February 24, 2016
Social Security Disability for Breast Cancer
While many people fully recover and are able to return to work after being diagnosed with breast cancer, some do not. Unfortunately, for some people, the treatments and procedures do not work, or they not work well enough to allow the patient to return to her previous level of functioning. The Social Security Administration (SSA) recognizes breast cancer and other types of cancers as disabling conditions. Even though a breast cancer diagnosis can be scary and life-altering, in my Indianapolis Social Security Disability practice I see many of these types of claims denied. Here are a few common reasons Social Security gives for denying breast cancer claims:
Your condition has not lasted, or is not expected to last, twelve months or longer. Often, the Social Security reviewers will review your diagnosis and medical records, see that you are receiving treatment, and conclude that you will improve enough to return to work within twelve months from the date you were diagnosed. If that turns out to be the case, then you will not be eligible for Social Security Disability or Supplemental Security Income benefits, no matter how severely you were disabled during the months you were receiving treatment. However, for many people, treatment extends beyond twelve months or leaves them with residual symptoms that do not improve, even if the cancer goes into remission. For example, some of my clients acquire neuropathy in their arms from the effects of chemotherapy, and others have painful scarring that prevents them from being able to use their arms the way they used to. Therefore, even if Social Security denies your claim because you are expected to get better, it is a good idea to appeal that denial to keep your claim going in case your recovery does not go as well as expected.
Your diagnosis does not meet Listing 13.10 in Social Security’s Listing of Impairments. In the Listing of Impairments, Social Security lists criteria which, if met, are considered disabling without further consideration of the impairment’s effects on the claimant’s ability to work. If you have breast cancer, you must fall into one of the following categories to meet Listing 13.10 for breast cancer:
- Locally advanced carcinoma (inflammatory carcinoma, tumor of any size with direct extension to the chest wall or skin, or a tumor with metastases to the ipsilateral internal mammary nodes)
- Carcinoma with distant metastases or metastases to the supraclavicular or infraclavicular nodes or to ten or more axillary nodes
- Recurrent carcinoma (except local recurrence that remit with antineoplastic therapy)
- Small-cell (oat cell) carcinoma
- Breast cancer with secondary lymphedema caused by anti-cancer therapy and treated by surgery to salvage or restore functioning to an upper extremity
- Soft tissue sarcoma with regional or distant metastases or that persists after initial antineoplastic therapy
If your medical records do not show that your breast cancer fits into one of these categories, it does not mean that you cannot be found disabled. It simply means that Social Security must further evaluate your symptoms and their effects on your ability to work. This evaluation requires a subjective evaluation of your credibility regarding your symptoms related to your doctors’ opinions and objective testing. Many of my clients have very severe symptoms, but because their conditions do not fit neatly into the criteria of the listings, their initial application is denied because the evaluators don’t believe that the medical evidence supports their complaints. When this happens, I reassure my clients that it does not mean that they don’t have a strong claim; it just means that we have to keep appealing until we get the chance to present our case to an Administrative Law Judge (ALJ). In my experience, a hearing in front of an ALJ is where we have the best chance at a favorable decision.
Your symptoms do not prevent you from performing all types of work. The Social Security Administration may also say you have the capacity to work a full time job despite your disabling condition. Another way to achieve success and receive the benefits you deserve is to show the SSA or ALJ that your Residual Function Capacity (RFC) is so reduced that you cannot work a full time job. There can be many reasons breast cancer and its treatment may render a person unable to work. The treatment itself, including chemotherapy and radiation, can leave a person with residuals such as fatigue and neuropathy that prevent them from working. Breast cancer surgery itself may leave a person with residuals such as scarring or weakness that prevent them from using their arms and hands in a repetitive manner, severely limiting the type of work available to them. The SSA must also consider your symptoms’ effects on your concentration, persistence, and working pace. Breast cancer, its treatment, and its residuals may simply leave you unable to complete an eight-hour work day.
In my practice I have represented individuals with breast cancer and have helped them receive the benefits they deserve. Unfortunately, in my line of work I see many people suffering from cancer, and I understand the major role it can play in a person’s family and work life. Applying for Social Security Disability may be in your best interest if you find yourself unable to work for any physical or mental condition that is severe in nature.
Filed under:Evaluation Process, Qualifying Disabilities and Impairments, Social Security Disability Benefits || Tagged under: cancer, disorders, impairments, Listings, time