A Guide to Disability Benefits for Breast Cancer

Table of Contents

Breast cancer is one of the most common forms of cancer in the US. According to breastcancer.org, 1 in 8 women in the US will develop breast cancer at some point in their lifetime.

If you or a loved one has been diagnosed with breast cancer, there could be help available for you. The Social Security Administration offers disability benefits for those with breast cancer who are no longer able to work due to their disability.

How to Apply for Breast Cancer Disability Benefits

1. Meet Disability Criteria

Whenever the SSA receives an application for benefits, it evaluates the condition and symptoms based on their own guide. This guide, known as the Blue Book. The Blue Book lists hundreds of disabilities that could potentially qualify for benefits, along with the medical test results or symptoms that are necessary to be approved.

You can find the requirements to be eligible for breast cancer benefits listed along with other cancers in Section 13.00 of the Blue Book—Malignant Neoplastic Diseases. To medically qualify, you must provide detailed medical documentation proving that your cancer significantly limits your ability to perform substantial gainful activity (SGA), meaning you cannot already earn more than $1,550 a month due to your condition. This includes records of diagnostic tests, treatments, and the progression of the disease.

Additionally, you need to prove that you have not worked in the last 12 months and meet work credit requirements for Social Security Disability Insurance (SSDI), which are based on your age and work history. Typically, you must have earned the required amount of work credits, with at least half of them earned in the last ten years before your disability began. 

It’s crucial to record your symptoms and troubles with activities of daily living thoroughly, as this information can help display the severity of your condition and its impact on your ability to work. Keeping detailed logs of your symptoms, treatments, and how cancer affects your everyday activities can strengthen your application and increase your chances of approval.

2. Collect Medical Records & Documentation

Collecting medical records and other essential documents is a crucial step in applying for disability benefits. 

You should gather comprehensive medical evidence including: 

  • Physician notes
  • Psychiatric evaluations
  • Hospital records
  • Lab results
  • Imaging studies
  • Documentation of prescribed medications and therapies

Additionally, obtain statements from your doctors detailing how your condition limits your ability to work. 

Employment records such as recent pay stubs, W-2 forms, and a detailed work history, along with financial documents like bank statements and proof of other income, are also necessary. Collecting all possible evidence is important to increase your chances of approval. 

Working with a disability lawyer can simplify this process, as they are experienced in knowing exactly what documentation to collect and how to present it most effectively to the SSA for the best chance of approval.

3. Fill Out & Submit Application

Completing and submitting your SSA application for disability benefits requires careful attention to detail. You can get the application form online through the SSA website, by calling the SSA, or by visiting a local SSA office. 

When filling out the application, it's important to include accurate information about your disability, work history, and financial situation. You’ll want to double and triple-check to ensure all entries are accurate and complete to avoid delays or denials. Once everything looks correct, you can submit your application and wait for approval.

Here are some tips for applying: 

  • Organize all required documents beforehand
  • Follow the SSA’s instructions precisely
  • Be honest about your condition and its impact on your daily life

Applying for benefits while dealing with a disability can be stressful and even hard at times. Working with a disability lawyer can be helpful during this stressful time, as they can guide you through each step, avoid mistakes when completing forms, and gather the necessary supporting documents. Hiring a professional can simplify the process, reduce stress, and significantly improve your chances of approval.

4. Follow Application Progress & Follow Up

After submitting your application, you can monitor its status online through the SSA's website, by phone, or by visiting a local SSA office. Regularly checking the status helps you stay informed about any additional documentation or steps required by the SSA. The average application takes 5+ months until a decision is made.

You’ll also want to maintain close communication with your disability lawyer—they can provide application updates and advise on next steps. Your lawyer can also follow up on your behalf, ensuring that all deadlines are met and that your case is progressing smoothly. Staying proactive throughout the process can increase your chances of approval and lead to a quicker decision.

5. File for Appeal if Necessary

If you are initially denied benefits, don't be discouraged—this is common and many applicants find success after filing an appeal. If your claim has been denied, the first step is to review the denial letter to understand the reasons. 

Next, gather any additional medical evidence and documentation that may strengthen your case. You will need to submit a formal appeal within the specified timeframe, which typically involves a request for reconsideration or a hearing before an administrative law judge (ALJ). 

The appeals process can be complex and stressful at times, but a disability attorney can simplify the process. A disability lawyer for your breast cancer case can ensure all paperwork is correctly filed for an appeal and represent your interests in the best possible way to increase your chances of approval.

Qualifying Without Meeting a Medical Listing

If you’re lucky, your breast cancer will have been diagnosed at an earlier stage than III or IV. Although early stages of breast cancer are not listed in the Blue Book, you can still qualify for disability benefits.

To qualify for benefits without meeting a medical listing in the Blue Book, you will need to have doctors’ notes and hospital records that show that you are expected to be out of work for at least 12 months. Speak with your doctor about your treatment and whether or not you’ll be out of work for more than a year.

The most common way women can get approved for disability benefits without the Blue Book is through a physical Residual Functional Capacity (RFC) evaluation. This is a long form filled out by your doctor about your general health and wellbeing.

Keep in mind that if you do need to file for disability benefits via an RFC, your education level will be factored into your evaluation.

If you went to college and could be qualified for sedentary work, the SSA might think that although your symptoms are severe, you could find some form of desk work to do and do not qualify.

A woman who has no education and worked her entire life as a construction worker or a stay-at-home mother would have a much higher chance of qualifying via an RFC than a woman who went to college and got her degree in finance or any other. A disability lawyer can help with this process can determine your chances of approval.

Breast Cancer Compassionate Allowances

Those with late-stage breast cancer can often get their disability sooner. When a disability is severe and an applicant clearly needs assistance, the SSA will expedite the application process. 

Instead of having to wait for 5+ months to be approved like the typical applicant, conditions that qualify for a Compassionate Allowance will be approved in as little as ten days.

Breast cancer that is advanced can usually qualify for a Compassionate Allowance if it meets one of the three following conditions:

  • Your breast cancer has metastasized (spread to distant organs).
  • Your breast cancer has returned despite undergoing chemotherapy or another cancer treatment.
  • Your breast cancer is inoperable.

Applying for disability benefits successfully typically requires a wealth of medical history or paperwork, but if you can have one piece of medical evidence showing that you qualify for a Compassionate Allowance, you should be approved quickly.

Examples of qualifying medical records could include a surgeon’s testimony stating that your cancer is inoperable, or an oncologist’s record of your cancer returning despite you successfully undergoing a year of chemotherapy. You could also provide a biopsy report that shows that your cancer has spread to nearby organs, such as the lungs.

Get Connected with a Disability Attorney Today

When facing a breast cancer diagnosis, connecting with a disability lawyer will help secure the benefits you deserve. A disability lawyer specializes in working through the application and appeals process, ensuring that all necessary medical documentation and evidence are compiled and presented. They understand the specific challenges and requirements associated with breast cancer cases, which can significantly enhance your chances of a successful claim. 

Additionally, a disability lawyer can provide guidance and support to help relieve you of the legal burdens so you can focus on your health and recovery. By working with a knowledgeable attorney, you can work with an advocate who will fight for your rights and help you get the financial assistance you need during this challenging time. 

FAQs

What Are The Financial Costs of Breast Cancer?

A diagnosis of breast cancer will almost always require surgery and/or radiation. Most breast cancer patients will also require chemotherapy. 

Without insurance, the costs of these treatments can be astronomical. Of the 12 drugs approved for cancer treatment by the FDA, 11 of them cost $100,000 or more for just one year of treatment. The 12th drug costs $70,000 per year.

How Much Can You Receive from Breast Cancer Benefits?

The amount of money you can receive for breast cancer benefits varies depending on several factors, including your work history, the severity of your condition, and other financial resources you may have. You can earn up to $3,882 per month from SSDI, with the average being around $1,600 per month. 

A disability lawyer can also tell you how much you can earn by evaluating your situation and advocating on your behalf. They can also assist in maximizing your benefits by identifying all eligible programs and ensuring your application is completed thoroughly.

What Is The Average Time Off Work With Breast Cancer?

It's not uncommon for women who have breast cancer to take time off work with breast cancer. In fact, according to recent research, most women (almost 6 months on average) take a significant amount of time off work after receiving the diagnosis.

Your Breast Cancer Case - Get Assistance Today!

You have a lot to gain from a successful Social Security disability claim. A successful claim wouldn’t just mean consistent financial support for your ailment—it would also grant you the kind of stability that you may have been missing out on for years now. 

Unfortunately, winning a claim isn’t a cakewalk, which is why you should consider consulting a Social Security disability attorney or disability advocate. 

Your attorney will use his or her knowledge and experience to fight on your behalf and help you get the benefits you need—and you don’t even need to pay your lawyer unless you win.

A successful Social Security claim could be life-changing, so don’t wait to get a 100% free evaluation to get connected and talk to a Social Security disability attorney who can help you today as soon as possible—all at zero out-of-pocket cost to you. 

Additional Resources