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The SSA in evaluating disability claims based on cancer requires documentation based upon the medical records of the patient. The SSA uses the following general evaluations rules. When a malignant tumor is a local lesion that has spread into regional lymph nodes and all of the cancer has been surgically removed the SSA assumes that the cancer will not return immediately and will not award disability benefits. However there are a number of exceptions to this general rule.
In a case where there has been a recurrence of cancer either locally or in the region after radical surgery or after a pathology report shows that despite the radical surgery that cancer remains in the area, the SSA can determine that the cancer is inoperable under its guidelines and pay disability benefits if the patient meets the other listing requirements. When a malignant tumor has spread beyond the regional lymph nodes, this cancer will normally be considered to meet the requirements of a specific listing for a cancer associated with the original location of the tumor. .
The SSA will also consider any side effects from cancer therapy such as chemotherapy, radiation or surgery which can be very hard on the patient. The SSA will consider the type of therapy undergone, the drugs given, the dosage of the drugs, frequency of the drug usage and future plans for chemotherapy. The SSA is also required to consider any side effect from the therapy such as nausea, vomiting, diarrhea, weakness, dermatological disorders or reactive mental disorders such as depression.
In general a patient meets the SSA standards for a disability claim based upon cancer when it is determined that the malignancy is inoperable or beyond control of any other forms of therapy. It is possible for disability benefits to be granted for a period prior to the determination that the cancer is inoperable if the patient’s physician bases his opinion on the patient’s medically reported symptoms, the type of specific malignancy, its location and the extent of the involvement of the tumor when it is first diagnosed.
When a patient has been cancer free without a recurrence for three years that the patient is deemed no longer disabled. This rule primarily effects patients who have been awarded disability benefits based upon cancer when the SSA makes a routine review of their disability claim to determine if they should still receive disability benefits.
Cancer is difficult enough for a family to face. The financial burdens can be eased to some extent by the successful pursuit of a Social Security Disability claim.
Note: Since Social Security Disability is directed under Federal law, the information in this column will apply anywhere in the United States. However each Office of Hearings and Appeals and District Office have their own ways of doing things as does the various Federal District and Circuit Courts. This column primarily deals with the mechanics of how the Social Security District Offices and Office of Hearings and Appeals evaluates disability claims.
Disclaimer: These pages are created to inform and educate the public only. They are not and should not be considered legal opinions or advice.