CANCER AND DISABILITY BENEFITS

There are many forms and stages of cancer.  Depending on the type and stage of cancer, it very often qualifies for Social Security disability.

Cancer is usually considered disabling and eligible for benefits when

1.  it has spread beyond the regional lymph notes, or
2.  it has been treated and has recurred, or
3.  it has required a stem cell or organ transplant, or
4.  it's symptoms or treatment results in the inability to sustain basic work-related functions on an ongoing basis (8 hours per day, 5 days per week).

There is a Duration Requirement which says that a medical condition must have lasted at least 12 straight months, be medically expected to last at least 12 straight months or to result in death.  Most forms of cancer will meet the duration requirement but some may not.

Your doctor and medical team will provide specific information to help determine if you qualify for benefits.

What you, the claimant, can do to speed up your benefits:

A.  Notify Social Security on your application that you have cancer.  Be specific as to the location, type and stage of cancer.  Special attention is paid to claims involving cancer.

B.  Get a record of pathology from your doctor and send it to Social Security as soon as possible.  This may be a laboratory test or biopsy report showing a cancer diagnosis., giving the location of the cancer.

C.  Provide Social Security with the name, full address and telephone numbers of all the doctors who treat you.

D.  Ask your doctor to provide a written statement which details your specific functional limitations.  This will state, for example, what your limits are on sitting, standing, walking, reaching, lifting, bending, etc.  If you are likely to miss several days a month for chemotherapy or treatment, the doctor should explain this, also.

The more details you are able to furnish Social Security, the more likely you are to get a quick and favorable decision on your benefits.

Please remember that SSDI (the normal Social Security disability program) does not pay for the first 5 months of disability because of the waiting period.  However, if you have already been out of work several months before you file your application for disability, claim those months to reduce the time you must wait.  For example, if you file on 2/20/20 but became too ill to work on 10/20/19, you have potentially already met 3 months of the waiting period.

Don't be hesitant to ask for help with your claim. Any experienced advocate or attorney will be glad to assist you in getting the quickest possible resolution to your disability claim.  It's a complicated process for anyone, and especially so for a patient undergoing cancer treatment.

A SUPPORTIVE DOCTOR HELPS YOU SSDI CLAIM

Perhaps the strongest ally you can have when filing for Social Security disability is a supportive doctor.

Social Security will need 2 things from your doctor:

1.  Your complete medical records.
2.  An opinion of your functional limitations (called a Residual Functional Capacity statement).

Just like any other legal case, Social Security disability must be proven.  This proof always rests in your doctor's office.

If you are considering filing for disability, I urge you to talk to your doctor.  His or her support can be instrumental.

The truth is, Social Security denies about 75 percent of all disability applications at first.  Those denials require an appeal process in order to be approved.  

If we handle your SSDI case, we will obtain the necessary medical records for you.  We will also request a Residual Functional Capacity opinion from your doctor.  This detailed form is a lot of work for your doctor.  But it can form the absolute best piece of evidence to help prove your case.

Let me say something about the term "your doctor."  This refers to a qualified medical doctor who has treated you over a period of time and has an established professional relationship with you.  This is not a new doctor you see just to get forms filled out for disability.  The longer you have been treated by this doctor, the more weight is likely to be given to paperwork he or she provides.  Also, the term doctor refers to a licensed physician--either a Doctor of Medicine (MD) or Doctor of Osteopath (OD).  A podiatrist can provide evidence about foot or ankle disorders.  An optometrist can provide records concerning vision.  A licensed psychologist (Psy.D. or Ph.D.) can explain mental or psychological disorders.  A psychiatrist, of course, is an MD or DO. 

If your doctor is not supportive, it may be that you will have difficulty getting Social Security disability benefits.

Of course, doctors cannot approve you or sign you up for disability benefits.  But they can provide important evidence.

THE BIGGEST KILLER OF SOCIAL SECURITY DISABILITY CLAIMS

Here is the most dangerous and biggest killer of Social Security disability claims:


Failure to file an appeal within 60 days of denial.

This thief stalks every single Social Security disability claimant.

The law allows you 60 days to file an appeal and have an unfavorable decision reconsidered.  But only 60 days.  Wait longer and the door to the appeal process closes and you cannot reopen it.

It's important to realize that about one-half of Social Security denials are mistakes.  Mistakes get corrected in the appeal process.  But if your case never goes to appeal, the mistake is never corrected and you never get benefits.

The most important thing you can do if you get denied is to file an appeal within the 60 day time limit.

MOST COMMON DISABILITIES

The top 5 impairments for which SSDI benefits are awarded are:

1. Musculoskeletal system and connective tissue disorders: 30.5 percent of SSDI beneficiaries. Includes osteoarthritis, fibromyalgia, spinal cord injury, carpal tunnel, degenerative disc disease, amputations and more.
2. Mood disorders: (14.9 percent): Includes bipolar disorder, depression and more.
3. Nervous system and sense organs (9:3 percent). Includes stroke, Meniere’s disease and more.
4. Circulatory system (8.3 percent): Includes coronary artery disease, peripheral vascular disease and more.
5. Schizophrenia and other psychotic disorders(4.8 percent):.

Does a diagnosis for one of the above disorders automatically qualify for disability benefits?

No.  Social Security will look at severity, duration and functional restrictions of each disease or injury.

Severity:  The impairment must be severe.

Duration: Social Security must believe that the impairment has lasted or will last at least 12 straight months or result in death.

Physical Functional Restrictions:  The impairment must be shown to significantly reduce the ability to perform basic work functions (such as sitting, standing, walking, lifting/carrying, pushing/pulling, reaching, etc.).

Psychological Functional Restrictions must reduce functions such as the ability to understand, remember and carrying out instructions; appropriately relate to others, complete work in a timely manner, etc.

Claims are evaluated using medical evidence from the claimant's doctors and other providers. 

About 75 percent of applicants are initially denied and will require one or two appeals to be approved.  Most claims are approved in the appeals process, not in the initial application process.

Have you been denied with the past 60 days?  File an immediate appeal.

HOW WE CAN HELP YOU GET SSDI BENEFITS

How can we help you get Social Security disability benefits?

As experienced and successful disability representatives, we advocate for you.  We start by building your case, then effectively presenting it to decision makers at the Social Security Administration--and if need be, to appeals.

1.  We meet with you to get the facts of your situation.

2.  We obtain objective medical evidence.

3.  We attempt to get doctor's opinions to support the case.

4.  We analyze the case to develop a legal theory:  how does the law support the fact that you are entitled to benefits?

5.  If you are denied, we prepare for a hearing with an administrative law judge and appear with you to present the case.

6.  We stay with you until your case is resolved.

How do we get paid?  When your case is approved, the Social Security Administration will approve our fee, which is based on a percentage of the back pay you receive.  This fee will be deducted and paid to us directly by Social Security.  If you are not approved, we do not charge any fees for the services we have provided. 

STILL WORKING BUT NEED DISABILITY

We get calls frequently from individuals who are still trying to work but want to apply for disability benefits.  In most cases, this is just impossible.

The first step in the disability screening process eliminates persons who are working at substantial gainful activity.  That's defined as working and earning at least $1,260 per month before deductions.  

If an individual earns at least $1,260 per month from a job or from self employment, the application is denied right off the bat. (This amount is for non-blind individuals). Social Security won't even look at whether the applicant is disabled if they are earning this amount.  There is substantial work, so the claim is automatically denied on technical reasons.

It doesn't matter why you are working.  It only matters that you are.  

This rule forces a person to either quit work before filing for disability--or at least to reduce earnings to below $1,260 per month.

Are there any exceptions to this?  Not for most claimants.  If an individual is legally blind, the test for substantial gainful activity is $2,110 per month.  So, a claimant who meets the regulations for blindness is able to earn a higher income from work and still be considered for disability.

REPRESENTING YOURSELF IN DISABILITY CASES

I've seen very intelligent, very organized individuals represent themselves in disability cases.  They do an inordinate amount of work, make perfectly logical arguments, and they lose their case.

Let me explain, using a "what if" story:

Suppose you have become disabled and filed an SSDI claim which is then denied.  I come to you and say:

 "I want to represent you.  I have never handled a disability claim before.  I don't know the first thing about Social Security law, and yours will be my first case.  Your hearing will also be my first one. I'm going to figure this out as I go along. I would like to practice on you as my very first case. I'm intelligent and well organized.  How about letting me represent you?"

What would your answer be?  I think you would rightly say, "No, thank you.  There's too much riding on this."

Yet, this is exactly what you get when you represent yourself.  

Social Security disability is one of the most complicated processes that you will ever deal with.  It's based on a certain set of laws, rules and burdens of proof.  It is certainly not for the beginner.  Do you really want a beginner handling your case?  If not, is it wise to represent yourself.

I think most people who choose to represent themselves feel that they might save a few thousand dollars.  It's true, of course, they might.  But if they lose, there is no way to come back and do it over.  When the judge has ruled, the decision is made.  You may appeal, but your odds at the appeal are less than half as good as they were at the hearing.  

The advice to get counsel may seem self serving.  However, my firm has all the work it can handle and I often refer prospective clients to other firms in the area.  My sincere advice is, "If you don't hire us, hire someone else to help you with this."

Look at your own resume, then decide if it's wise to hire yourself to represent your disability claim.