Few people realize how financially devastating cancer is for many people. It drains one’s savings (even with good health insurance); it may disrupt one’s ability to earn a living in the short and long term; and incurs endless bills outside traditional “health care” that go on and on.
This is part of a series of personal stories about the financial (and very human) cost of cancer. You can find the earlier articles by searching #CancerCosts on the site.
Over the next several weeks we will be looking at the process of applying for disability. The disability bureaucracy can be frustrating, laborious and repetitive. This series is compliments of The Outreach Team at Disability Benefits Help www.disability-benefits-help.org.
The Disability Application Process
For thousands of people with cancer, Social Security disability is a financial resource that keeps families afloat during trying times. You’ve likely heard it’s “nearly impossible” to qualify for benefits, and that the process is long and complicated. While it is true that only about 30% of initial claims are approved, there is a thorough appeals process available for you to help get you and your family the resources you need.
Step one of the process: Initially applying
Applying for Social Security benefits may feel daunting, but most applicants can actually complete the entire form online. You can even save a partially completed form for later. If you prefer to file in person, or if you’re filing on behalf of a minor child, you can complete the application at your local SSA office. There are about 1300 regional offices across the country.
The most important component of the initial application is making sure you submit as much medical evidence as possible. This means listing every oncologist or doctor who’s treated you, what hospitals you’ve received chemotherapies or surgeries, and how well you’ve responded to treatment. If the SSA is unable to find medical records proving the severity of your cancer, you will not be approved.
In most cases, it takes about 3-5 months to get a decision from the SSA.
Step two of the process: Filing for reconsideration
Overall, your chances of getting denied initially are around 65%, although if you have advanced or aggressive cancer these denial rates will drop. If you are denied, your next step will be to file for reconsideration. This is an online form you can fill out simply asking the SSA to evaluate your claim again.
Step three of the process: Appearing in an ALJ hearing
Unfortunately, less than 1 of 5 reconsideration requests are approved. If this is the case for you, the next step in the application process is to have your claim evaluated by an Administrative Law Judge (ALJ). An ALJ will hear your case in court, determining whether or not your cancer prevents you from working. You may also speak with a vocational expert, who will ask you questions about your work history and the types of work your cancer prevents you from performing. Your medical evidence and testimony, combined with the findings of the vocational expert, will help the judge make a decision on your case.
An ALJ hearing may seem daunting, but the vast majority of disability recipients are approved at this stage. Nearly 50% of claimants are awarded benefits after an ALJ hearing. Additionally, you can have assistance at your ALJ hearing, such as testimony from family and friends, or help from a Social Security advocate or attorney.
Step four and beyond: Continuing your claim, or trying again
If your ALJ hearing does not go well, you can continue your appeal, but it’s not usually advisable. After an ALJ denial you can have your claim revaluated by an appeals council, which will decide if the ALJ made a correct decision or not. At this stage, you may be awarded benefits, sent back for another ALJ hearing, or denied benefits again. Appeals council decisions are typically denied because no new medical evidence can be submitted. If your cancer worsens after an ALJ denial, your best bet is to refile for benefits.
If you still wish to peruse a claim after an appeals council denial, you will need to go to federal court. This is arguably the most challenging stage to win, because you’ll be required to have legal representation, and most attorneys are wary of taking a claim that’s been denied so many times. If you reach this stage of the application, you should simply file again instead of drawing out the appeals process.
Important factors to keep in mind
If your cancer progresses or is unresponsive to treatment during the initial, reconsideration, or ALJ hearing stage, be sure to submit new medical evidence. The more evidence you have on your side, the better your chances of approval.
If you’d like to start the application process, you can visit the SSA’s website to file online, or call the SSA toll-free at 1-800-772-1213 to schedule an appointment to file in person at your closest SSA field office.