Can I get SSDI for brain cancer?

Recently on our legal forum a user asked, “I have inoperable brain cancer. I know I won’t be able to work much longer. What do I need to know about applying and winning Social Security Disability Insurance benefits (SSDI)? I have heard that a most claimants are denied benefits, even those who are severely injured. What is the key to winning the first time that you apply?”

SSDI overview

Social Security Disability Insurance is awarded to claimants who have a severe health condition which is expected to last at least 12 continuous months or end in their death. Claimants must also have sufficient work credits to be insured for benefits and meet other nonmedical requirements. Claimants who are working too much or making too much money when they apply for SSDI will be denied benefits regardless of the severity of their health condition.

Brain cancer and SSDI benefits

Assuming your cancer is inoperable, you have tried various treatments, or it has metastasized to other locations in your body, there’s a good chance that you will eventually qualify for SSDI benefits.

Although this may not apply to you, others might also qualify benefits if they have a brain tumor and it is removed, but they are out of work for at least a year, even if the brain cancer does not reappear. Benefits awarded in this case are called closed period benefits. They will not be ongoing but rather just offered for the months of missed work.

How do I qualify for benefits?

Qualifying for SSDI benefits can be done by meeting or equaling a listing in the SSA Listing of Impairments. For example, claimants who have cancer may qualify under the appropriate cancer listing (i.e. lungs, colon, kidney, prostate and ovaries) in the SSA Listing of Impairments if they meet the nonmedical requirements for SSDI and their medical doctor has confirmed that they have a tumor that either cannot be treated with surgery, chemotherapy, or radiation, or a tumor which is treated or removed then reappears or is “recurrent.”

If a claimant’s condition does not meet a listing, they may still receive benefits but they will have to prove their cancer and corresponding symptoms are so severe they cannot work – a process referred to as a medical vocational allowance.

What evidence do I need to provide for my brain cancer?

Qualifying for benefits will require you to provide evidence and medical documentation to the SSA. Evidence must include a diagnosis, biopsy report, surgical information, copy of the x-ray, MRI, or CT scan.

Treatment information should also be provided, as well as information about the debilitating effects of the treatment. For example, if you have undergone surgery and you take medications or you receive radiation or chemotherapy it’s likely the side-effects could be so severe that you may not be able to work. For instance, common side-effects of chemotherapy can include nausea, vomiting, diarrhea, fatigue, weakness, and skin irritation.

Why are some claimants denied?

Seriously ill claimants are often surprised to find that their SSDI claim is denied. Denials may occur for a variety of reasons. For example, the Social Security Administration may believe the claimant is seriously ill, but still deny their case because the claimant does not meet the nonmedical requirements to qualify for SSDI benefits.

Denials may also occur if the claimant is working too much when they apply. You mentioned you are currently working. Working too much and making too much money is one of the most common reasons claimants are denied benefits. In fact, if you are making more than $1170 (for the non-blind in 2017) per month the SSA will consider you not disabled. Does this mean you have to stop working to be approved fort SSDI? Not necessarily, but even part-time work can jeopardize your chances of winning SSDI.

Earning work credits for SSDI benefits

Another reason your claim may be denied if you have brain cancer and you have stopped working is that you may lack sufficient work credits to be considered insured. You did not mention how long you have been working, but if you have not worked and paid enough taxes you will not have work credits for SSDI and you will not be insured for benefits.

To find out your insured status prior to applying for SSDI benefits you can contact the SSA at 1-800-772-1213. Review your work credits and ensure you are insured BEFORE you apply. Lacking work credits is an automatic denial.

Bottom line:

Claimants with brain cancer that is inoperable can generally qualify for SSDI benefits, but they will have to quit working and have sufficient work credits to be insured for SSDI benefits. Before you apply for SSDI, contact the SSA, verify your insured status, and make sure your medical evidence is complete.