Nearly one in eight women in the United States develops breast cancer.
It’s the second most common cancer, and it can occur in men. The Social Security Administration (SSA) doesn’t always make it easy for those with breast cancer to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve.
Many Social Security disability claims are denied because SSA says:
(1) Your breast cancer won’t prevent you from working at least 12 months because:
You should be able to return to work after treatment,
You should be able to return to work if your symptoms are in remission,
(2) Your breast cancer isn’t severe because:
Your breast cancer chemotherapy side effects are subjective, or
You are in remission.
(3) Your breast cancer doesn’t meet the requirements of, or is the equivalent of, a Medical Listing,
(4) You can return to the lightest job you held in the 15 years before you became disabled, or
(5) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
A diagnosis of breast cancer does not automatically mean you are entitled to Social Security Disability benefits.
It is the location of the cancer, the formation and development of the cancer, the prognosis, the response to treatment and treatment side effects that are key to winning your benefits.
I have successfully represented many SSA applicants with all types of cancer.
I’ll work to overcome the claims denial by working closely with you and your physician by showing that you:
Qualify for the Compassionate Allowances program,
Meet the requirements for a disability listing for breast cancer, or
Proving that your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.
She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
Cancer is an uncontrolled abnormal cell growth that damages a cell’s genetic material.
Each of the more than 100 types of cancer has its own symptoms, stages and treatment options.
A staging system is used to evaluate breast cancer based on the size of the tumor, whether the cancer is invasive or non-invasive, whether the breast cancer has spread, and whether lymph nodes are involved.
The treatment options depend on the type of cancer and the stage of the cancer.
These options can include chemotherapy, radiation therapy, hormone therapy, lumpectomy and mastectomy.
Each has its unique side effects that, alone, can be disabling.
The stages of breast cancer are:
Stage O is a non-invasive breast cancer that has not spread.
Ductal carcinoma in situ is a Stage 0 cancer.
Stage 1 is marked by cancerous cells that invade normal neighboring tissue and can be up to 2 cm large. No lymph node involvement.
Stage 2 is invasive, with two subcategories.
2A can range from no tumor but cancerous cells in the lymph nodes under the arms, to a tumor 2 cm or less that has spread to the lymph nodes under the arms, or the tumor is between 2 and 5 cm but has not spread.
2B involves a tumor 5 cm or greater with no lymph nodes under the arms, or the tumor is 2 to 5 cm and has spread to the lymph nodes.
Stage 3 has 3 subcategories.
3A is diagnosed when the cancer is located in the underarm lymph nodes with clumping, the cancer has spread to the lymph nodes near the breast bone, the size of the tumor is more than 5 cm, or less than 5 cm and the cancer has spread to the axillary lymph nodes with clumping.
3B involves any-sized tumor that has spread to the chest wall, breast skin, or both, and the cancer may have spread to the axillary lymph nodes with clumping, or the cancer has spread to the lymph nodes near the breastbone.
3C involves any-sized tumor that has spread to the chest wall, breast skin, or both, and the cancer may have spread to the lymph nodes above and below the collarbone, and the cancer has spread to the lymph nodes in the underarm or near the breastbone.
Stage 4 is diagnosed when the cancer has spread to other organs, including the brain, bones, lungs or liver.
The common symptoms of breast cancer can include:
A change in how the breast or nipple feels,
A change in the appearance of the breast or nipple,
A nipple discharge.
Surgery, chemotherapy or targeted drugs used to treat breast cancer can cause disabling symptoms.
These symptoms can include:
Nausea
Fatigue
Pain
Dizziness
Chemo brain
Tingling and numbness in the fingers and toes
Bowel problems
Anxiety
Depression.
The Compassionate Allowances Program and Cancer
Breast cancer that involves distant metastases, is inoperable or unresectable or has been staged as Stage 4 qualifies for the Compassionate Allowances program.
If you qualify, your claim for Social Security disability benefits should be approved in a matter of weeks.
If you qualify for SSDI, before you can collect your benefits, there is a five-month waiting period after the onset of your disability.
If you qualify for SSI, your SSI benefits will be paid immediately.
When Your Breast cancer Meets A Listing
If you don’t qualify for a compassionate allowance, breast cancer is included under Listing 13. 10 of the SSA’s “Listing of Impairments.”
If you meet or have the equivalent of a Listing, your Social Security disability benefits will be awarded at Step 3 of the Five-Step Sequential Evaluation.
Your medical records must establish that you meet every element of the listing for your cancer to be considered disabling.
The breast cancer listing requires one of the following:
Inflammatory carcinoma,
A tumor with a direct extension to the chest wall or skin,
Distant metastases,
Metastases to the supraclavicular or infraclavicular nodes,
Metastases to 10 or more axillary nodes,
Metastases to the ipsilateral internal mammary nodes, or
Recurrent carcinoma.
If you don’t meet or equal a listing, then SSA will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.
When Your Breast Cancer Makes It Impossible to Work
If your cancer doesn’t meet a listing, you will have to prove that you:
Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity.
Your RFC is what you can do despite your breast cancer.
Residual Functional Capacity For Breast Cancer
The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial.
The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work.
SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that explain:
How far you can walk,
How long you can stand and sit at one time and for an eight-hour work day,
How much and how often you can lift, stoop, squat, bend during an eight-hour work day,
How your pain, fatigue, headaches or chemo fog impacts your physical activity and cognitive abilities,
Whether you need to take frequent breaks and how long those breaks must last,
Whether you have swelling known as lymphedema and how it impacts the use of your arms,
Whether side effects of treatment affect your ability to use your hands or feet,
Whether you have good days and bad days and how many days per month you would miss from work, and
Whether you have psychological problems, including depression, mood swings or anxiety, that would interfere with your ability to work.
This is not an exhaustive list of all of the questions on a breast cancer RFC form. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form.
That is one of the many reasons you should have an experienced Social Security attorney, such as myself, to represent you in your claim.
How Your Residual Functional Capacity Is Used At A Social Security Hearing if You
Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing.
The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
Whether you can return to the lightest job you held in the last 15 years,
Whether there is other work you can do or could learn to do.
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
How Do I Get The Social Security Disability Benefits I Deserve? For Breast Cancer
Breast cancer and the side effects of treatment can interfere not only with your daily activities but with your ability to work.
If you no longer can work or your doctor has told you to apply for Social Security disability, you should hire me to help you:
I will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.
The SSA is in the business of denying claims and will use any reason to deny your benefits.
The odds of getting your Social Security benefits are greater when you are represented by an experienced Social Security Disability attorney, such as myself.
Contact Social Security Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live in Florida
Breast cancer can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits for cancer. Call today for a free consultation at 727-894-3188.
