Filing for Disability Benefits with Hereditary Colon Cancer

Hereditary colon cancers like familial adenomatous polyposis (FAP) and lynch syndrome are relatively rare, accounting for only about five percent of all colorectal cancer diagnoses.

 

Colon cancer can automatically medically qualify you for disability benefits if it is advanced. This is true whether the cancer was caused by an inherited condition or not. It can be more difficult to be approved for benefits when cancer is caught early and responds to treatment, though. You will need to show that the physical effects of your cancer or treatment have or will stop you from working for at least a year. Your medical records and other evidence will be used to prove this. Disability benefits offer a consistent income on which you can count for covering your everyday expenses and your incidental costs or medical bills.

 

Medically Qualifying with Advanced or Recurrent Colon Cancer

 

The Social Security Administration (SSA) maintains standard disability listings which determine how common medical conditions are reviewed. Hereditary colon cancer is evaluated under the listing in Section 13.18, which covers all cancers that start in the colon and rectum.

 

To qualify under Section 13.18, your colon cancer must have spread (metastasized) beyond the lymph nodes near the intestines intestinal OR have returned after surgery. If your colorectal cancer is a more aggressive form, like oat cell carcinoma, is inoperable, or is terminal, then you automatically medically qualify for benefits under Section 13.18.

 

The SSA will still need to see medical evidence with your disability claim. Medical evidence include:

 

  • biopsy or pathology reports

  • surgical notes 

  • treatment records

  • a statement from your doctor

 

The statement from your doctor should describe your particular case and include the likely outcome of your cancer.

 

Qualifying with Other Cancers Caused by HCC Syndromes

 

If you have been diagnosed with another form of cancer, such as ovarian cancer or endometrial cancer, you will need to review a different Blue Book listing to determine whether or not your cancer will qualify. The following cancers will qualify with just a diagnosis:

 

  • Esophageal cancer

  • Gallbladder cancer

  • Imflammatory breast cancer

  • Liver cancer

  • Pancreatic cancer

  • Cancer of the salivary glands

  • Sinonasal cancer

  • Thyroid cancer

  • Any ‘small cell’ form of cancer

 

Every cancer listing can be found in Section 13 of the Blue Book. Speak with your doctor to determine whether or not your specific cancer has progressed enough to qualify for disability benefits.

 

 

Qualifying for Disability with Hereditary Colon Cancer that is Detected Early

 

Frequent and consistent monitoring for precancerous or cancerous cell growth is strongly recommended for people with a family history of colon cancer. Doing so increases the chances of detecting cancer early, before it has the chance to spread and when it can be more effectively treated.

 

Even if your cancer is found early and responds to treatment though, your symptoms and/or treatment side effects may disable you. This could happen if symptoms and/or treatment side effects cause lasting or permanent changes in your everyday abilities. If you are unable to continue working at a “substantial” level, (meaning that you are unable to earn more than $1,130 per month in 2016) then you may still qualify for disability benefits. This will mean that you will be approved even though your medical records will not match the SSA’s disability listing for colon cancer.

 

To get approved for disability, the SSA must look at your functional capacity. The process to do so involves reviewing your medical records and issuing detailed questionnaires to you, your doctor, and possibly other people who you list on your disability application. These include people who understand how your cancer affects you every day, like friends, family members, or caregivers. 

 

This process is known as a “residual functional capacity” (RFC) analysis. If the RFC shows that your limitations prevent you from working in any job that, without cancer, you would be qualified to perform, then the SSA will find you medically eligible for disability benefits.

 

An RFC analysis may be preformed if your HCC condition causes other illnesses that are not listed in the Blue Book, such as Desmoid tumors.

 

Submitting Your Disability Application

 

You should work closely with your doctor before and during the disability application process. Your doctor plays a very important role providing medical records and other information to the SSA.

 

There are two types of disability benefits for which you may apply: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI applications can be completed online or at a local SSA office. An in person interview is a standard part of the SSI application, however, and usually requires a trip to the local SSA branch.

 

 

 

The above information was provided by Social Security Disability Help, an independent resource dedicated to assisting people at all stages of the Social Security disability application process, from initially applying, to keeping benefits after being approved. It is not affiliated with the Social Security Administration. If you’d like to ask SSDH for help with your claim, please feel free to contact the staff at help@disability-benefits-help.org.