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What to Do After You Are Denied Social Security Benefits for Breast Cancer

You’ve had to cope with a lot of unexpected turns in the past few weeks. First, you couldn’t believe it when your doctor told you had cancer. Then, you couldn’t believe how hard it would be to convince your insurance company to pay for treatment. Now, you come home from a day of treatment at the Carol G. Simon Cancer Center to another unbelievable event: Social Security has denied your application for disability.

How Can Social Security Deny Disability Payments for Breast Cancer?

While the Social Security Administration (SSA) may accept your breast cancer diagnosis, they may not consider you sufficiently disabled to receive benefits. In order to qualify for disability payments, breast cancer patients must either meet the official disability listing for breast cancer or be able to show that their limitations due to the condition are too great to perform any regular work.

Under the SSA’s breast cancer disability listing, a patient must have one of the following to in order to qualify for disability benefits:

  • Inflammatory carcinoma
  • Tumor with direct extension to the chest wall or skin
  • Distant metastases (tumors that have spread to other locations)
  • Metastases to the supraclavicularor, infraclavicular, or ipsilateral internal mammary nodes
  • Metastaes in 10 or more axillary nodes
  • Recurrent carcinoma that is not controlled by treatment

For each of these qualifications, patients will have to provide medical evidence of their diagnosis and treatment plan to SSA. If you do not have one of the above, you may still qualify for benefits by proving that you cannot do any sustainable work at a level that pays your bills.

Getting Payments Based on Your Inability to Work

If your cancer is not advanced enough to qualify for benefits on its own, you may be able to prove to SSA that your work capacity has been significantly affected by your condition. For instance, chemotherapy and radiation treatments can cause a number of side effects that make it difficult to work, including pain, fatigue, nausea, headaches, depression, and memory loss. You may not be able to concentrate or think clearly, sit for long periods, walk without becoming tired easily, or be able to lift or carry objects over a certain weight limit.

Using your limitations, SSA will examine the level of work you are still able to do, called your residual functional capacity (RFC). Using this measurement, SSA will determine if you can perform your regular work, but also if you are able to do any work at all as you undergo treatment. If they believe you could still perform sedentary work that will pay your bills, your application may be denied.

The key to getting your Social Security disability application granted is medical evidence. Click the contact link on this page to find out what to include in your next application that can get your benefits approved.


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