Breast cancer its treatments can prevent you from maintaining employment. It may put you out of work for a few weeks, or indefinitely. When your illness is likely to prevent you from working for a year or longer, you can potentially qualify for Social Security disability benefits. Disability benefits can be the financial support you need to get by without employment income.
Social Security Disability Benefit Programs Available
Disability benefits from the Social Security Administration come in two forms. Qualifying medically is the same for both, but each will have its own technical requirements.
- Social Security Disability Insurance (SSDI) – which is for disabled workers who have paid Social Security taxes over their employment history and who have accumulated between 20 and 40 work credits, depending on the age in which you apply. A work credit is a metric that represents how much you actually paid in taxes. Most workers earn the maximum of four work credits per year, so your employment history must typically range from five to ten years to qualify. SSDI recipients in Texas will receive Medicare 24 months after their cancer started.
- Supplemental Security Income (SSI) – which is a support program available to low-income individuals of all ages, including disabled children and adults as well as the elderly. This program has strict income and financial asset limits, but there are no work history requirements to qualify. SSI recipients in Texas will automatically be enrolled in Medicaid.
Meeting the program requirements for SSI and/or SSDI additionally requires you either:
- meet a Blue Book listed condition
OR
- qualify through a residual functional capacity (RFC) analysis.
These options are the medical eligibility portion of qualifying for SSD benefits.
Medical Eligibility and Breast Cancer
Breast cancer is among the Social Security Administration (SSA’s) listed disabilities, though usually only those with advanced breast cancer meet the Blue Book specifications. The Blue Book is the SSA’s manual of impairments and is used by disability examiners when they review benefit applications.
The breast cancer listing appears in Section 13.10 of the Blue Book. This listing requires advanced cancer that has spread beyond regional lymph nodes. To meet the listing, your cancer must be:
- An inflammatory carcinoma with adhesions to the skin, chest wall, or mammary gland internal nodes
OR
- A carcinoma that has spread, with tumors present in axillary as well as regional lymph nodes, including infraclavicular (below your clavicle) or supraclavicular (above the clavicle) lymph nodes
OR
- A carcinoma and has returned after initial treatment and is no longer responding to available therapies
Early Stage Breast Cancer and Disability Benefits
Breast cancer in its early stages does not meet the SSA’s Blue Book requirements, but you may still be able to qualify for benefits. The SSA must look at your “activities of daily living” or ADLs and decide if your illness and required treatments make it impossible for you to work for 12 months or longer. This process is known as a residual functional capacity (RFC) analysis. Activities of daily living include your ability to sit, stand, walk, or do other household activities like cooking or cleaning.
Severe reactions to chemotherapy and radiation may cause significant daily limitations and make it impossible for you to complete everyday tasks in your personal life. These same reactions can certainly prevent you from returning to work. If you are so impaired by your cancer and treatments that you cannot work, then you may be granted benefits through an RFC analysis.
Compassionate Allowance and Metastatic Breast Cancer
While the SSA’s Blue Book listing requires particular medical evidence for documenting breast cancer with metastases, it is also important to note that the SSA understands the debilitating nature of advanced breast cancer. As such, metastatic breast cancer is among the medical conditions that qualify for expedited review under the SSA’s Compassionate Allowance (CAL) program.
If you have advanced breast cancer and submit an application for benefits, your application is flagged and pushed through the review process quickly. The CAL program also minimized the medical evidence requirements in order to get your medical approval for benefits as fast as possible. You can be approved in as little as 10 days if your breast cancer has metastasized.
Applying for Benefits
The SSI and SSDI programs have separate applications. The SSDI application can be filled out online, but if you’re applying for SSI, you must participate in a personal interview with an SSA representative. SSI interviews are typically conducted at the local office. SSDI applications can be completed at the local office as well, if you choose.
Here are just a few of the SSA branch offices in Texas at which you can submit your SSI or SSDI application:
- Abilene – 1202 E. South 11th St., Abilene, TX 79602
- Austin – 1029 Camino La Costa, Austin, TX 78752
- Dallas – 2530 S. Malcolm X Blvd., Dallas, TX 75226
- Houston – 16200 Dillard Dr., Houston, TX 77040
- Lubbock – 5826 16th St., Lubbock, TX 79416
- Fort Worth – 819 Taylor St., Fort Worth, TX 76102
- Odessa – 2015 E. 37th St., Odessa, TX 79762
- San Antonio – 3438 E. Southcross, San Antonio, TX 78223
Deanna Power
Community Outreach Manager
Social Security Disability Help
857-366-7629