Undergoing treatment for brain cancer or a brain tumor may make it difficult for you to work, and therefore may leave you strapped financially. Social Security Disability (SSD) benefits can remove some of the stress by providing financial support during this difficult time.
Medically Qualifying for Benefits
To meet the eligibility requirements for SSD, you must prove through thorough medical records that you have:
- A definitive diagnosis,
- A condition that has prevented or will prevent you from working for a period of at least 12 months,
- And a condition that can either be matched with a Social Security Administration (SSA) listed condition,
- Or a condition that is so severe that it meets eligibility requirements without meeting or matching a listed condition.
Qualifying under the Compassionate Allowance Program
Some forms of brain cancer and other types of brain tumors qualify medically for disability benefits under the SSA’s Compassionate Allowances (CAL) program. CAL is an expedited review procedure designed to get you a decision on your eligibility for benefits more quickly.
Rather than waiting months for a decision, you will know if you can receive SSD benefits in just a few weeks under CAL. Even under the CAL program though, you must still provide the SSA with the appropriate medical records in order to receive benefits.
The most important piece of documentation that must be in your medical records is a pathology report from a biopsy or surgical specimen, but your records should also include:
- A thorough clinical history
- Treatments received
- Medications and other therapies used
- Extent and severity of your symptoms, including the effects of treatments
- All lab test, imaging, and other diagnostic test results
- A statement from your physician detailing the diagnosis, progression, and prognosis
For more information on the compassionate allowances program and a complete list of conditions that qualify visit: http://www.disability-benefits-help.org/compassionate-allowances
Qualifying for Benefits without Meeting CAL Guidelines
Even if your brain tumor or cancer is not qualified to be considered under the CAL program guidelines, you can still potentially qualify medically for SSD benefits under standard review practices. The SSA will evaluate your claim to see if it meets a listing in the Blue Book, which is a manual of disabling conditions and the evidence required for proving disability with each.
- Primary brain tumors, or those that start in the brain, are evaluated under the listing in Section 13.3 of the blue book: http://www.ssa.gov/disability/professionals/bluebook/13.00-NeoplasticDiseases-Malignant-Adult.htm#13_13
- Cancers that start elsewhere and spread to the brain are evaluated under the listing for the body system in which the cancer originated, though other listings for the neurological effects of the brain tumor(s) may also be consulted. You will find listings for various forms of cancer in Section 13.00 of the blue book: http://www.ssa.gov/disability/professionals/bluebook/13.00-NeoplasticDiseases-Malignant-Adult.htm
- Brain tumors that are not cancerous appear in the Blue Book under Section 11.05 and are evaluated under one of three listings, dependent upon what symptoms they cause:
- Section 11.02 – convulsive epilepsy
- Section 11.03 –non-convulsive epilepsy
- Section 11.04 – stroke
Applying for Benefits
It is important to understand that the SSA needs to see as many of your medical records as possible to determine how severe your symptoms are and the types of treatments you have undergone or will be undergoing.
It is also important to understand that there are two disability programs for which you may qualify and that in addition to qualifying medically, there are technical or financial eligibility rules as well:
- Social Security Disability Insurance (SSDI) – requires you have a work history and that you have paid into the SSD fund through Social Security taxes.
- Supplemental Security Income (SSI) – requires you have very limited income and other financial assets or resources available to you.
You can learn more about SSDI and SSI here: http://www.ssa.gov/disability/
Whether you qualify under the CAL program or your application is evaluated through the standard review processes, you can apply at the local SSA office or via the online application on the SSA’s website.
CAL applications are typically reviewed in just a few weeks. Non-CAL applications take four or more months on average to go through the initial review.
- If you are applying in person, you must make an appointment in advance and can do so by calling 1-800-772-1213.
- If applying online, your application can be completed at any time.
Either way, you should ensure your application is thorough and that you submit as many of your medical records as possible, either at the time you apply or shortly thereafter.
You must also ensure you respond to any requests for additional information or any appeal procedures within the allotted timeframe to make sure your application for benefits remains active.
CAL conditions are rarely denied, but standard applications may be. You can appeal if you are denied and having the assistance of a Social Security advocate or attorney can help.
Article by Ram Meyyappan
Social Security Disability Help