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Is Medulloblastoma a Condition Which Automatically Qualifies for Disability?

A medulloblastoma is a form of brain cancer. The cancerous tumor forms in the lower part of the brain called the cerebellum, which controls muscle coordination, balance and movement. Medulloblastoma is a fairly common brain tumor, typically found in children. The cause of the tumor is unknown but has been linked to genetics. While this form of cancer is typically found in children, it can also be found in adults, usually in their younger years.

The typical symptoms associated with this cancer include:

  • balance difficulties
  • cognitive decline
  • dizziness
  • blurry vision
  • fatigue
  • headaches
  • nausea
  • hearing loss

Depending upon the severity of the tumor, your doctor may recommend different treatments such as brain surgery, radiation therapy or chemotherapy. All three treatment options leave the individual exposed to potential lifelong issues.

Social Security’s Compassionate Allowance

Having a cancerous tumor in your cerebellum is considered quite severe and frankly life-threatening if left untreated. Because of the symptoms related to this type of tumor along with the potential side effects from treatment, social security has included this condition on its compassionate allowance list. A condition that is designated as a compassionate allowance is one in which the social security administration believes to be so disabling that as long as there is certain medical proof supporting the condition, you will automatically be found disabled. Medulloblastoma is found to be one of those conditions.

To be found disabled under this compassionate allowance, you must have diagnostic testing diagnosing medulloblastoma made by imaging, spinal tap, or an analysis of the tumor after surgical resection. In addition to diagnostic testing, you would need to show physical findings related to the tumor such as headaches, nausea, problems with motor skills, fatigue, head tilting, double vision, facial weakness, tinnitus, neck pain or inability to control the bladder.

Social Security’s Listings

If your imaging or physical findings are insufficient to qualify as a compassionate allowance, social security may also review your condition for a possible Listing. The Listings are similar to a compassionate allowance in that both involve lists of severe medical conditions that would automatically qualify you for disability benefits. Compassionate allowance conditions tend to be more life-threatening and irreversible whereas Listed conditions do not always have the same urgency to them. In terms of medulloblastoma, social security will review Listing 13.13 to see if your condition meets this specific listing.

Listing 13.13 reviews cancers involving the nervous system, including the brain and spinal cord. You may be found disabled either under the A or B criteria:

  • The A criteria requires proof of a primary central nervous system cancer that is either a glioblastoma multiforme, any grade III or Grade IV cancer including medulloblastoma, or any cancer that is metastatic, progressive or recurrent following initial anticancer therapy.
  • The B criteria require proof of a peripheral nerve cancer that is metastatic or progressive following therapy. Both criteria require the cancer be metastatic or recurrent.

If your medulloblastoma is treatable or in remission, you likely will not automatically qualify for disability benefits. This does not mean you are not disabled. It simply means you will not automatically be found disabled using a compassionate allowance or a Listing.

If this is the case, you may also be found disabled by showing either the tumor itself or the effects of treatment have caused significant limitations, such that you are unable to work in any capacity. After reviewing your case for a compassionate allowance or a listing, the social security administration will then determine what residual functional capacity you have.

Residual Functional Capacity

Your residual functional capacity is the most you are functionally capable of doing, in spite of your limitations. It is important to note that the regulations look at the most you are capable of doing, not what the average is. This factor alone makes proving you are disabled quite difficult. Especially if you struggle with good and bad days during the week, where you have a couple of good days followed by a few bad days. Social security will see those good days and use those to determine your functional capacity.

When determining your residual functional capacity, social security will take the following into consideration:

  1. First review your medical records for diagnosis, limitations and treatment recommendations. It is important your medical provider documents all of your limitations. If those limitations are not documented, social security will not use them in determining your limitations. It is also important your medical provider does not simply cut and paste your treatment notes. This is something common in the medical profession. Rather than update the treatment notes after every visit, they will simply copy and paste the notes from your initial visit and then just add at the end any changes in your treatment plan. This does not help if at your initial visit with the provider you were having a “good” day. If that is the case, then your treatment notes, no matter how extensive, will all portray minimal limitations, even if the treatment plan is more extreme. This will call into question the severity of your conditions and residual functional capacity.
  2. A statement from your medical professional is helpful for the social security administration when determining your residual functional capacity. Oftentimes a statement from your doctor about your limitations will provide the best evidence for your disability claim. Specifically, with medulloblastoma, it would be important for your medical provider to note coordination and balance difficulties along with comprehension or cognitive decline.
  3. Once your residual functional capacity is assessed, social security will then determine how that impacts your ability to work. They will first assess your ability to perform any work you have done in the past fifteen years. If your functional abilities preclude performance of your past work, social security will then look to see if there is any other work available in the national economy which can be performed in spite of your functional limitations. If no work is found, you will then be deemed disabled.

There are several avenues in which you may be found disabled from medulloblastoma. Depending upon the severity of your diagnosis, you may qualify for a compassionate allowance or a listing. If your condition does not meet a compassionate allowance or listed condition, your functional capabilities will then be reviewed to determine if your limitations are work preclusive. Whatever the severity of your condition, if you have found yourself unable to work due to the symptoms of medulloblastoma, you should consider applying for disability benefits.

LaBovick Law Group Can Help Win Your Claim

At the LaBovick Law Group, we are experienced in winning these types of claims. We also do not charge upfront costs. We only get paid if we are able to win your claim. Call us today for a free consultation at (561) 623-3681.

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