Prostate Cancer Disability Benefits

 Paid by Social Security

Treatments for prostate cancer can quickly become expensive, especially if a man does not have adequate health insurance.  And some men may find that they are unable to work due to their prostate cancer diagnosis.  

Fortunately, the Social Security Administration (SSA) offers prostate cancer disability benefits, an important source of financial assistance to those applicants who qualify.

How to qualify

The SSA evaluates disabilities by using a medical guide called the Blue Book, which lists hundreds of conditions or diseases.  It also explains how a man could potentially qualify when he is diagnosed with prostate cancer.

According to Section 13.24 of SSA’s Blue Book, there are two ways a man can medically qualify with prostate cancer:

  1. His cancer needs to be recurrent or progressive despite hormonal treatment
  2. Or he has visceral metastases

Visceral metastases are when prostate cancer spreads to internal organs like the lungs or the liver.  It does not include prostate cancer that spreads to the bone. 

“If your loved one’s prostate cancer meets either of these requirements, not only are you eligible for Social Security disability benefits, but you are also eligible to be approved under the SSA’s Compassionate Allowances List (CAL),” says Deanna Power, Community Outreach Manager of Social Security Disability Help.*,† 

The CAL is a list of serious conditions that cause people to be unable to work for an extended period of time.  “CAL applications can be approved within a few weeks, if all of the paperwork is filled out correctly and all of the necessary medical evidence is included,” says Power.  “Instead of waiting for months or even years to hear back from the SSA about an application, applicants with conditions such as prostate cancer can expect to get approved in as little as 10 days.”

Documents needed

“When applying for prostate cancer disability benefits, it is important to have enough medical evidence to prove that your cancer qualifies for benefits,” suggests Power.  “A critical document to send to the SSA are the results of a prostate biopsy, which resulted in your diagnosis of prostate cancer,” she adds.

The SSA specifically suggests that you include:

  • The pathology report of the biopsy
  • Clinical history and examination report of diagnostic features of the impairment
  • Treatment notes or other statements from your loved one’s doctor, especially those indicating antineoplastic therapy (treatment to prohibit growth or development of malignant cancer cells) and surgery
  • Or imaging reports that document the spread or reoccurrence of the cancer

“Make sure to also include any other lab or test results. The more medical documentation you can provide to the SSA, the better your chances of getting approved for disability benefits with prostate cancer,” suggests Power.

Two types of prostate cancer disability benefits

The SSA offers two forms of disability benefits for men with prostate cancer.  The first type is Supplementary Security Income (SSI). SSI is:

  • An income supplement for those with low income and low levels of resources
  • An option for those with little work history or those who have not paid taxes from working

When determining eligibility, the SSA will evaluate an applicant’s income and assets.  The 2015 monthly limits are:

  • $733 of earned income for a single man
  • $1,100 for a couple

“You should start receiving benefits the first month after applying if you are approved,” says Power.  “The average SSI monthly payment is around $500.  In most states, once you are approved for SSI, you will automatically start receiving Medicaid as well.”

The second form of benefits is Social Security Disability Insurance (SSDI). SSDI is for adults who have a rich career history and who have paid taxes throughout their lives.

Generally, you need to have worked and paid into Social Security taxes for any five of the last ten years to qualify. The amount of benefits you will get depends on your previous income.

“The national average SSDI payment is around $1,200, but some people earn up to $2,600,” says Power.  “After receiving SSDI benefits for two years, you will be automatically enrolled in Medicare A.  If you are denied for either SSI or SSDI benefits, you can appeal the denial online or in person at an SSA office. If it takes more than five months, you can expect to be paid a lump-sum check for the missed months,” she adds.

How to apply for prostate cancer disability benefits

For SSDI, you can apply online at the SSA’s website. There’s also a disability checklist to help ensure you have all necessary documents, including:

  • Tax information
  • Medical evidence
  • Work history
  • Education history
  • Birth certificate and more

“SSI applications can only be completed in person, so you need to make an appointment at your local SSA office,” advises Power.  “There isn’t a separate application for CAL conditions. The SSA automatically speeds up the approval process.” 

If you have any questions about your application, you can call the SSA at 1-800-772-1213 or 1-800-325-0778 for TTY.

*Disclosure: Social Security Disability Help is an advertising referral service that connects people to attorneys and advocates and provided information for this article.  HisProstateCancer received no compensation for posting this article.

† Information and requirements are always subject to change.  Visit http://www.ssa.gov/disabilityssi/ for the most updated information. 

Prostate Cancer Disability Benefits Reference: Social Security Website.  Disability Benefits.  http://www.ssa.gov/disabilityssi/.  Accessed April 30, 2015.

Always consult a medical professional.

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