach out to me immediately. I have years of experience working with and for the SSA on its disability cases. I can help you navigate the system to get the benefits you deserve. Reach out immediately.