Lung Cancer: Getting Your Disability Claim Expedited

 In Law Planet

lung cancer awareness and disability benefitsNovember was lung cancer awareness month. Did you know that lung cancer is the leading killer in both men and women? Lung cancer causes more deaths than colon, breast and pancreatic cancers combined. In 2014 lung cancer is expected to account for 27% of all cancer deaths for the year. A little known fact is that Kentucky has the highest rate of lung cancer while Utah has the lowest.

The Social Security Administration (SSA) takes cancer diagnoses very seriously. If you are diagnosed with lung cancer you should consider applying for Social Security Disability (SSD) benefits. Disability benefits are typically for those individuals who are prevented from working due to a physical or mental disability. If diagnosed with lung cancer you more than likely will have some type of difficulty working and thus should apply for the program.

Get Your Claim Expedited

As with any types of cancer, depending up the stage of the cancer your case may be expedited for review by the SSA. There are two ways a claim can be expedited. If your case is terminal or expected to end in death then your case will be flagged for immediate handling. If you are not familiar with the Social Security system it is easy to overlook this option. This is one way having a knowledgeable representative could help your case. It is easy enough to contact your local SSA office and ask for your case to be expedited. All you would need is some type of supporting evidence from your doctor indicating your case is terminal, meaning expected to end in death. Once your case is flagged it should take a matter of weeks for a decision to be made.

The other way for your claim to be expedited is if it meets a compassionate allowance. This is similar to having your case expected due to a terminal illness. The only difference is a compassionate allowance claim does not necessarily require your condition to be terminal. Although, in terms of cancer claims it often is. Compassionate Allowances are conditions for which Social Security has deemed so severe as to require expedited handling and approval. The Social Security Administration has deemed non-small cell lung cancer to be one of those severe conditions which if diagnosed with it you will automatically be found to be disabled. Social Security requires a pathology report and an operative report to support the diagnosis.

If your claim does not represent a compassionate allowance condition your case may still be approved without the necessity of a hearing. SSA would then determine if you meet a disability listing. The disability listings are conditions that with enough medical evidence will automatically qualify you for benefits. This is similar to the compassionate allowances but usually not as severe, and they are not expedited. This is another place where having a knowledgeable representative fighting for your claim will save you several months of waiting. The disability listing for lung cancer is 13.14. Generally you must show that the condition is inoperable or has metastasized. Again this can be demonstrated through a pathology report. If you do not have a pathology report then a note from your physician stating their opinion will be sufficient.

Types of Lung Cancer

There are two main types of lung cancer, small cell lung cancer and non-small cell lung cancer. Approximately 87% of lung cancers are non-small cell. This type spreads slower than small cell lung cancer. The survival rate for this condition is pretty slim. Most cancer patients die within a year of diagnosis. However, early detection provides the greatest chance of survival. If diagnosed in the early stages the survival rate is approximately 49% for five years or longer.

For most people who are applying for disability benefits with a later stage cancer diagnosis the goal is not for the monetary compensation. The goal is usually to receive some type of medical care, either Medicaid or Medicare. One example of this was a case where a compassionate allowance was met for non-small cell lung cancer:

Claimant was 56 year old female with past work as a cashier. She was diagnosed with Stage IV Lung Cancer. Her health insurance was very limited, essentially through a free clinic. She treated with an oncologist through the free clinic who recommended chemotherapy to extend her life. However, her insurance (or lack thereof) would not cover the recommended treatment. She came to me asking for help and wanting to know her options. Because the Claimant was diagnosed with lung cancer, we were able to have her case flagged as a compassionate allowance under “small cell lung cancer.” The benefit of having your case flagged as a compassionate allowance is that it will receive “special handling,” essentially meaning your case will be fast tracked through the disability claims process. Once we notified Social Security of the compassionate allowance, we were able to argue the Claimant met Listing 13.14 for lung cancer. To prove the Claimant met the definition of this listing (and should be found disabled) we submitted her pathology report diagnosing the cancer and also a narrative statement from the oncologist documenting the diagnosis and the treatment recommendations. When everything was said and done our client was approved benefits one month after submitting the application. There was an interesting twist in this case regarding the Claimant’s health insurance. We were able to get her disability date pushed far enough back so that she qualified for Medicare immediately…which truly was a life-saver!

Social Security oftentimes is associated as a welfare program. But it doesn’t always have to be viewed that way. For those individuals diagnosed with a terminal condition it can literally be the difference of extending their life for a few months. The Social Security disability program is meant to help people who are struggling with a disabling condition. It is supposed to relieve some financial and medical stress, so you can focus on your medical treatment. If you know someone who has been diagnosed with late stage cancer, they should definitely consider applying for SSD benefits. Getting approved for disability benefits is not going to “cure,” you but it certainly can ease the financial struggle a bit. Because these cases are time sensitive I whole heartedly recommend finding a knowledgeable attorney to help you with your claim. This could mean the difference of having your claim approved in a month or it taking 2 years if you try to do this yourself.

Image courtesy of freedigitalphotos.net by renjith krishnan

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