When faced with a diagnosis of metastatic breast cancer a large number of people wonder how they will be able to support themselves if they are unable to work and going through treatment. Most individuals, if they have been having Social Security payments deducted from their check, which includes almost all workers, have an option that they do not realize.
Part of the Social Security deduction is for disability if you have an impairment that is expected to last 12 months or result in death. You even have the ability to apply for benefits for your dependents (usually children) who are under the age of 19 and a full time student up through high school. If your monthly benefit amount is $1000 per month your dependents can receive up to ½ of that amount or $500 per month. If you have one child they get the full $500. If you have more than one, it can be split equally among all of your dependents. (i.e. two children each is entitled to $250).
The best way to determine how much of your estimated monthly benefit will be is to go to SSA.gov and request that you be sent an estimate. Make sure you go to the official site. The information is free and the website is surprisingly easy to navigate. They have a wide array of online services including the ability to apply for disability.
This discussion is only going to apply to those individuals whose breast cancer meets the level of severity described in the Listing of Impairments (see next paragraph for relevant listing). Social Security has developed a Listing of Impairment that, if they apply to your condition, should result in an automatic approval of your claim. You may also be entitled to disability benefits if your condition or side effects of your treatment so limit your capacity to engage in work related activity that you cannot engage in substantial gainful activity. Examples of this would be side effects of chemo or radiation therapy or lymphedema that impairs the use of one or both of your upper extremities. My wife would get violently ill from one particular chemo therapy for several days that she would call the “red devil” and she would get fatigued easily while she was undergoing radiation treatment. An inability to use your upper extremities for certain types of activities, fine work or holding objects, might limit your ability to do any vocation on a sustained basis for 8 hours a day, 5 days a week and result in your being given a vocational allowance but the nuances of that type of decision would take far more space and time and be too confusing to cover in this limited discussion. Suffice it to say that most individuals with Stage III or IV Breast Cancer will probably meet the Listing of Impairments.
The Listing of Impairment for Breast Cancer is found in DI 34001.034 – Malignant Neoplastic Diseases 13.10 which says:
A. Locally advance carcinoma (inflammatory carcinoma, tumor of any size with direct extension to the chest wall or skin, tumor of any size with metastases to the ipsilateral internal mammary nodes). OR
B. Carcinoma with metastases to the supraclavicular or infraclavicular nodes, to 10 or more axillary nodes, or with distant metastases. OR
C. Recurrent carcinoma, except local recurrence that remits with antineoplastic therapy.
You are probably are ready at this point to have it explained in plain English. At this point in your medical treatment you have probably discovered that doctors seldom speak in plain English and at this stage of your life you are probably aware that the government seldom does either. I will try to translate a little for you to make it easier.
For most conditions involved with breast cancer you are probably already keeping a folder with copies of your operative notes and pathology reports. You are going to need copies of these for Social Security. If you have tests that document the metastases such as ultrasound, MRI, CAT scan, needle or incisional biopsy keep and send copies of those tests as well. Your physicians statement that the cancer is inoperable and the reason why is also important if that is the case.
Breast Cancer is also an impairment that qualifies as a CAL (Compassionate Allowance) for fast track processing. The more information you can submit with your original disability filing (send copies, never your only copy) the sooner you can expect a decision.
Nothing is perfect and you will find some people who work for Social Security who do not know what a Compassionate Allowance case is. They will not even realize that your evidence shows you meet a Listing Impairment. If you run into such an individual ask to speak to their supervisor and get a name and number before you are transferred. Ninety-nine (99%) of the people who work for Social Security disability are competent, compassionate and will help you in any way they can.
One of the benefits of going onto Social Security disability is that after you have been disabled for 29 months (5 month waiting period and 24 months of monthly benefits) you qualify for Medicare. You will receive notice automatically from SSA a few months before you qualify explaining the cost and provisions.
This is an overview of what you can expect in dealing with Social Security and is not intended to be nor can it be an answer to questions about your individual situation or claim. I will tell you that I have been doing Social Security disability work since I was 21 years old and I am now 66. I have been an initial claims adjudicator, a reconsideration and continuing disability examiner, a supervisor, a vocational expert, an attorney representing individuals before Administrative Law Judges and federal courts and am not foolish enough to think that I know it all. I recently lost my wife to metastatic breast cancer and was looking for a way to help give back something to the people going through the same journey the best way I know how. This is a volunteer effort which I hope will help those of you who are wrestling with enough without having to deal with a new and unfamiliar bureaucracy. I will be happy to answer whatever questions I can though this site if you care to submit them. There are no stupid questions, only stupid answers. Do not be afraid to ask them. I will also, if I see a developing trend of questions, try to add more in depth information on specific issues and topics as time permits.
