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Malignant Neoplastic Diseases and Social Security Disability

The Social Security Administration (SSA) covers malignant neoplastic diseases in Section 13 of the Blue Book. This includes a wide range of cancers and cancer related conditions. The Section is further divided into 27 subsections relating to which specific type of disease and/or where the disease originated. These subsections include:

  • Adrenal glands, kidneys, ureters
  • Breast
  • Diseases treated by stem cell transplantation or bone marrow transplantation
  • Gall bladder or liver
  • Genital tract (female)
  • Leukemia
  • Lungs
  • Lymphoma
  • Mediastinum or pleura
  • Multiple myeloma
  • Nervous system
  • Large intestines
  • Pancreas
  • Penis
  • Prostate gland
  • Salivary glands
  • Skeletal system
  • Skin
  • Small intestines
  • Soft tissue sarcoma
  • Soft tissue tumors of the neck or head
  • Stomach or esophagus
  • Temporal fossa, orbit, or maxilla
  • Testicles
  • Thyroid gland
  • Unknown original site
  • Urinary bladder

Cancer, because it is complex, and each patient’s response to treatment is different, is treated on a case by case basis. It is worth noting that those who have advanced stages of certain types of cancer may be eligible for a compassionate allowance (CA). Those who qualify for a CA will automatically be approved for disability benefits, and will begin receiving benefits much faster than other claimants.

Whichever type of malignant neoplastic disease you are afflicted with, the SSA will need medical documentation showing:

  • Where the malignancy originated
  • The extent of the malignancy
  • All treatments which have been attempted (i.e., surgery, chemotherapy, transplantation, radiation, etc.)
  • Your response to those treatments
  • The residual effects of all therapeutic treatments

They will need copies of all pathology reports and operative notes when possible. Alternately, other reports which include the details and findings of all procedures tried can be accepted.

In some situations, the SSA will need three or more months’ worth of records showing the types of treatments tried and your response to them. This includes:

  • When only one type of treatment is attempted
  • When other malignancies are present
  • When your tumors have distant metastases (spread extensively)

The exact requirements to qualify for disability benefits vary significantly depending on where your cancer or other malignant neoplastic disease originated. While it is beyond our scope to list the exact requirements of each origin point, there are some common things the SSA looks for which will often qualify you for disability. These include:

  • Inoperability
  • Unresectable
  • Distant metastases
  • Recurrence
  • Anaplastic carcinomas
  • Transplantation

Generally those who have received a stem cell or bone marrow transplant will be automatically considered disabled for one year, after which they will be evaluated from time to time. The extent of metastases required before a claimant is considered completely disabled vary depending on the origin of the disease.

Specific Conditions that qualify under the malignant neoplastic diseases evaluation: