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How to Get SSDI Benefits for Breast Cancer?

How to Get SSDI Benefits for Breast Cancer?

To be eligible for SSDI or SSI due to breast cancer, you must be unable to work and your cancer must have lasted a year or longer – or be projected to last a year or more.

Breast cancer affects one out of every eight women throughout her lifetime. Two-thirds of breast cancer patients are above the age of 55. The majority of the others are between the ages of 35 and 54.

Breast Cancer and SSDI

Breast cancer, like all cancers, is made up of abnormal cells that proliferate uncontrollably. These cells may also migrate to areas of your body where they are not normally prevalent. When this occurs, the cancer is said to be metastatic.

Breast cancer generally starts in the glands that produce milk (called lobular carcinoma) or the ducts that transport it to the nipple (called ductal carcinoma). It can spread from your breast to neighboring lymph nodes or into your bloodstream to other organs. The cancer may spread to surrounding tissue, such as your skin or chest wall.

Men can develop breast cancer, however they account for less than 1% of all cases. Breast cancer is the second most prevalent cancer diagnosed in women, after skin cancer, and the second greatest cause of cancer fatalities, behind lung cancer.

Breast cancer, fortunately, is often curable if detected early. Localized cancer (that hasn't gone beyond your breast) is frequently treatable before it spreads.

However, when the cancer spreads, therapy becomes more difficult. It can typically keep the condition under control for years leading to complications making it unable for you to perform work under substantial gainful activity (SGA). Fortunately, the Social Security Administration is mindful of the severe complications that some applicants with breast cancer can develop, significantly affecting their Residual Functional Capacity (RFC).

How to Get SSDI Benefits for Breast Cancer?

In order to win benefits, you should be able to prove to the SSA that your symptoms are indeed severe enough to impact your daily functioning levels. You should have medical evidence for all hospital visits, doctor's statements, prescriptions and tests such as a CT/MRI scan, breast biopsy, mammogram, ultrasound, chest X-ray, etc,. indicating the intrusiveness of your breast cancer.

Breast cancers are of different types affecting different regions in your breast. Some types of these cancers are more invasive than others, leading to more severe complications, leading you to meet symptoms under a disability listing in the SSA's Blue Book of Impairments, making you eligible to receive SSDI benefits. Some of these types include:

  • Triple-negative breast cancer (TNBC) is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time it's found, and is more likely to come back after treatment than other types of breast cancer.
  • Adenosquamous carcinoma of low grade (a type of metaplastic carcinoma) This unusual tumour grows slowly and is sometimes misdiagnosed as another form, which is why treating it becomes difficult as it is discovered too late at times
  • Breast cancer that has spread This is cancer that has spread to another region of your body, such as your brain, bones, or lungs.

Who Qualifies for SSDI with Breast Cancer

The SSA has developed a Listing of Impairments (dubbed the "Blue Book") that includes a wide variety of particular medical illnesses as well as the standards for proving impairment for these conditions. If your disease meets the criteria for one of these disability categories, the SSA will automatically determine that you are handicapped. Listing 13.10 includes breast cancer.

To fulfil the breast cancer listing, you must demonstrate medical proof of locally advanced cancer in the breast tissues. You must additionally demonstrate one of the following factors:

  • -Breast cancer that has progressed to the supraclavicular or infraclavicular nodes, or to 10 or more axillary nodes.
  • -Breast cancer that has spread to other parts of the body (spreading of the cancer to distant areas).
  • -Recurrent breast cancer (cancer that has reappeared), with the exception of a limited recurrence that resolves with antineoplastic treatment.

The SSA will want medical documentation detailing the kind, size, and location of your breast cancer. If you have been hospitalised, the SSA will request a copy of the pathology results as well as any additional medical records.

For more information, you can seek legal help from our expert disability attorneys at the Law Office of Irene Ruzin. 

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Thursday, 08 June 2023