Cancer, the No. 1 Killer in America

March 26, 2014 in

Many of you have loved ones who have been affected by cancer. Cancer hit close to home for me a very long time ago when my father was diagnosed with stage III colon cancer. Since that time, he has been diagnosed and treated for colon cancer, lung cancer, prostate cancer, and skin cancer. It wasn’t very long ago when it was unusual to know someone close to you who was suffering from some type of cancer. Nowadays, it seems to be more prevalent. In fact, the American Society of Clinical Oncology has reported that in 16 years cancer will become the leading cause of death in the United States, surpassing heart disease. The number of new cancer cases is expected to increase nearly 45% by 2030 from 1.6 million to 2.3 million cases annually. The United Nations has reported the disease causes 1 in 8 deaths worldwide. The most common cancer diagnoses are of the lung, breast, and colon.

There are certain things you can do to lower your risk of cancer. You can stay away from tobacco products, maintain a healthy weight, have regular physical activity, stay updated on your vaccinations and avoid unnecessary sun exposure.

Social Security Disability Benefits and Cancer

I don’t want to scare you; I want to show you that you have financial options if you suffer from cancer, so you can focus on your health.  If you are unfortunate enough to suffer from any form of cancer, you may qualify for Social Security disability (SSD) benefits. Depending on the type of cancer and the required treatment, you may find yourself unable to work. If that is the case, you should consider applying for disability benefits. One of the ways to show you qualify for disability benefits is through the Social Security Administration’s (SSA) impairment listings for cancer.

Because cancer has become more prevalent and ever-changing, The SSA has proposed changes to the regulations for evaluating a disability claim based on cancer. SSA is seeking to update the Malignant Neoplastic Diseases Listing (13.00) since they haven’t been revised since November 2009. These listings are one way SSA determines if someone is disabled because they contain the most common medical conditions, which are considered to be severe enough to meet disability standards. If you meet one of the noted listings you will be considered disabled and unable to work. Some of the proposed changes include how cancers are evaluated when treated, the definitions and names of specific types of cancers and how many of these cancers are treated.

Compassionate Allowance

If you are diagnosed with some type of cancer you may meet a compassionate allowance (CAL). This is a program offered by SSA in which they provide benefits relatively quickly to disability applicants whose medical conditions are so severe that it is clear they would qualify for disability under a Malignant Neoplastic Diseases Listing. There are several different types of cancers that would qualify your claim for this compassionate allowance treatment.

I recently had a 56-year old client diagnosed with stage IV lung cancer who we were, fortunately, able to help. She was expedited through the system because of the CAL program. She worked in the past as a cashier. Her health insurance was very limited, so it would not cover her recommended treatment. Because the claimant was diagnosed with lung cancer, we were able to have her case flagged as a CAL under “small cell lung cancer.” The benefit of having your case flagged as a CAL is that it will receive “special handling,” essentially meaning your case will be fast-tracked through the disability claims process. Once we notified SSA of the compassionate allowance, we were able to argue that the claimant met Listing 13.14 for lung cancer. To prove she met the definition of this listing and would therefore be found disabled and granted benefits,  we submitted her pathology report diagnosing cancer, and a narrative statement from the oncologist documenting the diagnosis and the treatment recommendations. When everything was said and done, our client has approved benefits one month after submitting the application, and we were even able to help her qualify for Medicare immediately! This was truly a life-saver for her.

I was also proud to help a 43-year-old client suffering from stage IV prostate cancer.

He was bedridden, paralyzed from the chest down. We submitted the application for benefits, asked to have the case classified as a CAL under prostate cancer and argued the claimant met listing 13.24 for prostate gland carcinoma. His case was approved within 2 weeks of application submission!

Both examples, while severe cases, show how the CAL program and the listings can work together to have your case approved faster than normal. Typically, a disability claim takes three to four months for the initial review. If you are denied, it can take up to two years before receiving a decision on your claim. If you suffer from late-stage cancer, you have a great chance of being approved for disability benefits quickly. It’s important you consult with a knowledgeable source to ensure your claim is flagged appropriately.

Having an attorney navigate the system for you relieves some financial pressure from your shoulders while you can focus on your health. If you have been diagnosed with any type of cancer, I urge you to seek help through the Social Security disability program as soon as possible. Call an experienced attorney who can help you get the benefits you need, which sometimes includes health insurance!